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The Legend of the 10 lb 13 ounce Baby

Shelley’s note: This story is a great example of how inaccurate ultrasound can be in estimating weight, and despite recommendations to deliver via c-section, this mama had a wonderful and uncomplicated vaginal delivery at 40 weeks.

Lisa and Jason were first time parents with lots of first time questions. They knew they’d need all the information and support to help them through their pregnancy and birth. So they hired me- their doula. This is the story of their baby’s birth from my perspective.

Her pregnancy was healthy and uncomplicated. At 36 weeks she had a routine ultrasound which determined the baby to already be nearly 8 ½ lbs. Her doctor “warned” her that she was likely to have a big baby, and suggested considering planning a cesarean instead of risking a vaginal birth with complications. Lisa did her research and decided since she was no tiny person (5 feet 11 inches) she trusted her body would do what it needed to do when the time came.

The day following her due date, she started noticing contractions around 9:30am. They were mild at first, but gradually grew stronger. She contacted me at 12:00pm letting me know “We are getting some action over here”. Contractions were 5-6 minutes apart and she was easily breathing through them. They wondered if they should keep their 1:30 doctor appt that day and I said yes. It would be a good check in, and they could feel assured the baby was doing fine. She wondered if her doctor would recommend going to the hospital, so I said to pack the bags just in case. It was likely they’d be coming home, but better prepared than sorry.

At 2:20pm, Lisa texted me that she was 2 cm dilated and 90% effaced! That was huge progress since last week when she was “nothing”. So we knew things were moving along. They were doing a non-stress test and they would check in later. She was a little worried– ultrasound had measured the baby at 10 lbs 13 ounces, but her doctor said she could go ahead and “try” for a vaginal birth.

By 3:30pm, Jason called, and said things were starting to pick up. They were going to walk around a bit, get a snack, and plan to head into the hospital soon. I asked if I should join them- I heard Lisa working through a contraction, and said “Never mind, there’s my answer”. I gathered my things and headed out the door within 30 minutes.

I arrived at Seton at 4:40pm. Lisa was in bed, on monitors, looking a lot less cheerful than when I last saw her! Both her mom and Jason were by her side. She said Dr. B had checked her at 4pm and broke her water- she was still about 2cm, but the contractions were way more intense now. There was also meconium in the water, which would change our plans at the birth. I asked her if she wanted to try another position and she said yes. So we got her more comfortable on a birth ball. She was truly working- breathing and trying to stay relaxed. Jason and I offered back massages and encouraging words. She was doing great. The contractions were now 2-3 minutes apart, and felt really strong.

Lisa’s best friend came in to offer love and encouragement. Lisa was working so hard, she could barely acknowledge her presence. She and the rest of the family would be in the waiting room.

After about an hour of this, I asked Lisa if she needed to use the restroom. “I don’t know”! I suggested emptying her bladder might help, and a position change was always good. We helped her to the toilet. The contractions seemed to space a bit, but they became even more powerful. Lisa said “I don’t know how much more I can do”. I assured her she was doing great, and it was likely things were moving along well– she would not be 2cm still. “How much longer?” She did have options, if she thought she wanted an epidural it might be wise to get an exam just to see where we were. She agreed.

At 6pm our nurse called Dr. B in to do the exam- he said she was a good 4 to 5cm, 100% effaced and the baby had moved to -1 station. That was amazing progress in only 2 hours! Lisa was feeling pretty overwhelmed, and knew she still had some work to do, so opted for an epidural. Our nurse was right on it. Dr. J from anesthesia was in within minutes and easily placed the epidural. Jason and I were able to provide support and stay by Lisa’s side. As the epidural took effect, each contraction felt a little less intense. Within 30 minutes, Lisa wasn’t feeling them at all!

We got her settled laying down, and she couldn’t say enough good things about that epidural. She became an endorsement! She was so relieved to have the pain taken away. She could smile again! Dr. B said “Now you can enjoy this labor. It’s still going to be a big baby”. Our nurse got the urinary catheter in place– that’s when we discovered the poor positioning of the large room mirror. Luckily, I had my handy dandy scarf to help cover up things Lisa did not want to see.

Lisa felt ready for visitors, so Jason went to get the family. Lisa’s mom and dad, and brother and sister in law came in to offer love and comfort. They were curious how the epidural was working, and all the machines and monitors. Everyone was so excited to meet this baby! Lisa asked how her first “baby” was doing– their trusty hound was safe and sound and well cared for. Lisa got a little emotional just thinking about him.

Friends came in later, and Lisa greeted them with “Epidurals are amazing”. They were glad to see her pain had been taken away, and said they’d be in the waiting area. “We’re here”.

By 7:30pm, things settled down. Two new nurses took over and I encouraged Lisa to take a pause and rest. Her pain was gone, but she was still in labor. It was important to stay connected to her baby and body. Jason sat close by, stroking her arms and legs while I stroked her hair, helping her relax. I warned her- there would be little sleep after this baby came!

I gently rocked Lisa’s pelvis back and forth- it felt good and it would help the baby find his way. Around 7:45pm we turned Lisa to her other side- to keep the epidural even. Lisa was lucky- the only unpleasant side effect she had from the epidural was the shivers. All else looked great.

By 8pm, Dr. B came in again to check on Lisa’s progress. He gleefully stated she was 9cm now! Holy Cow- that was amazing. No wonder she was hurting so bad before- another 4 cm in only 2 hrs! She was really rocking and rolling now. He reminded her she still had work ahead of her- getting to 10cm was only the first part. He still was worried about a big baby. “But you’re tall”. He liked tall women. They get babies out well.

We continued with the pelvic rocking while Jason updated the “fans” in the waiting area. They started making bets about when this little guy would come and his weight. In the back of everyone’s mind was that ultrasound– how big would this baby be?

I gave Lisa a pep talk. There was no reason to be worrying about his size. Either he would fit or he wouldn’t. And if he didn’t– we knew what to do. She could have closure even if she ended up needing a c-section, knowing she had “tried”. We waited and rested some more.

Dr. B came back at 8:40pm and said “Let’s check you again. I bet you’re complete”. Sure enough, she was. He said “Let’s start pushing!”. Lisa and Jason looked shocked- how could they have come so far in such a short time? Only 4 ½ hours ago she was only 2 cm? It was crazy to think about.

It took the nurses a few minutes to get things ready for pushing and delivery, so we let Lisa rest while I gave the fans an update again. I Lisa’s mom asked what I thought- if the baby was too big and I told her “She’s gonna push this baby out”.

When I got back I gave Lisa my quick pep talk on pushing- positioning, strategies, and getting down to business. Pushing with an epidural is different– we’d be relying on the nurses to help us know when she was having a contraction and would need their guidance on how. At 9pm, Lisa started pushing and it seemed she got the hang of it pretty quick. “I’m pooping”. The nurses and I assured her that was a good sign that she was actually pushing correctly– it was ok. Poop happens.

Lisa kept pushing, and we began to see glimpses of the baby’s head within just a few minutes! The nurse said “This isn’t going to take long”. Lisa asked- “What’s happening down there?” I said “You’re moving your baby down!” and she gave me a look of almost horror and disbelief. We got a mirror so she could see- and she was amazed!!! At 9:20pm the baby’s head was almost crowning and the nurse said “STOP!” It was time to call Dr. B back in.

The whole “baby SWAT team” entered the room– with meconium present in the water, we had to have a team ready to care for the baby in case he needed help. Lisa gave it one more good push and the head was out. Another push and the rest of his body followed at 9:26pm — no complications or difficulties whatsoever. He was indeed a large baby– but I doubted he was an 11 pounder.

The baby let us know he was ok immediately with his vigorous cries. They cut the cord and took him to a warmer where the pediatric nurse looked him over. They didn’t even have to do anything. He was fine. They did a quick weigh– he was a mere 9 pounds even!

The baby was brought back to Lisa and placed on her chest skin to skin– she was so happy to hold him! She started crying, so happy it was all over and her baby was finally in her arms. Jason was close by, admiring his son– I took pictures so they could focus on enjoying the moment. All the craziness and intensity of the day finally faded. Their “Ten lb 13 oz” baby was finally here!!