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Was that Baby Really too Big? A Great VBAC story…

Teresa had an uncomplicated vaginal delivery with first child Joe (which I had attended), but had ended up with a cesarean with second Issac- who was a full 2 pounds bigger. Most involved thought “he was just too big for her”. She consulted with her doctor who advised her to attempt a Vaginal Birth After Cesarean this time, being a safer option for both her and the baby. Teresa knew she’d need extra help and support, so hired me to be her doula again.

 

Her due date came and went- and Teresa began to get a little worried about approaching the Thanksgiving holidays, and going too far past her due date. We knew she was already 3 cm dilated, so hoped labor would start soon!

 

Monday night the 19th she noticed some light contractions, but went to bed. They were mild and not enough to keep her awake. Around 1:30 or 2am she awoke with contractions close- 2-4 minutes apart, and much stronger. She called me at 2:30am and said they were headed in. I reminded her to call and let Dr. Mingea know and I’d meet them there.

 

I arrived at St Davids Medical Center around 3:30am. Our nurse, Shelly had gotten Teresa settled in bed, and on monitors. Teresa was still smiling between the contractions, but when they came, she was having to work through them. I encouraged her to relax and breathe. Shelly did an exam at 3:40am and said she was already 6cm, 100% effaced, and the baby was -2 station. That was a great start! Contractions were 2-3 minutes apart. Teresa indicated she did want an epidural. Shelly said as soon as they could get her admitted and fluids in her they could do that.

 

In the meantime, Shelly notified Dr. Mileur, who was on call for Dr. Mingea. We started consent forms, and drew blood work and set up an IV. Shelly notified us that the hospital required an internal monitor for VBAC patients, indicating Dr. Mileur was on her way to break her water and insert that.

 

At 4am, Dr. Mileur came in, broke Teresa’s water and inserted the scalp electrode. She also checked her cervix, and called her 7cm– wow, things were progressing! Now that her water was broke we knew things had the potential to move fast, so Shelly made sure fluids were going in quickly, and called the lab to get her results as soon as possible. In the meantime, I helped Teresa stay calm and focused on getting through the now more intense contractions.

 

Teresa had had an epidural with both of her previous labors, and had issues with her blood pressure dropping each time. This was a concern again. We re-iterated we needed to get a whole bag of IV fluids in her before getting an epidural on board to try to prevent that. We got forms signed, and waited. Teresa began to ask “how much longer” and both of us reassured her it was coming. She needed to continue to do what she was doing– she was managing her contractions beautifully.

 

Anesthesia came in around 4:20am and the epidural was in place by 4:35am. We helped get Teresa comfortable laying down and waited for the medication to take effect. Teresa said the contractions were beginning to feel less intense already. Travis had been watching all this from the corner!

 

By 4:45am Shelly insisted on getting a catheter in place– Teresa had a lot of fluids and they needed to keep her bladder empty. While she did that, she also checked her cervix– 8-9 cm now and the baby was lower at 0 station. We couldn’t believe things were moving along so well! It looked like we’d have a baby before the night shift was even over!

 

 

 

Once things settled down, I dimmed the lights and encouraged Teresa to rest. She was not completely comfortable from the epidural yet, still having to breathe through the contractions. We tried rolling her to her side to see if that would help. She had been battling nausea off and on- could have been part of labor, also a common side effect from the epidural. Peppermint oil seemed to help. Her blood pressure was lower, but not low enough to be worried, and the baby looked great. Both Shelly and I assured her things looked fine, but she still felt crummy. We helped her with cool washcloths, and gently fanning her as she got hot flashes.

 

Travis headed out to grab a coffee. He had been a quiet observer during all this! We asked about names– they had a few in the works, but nothing confirmed. Waiting to see what the baby looked like!

 

By a little after 5am, Teresa was still having “too much pain” so we pressed her bolus button and rolled her over again. It was possible getting an epidural so late in labor that it would not have time to take effect completely– I encouraged her to close her eyes and rest, at least in between the contractions. Her being worried about her blood pressure and the epidural wasn’t helping things!

 

By 5:25am, Teresa stated she had “constant pain” and wanted to be checked. Shelly said she was completely dilated now, and the baby was even lower at +1 station. She felt it would be a good idea to wait til the baby moved down even farther, so suggested “laboring down” for a while. Baby looked good- and it gave Teresa a chance to rest.

 

Teresa’s blood pressure continued to drop slightly but the baby was never affected. We tried to keep her comfortable with peppermint, cool washcloths, and fanning. She felt very uncomfortable and a little scared. Shelly even stayed with us to reassure her that all was well. I helped her visualize welcoming the baby, or a safe wonderful place in her head– trying to help her get her mind off the epidural side effects.  Her pain levels seemed to diminish and she rested finally.

 

Travis hung out in the rocking chair. I encouraged him to take a quick nap too- he was too wired at this point to sleep, enjoying his hospital coffee which was “not as bad as he thought it would be”!

 

By 6am Shelly checked again– The baby had shown signs on the monitor that she was getting some head compression, a good sign. She had moved down nicely and we could start pushing! She notified Dr. Mileur.

 

At 6:10am we took our first “test push”. Within a couple pushes we could see quite a bit of the baby’s head! Shelly called Dr. Mileur in, who arrived at 6:20am. “Show her what you’ve got!”. Teresa got the hang of pushing quickly– she was really moving that baby down. Things were looking great! Staff quickly got ready for delivery– Lots of cheering and encouragement as Teresa brought that baby right on down. Helen Grace was born at 6:44am on Tuesday, November 20, 2012, after only 30 minutes of good pushing! She was placed immediately onto Teresa’s chest skin to skin, where she settled down. We covered her with warm blankets and let mother welcome her daughter. Travis was close by– we were so happy to have her here already!

 

We all started making bets on her weight– she looked like a good size baby. Would she be as big as her brother? She had 8/9 Apgar scores– she looked perfect. Dr. Mileur reported that Teresa had some tears that would require some stitching, so we just hung out skin to skin for a while. Teresa enjoyed snuggling with her new baby girl– announcing her name officially. The nursery nurse came in and offered to weigh her– we were all curious. She was 8 lbs 14 oz– exactly the same size as Issac who was born by cesarean!! Teresa had done an amazing job of bringing Helen into the world with love, joy and gentleness. Congratulations on a successful and beautiful birth!

 

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Arrival of the Little Dragon

Summer and Anthony were hoping to have a VBAC after the birth of your BIG brother…(The Little Tiger) they chose Dr. Swensen this time who supported their wishes, and asked that I come as their doula again to offer labor support. Here is your birth day story from my perspective.

As the weeks went by, Summer’s body made all the right changes indicating labor was getting close. You remained “high” but her cervix got all the way to 4cm before she even went into labor! Dr. Swensen said she would allow Summer to go all the way to 42 weeks and a day before scheduling a repeat cesarean… which was scheduled for Friday, Oct 5th at noon. (Dr. Swensen’s birthday!)

Summer went into labor on Wednesday night the 3rd around 9pm. She had mild to moderate contractions which progressed over the evening. “Don’t get too excited Shelley”…They got consistent enough that she called the doctor around 2am– she called me too. It didn’t sound like Summer was working hard enough to go in, so I helped her re-evaluate things. They decided to “take their time” which meant wait til morning to go.

They arrived at 6:30am at Seton Medical Center and were admitted. We had talked about doing a breastpump induction today anyway, but Summer was already having contractions! Upon admission, Summer was 5cm dilated. They were coming every 4-10 minutes, so still irregular, but seemed to be making some change. I checked in with them around 8am and she said they were fine, they were getting another exam around 9:30 and would check in then.

At 10am, Summer texted me she was “almost 7cm, 90% and -2″… so I said I was on my way! Anthony was still sleeping through most of it– so different from their last labor!

I arrived at 10:45am with Summer mobile and still smiling. She was enjoying moving around, using the ball, changing positions. Our nurse Sara was super encouraging and helpful. We started augmenting labor with the breastpump- to help the contractions come a little more regularly and stronger. (In my opinion, Summer was still way too comfortable!) As Summer pumped each time, the contractions immediately got much stronger and closer… in fact, enough for her to say “I think I want to stop this”.

By 11:30am, Summer was getting sensitive to sounds and distractions. She needed to focus. She also did not want touch during the contraction, so different from her last labor! The pumping got the contractions 2-3 minutes apart, so it seemed like the “real deal”. She kept moving, changing things up. Anthony went out to grab “breakfast” and brought me back a slice of pizza! (Need to keep the doula’s strength up!)

As the contractions settled down, we started pumping again- about every hour. Summer was feeling more pressure on her bladder, so we hoped that was a good sign you were moving down! Dr. Swensen came in around 1pm, wanting to check on progress. She called Summer about the same as earlier- 6-7cm- and agreed we needed more regular contractions. We also talked about techniques to help the baby descend into the pelvis- using the rebozo to hold her belly in and tilt the baby’s body more vertically (Summer’s belly went straight out!)

More breast pumping… each time we did it the contractions literally were one on top of the other. Summer began to vocalize… that was more like it. I reminded her those were the type of contractions that got a baby here! I recommended some sidelying to help the baby move down in a more gravity neutral space– plus it allowed Summer to rest between the contractions. She had a restless night’s sleep the previous evening. The contractions spaced to 5-7 minutes apart but we allowed them to so Summer could rest.

Around 3pm Summer was up again and ready to pump- it only took a few minutes and those contractions were strong and close once again! More vocalizing- Anthony rubbed her back between the contractions, and even crawled in bed with her to snuggle and nap.

As the afternoon progressed, we moved around a lot, changing things up. Summer liked the “throne” position, the ball, and walking around. Frequent bathroom trips kept us on the move! I encouraged her to stay there for a while– a good quiet place to labor and bring the baby down. Anthony stepped out for another bite to eat. Summer was feeling “kinda crappy all over” which told me things had to be moving along! We expected to see Dr. Swensen soon and thought another exam seemed appropriate.

Dr. Swensen arrived around 5:40pm and did suggest an exam. She reported Summer was now a very stretchy 7cm. While it was progress, she had only gone 2 cm in almost 11 hrs of labor. She asked Summer what she thought about some gentle augmentation to get this ball rolling. We all agreed more consistent contractions is what it would take to make the kind of progress we were hoping for. Summer did not want another whole night of contractions without some change! She was not ready to break the water yet– so we decided to do some light Pitocin to bring the contractions together. Dr. Swensen said goodbye and said Dr. Oliver would be on call tonight.

Summer was a little fearful about what pitocin contractions would feel like– so she asked about getting in the shower. It was perfect timing. As the contractions gently became closer and stronger, Summer had the warm water helping her stay relaxed. Anthony put on his swimsuit and stayed nearby– Summer was in heaven. The contractions felt way less intense. “Screw the epidural… I say that now”. I told her to stay in there til she felt pushy!

At 7pm Dr. Oliver came in to give us the “hard nose pep talk”. She felt we were on the same path as last time– and was ready to get a little more aggressive with the pitocin. We were only bumping it up 1 ml every 30 minutes, so she suggested 1 ml every 15 minutes. Summer was open to that. She too wanted to make progress and not be doing this all night! Dr. Oliver suggested another exam around 8pm and re-evaluate at that point.

I encouraged Summer to just stay in the shower as long as she could and not come out til it was absolutely necessary. She was really doing great. Anthony asked how the contractions felt compared to outside the shower and she said “I’m not going out there to find out!” We were seeing a much better pattern now- 3-4 minutes apart and steady. Summer reported some light rectal pressure, so I was sure we were making change and bringing the baby down. We talked about what might be next, the sensations, and cues for pushing. Our nurse Sara said goodbye and we welcomed Olivia.

At 8pm Dr. Oliver returned and we got Summer out of the shower (relunctantly) for an exam. She was 8cm now and -1 station- not bad! Dr. Oliver was happy and said she felt good about the progress now- no need to change things. We’d re-evaluate in another hour. She offerred Summer a popsicle- Summer said yes- grape!

Around 8:30pm, during a contraction, Summer suddenly said “water broke”. Sure enough, there was a large gush of clear fluid! That was great news- a sign things were progressing! I warned Summer the next few contractions would feel more intense both with pain and pressure, and it was all good. Sure enough, she was working hard now– lots of deep vocalizing. We offered to go back to the shower, but it sounded like too much work, so she stayed where she was, in her “throne” position.

Summer started getting pressure sensations so Dr. Oliver returned around 9pm to check- she was 9 ½ cm at that point- the baby was 0 station! Hooray! She was confident Summer would need to start pushing within the hour, and gave lots of praise. She would be close by. Within 20 minutes those pressure sensations moved to pushy sensations– at 9:30pm Summer was officially complete! The baby had come down nicely but she didn’t feel the strong urge to push, so we just let her rest.

Within 30 minutes, I suggested a visit to the bathroom- it had been a while since she emptied her bladder, and I was hoping the change in position would bring on that urge to bear down. Summer was not real pleased with the move, but I asked her to “trust me”. Sure enough, she sat on that toilet and we heard good groaning/pushing sounds. Olivia and I gave each other a “high five”. She was comfortable letting Summer stay there a while, which was great. Summer leaned on Anthony for support and pushed away!

She was ready for change by 10:30pm, so we headed back to bed. We tried the squat bar for a while. Summer was pretty tired, but liked “hanging” on it– she was really getting her rhythm now. That was tiring her out, so we tried side lying for a bit to help her rest completely between the contractions. At 10:45pm Dr. Oliver came to check on progress and said she had moved the baby down to +1 station now, so he was on the move. It was great news!

Summer was getting exhausted, but kept listening to her body. We alternated various positions, even tried hands and knees. We ended up back on the squat bar, hoping to utilize gravity and open up Summer’s pelvis. We knew you she would need all the room we could make! By 11:45 Summer was ready to rest again. There had been some decelerations of your heart rate off and on, so Anthony continued to offer oxygen between the contractions. I realized you would not be a “10/4” baby after all!

Dr. Oliver came in again around 12:15am– to check on progress. She said the baby was still about the same- +1 station. There was not a lot of molding going on, and she felt, with Summer’s effective pushing, she should have made more progress by now. The baby was still really high up- not even close to consider a vacuum or forceps assist. In fact, he was so high up, she could not even tell if he was face up or face down– she could not reach around Summer’s pubic bone to feel the baby’s head.

Dr. Oliver was open to letting Summer continue to push– there was no hurry– but she was thinking the baby was “stuck” and was probably too large to fit through.

Summer didn’t need long to make her decision– she was pretty tapped out and not sure if she had much left in her to push anyway. She felt she had given it as much as she could- it was time to get you here. So Summer decided to do another cesarean at 12:30am. Because you were doing fine, there was no reason to “rush” so while the nurses got things ready, we talked about our options. Summer really wanted to hold you right away, since she had not done so with your brother. And there had been separation last time too. I pleaded with the staff to allow you to be held, and for your family to stay together, unless it was clearly medically indicated for you to go to nursery. They said they would do their best… it was not the norm, but they were open minded.

Summer was wheeled away and Anthony walked along with her. It didn’t take them long to get her anesthesia in place and start the surgery– at 1:12am on 10/5/12 you were born! They took you immediately to your mama, where she welcomed you on her warm chest. They let you stay there, skin to skin, with Anthony nearby. Your parents welcomed you with love and joy – all 9 lbs, 6 oz of you! They were delighted to meet you finally, and so happy to be able to hold you and snuggle together. They remained together as a family all the way into recovery where I joined them. Summer glowing (even though she was exhausted)– so happy. I helped her get you positioned for breastfeeding, and guess what– you latched on without hardly any help, and Summer breathed a sigh of relief. “This was what it was all for”. She was so happy to be holding you, nursing you less than an hour after you were born. Every contraction, every part of the day culminated in this one moment– I felt such peace, and joy, as we sat and watched you eagerly nurse for the first time.

(Note: Immediate skin to skin in the OR after a cesarean is not currently the norm. Special thank you to Dr. Oliver for being open minded and to the rest of the Seton staff who supported Summer and Anthony’s wishes. We know babies benefit greatly from immediate and uninterrupted skin to skin contact – whether it’s a vaginal or cesarean birth. I hope this story is the beginning of many where hospital routines change to help families have more family centered cesarean births. sls)

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A Healing VBAC

Your mom had an unplanned cesarean with big sister Madeline and was determined to have a VBAC this time around. She did her homework, carefully chose a care provider who would support her wishes, and hired a doula to help her and Chris through childbirth. That’s me, and this is your birth story from my perspective.

When I met Betsy, she shared her experience with Madeline’s birth. There was still a lot of disappoinment and sadness surrounding those memories. We focused on getting her as ready and prepared for a good Vaginal Birth After Cesarean this time. She did her reading, took a class which helped her and Chris learn ways to cope with labor, and talked to me and her care providers about what she needed this time. She was doing all the right things to line herself up for a successful birth!

We patiently awaited signs of your arrival. Betsy was eating well, doing her exercises and stretching, and knew you’d come when you were ready. We knew you would not be a “small thing”– but hoped you wouldn’t wait too much past your due date to come.

Things started around midnight on your exact due date! Betsy started noticing some regular contractions that felt different from all those Braxton Hicks she had been experiencing for weeks. By 2:30am they were anywhere from 6-10 minutes apart, and were lasting 90 seconds. She called me for my advice– knowing they were a good distance from the hospital, should she go in? After chatting with her on the phone, listening to her “talk through a contraction”, I recommended she wait til they were much stronger, and were taking more of her full attention.

By 6am she called again and merely said “I’m ready.” I could hear in her voice she was working through the contractions now… I didn’t have to ask how far apart they were or anything. She said she was shaky and feeling a little nauseous– a good sign. I said I’d meet them there.

I was already in front when they pulled up at 6:35am on Sunday 9/16/12. I ran upstairs to get a wheelchair and helped them get into labor and delivery. Betsy informed me her water broke in the car just as they pulled up, and her contractions were strong, steady, and long. She was doing beautifully but definitely had to stop and breathe through them. The nurses prepared to put her in a “triage” room– I mentioned her water had broken, and they said “Oh that changes things”… so we headed directly to Labor Room 3 and got settled.

Betsy has spoken to Dr. Sebestyan on the phone on the way in. She was not in the hospital so asked our nurse, Nina to do the exam. At 7:05am Betsy was already 8-9 cm, her cervix was thin and the baby’s head was well applied– that was amazing news!! I was so excited Betsy had done exactly what she had wanted– spent most of her labor at home and showed up when it was really time to have a baby! I told Chris to go ahead and move the car and to hurry back!

Meanwhile the nurses had to get Betsy admitted to the hospital. They made various attempts to draw her blood and get her IV set up– unsuccessfully. Meanwhile Betsy was working hard, vocalizing and trying to stay relaxed through the contractions, which were coming every 2-3 minutes and very powerful. She even started gently bearing down and indicated she was feeling the beginning urges to push. We kept her calm, encouraged her, and offered a sip of water here and there. She was a little queasy, so I placed a washcloth with some peppermint oil under her nose to ease that. At some point the nurses “realized” she was a VBAC and rushed around, getting the right consent forms to sign… Betsy hardly looked at them, focusing just on labor.

Dr. Sebestyan arrived at 7:30am and did an exam– she was “almost there”– just a slight lip on one side, and the baby was at 0 station. She encouraged Betsy to go ahead and push a little to move cervix out of the way… Chris was way off in the corner- I teased him it was ok to come out, this was his baby too!

Betsy had great control and pushed very effectively. By 8am Dr. Sebestyan checked again and said she had already moved the baby down to +2 station– it was looking great for a vaginal delivery!

Simon, you were looking great the whole time– your heart rate was steady and strong. Dr. Sebestyan asked to have anesthesia come in and at least set up an IV just in case– Betsy was a little dehydrated and being a VBAC they needed a line hooked up in case of emergency. Finally that was done and we could focus just on pushing!

Betsy was doing great but I asked her if she thought the squat bar might help to have something to “push against”– she ended up using it as a leverage for her legs, which brought you right on down. By 8:35am, we could see your head “right there” and Nina had to ask you to STOP pushing so she could get Sebestyan back in for delivery!

It took a few moments, but once everything was ready, we encouraged Betsy to push again, and your head gently emerged, followed by your body– at 8:41am. Everyone remarked what a big guy you were! You were placed immediately onto your mama’s belly, where she could touch and hold you for the first time! She was so relieved and joyful, Chris was in total awe of what he just saw! I took a few pictures, to capture those moments, of your parents meeting you for the first time. After Chris cut the cord, the nurse asked “Do you want to know how much he weighs?” and Betsy said sure… You were a whopping 9 lbs 9 oz!! A full 12 oz larger than your sister, a 14 inch head, and 21 ¼ inches long. You had the biggest feet I have ever seen!

You were returned quickly to enjoy some skin to skin snuggling with your mom (after daddy snuggled with you for a few moments) After about an hour you finally let us know you were interested in nursing, and after a few tries, you got it. Betsy was so happy, so relieved, and I was so proud of her– she did amazing!

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A Change in Plans

Toby and Dana eagerly awaited your arrival– they had done their homework and prepared for as natural birth as possible. On the morning of 7/18/12 Dana thought her water broke around 3am, so the day was spent trying to get Dana in labor, including an acupuncture visit to Melissa Light, anticipating a medical induction by 3pm if they were unsuccessful. Family drove in, expecting a baby soon! Finally they ended up in the doctor’s office and were told her water was NOT broken, and were sent home. Although both of them were disappointed, I reassured them this was good– they had wanted to labor at home anyway, and a medical induction would have been a whole different experience they were hoping to avoid.

Melissa’s magic kicked in later that day…Dana’s real labor began around 5pm with strong contractions– she tried to rest initially but the contractions proved to be too strong to sleep through. They were still sporadic at the time, so they waited. Toby called me around 9:30pm to inform me they were getting more consistent, roughly 3-5 minutes apart, and stronger, and they were ready for support.

I arrived at the their household around 10:15pm. Toby instantly apologized for this being a late night event, to which I laughed. “Most births happen at night, that’s just how it goes”. Dana was sitting upright in bed, quietly breathing through the contractions, which were getting even stronger and closer. Dana’s mom was there too– Cindy, offering comfort and love. Ocean waves played in the background, and Toby encouraged her to relax and let go with each contraction. It was obvious Dana was working hard. I felt her uterus and those contractions felt moderate to strong– it sure seemed like things were moving along!

We labored like that awhile. Dana used the restroom… getting around was getting harder. She liked standing leaning positions and sitting upright best. Those contractions were getting closer to 3-4 minutes apart by 11pm. After she used the restroom, they seemed like one after another, so I suggested we may want to consider heading into the hospital. The way she was acting, it was good strong active labor. Toby put a call into the doctor and we waited for a call back. Meanwhile we got the car packed up. By 11:40 the caravan was on the road to Seton Medical Center.

We arrived about midnight and got Dana up to Labor and Delivery. Cindy and I stayed with her while Toby moved the car. Analisa was our nurse and she got Dana on the monitors. Contractions were now every 3 minutes and strong. We began some of the paperwork– Dana didn’t like it! Scary! Due to the active labor pattern, Analisa wanted to do an exam sooner rather than later. Sadly, she reported Dana was still only about 1cm, 70% effaced. Dr. Hansen was on call for Dr. Bushart and really did not want to admit Dana, since it didn’t appear she was in active labor based on her cervix. We talked about the possibility of there being scar tissue on her cervix, which causes this type of labor– all the signs of labor progressing without cervical change. I said Dana was acting more like 5-6 cm, not 1cm, and to not give up. Her cervix would give in eventually. We decided to stay for a couple hours and see what happened. They would check her again then. Toby could not believe they would even consider sending her home. Analisa agreed– so we kept our fingers crossed the next exam would be good news.

Dana continued to work with her labor, mostly sitting upright in bed. I told her to “be 7cm in her head”, to welcome the surges as they came. At 1:30am, I walked to the visitor restroom and found the Fan Club all in the waiting room! I assured that all was good– baby looked wonderful and mom was hanging in there. Of course, we were disappointed she was only 1cm, but we were taking it one step at a time.

Dana was fighting nausea off and on. The peppermint oil helped. The contraction intensity was building and Dana was doing a great job of managing them. Toby had the ocean waves going again. The room was dimly lit and quiet. Dana continued to have good signs– mucous and bloody show. We felt encouraged!

At 2;45am, Analisa did another exam– she said she was now 2cm and 80% effaced. She could feel a “tight band” of tissue in the cervix and tried to work on it… it was very uncomfortable for Dana but we hoped it would help move things along. The good news was there was cervical change, so the hospital could officially admit her. Yeah! Surges were coming every 2-3 minutes, it was crazy to think we could have been sent home. Analisa began the admission process, which meant more forms and getting the saline lock set up.

By 3:30am, Dana was battling nausea again, and finally gave in. She felt better after that for awhile… She remained in her “throne” position. I suggested position changes, or alternatives, but she really was most comfortable like that. Exhaustion was beginning to set in, so we encouraged her to rest as much as possible.

At 4am, I stepped out again to use the restroom. More Fans were in the waiting area! I convinced them it would be awhile, and I strongly advised they consider getting some sleep. A baby wasn’t going to “fall out” anytime soon, so I turned out the lights and told them firmly to go to bed. No one argued with me!

Dana took another restroom break too and we saw more bloody show– great news. We tried standing leaning over the bed for a change in pace, but Dana was just too tired, so we ended up sitting in bed again. All of us were feeling the effects of a long night, so we all dozed between surges.

Around 5:15am, Dana wondered when her next exam would be. What if she was still 2cm? I encouraged her to keep an open mind– it was hard to know when her cervix would “give in”. Her uterus was doing all the right work, and she needed to trust her body. We discusses options– breaking her water, pain medications, and an epidural. All those options were available to her whenever she wanted.

Analisa did another exam at 6:15am and reported Dana was now 3cm and 100% effaced. So we were making progress, just very slowly. The cervix had begun to move more forward, which was also good news. She predicted once that band finally let go, it could be fast. We just didn’t know when that would happen.

I convinced Toby to take a break at 6:45am. He headed to get his sweatshirt from the car. Dana and I tried a sidelying position, to help her get more rest between the contractions, but it was just way too intense. We moved her back to the “throne” where she stayed. At 7:15am, Rachel took over for Analisa. We talked about getting some IV fluids to help– Dana had not been able to keep much down over the course of the night and it was likely she was dehydrated. She would probably feel better and her labor could become more productive if her body had what it needed. She agreed. At that point, she had been in labor about 14 hours. Rachel offered something for the nausea, but Dana declined. Dr. Cosantino was on call, and we again talked about options– Dana decided on a dose of an analgesic to help her relax and reduce the pain. She received that around 7:30am. It did help calm her, and helped her relax. It was a quiet, peaceful morning.

8:20 am Dr. Bushart stopped by. He was not on call for deliveries that day but would check in when he could. He did recommend considering having the water broken to “stir things up”… with a warning that those contractions would be even more intense after that was done. That was a little scary for Dana to think about– she was feeling pretty much maxed out at this point and could not think about doing even more. She started considering if an epidural would be the right choice for her at this point, even tho she had previously felt strongly about not getting one. She and Toby went back and forth, talking about the risks/side effects… I mentioned that sometimes when the benefits of an epidural begin to outweigh the risks/side effects, that’s when a mom needs to consider it. At this point, Dana had been in labor about 15 hours, and it wasn’t looking like we were close to having a baby. She used the restroom one last time and had a few tough surges. That was when she decided she was DONE and needed some rest and relief. So we called in an order for an epidural.

Anesthesia came at 9:20am – the epidural was easily placed by 9:35am and Dana began to feel it’s effects almost immediately. The contractions began to feel less and less painful and within about 20 minutes she could not feel them at all. I encouraged Toby to go get a bite to eat and to update the Fans. Of course they were all thrilled Dana had chosen to get some rest. She was feeling much better, and even a little chatty! I reminded her firmly that although she felt better, this was a critical time to sleep– we still had a long day ahead of us potentially and pushing was still work.

At 10:20 Dr. Cosantino arrived and offered to do an exam. He said she was still about 2-3 cm, very thin, and the baby was still a little high. He broke her water with a small needle so that there was just a gentle leaking, so that the baby could come down. At that point, all we could do was wait.

Dana, Toby and I dozed through the last morning. Rachel came in saying the baby was having some “telltale signs” of moving down and she wanted to check her– great news, Dana was 5-6 cm and the baby had come down to -1 station. We were all so relieved to hear there was good change! We helped clean Dana up (she had leaked a LOT of amniotic fluid!) and got her comfortable on her other side. Back to sleep.

Buzz popped in for another visit around 1:30pm. He offered encouragement that things were moving and assured her she had chosen the right thing by getting an epidural. Dana ready to head back to sleep. Toby put in an order for a smoothie for lunch while I quietly munched on my sandwich. Cindy delivered the smoothie and stayed for a quick visit– offering love and encouragement!

By 2:50pm Dr. Cosantino came in– he had noticed a few more decelerations on the baby and wanted to check and make sure they were due to head compression, not a problem. Sure enough, Dana was now 8cm and 0 station. She was making great progress now! There was light at the end of the tunnel– he’d wait for another couple hours for an exam, but felt very reassured things were moving along nicely.

We continued to rest off and on the rest of the afternoon. We went through probably 4 nurses over the day– finally getting Marty at 5pm, who promised she’d be “ours” til she left at 7pm. About then Dr. Cosantino arrived and said Dana was almost there– just a slight rim around the cervix and now +2 station! He wanted to give it a little more time and wait for Dana to feel more pressure, indicating it was time to push.

I recommended to Toby he probably should go grab some dinner. He placed an order and visited with the Fans. Cindy and Lillian came into offer love and support– they were so proud of her! There was finally laughter and joy– it had been such a long night/day. We new baby would be here tonight for sure. We hoped she would have the baby before shift change– they really liked Marty and were tired of the “revolving door” of nurses.

At 5:50pm, Dr. Cosantino came back to check again– helped push back that last part of the cervix and called her complete and +2. Time to start pushing! We did a little “pushing pep talk”– I explained that because she had an epidural, things would be different than we had planned. She was not feeling the urge to push, so she’d have to follow our lead on when. Her legs were pretty numb too, so we were limited in positions. Dana worked really hard, giving it all her might. The baby was making progress– just taking his time, like most of the day. We reassured Dana she was doing great, it was just going to take a while. The good news was, Analisa was back on and was our nurse at 7pm– although we were sad to say goodbye to Marty, at least we welcomed a familiar face.

Analisa and I started getting creative to help Dana’s pushes become more effective. The tug of war game worked great! It was exhausting, but each time she did it, we could see real movement. Even Dr. Cosantino was impressed with the strategy and held the sheet for a push! He seemed to enjoy getting into the game. It took some time, but by 8:30pm, the baby’s head was getting close and the staff prepared the room for delivery. The birthday party was called in– lights, camera, action!

Finally, after over 24 hours of labor and almost 3 hours of pushing, Harlan Cash was born at 8:54pm on 7/19/12… after a brief moment to let the cord pulse, his cord was clamped and he was placed onto Dana’s belly for skin to skin. Dana and Toby fell in love instantly! They were so glad he was here– it had been such a long day. Dana was so glad it was OVER! (Although I reminded her– it was actually just beginning.)

Toby and Dana just admired Harlan’s face while I captured those first moments on the camera. It was quiet, peaceful, dimly lit– just what they had wanted to welcome Harlan into the world. We knew the Fans were waiting outside, but after such a long haul, Toby and Dana deserved a few moments together, as a family, to just cherish the moment. Welcome Harlan Cash!

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The Birth Story of Awesomeness

Laine, your mom had an unplanned cesarean with your brother Issac. Although it was the best thing for him, she really hoped to have a Vaginal Birth After Cesarean (VBAC) with you– she knew a vaginal birth would be the best for both of you. She started doing her research early– she chose a supportive doctor and midwife, and hired a doula (that’s me). Together, with husband Todd, we were the BIRTH TEAM OF AWESOMENESS. This is your story from my perspective:

Heather had been doing everything she could to maintain a healthy pregnancy– She was seeing Robb Hoffman for acupuncture to keep her blood pressure down, Myra Hoffman for adjustments, she did a Birth Story Processing workshop with midwife Liane to “process” Issac’s story. She read, she researched, she took an Advanced Comfort Strategies class with Todd, all in preparation for a natural VBAC. They took care of a few last minute “home” items– a new car, sewer hookup at the house… finally things felt “ready”.

She informed me Thursday 3/22/12 that she had lost her mucous plug, and she was seeing Liane that day. She also went to Hoffman Health for an adjustment and “was stabbed by Robb” too– trying to get labor going. (she was 39 weeks and ready!) She walked 3 miles, ate lunch at Tacodeli and had a spicy cheesecake known for starting labor… said it was delightful. She worked on her tile project from Liane, had a romantic evening with Todd… all trying to get labor rolling. Friday, still “nothing”… more walking, a massage and pedicure… Reale’s for dinner that night. I told her even if labor didn’t start, it sounded like a great day!

Saturday around dinnertime Heather texted me that she was having “mild back pain” and more mucousy discharge. We agreed it could be very early labor… but not to give it much thought. Rest, hydrate, and relax… if it turned into something, great… By 8:20pm she texted again the contractions had started, but they were very mild and she and Todd were going to bed. (He had been on the roof most of the day putting up gutters, and was exhausted.) I hoped they would get some rest. But I had a feeling– and got my things ready.

By 8:50pm Todd called, and said “Today’s the day”… Heather was having contractions every 7-8 minutes, and they were strong. She was definitely having to work to get through them. We decided we’d wait til they were closer to every 5 minutes apart before heading to the hospital, but that I would join them at home until then. I changed and gathered my things, and was heading out within about 15 minutes, when I got another call… “Shelley, my water broke, Liane said to come right in”… ok, headed straight to the hospital instead!

I arrived at the Women’s Center of Central Texas at North Austin Medical Center around 9:30pm. Heather and Todd pulled up shortly after I arrived… Heather stating immediately– “We had to stop 7 times. Contractions in the car are no fun”. She was her usual smiley and cheerful self- until a contraction came. It was obvious she was really in labor now. I helped her get out of the car while Todd grabbed the essentials. We got her a wheelchair and a helpful daddy to be assisted us in getting up to labor and delivery. I told Todd he could leave the car there for now– best to get Heather settled into a room. Liane met us in the lobby and walked us in… we were escorted to room 2 right away. Liane saw Heather working hard, contractions now coming every 2-4 minutes, and was really glad she had come straight in. Heather just complained about her pants, they were wet, and she could not wait to get them off! I told her that would be no problem, we could not have a baby with pants on anyway!

Liane wanted to do an exam right away– we listened to your heartbeat and you were doing beautifully. “What a good girl”, remarked Liane. Heather was in bed, breathing, with Todd right by her side, telling her she was doing a good job. I reminded her to stay relaxed, although it was getting harder and harder. Heather said “Do not even try to tell me I am still 2.5 cm… Liane, if you have to lie, do it”. Liane promised to “lie through her teeth if she had to” although also said “I doubt I’ll have to!”

Sure enough, around 9:45pm Liane reported Heather to be 6cm, 90% and 0 station… wowza! That was amazing progress in only 1.5 hrs of “labor”. The staff began to scurry, getting things ready for a delivery– we anticipated things would go fast. Cathy, the charge nurse, came in to get Heather’s blood draw and saline lock set up. Sarah was our nurse, and did only the essentials to get Heather admitted– forgoing the routine questions and consent forms. Heather’s back was aching, so Liane got a hot pack… “wonderful”.

Dr. Andrea Campaigne arrived around 10pm, smiling, and in flip flops. “Dr. Bubbles is here”… said Todd– explaining he could never remember her name but it sounded like champagne– “I like it”, she said. It fit her- cheerful and smiley!

As Heather continued to work through the increasingly tough contractions, Todd stayed close, encouraging her, keeping her relaxed, reassuring her she was doing a wonderful job. Heather began to doubt if she could go on– wondering “how much longer… I don’t think I can do this much longer.” I told her at the rate she was going, she would not be doing this long. A fast labor can feel overwhelming and scary, but she was doing a great job. “Your body rocks!” We helped her get completely relaxed in between the contractions, and to moan and vocalize during them. “Think dying cow”. Todd moaned with her, helping her stay focused. Despite the intense labor, Heather was pretty much her usual self, chatty and laughing in between the contractions. If you didn’t catch her during a contraction, you wouldn’t even know she was in labor! (She even laughed at Liane’s cheesy jokes!)

Within an hour, Heather began to make sounds like she was beginning to push. Liane told her it was ok to push if she wanted… Heather was not sure. So we tried pushing a few times, but Heather said it did not feel right. Dr. Campaigne checked her- it was about 11pm– and said she was about 9cm, the baby was nice and low- but that we should hold off from pushing. I recommended the toilet, thinking she probably needed to pee, and the position would help her finish that last centimeter. Liane propped up a pillow over the back of the toilet, and Heather straddled it. Todd moved right in, touching and soothing Heather through the contractions, while I rubbed and pushed on her back. Within minutes, Heather’s sounds became primal and grunty– I told her she was doing just right, those were all the right sounds. She said incredilously, “THOSE are the right sounds?” I smiled, and assured her, yes, they were.

While Heather got more and more “pushy” Liane and Andrea waited patiently in the room… just listening. It became obvious Heather was actively pushing, so I recommended she get back to the bed so we could have her checked again. She wasn’t happy about moving, but Todd and I helped her.. and we made it back. Andrea did a quick check- cervix was all gone and it was ok to push!

It was about 11:30pm by then– we started pushing in a hands and knees position… Andrea gave good feedback initially. She recommended having Heather roll over so she could really check her progress. She tried to “help” make more room for the baby, but Heather asked she not. After about 45 minutes of great effort on Heather’s part, we still could not see your head. Andrea asked if she could have permission to “help” by making room for the baby to get around the pubic bone. Heather agreed to it. It was really painful, but within a few pushes, we saw instant improvement– we began to get glimpsed of your head!

We continued to try various changes in position to see what worked best. We tried side lying, and then the squatting bar– that seemed to work great, with Heather’s legs “leveraged” by the bar, holding onto the handles– like a rowboat. It didn’t take long at that point before we saw more and more of your head. Even Todd took a quick peek, and got even more excited– really stepping up the “coach” instinct– counting and shouting for Heather to PUSH!

After about 1.5 hrs of pushing, Heather began to really wilt and say she couldn’t go on. She asked about how much longer– and no one could answer for her. We assured her she was doing great, that there was absolute progress, and this type of forward motion, with slipping back was so normal, especially for a first vaginal baby. It didn’t help to hear “It’s normal”. Heather wanted to be DONE. She was exhausted– it was now about 1am, and she felt she had no more to give.

Andrea recommended some juice- to give her some fuel. She sipped cranberry juice and I encouraged her to rest completely between the contractions– to reserve her energy. Todd stepped the coaching up one more notch– probably most of the nurses station could have heard we were pushing! Your head was so close— almost crowning– for what seemed like forever. Heather begged Andrea to “Just take her– pull her out”, but Andrea insisted that wasn’t how this story was supposed to be… she assured Heather she could finish this. By now, Liane, the nurses, Todd and I were all actively coaching Heather to PUSH PUSH PUSH! Andrea was calling to you, “Come on Laine, come on little girl”. She was saying “yes, yes yes” when Heather’s pushes were particularly effective… finally you eased out at 1:19 am on Sunday, March 25th, 2012… Right into your mother’s open arms. Todd was emotional right away- he couldn’t believe you were here! Initially, Heather was just exhausted– but she welcomed you with love and joy. It was obvious both of your parents were thrilled to meet you. You had wonderfully chubby cheeks, and a sweet little face which looked a lot like your daddy.

You were eager and ready to nurse after some quick health check ups… a weigh in said you were 7 lbs 14 oz, and 19 ¾ inches long… you were brought back to your mama, who was so tired– I recommended she lay on her side so you could nurse and she could nap… which you both did. Even Todd snuck in a quick 30 minute nap while I helped keep an eye on you, so she could close her eyes. It had been a fast and furious labor– about 5 hrs start to finish, quite a sprint! And… quite awesome!

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Ten Pound Cake!

Your mom and dad, as new parents, were a little nervous about going through pregnancy and birth on their own. A friend recommended considering having a doula present, a professional who provides information, support, and encouragement to families before, during and after the birth of their babies. They met with me and decided having a doula was a perfect fit for them!

We met several times before your due date, to talk about Twyla’s concerns and fears, and to help both of them prepare for labor. We also met with Dr. Holley, to discuss Twyla’s wishes for birth. As the days went by, both Twyla and Jonathan became more and more excited to meet you.

We knew you were not going to be a “small warrior” by any means– ultrasound predicted you to be about 9 lbs at 39.5 weeks, so Twyla decided it was ok to go ahead and induce labor. So in the evening of 2/20/12, a few days before your due date, she and Jonathan entered the hospital to get labor started.

Because her cervix was not very open and still firm, they used a special medication to help it get soft and start to open more, in preparation for labor. That Cytotec caused Twyla to have mild contractions over the night. The nurses gave her an Ambien to help her sleep, but because Twyla hardly ever took any kind of medication, she had some interesting dreams as a result– about having to work through layers of pound cake as she labored having you!

By morning, her cervix was about 2cm dilated and 80% effaced, and she was ready for labor. Dr. Holley broke her water and the nurses started Pitocin around 7am. I checked in around 7:45am and Twyla said the contractions were really starting to hurt and they would welcome my support.

I arrived around 8:30am at Cedar Park Regional Medical Center. Twyla was in bed, and surprisingly enough, did not have her usual smile on her face! I remarked “No one said labor was a piece of cake”, which brought on some laughter and smiles– after her strange dream! We had two great nurses- Deb and Tracy who supported Twyla’s wishes. Twyla was having a hard time managing the stronger contractions. Over the morning, they were inching the Pitocin levels up and up. I advised her to get out of bed, and find a better position to manage labor. She decided to try sitting in the chair a while. Jonathan ran home to get the ipod speakers, Twyla’s toothbrush, and some reinforcements. (Food!)

I did a foot massage with lavender to help her relax. She was able to get herself calm and was doing a great job of breathing through the contractions. Jonathan was able to “shove” some food in his body quickly and get back to helping Twyla. There was construction going on next door, which was loud and distracting, and then a floor cleaner went by outside. The final “straw” was Twyla’s phone going off– just too much. She broke down in tears, really doubting if she could go on. She started talking about possibly getting an epidural for the pain. Her contractions were 1.5 minutes apart, with hardly any breaks in between. The Pitocin was up to 8ml/hr.

We discussed her options and I suggested another exam before making any final decisions. Tracy checked her and said she had made some nice progress, was a “good 3cm” and 90% effaced. The baby had come down even more. She was wonderfully supportive, letting Twyla know even though it felt scary and overwhelming, that she was really doing a great job managing her labor. But ultimately it was her call how she needed to manage her pain.

Twyla felt “out of control” and since she was only 3cm, knew it would be awhile – so decided to ask for an epidural at 10:30am. The staff immediately got things prepared for it’s administration. As Jonathan and I helped Twyla to the restroom one last time, she began to feel “pushy” with the contractions… could things have changed that much? I notified the nurses, asking them if they wanted to check her one last time before actually putting the epidural in. They felt it was most likely just the position, so we moved forward. Dr. Klein was the anesthesiologist, and he was super kind and encouraging. He easily placed the epidural by 11am. It took a few minutes for it to work completely, but by 11:15am, Twyla was comfortable during a contraction. She stated “I feel SO much better!” Although she had hoped to avoid an epidural, she was glad she had chosen it.

As things settled down, Jonathan shared how happy he was that I was there– there was no way he could have handled all this on his own. Twyla agreed– it would have been overwhelming. I was happy to be there.

Tracy needed to put a urinary catheter in Twyla and did another exam– surprising us by saying she was already 6cm dilated! Well, no wonder Twyla was hurting so much– she had just dilated 3cm in a little over one hour! That was amazing progress in such a short time. We praised her for a job well done! Tracy went ahead and reduced the Pitocin back down to 4ml/hr since it was obvious Twyla didn’t need much!

I encouraged Twyla to get a little rest in– pushing would be hard work, and then when Ronin got here– sleep would be hard to come by! She got out her sleep mask and tried to nap. Jonathan was too “ramped up” to sleep, but I encouraged him to relax and take a few minutes to update friends and family.

Twyla continued to feel strong “pressure” during the contractions, and some discomfort, but nothing like what she had endured before– she nurse informed her she could add more medicine to her epidural, but Twyla was happy. She had good control of her legs and body and was not in miserable pain. Her contractions were still 2 minutes apart and looked nice and strong!

Jonathan ran out to grab more gatorade for Twyla. While he was gone, her BP dropped to 97/56 (probably due to the epidural) and anesthesia came in to give her some Ephedrine to help it back up. Other than that, she really had no major side effects from the epidural, which was great. When Jonathan returned, he commented they had gotten the baby warmer ready– yes, apparently the nurses had an inkling there was a baby coming!

Around 12:15pm we switched Twyla to her right side– she was getting some of her hip pain back and we hoped the position change would resolve it. It felt good to have her legs open, feeling pressure of the baby moving down, so I propped her leg up with the birth ball! I am sure we looked ridiculous, but it’s all about comfort…

Dr. Holley came in at 12:30pm and said “I know they just checked you an hour ago, but let’s see where you are”. She did an exam and said “She’s complete!” Twyla had dilated the last 4 cm in literally one hour! We were all pleasantly surprised– few first time moms dilate that fast. It was time to start pushing.

Because of the epidural, Twyla needed a little guidance how to push effectively. Jonathan and I helped hold her legs while the nurses gave her feedback. We got started around 12:45pm and it took a few tries before she “got it”. Soon we could begin to see a little bit of your hair– long and dark. I suggested a mirror so Twyla could see what we were seeing… as soon as she looked her eyes got really big and a smile crossed her face. She knew she’d be meeting you soon.

Within 30 minutes of that, we could see lots of your head, and it was time to call Dr. Holley back in. She got ready and within a few pushes, you were crowning! That last big stretch was a tough one, but Twyla was strong and pushed you out into the world at 1:48pm on Feb. 21, 2012. Everyone oooh’d and aaah’d– You were quite a good sized baby!! Chubby cheeks, chubby arms, and legs. You even had a double chin already! You were placed onto Twyla’s belly immediately and towel dried off. Twyla even cut her own umbilical cord! We were all very curious how much you weighed, so the nursery nurse took you over to the warmer— 10 lbs, 1 oz of baby! Now that’s a 10 pound cake!

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Ann’s Planned C-section

Ann lined up a great team to create the most positive birth experience possible. Her previous “surprise” c-section with Cate had been traumatic and scary. She needed something predictable this time. We talked about creating a family centered cesarean birth– to help her have a positive birth experience this time around. She let Dr. McIntyre know what she needed and even created a written birth plan outlining her preferences. She arranged for a birth doula to help with the birth, and two postpartum doulas to help later at home. She toured the hospital and found out what to expect, and what her options were on the big day. She outlined her plans and communicated them clearly to everyone involved.

We arrived at 5:30am at St Davids Medical Center.  I took one last “pregnant” picture just outside of labor and delivery– this was it! Brooke was our nurse initially and helped get Ann admitted. We kept the mood light, keeping Ann relaxed through the routine stuff with a nice lavendar foot massage. Ann has asked that anesthesia get her IV set up–Dr. Fason was not available, but Joe Kocks took his place and helped get Ann’s IV set up easily. (This was a major source of concern for Ann based on previous experience!)

Dr. McIntyre dropped in too, his usual calm demeanor. Ann remarked “That’s why I love that man”. He truly was so calm, and reassuring. Nothing fazed him!

We laughed about Ann’s evening “cocktail” of Gatorade and Maalox. (yum) Jeff ran out for a Diet Coke to help him through the morning. We took guesses at how big you’d be– there had been preductions you were around 7lbs- Ann said she hoped you were bigger- she said she felt BIG! Bit by bit we got through all the “pre-op” stuff. Ann was really hankering for a breakfast taco- sorry, no food yet, mama.

Aurelia took over at 7am and photographer friend Jenn arrived. She got a few fun photos of the “before” belly– soon we’d be meeting you. The mood was light and fun- we were excited things were going so smoothly. There was lots of laughter and positive energy in the room. Ann was really wishing she could have some breakfast– “Can I just smell your coffee?”

At 7:30am Aurelia announced, “Ok, it’s time to go, Mama”. She started getting Ann out of bed. “Oh, I’m walking?” It was so different from last time! We sent her out with love and laughter, with Jenn grabbing a couple extra photos of her heading off to the Operating Room.

We had about 25 minutes to wait while Ann got settled in the OR. Jeff and Jenn talked “shop”, chatting photography stuff. I made sure Jeff was dressed and equipped with a peppermint tissue just in case anyone got nauseous during the surgery. (Ann had had horrible nausea/vomiting last time.)

At 8:00am, Jeff was escorted back to the OR by a nurse. Jenn and I grabbed the suitcases and headed to the family waiting area, where we met Jeff’s parents, who were eagerly awaiting your arrival. I let them know you’d be coming right through those doors with your daddy in about 30 minutes, and they’d be able to meet you!

I headed back into Labor and Delivery and waited outside the OR, chatting with the nurses. It didn’t take too long before I saw Jeff coming out, proudly carrying you! You had been delivered at 8:18am. You had a wonderful set of cheeks, complete with dimples, and we commented that you certainly were much bigger than expected! Jeff took you to the nursery for a little inspection and I headed into the OR to be with Ann.

She said she was doing ok– the spinal went in easily and surgery went well. The sensations were strange though- no pain, but lots of movement and pressure which was very uncomfortable. She was debating medication to help her but didn’t want to be “knocked out” like last time. I reminded her how this was going to be the hard part and to hang in there. We tried relaxation and deep breathing, visualization, and just encouragement to keep her in control. She asked “How much longer?” and Dr. McIntyre said “11 1/2 minutes”. What a joker. The anesthesiologist, Jeremy, said it would probably be about 15 more minutes. He was also very kind and encouraging, and recommended she just wait. He could give her medicine, but it would make her sleepy and disoriented, and she wanted to remember this birth. So she hung in there. I massaged her scalp and face, held her hand, and talked her through it. It wasn’t easy, but she did it.

Aurelia came back in and asked Ann how big she thought the baby was– it was a great distraction… you had been weighed in at a whopping 9 lbs 4 oz! No wonder Ann reported feeling “BIG”… your sister had been only 5 lbs at birth! We laughed that you were nearly double her size!

It seemed like it took “forever” but finally I heard them wrapping things up, getting Ann cleaned up, and they moved her to another bed. We left the OR at 8:50am and headed to recovery. As soon as Ann was settled, Aurelia asked “Are you ready for your baby?” and Ann replied yes! She was in some pain, wondering about needing some pain meds, but I advised her to wait- Baby might be the right medicine! Aurelia called nursery immediately and asked for you. Within minutes, you and your dad arrived!

We undressed you and got you skin to skin with your mama right away. You were already rooting, looking for a breast! I just barely assisted Ann with positioning and you practically helped yourself! We had you latched on by 9:05am, not even 45 minutes since your birth. And you fed for a good hour– you knew exactly what to do and what was right for you and your mom. Ann was able to relax, take a deep breath, and realize you were here- healthy and perfect. She was fully present, and had been able to ENJOY this birth…. and to welcome you into the world with love and joy!

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By the Book!

I met your parents in childbirth classes. They had heard of doulas and were interested in having one attend your birth. They knew having an experienced person walking them through the process would help them have a better birth experience, feel more confident and relaxed, and answer their many questions as first time parents!

The days that led up to your birth were filled with excitement and anticipation. Lauren finished work with a half day on Thursday, and worked from home Friday. She had seen Dr. A Wednesday and was told she was about 1.5 cm dilated and 80% effaced, which was a nice start. They made sure their bags were packed and everything was done, just in case. Even Sam was nesting, making sure the new thermostat was in place before you came!

On your official due date, Sunday Aug 7th, 2011, Sam called me around 11:20am to let me know they thought Lauren was in early labor. She had started having contractions around 9am that were mild at first, but they had progressed and were now uncomfortable. They were irregular still, 7-20 minutes apart, but thought I should know. I reminded them to stay hydrated, change positions for comfort, use heat and cold for her aching back, and to update me as things changed.

I texted Sam around 12:30pm, checking in. He reported the contractions were getting stronger and close, now about 5-8 minutes apart. I had a feeling things were moving along. I told him I was available to come over whenever they were ready. He wanted to check in with Lauren but said they were ok for now.

By 1:30pm Sam texted me and said they were ready for me to come. At 2pm when I arrived, Lauren was in the bedroom, sitting on her ball, soft music in the background, with her heating pad in place on her back. She was happy to see me, but I could tell she was working. They updated me that contractions were very steady now, about 5-6 min apart, and she was feeling intense pain in her back, even between the contractions. “This is way harder than I ever thought”. I massaged Lauren’s back, and helped her focus on staying calm and relaxed through the contractions. Lauren was started to feel a little scared, so I reminded her to do one at a time and we’d see where things took us.

Sam took advantage of me being there to take a quick shower and grab a bite to eat. Lauren especially liked being on hands and knees, and on the ball, due to her back pain. I suggested either a shower or bath, but it seemed like too much work, so she declined for now. The contractions intensified over that hour, and by 3pm they were 3-5 minutes apart and Lauren was ready to head in. We called the “on call” doctor and packed the car for the hospital.

We arrived at Seton Medical Center around 3:45pm. I helped Sam and Lauren get upstairs and we checked in. As we entered the labor room, Lauren had a tearful moment. I assured her things were fine, just perfect in fact, and she was loved and supported. Everything was going beautifully and I knew she could do this. Just as she was getting settled down, our nurse, Shannon came in. I recognized her from another labor and remembered she had been very kind and respectful before, and was delighted to see her. She was happy to work around Lauren’s positions, and asked about her preferences for birth. While Elise (another nurse) got Lauren’s blood drawn and saline lock set up, Shannon gently asked all those admission questions and got us officially admitted. I reminded Lauren to just focus on getting through those contractions, and all the rest of us would do our jobs! Shannon wanted to do an exam and see where things were– Lauren was already 4 cm dilated, 100% effaced, and you were a low-1 station. It was a great place to be! I congratulated her on getting so far in a relatively short time. (She had only been in “real” labor since maybe noon or 1pm!)

Dr. S was on call for Dr. A, and both nurses provided some helpful feedback about Dr. S’s style and personality. She came in shortly thereafter and wanted to do her own exam. She reported Lauren was “3-4 cm” and suggested she break her water as the bag was really bulging and it would help speed things up. We had wondered about your position so she checked that and confirmed you were facing down, which is where you needed to be. (I wondered what the source was of Lauren’s excrutiating back pain!) Lauren wanted some time to think about things before making any decisions to intervene.

Both Shannon and I agreed, labor seemed to be progressing beautifully on it’s own right now, and advised there was no “need” to move things along at this point. Lauren agreed, she was ok with allowing her body to continue at it’s own pace, plus she didn’t necessarily want stronger contractions right at that moment! What she was doing seemed enough!

Around 4:45pm, I suggested a shower to help with the back pain. Lauren was starting to feel like this was more than she could handle. I reminded her all options were available to her, and only she knew what she needed to make this a good experience. We decided to try the shower for a while and see how she felt afterwards.

Sam helped get her set up with the ball in the shower. The hot water felt magical on her back! She visable relaxed and calmed down greatly. Sam took this opportunity to go move the car into the parking garage. Lauren spend probably 45 minutes in there, letting the hot water ease her back pain, which was constant. She and I both agreed, if she just had contraction pain, this probably would be a piece of cake. But the back pain was getting worse, and there were no breaks.

By 5:30pm, Lauren decided while the shower was helping greatly, she saw no relief “anytime soon”. She knew she had quite a ways to go still, and was ready for some help. I asked her if she was read to consider an epidural, and she said yes. I let Shannon know, and asked if we could start the process while Lauren was still in the shower, and she said “sure thing”. She got IV fluids going and called anesthesia.

Within 25 minutes, Shannon asked Lauren to get out of the shower as anesthesia was on their way. Sam and I helped dry her off and just as she was walking into the room, the anesthesiologist arrived. We got Lauren into position as anesthesia got going. He easily placed the epidural, probably the fastest I’ve ever seen! By 6:05pm, Lauren was already laying down, feeling better! “This was a good call– no regrets”. She was her usual chatty self again, so relieved to have that pain gone.

Sam, meanwhile, had received notice that his parents, excited as they were, were in the waiting room. Since Lauren was feeling better, he took that opportunity to visit with them briefly. Lauren was ready to chat with her mom now, really missing her. She kept saying she felt soooo much better!

At 6:20pm, Dr. S came in to do another exam. She reported Lauren was a “very stretchy” 5 cm, which was good progress, and decided to break her water. They saw light meconium, which meant you had already had your first bowel movement inside your mom! She confirmed your position was perfect, and spent a while explaining good positioning to Lauren. I suggested it was a great time to take a nap, as there was still plenty of work ahead of us, including pushing!

Sam realized it was already 6:45pm and went to get something to eat from the cafeteria before it closed. I stayed close by, with my book, while Lauren rested…. lights out, all was quiet. Contractions were now 2-3 minutes apart, and looked nice and strong on the monitors. I had a feeling with rest and relaxation, things would move along nicely.

The staff just let Lauren rest til 7:45pm. Shannon checked her and said she was a good 6, maybe even 7cm now, and you were even lower, which was great change! We flipped Lauren to her other side to keep the epidural even. Lauren was beginning to feel more pressure, especially with the contractions. I assured her this was normal and good! It was a sign the baby was moving down. Sam sent out messages to the right folks, and went to update his parents again.

At 8:30pm Shannon returned for another “flip”.  Sam was resting by then too, realizing what a drain today had already been, physically and emotionally! Lauren was reflecting on how good all those “Last” moments as a couple had been, the “last walk together alone, just us” last night, the “last leisurely morning in bed”, the “last couple breakfast together at her favorite place on the lake”. It’s really been an amazing day, she couldn’t believe in just a few hours she was going to finally meet you!

The pressure in Lauren’s bottom increased enough for her to need to press her “bolus” button, which delivered a small amount of medicine into her epidural. At 9pm Shannon did another exam, 8 cm! She was pleased things were moving along so well.

I decided this was probably the “last” time Sam and Lauren would have together, alone, as a couple, so told them I was going for a walk to give them a few minutes alone. I went into the waiting room where I met Sam’s parents, who were eager to hear how things were going. While I was out, I ran into Penny, my favorite night charge nurse– it seemed the stars had aligned perfectly for your birthday today! We had gotten wonderful staff and nurses, throughout the day.

When I returned, Sam was deflating the birth ball, and we remarked how much we used or didn’t use from the labor bag– Sam was ready for a cup of coffee, knowing it was going to be a long night still. Finally at 10pm, Lauren was “legitimately tired” from her long day and tried to nap. She was feeling more and more “rectal” pressure which I knew was your head moving down. Sam put on some relaxing music, which set a nice mood. Lauren was a little worried about pushing, and if it would hurt. We talked about how things would go and I assured her, compared to everything else she’s done today, pushing would be a breeze! We talked about techniques to make pushing time as effective and short as possible. We also contemplated whethere Baby White’s arrival would be the official due date OR 8/8/11, Lauren’s pick. It was going to be a good story, either way!

At 10:15pm, Dr. S did another exam, and said all that was left was an anterior lip, so called her 9cm. You had moved down to the +1 station, so I knew it would not be long! I encouraged Sam to stay close, and to have some snuggle time together, enjoy the peace and quiet before the excitement begins!

At 10:40pm, while Lauren slept, Sam went out to check in with his parents again. Staff began to prepare for the delivery, getting the delivery cart in and ready, warming the baby isolette, etc. The contractions were a steady 1.5-2 minutes apart, all on Lauren’s own– no Pitocin!

Sadly, it was time for Shannon to leave, so she introduced Sarah to us who would be taking over. At 11:15pm, Sarah did an exam and found Lauren to be completely dilated, and you were very low, so it was time to start pushing. It took a few minutes to get things ready, so we rolled Lauren over one more time to even out the epidural. Finally at 11:35pm, we “officially” started pushing. It was obvious this wasn’t going to take long, as I saw your head by the second push! Lauren was a good strong pusher… she made excellent progress! By midnight, Sarah asked her to stop– we needed to get a doctor in here!

Dr. S arrived a little after midnight, and they called neonatal staff to be present for the birth (because of the meconium) We asked Lauren to do gentle “half” pushes for a while til things were good and ready. Then Dr. S gently guided her, “half push, ok, stop, ok, strong push, relax”… and ever so gently let your head emerge from your mom. You were born at 12:14am on 8/8/11!

Dr. S handed Sam a pair of scissors and he cut the cord. Because of the meconium, Dr. S handed you over to a special nurse so she could check you out, but you were crying vigorously, obviously doing just fine. So Dr. S asked the nurses to bring you right back, so you could enjoy some skin to skin time on your mom. As soon as we got you there, you immediately calmed down and started opening your eyes, looking around. Sam and Lauren couldn’t believe you were finally here! What a great day to welcome you to the world, Quinn!

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She Made it Look Easy!

I met your mommy in January of 2011. They had recently relocated to Texas from California and she was looking for a doula to support her through your birth. She and your daddy had hired a doula when your brother Noah was born, and they knew they needed the extra help and guidance again, especially being new to the area.

We kept in touch over the months. Your family was building a house, and it was scheduled to be done well before your arrival.

Around 32 weeks your mommy had a pre-term labor scare. We thought maybe you were going to come early. So she was told to slow down and rest a lot in hopes of keeping you in longer. It was a very busy time and hard for your mommy to stay in bed all day. But with lots of help from friends and family, she was able to rest a lot, and made it to 36 weeks with no problems. At that time, her doctor, Christina Sebestyan, said if she went into labor then, it would be ok.

I had a short little vacation, so we hoped you would wait til I got back. Even those days came and went and Melissa was still pregnant!

Saturday night, June 25th, she had a lot of mild contractions while she and your daddy were at a movie, and she knew something was starting. It was not until Monday the 27th though that this story really gets going!

Melissa called me at 4am on the 27th of June to let me know she had woke up around 3:30am with strong contractions which were about 9 minutes apart. She was ok for now but wanted to give me a “heads up”. By 7:30am she called again, the contractions were getting stronger but still 10-13 minutes apart. I reminded her to rest, even sleep if possible, and to stay hydrated.

Within an hour Melissa texted me, saying they were getting really intense. She had a lot of back pain. They were getting a little closer- 7-9 minutes apart, so I offered to come. She was ready for some help! I was ready to leave within 20 minutes and texted her to let her know I was on my way. She replied they were now 5 minutes apart, was it time to go in? Based on how she sounded, even through the text, I knew it was time. We arranged to meet at the hospital instead.

I arrived a little before them, and waited. Melissa and Scott entered the hospital lobby at 9:45am. Melissa looked a little worn out, but still greeted me with her sweet smile. I hugged her and said “Let’s go have a baby”.

As we entered Labor and Delivery, Melissa was able to have a normal conversation with the nurses… she didn’t even look like she was in labor! We were taken to a triage room to assess things. As the nurse began to ask questions, Melissa started a contraction– it was obvious she was working hard, moving and moaning to get through it. The nurse did a quick evaluation and decided it was time to check her, sooner rather than later.

At 10am, Melissa was already 7cm dilated! They wasted no time moving Melissa to a labor room.

We settled in, as the nurses began getting things ready. Our nurse got a saline lock hooked up while another set up a delivery cart and got things ready for a baby. Melissa liked leaning over the bed while I pressed on her back. She used movement and moaning to cope with the contractions. It was obvious they were very intense, but she was doing an amazing job of handling them. Melissa’s mom showed up soon after, super excited to welcome another grandbaby!

Within a short time, Melissa’s contractions became even more intense. The nurse asked her to rate her pain on a scale of 0-10 and Melissa said “9”… I told her … “‘NINE’ contractions get you to 9cm”. She was doing great and I had a feeling things were moving fast. She asked, “How much longer?” I assured her she was doing wonderful and it would be quick, to hang in there. I encouraged Melissa to totally relax and pause between contractions, which she did, using her breath to stay focused. We talked about you, listened to your heartbeat. Even in the midst of a very intense moment, Melissa was able to smile, thinking about meeting you!

Scott moved in closer as the contractions intensified. Around 10:30am, Melissa felt some wetness and wondered if her water had broken? There was a small puddle on the floor. She was beginning to feel a lot of pressure, like she needed to have a bowel movement. Both the nurse and I sensed that you had moved down and were getting very close to being born, so the nurse wanted to check Melissa again.

We got Melissa into a hands and knees position on the bed, to help keep the pressure off her back. The nurse was happy to check Melissa like that– At 10:35am, she reported she was 9 cm and the “forebag” was still intact… it was possible she had a high leak which is what had broken. Either way, Melissa was doing amazing, and we knew you’d be here soon. They called for Dr. Sebestyan to come for delivery.

Unfortunately, Dr. Sebestyan was tied up in a c-section and would not be available. It was looking like things were moving fast, so they called in another OB just in case, while they notified Cathy, the midwife on call, across the street. Dr. Fitzwater came in, gloved, and ready to catch, while we coached Melissa not to push.

It seemed like forever, but Cathy did make it. Her calm presence filled the room. At that point, she said “Ok Melissa, I’m here, you can push,”. She guided Melissa to make grunting sounds so that her pushing would be slow and gentle. Melissa was still in the hands and knees position and asked if she needed to move. Cathy told her she could do whatever she wanted to do– so she kept pushing.

Even with that slow, very controlled pushing, it did not take long. We saw Melissa’s amniotic sac bulge as she pushed, refusing to break. Cathy called it the “Sack of Steel”. Finally it released, and we were able to see your head! Cathy even suggested that Melissa reach down and feel your head. She could not quite reach, but knowing you were that close brought a sweet, satisfying smile to her face.

Your head emerged first, and rotated around to make your way. At that point, lots of fluid released and the staff was able to see that you had pooped inside your mom, as there was heavy meconium in the amniotic fluid. At that point, they were in a hurry to get you out so they could suction all that yucky stuff out of your lungs. So we urged Melissa to push with all her might, which she did. You were born at 10:52am, barely an hour from when your parents walked into the hospital!

Because of the meconium, Cathy urged Scott to cut the cord quickly so they could get you to the warmer. They used a special suction device to pull that gunk out and within moments we heard your fierce cries letting us know you were fine!

Melissa kept asking for you– “I need my baby.” I stayed with her, explaining why you needed a little extra attention. She was worried, and wanted to hold you more than anything. That was probably the hardest part– having to wait to hold you. I let the nurses know Melissa needed her baby as soon as possible, and to please hurry! It seemed like forever, but finally they brought you over, and Melissa held you for the first time. All that pain was gone, only love and joy as she looked into your eyes. Your daddy was there too, so proud of your mommy and so glad you were here!

Welcome to the world, Catherine Stiles!

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Done on the Due Date

Sherrie and Chris were typical first time parents– excited and nervous to welcome their new baby girl. Chris’ sister had strongly recommended they hire a doula to help them through the journey, so that’s where I came into play. We met several times before Sherrie’s due date, making plans, learning, planning, and preparing for the big day.

It was Thursday night, 6/2/11 around 6:15pm, when things first started. Sherrie texted me to let me know her water had broken. She had notified Dr. S, who said it was ok to stay at home until contractions were 5 minutes apart, or by 8am, if contractions didn’t get that close. I advised Sherrie to get some rest, since she was only having mild contractions every 10 minutes when we spoke at 8:30pm. She was so excited!

Friday morning I received another text at 7am stating nothing had changed much, and Sherrie and Chris were heading into the hospital to get labor going. I told them I’d meet them there.

I arrived at 8:30am, running into Chris as he headed out to the car. Sherrie was settled into a room, and was on monitors in bed when I arrived. She had experienced some stronger contractions overnight but they had died down this morning. Lisa, a midwife, was on call for Dr. S, so she came into the room to introduce herself, and to see if it was ok with Sherrie to use Pitocin to augment her labor. Sherrie was ready to get things rolling, so gave permission.

Lisa did an exam to see where we were starting… at 8:55am, Sherrie was already 2-3 cm dilated, 70% effaced, and the baby was -3 station. It was a huge improvement from Tuesday’s exam, when she was still closed! All those overnight contractions had done their job. It was a great start.

Our nurse, got the IV set up and began a very slow Pitocin drip. By 10am, Sherrie was feeling the contractions a little stronger, still nothing “difficult”– they were 5-7 minutes apart, so she was just resting. Chris’ parents were on their way, bringing all the “forgotten” supplies, including her Boppy!

By 11:30am, the contractions were 3-4 minutes apart, and getting more challenging. Sherrie was beginning to have to “relax and breathe” to get through them. She reported they were still very manageable and she was doing great! The Dads decided to step out to get a bite to eat– a good distraction.

At noon we set Sherrie up on the ball, leaning over the bed. It felt good to get out of bed for a while and have her back massaged. The French Open was a good distraction, with family chatting. The Pitocin was up to 10ml, and Sherrie had a good contraction pattern going, so they decided to hold there.

Around 12:30pm, the contractions started getting more intense, and Chris’ Mom decided it was time to “give us some space”. They headed to the waiting room. Sherrie announced “This isn’t fun any more”. Chris laughed– but it was clear she was now working hard. It became apparent why we use the word “labor” to bring babies here. She liked standing, leaning over the bed, using her breathing and relaxation to get her through the tough contractions.

At 1pm, after a restroom break, Sherrie declared “What’s the game plan?” Chris again laughed– “I think we are still on to have a baby!” Sherrie was beginning to feel exhausted, from a nearly sleepless night, and the contractions were clearly “no fun”. She was ready for a new position, as she needed to rest. We tried the rocking chair with her feet propped up and a neck support pillow– good. She was able to rest well between the contractions. “I know you told me not to forecast, but how much longer do you think I’ll be doing this?”… I reminded her to stay in the moment, one contraction at a time. There’s no way anyone can know how long it takes to get a baby here.

Something changed, because Sherrie stopped worrying, and really dozed between contractions. The contractions even spaced out a bit, giving her a little more break between them. We had soft music in the background, the lights dim, helping her be able to really relax. Her endorphins kicked in, making her feel sleepy and lightheaded– I assured her that was ok, and good! Those endorphins help those contractions feel more manageable. “Just keep doing what you’re doing”.

By 2pm, Sherrie was ready for a change again. I suggested hands and knees over the bed to relieve some back pressure. We were able to get her all propped up and comfortable. Lisa popped in for a quick check– everything was looking good! She was pleased to see Sherrie in active labor.

Chris stayed by Sherrie’s side, encouraging her as she worked through the contractions. She inquired about possibly taking some pain meds just to “take the edge off”. I told her they were absolutely available whenever she was ready. All we had to do was notify the nurse. Sherrie didn’t bring it up again for a while– she continued to work through the contractions, resting in between. By 2:30pm, she decided she needed a little help, and asked to speak to the nurse about a narcotic. She suggested a vaginal exam, just to make sure we weren’t really far along– you never know! She reported Sherrie was now 3-4 cm, still 70% and the baby was coming down. Sherrie was disappointed– “That’s all?” I reminded her it was normal to have slower progress in the beginning. “Don’t worry about the numbers”.

At 2:45pm, the nurse administered a dose of Stadol to help take the intensity away… We got Sherrie comfortable resting in bed. Chris went out to update his parents. Dad was away, checking on the house and big “canine” brother at home. I chatted w/ Mom for a while– she was praying. “Doesn’t she want to take the epidural?” I reminded her that Sherrie knew it was available to her at any time, and that her original wish was to go as long as she could without it. She was doing great and we needed to trust she’d do what she needed to get through this labor.

By 4pm, Sherrie had slept well between the contractions, but awoke, needing to use the restroom again. The contractions were feeling strong again… she need a lot of help and Chris was right there. She had a big surge of her own oxytocin and had 6 contractions in a row, with hardly any breaks! They were now 1-2 minutes apart, lasting 60 or more seconds. She was overwhelmed. We talked about having the nurse turn down the Pitocin, since it seemed obvious her own body had kicked into high gear. Sherrie was ready to “throw in the towel” so I called the nurse in to talk about an epidural.

By 4:40pm, Sherrie officially made the decision to get an epidural. The nurse started IV fluids and arranged for it’s administration. Anesthesia came and talked to Sherrie briefly, then began the procedure. It took a few minutes, and Sherrie was scared. Chris sat right in front of her and held her hand, talking her through it. She did great, and by 5:15pm, the epidural was in place. It took a while for the medicine to take effect, so Sherrie had to continue to use her breathing to get through the contractions. Chris put her relaxation music on again in the background which really helped. By 5:25pm, Sherrie was still fairly uncomfortable, so the anesthesiologist gave her another dose. By 5:35pm, she was hardly feeling them. She welcomed the break!

Our nurse finished getting things settled, got a urinary catheter in place, and we got Sherrie comfortable. I encouraged her to get some sleep-we still had a ways to go, and she would need her energy for pushing! I encouraged Chris to get a nap too, but he was way too wound up– I couldn’t convince him to close his eyes! He grabbed a Diet Coke and went out to visit with his parents, who were still diligently waiting in the waiting room.

Once Sherrie’s pain was taken away, she was suddenly aware of my needs– “Don’t you need a break, do you need to get some food?” I laughed, reassuring her I was taking care of myself, and not to worry one bit about me. She needed to focus all her engery on just getting this baby out.

Lisa came in at 6:30pm and did another exam– Sherrie was 7cm, thin and stretchy, and -2 station! Well, no wonder she had been hurting so much– she had really made great change since the last exam at 2:30pm. Lisa encouraged us to keep swtiching Sherrie from left to right, helping the baby continue to move down. Everything looked great. I encouraged Sherrie to keep resting! We hoped it would not be long now…

I took a break and went to visit with Chris’ parents in the waiting room. I gave them the good news, things were moving along!

I returned at 7:30pm, with Sherrie resting, Chris working on his John Grisham book. Andre Boccelli sang in the background. Our night nurse helped get Sherrie’s bed linens freshened up. We talked about what pushing would be like… would this little girl come today or on her due date, tomorrow? I said I thought there was a good chance it would be today, but only she knew…Lisa the midwife had predicted it would be in the “wee hours” of the morning– I hoped she was wrong!

At 8:45pm, Sherrie began to feel the contractions again… they were uncomfortable enough I had her press her “bolus” button, which gave her a little more medicine. Sherrie was a little shaky and there were mild decelerations in the baby’s heart rate with the contractions— all a good sign that she was getting close.

We continued to flip Sherrie back and forth to keep the medicine even, and to help the baby move down. The was getting more and more uncomfortable with the contractions, so I encouraged her to keep pressing her button. Chris livened things up with some reggae music! Sherrie was feeling good enough to allow Chris to take a picture, and to check her messages… she wondered who Chris had updated, friends and family would be wondering what was up!

At 9:30pm, Sherrie got a bad case of the shakes again– very common for late labor. I rubbed her arms and back, and helped her do her slow breathing, which helped. I assured her this was all ok and normal and a good sign labor was progressing! I hoped she was close to being fully dilated.

At 10pm, Lisa came in to do an exam– she was excited to report Sherrie was 9cm, 100% thinned, baby was in the perfect position and now 0 station! That was amazing progress! We were so excited and reassured things were getting close. We were finally on the home stretch! Lisa really liked the reggae music and did a little jig on her way out. Hopefully we’d be pushing a baby out soon.

At 11pm, it was finally time to talk names– Chris and Sherrie had both liked Isabela but after finding out it was the number one girl name for 2010, they decided against it. This baby’s name was “unreleased” still–

Sherrie was getting a little nervous about what was to come– pushing and delivery was sounding scary. I sat with her, describing how things would work, and reassured her that she’s come this far, surely she can finish this job. We would be right by her side, helping her along the way.

It was late– it was looking like it was going to be a while before we’d meet a baby. Chris decided he needed to send his Dad home one more time to check on the dog… it had been a long day for everyone. Sherrie was getting another little nap, which was great. She still had work to do! At this point, it was looking like she’d be born on her due date, 6/4/11 after all!

At midnight, I helped Sherrie roll over again, keeping her moving helped keep the epidural even. There was lots of shivering– more signs she was getting ready to deliver. She popped up, said she’s going to win the bet guessing the right date! We teased her– had she made it a long day today purposefully just to win the bet?

It had been a couple of hours since the last exam. Sherrie was not feeling any pressure or different sensations, but I was sure she was complete. I told her they were probably letting her “labor down” knowing the baby needed to get lower before they would have her start pushing. We were just waiting at this point for her to get the “feeling” like a baby was right there.

At 12:30am, we officially got our 3rd night nurse! I asked about when they would do the next exam, it had been nearly 3 hours since she was 9cm. She said the midwives usually do their own exams, but she’d check in with Lisa to see what she wanted her to do. She agreed, it had been plenty of time. I was worried about Sherrie losing her momentum, she had slept a bit, but wasn’t really resting well anymore due to the extreme shakes… if she was ready to push I wanted to get her going.

The nurse returned and did an exam at 1:15am, finding Sherrie completely dilated and the baby had desscended to +1 or +2 station– we were ready to push! She would check in with Lisa and let her know. Lisa came in, had just dozed off, so wanted to grab a cup of coffee and would be back. We started pushing without her, excited to get things going! Sherrie started on her side, and was making great progress. We moved her to her other side for a while, then to her back… it seemed that the baby was slowly but gently making her way down. As time went by, we saw more and more of her head, a lot of black hair! Chris stayed by her side, coaching and urging her on, to push more and more. Chris put on some good 80’s music for energy and inspiration, and we wondered which song would the baby be born to?

Finally, around 3am, we could see that head wasn’t sliding back at all… and I knew delivery was imminent. They had already brought in a team for support, and were completely ready. Sherrie pushed one more time, and at 3:05am, Naomi Christine entered the world. First her head came out, then her arm, it looked like she was waving at us! Then the rest of her emerged, and she was placed directly onto Sherrie’s belly where she welcomed her! Chris was right there too, amazed that his daughter was finally here!