The Birth of Baby Boy LK

The Birth of Baby Boy LK
Monday, November 26, 2007 at 12:40 PM
9 lbs 13 oz and 21.75 inches

Original due date: November 23rd

2nd baby, VBAC attempt, repeat cesarean

Mommy M had been my good friend for a couple of years now, ever since the birth of our first kids, so I was thrilled when she announced she was pregnant again. It was even more exciting when she asked me to be her doula. Yippee! Nothing could be a greater honor than to assist a friend during the birth of a child. It is simply amazing.

Mommy’s first birth was a cesarean after she dilated to 8 cm but no further. With meconium in the water, slight non-reassuring heart tones, and several hours of no dilation, the cesarean was performed with zero complications. Turns out that 9 lb 3 oz baby boy was posterior. He was born on his due date.

This pregnancy started very differently because conception happened without the help of fertility meds! Mommy also decided to search for a new care provider. Her old OB was not supportive of a VBAC, so Mommy signed on with a midwife group who attended births at Generic Hospital. The new group was very supportive and was willing to work with Mommy to give her the best chances for a VBAC.

Fast forward to the end of pregnancy. The baby was measuring large again. Mommy was ready for him to be born. Her due date (Thanksgiving Day) came and went. She had several bouts of pre-labor, but things always fizzled out after a few hours. She was somewhere around 3-4 cm dilated and 60% effaced. I tried to reassure her that though frustrating, this was important early work and that it was doing something! Finally, Mommy’s house emptied of family and she settled in and got serious about birthing this child.

On Sunday, November 25th, 3 days after her due date, Mommy was watching football with Daddy, Big Brother, and Daddy’s parents when contractions got started again. Mommy estimates they started around 4:45 pm, though she didn’t start timing them until around 5:20. At this point they were 4-8 minutes apart and 35-60 seconds long. I had called her earlier in the day, just to check in and say hello. She called me back at around 6:45, but I had to return her call just a little bit later. At 7:10, we got to talk and she filled me in. She said these contractions were definitely strongly than anything she had felt so far, and at that point they’d been going on for about 2.5 hours. I suggested she call her midwives and let them know what was going on, and see what they thought she should do. Mommy feared heading to the hospital and having everything stop, but I felt it was important to get the midwife’s perspective on this. She made the call, and they encouraged her to come in. With the VBAC, they wanted to make sure that if this WAS it, she was monitored closely for her safety and the safety of her baby. I asked Mommy to call me when they were parking at the hospital and if the contractions were still coming strong, I was going to go ahead and leave.

At 8:15 pm, Mommy gave me a quick call and said they’d just arrived at the hospital and things were still going strong. I told her I would leave in about 20 minutes, and asked them to call me back once she was checked and we knew if the hospital would be keeping her or sending her home. By 8:40 pm, I was out the door and on my way to the city.

At 9:00 I got a call from Daddy. He said Mommy was 4-5 cm and about 90% effaced, so they were staying at the hospital. WAHOO!!! This was it! I arrived at 10:30 and found them walking the halls. Mommy said her contractions were 3-5 minutes apart and about 60 seconds long. She was beautiful in her gown and fancy fuzzy socks. She had a telemetry unit for the continuous electronic fetal monitor, so Mommy was able to walk and roam and change positions to her heart’s content, as long as the belts kept the monitor in place. Mommy and Daddy looked excited and optimistic. They hugged often and were beautiful support for each other. Mommy continuously checked in with Daddy, almost as often as we checked in with her. It was a fantastic environment to be laboring in. I settled in, checked that everyone had water and encouraged eating since they’d both skipped dinner. Throughout the evening, I occasionally grabbed the camera and took some shots of Mommy and Daddy as they welcomed the labor and worked together to birth their son.

By 11:05 pm, Mommy made another bathroom trip and then continued standing and walking. She said that though she was feeling some discomfort in her back, it wasn’t excruciating. It didn’t sound like the typical back labor I heard stories about, but Mommy did say it felt just like it did during Big Brother’s birth, so I was a little concerned about baby’s position. When I asked her about it, Mommy said they’d been told baby was probably occiput transverse based on where his heartbeat was. At 11:35 pm, she asked for a birth ball so I hunted one down from the nurses. Mommy started looking more serious. Daddy turned on some music as Mommy hung out on the birth ball, and the midwife and the nurse adjusted her belts. At around midnight, Mommy requested some food and was told “clear liquids” only, so she enjoyed her chicken broth as best she could.

By 12:15 am, Mommy was back up and walking again, just going with the flow. I talked to her about her activity and what she felt was going on. Daddy was getting tired and Mommy ordered him to sleep, so he laid down to rest. We turned off the lights, turned on a few electronic candles, and set the room into “rest” mode. Mommy made another bathroom trip and then at 12:40 laid down to get some rest. Her right side was more comfortable to her, and it allowed the belts to stay in place, so that is what she did.

For the next hour, Mommy tried to rest and I just observed from the rocking chair. Her contractions were varying quite a bit. First they were 7 minutes apart and 80 seconds long, then 2.5 minutes apart and 90 seconds long, then 4.5 minutes apart and 90 seconds long. The midwife visited again and reiterated that she felt this was early labor because of the contraction pattern, but acknowledged that Mommy’s contractions seemed to be feeling stronger. A phlebotomist dropped in for a visit, and disrupted the rest time by turning on the lights and speaking very loudly. Mommy needed another blood draw because they’d messed up the last sample. Finally she left and Mommy was able to rest a bit.

While resting, Mommy seemed to drift to sleep, but then be shocked awake by each contraction. She was able to stay in position and breathe through each contraction, but I could tell they were growing quite uncomfortable. At times Mommy would let out a soft whisper of an “Ow” but otherwise, she was very quiet and determined to rest.

By 1:40 am, Mommy needed to pee again (yay! We were doing a good job with the water!). Contractions were between 3 and 7 minutes apart and 70-120 seconds long. They seemed to be getting stronger. The nurse popped in for another monitor check. Throughout the evening, the nurse visited at least a dozen times because the monitor fell out of place. While we knew these visits were necessary, they were quite disruptive, as they always flicked the lights on and spoke very loudly. Still, Daddy managed to sleep through much of it.

At 1:50 am, Mommy headed out to walk the halls again and then laid down again after that. Again, her right side was most comfortable, so she went with that. For the next hour, it was blissfully quiet and Mommy and Daddy were both able to sleep. Mommy was breathing beautifully through each contraction and would snooze in between. Contractions were 6-7 minutes apart. I draped myself in a towel (it was freezing in the room) and relaxed in the rocking chair.

Shortly after 3 am, Mommy got up to pee again and decided to try sitting/reclining in the bed for a bit. At 3:15, the midwife visited and offered another cervix check. Mommy wanted to know, so she got set up for the check. She was 6 cm and 90-95% effaced with baby’s head at -2 station and a bulging bag of waters. Contractions were still 6-7 minutes apart. This dilation was only a small change from 6+ hours ago, but it was progress, so we held on to that. The midwife suggested breaking her water (which she had also mentioned a couple of times earlier too), and Mommy politely but firmly declined. Mommy asked about the baby’s position, and the midwife indicated she believed the baby was anterior, but that she couldn’t feel the babies skull without breaking her water. The midwife suggested a shower or the tub. Mommy said she wanted to save the tub for later when things were more intense, and she certainly didn’t want to slow anything down at this point. But a shower sounded like a great idea. She asked me what I thought she should do and I agreed a shower sounded great – something different! The midwife additionally suggested Mommy try some manual nipple stimulation while in the shower and see if it brought on stronger contractions. So by 3:30 she hopped in for a good 20 minutes. Because of the telemetry unit for the EFM, she was able to stay on the monitors while in the shower.

By 4:00 am, Mommy was back out of the shower and ready for more action. The nipple stimulation didn’t seem to help a whole lot, but things didn’t slow down either. Mommy did agree the shower felt great! I demonstrated some lunges to her, and she worked on that with Daddy’s support a while. Because of the extended time with little progress, I continued to worry about baby’s position. The midwife had recently said she thought the baby was anterior, so I began to wonder about the position of his head. Could it be asynclitic? If malpositioned at all, the lunges might help and Mommy found that they felt really good.

Mommy had been reaching for her back during some of the contractions, so I asked her if I could help her by providing pressure to her back. She agreed, and it seemed to really help. So for a while, we three worked as a team. Mommy stood in the middle, content and talkative until a contraction hit when she would lift her leg onto the bench and lunge and sway with the energy. Daddy was facing Mommy and would hold her shoulders and support her balance. I was behind her providing pressure to the sore spots on her back. Throughout this entire time, I was amazed at how “normal” Mommy seemed between the contractions. It really seemed like her. It was an enjoyable time to spend with these expecting parents.

At 4:30, Mommy retreated to the birth ball again. This remained one of her favorite positions. We talked a little about emotions. I asked Mommy about being scared, and she acknowledged that she was (afraid of the pain). We talked a bit about how things really did need to get harder, but that it was good and necessary for this birth to move forward. Mommy seemed ready to accept what needed to happen.

At 5, the nurse checked Mommy’s blood pressure again (which was perfect). Mommy decided some jello sounded good, so I visited the nurses’ station to get that ordered. Mommy visited the bathroom again too. Contractions seemed to be getting still stronger and closer together with her new activity, sometimes as close as 90 seconds apart. At 5:30, Mommy decided to lay down again (right side). She was growing tired. Contractions spaced back out again to 4-6 minutes apart, sometimes 7.5 minutes apart. Back pressure continued to be helpful. After another 30 minutes, Mommy was back up to pee again, and then she went for a walk.

Just as the midwife’s shift was ending, she came in to check on Mommy one last time. She offered another cervix check, and Mommy agreed. I was so hopeful that all the activity over the last 3+ hours had resulted in dilation, but was skeptical because the contractions just didn’t seem strong enough, and they were still so variable in pattern. Sure enough, Mommy was 6-7 cm dilated, 95% effaced, and baby was still at a -2 station. I was feeling very frustrated for Mommy. Again, the midwife offered to break her water, and again Mommy declined with the plan to save it as a last resort. Shortly after the check, Mommy visited the bathroom again. We discussed a plan to get things going. I suggested we continue with the activity. The lunges seemed to speed things up. I also suggested we try acupressure, belly lifts (in hopes this may resolve any malposition we weren’t detecting), more position changes including hands and knees, and Mommy take another shower. Mommy began doing lunges.

By 7:30, Mommy had been visited by the new midwife, the old nurse, and the new nurse. All of them, including the old midwife expressed concern for how slowly things were going. The new midwife seemed very willing to work with Mommy and try hard to get things going, but she did acknowledge she would shortly be required to consult with the OB on call. Dr. OB was the OB, and the midwife said she would want to come in and meet Mommy before potentially meeting her in the operating room. I immediately felt uncomfortable with this change in language – suddenly we were talking about operating! I guess the reality was soon approaching, and Mommy seemed to know this deep down, but it was still hard for me to see this path before us when we still had so many tricks to try. Baby was doing fine and seemed very healthy, and Mommy was willing to keep working, so I didn’t see why we had to start talking about operating all ready.

Mommy also asked the midwife about using a breast pump for the nipple stimulation – something I suggested she ask about. The midwife said because Mommy was a VBAC, she was uncomfortable using the breast pump. While frustrated that she wouldn’t let us use one, I was pleased to realize she was acknowledging how strong nipple stimulation can be! The midwife also argued for AROM at this time, and suggested it was probably time to really consider it. Mommy suggested we wait just a little longer and really try hard to get things going, and that if at the next visit progress hadn’t been made, she would consent. The midwife agreed this was a good plan.

After she left, I snuck down to the cafeteria for a quick breakfast, giving Mommy and Daddy some much-needed alone time. I returned to find out through Mommy, through the nurse, through the midwife, that the OB was going to put Mommy on a shorter timeline. We were all worried about this news.

At 7:45 am, the OB came for a visit. She was very calculated in her language and movements. As she walked in the room, I felt immediately she just wanted this surgery to get going. I think Mommy could sense it too, as she later expressed how much she disliked this doctor. The OB discussed some time limits. She asked Mommy where she got stuck in her last labor (8cm) and where she was now (6cm). She asked about the size of the baby (estimated 9.5+ lbs). She strongly urged Mommy to allow the midwife to break her water. She suggested we do this immediately, or plan to move right on to surgery. She said if the AROM didn’t get things going, we just move on to surgery. And with that, she turned to leave and saluted Mommy on the way out while saying, “Hopefully things will get going, or else I’ll see you in the operating room.”

Daddy immediately embraced Mommy as she began to cry. This had been a rough hour, with visitor after visitor expressing doubts. Mommy had been in labor for about 15 hours, during which time she’d hardly slept or eaten, and she’d only dilated about 1 cm. I sensed that Mommy was tired, and disappointed. She talked about “having been down this road before.” I couldn’t help but cry too. The 3 of us just circled together and released our frustration. And then, we discussed really getting serious.

At 8, Mommy got back in the shower with instructions from me to be more aggressive with the nipple stimulation. By 8:30 she was back out. Contractions were definitely closer together, sometimes only 90 seconds apart and 60 seconds long, but still weren’t strong enough. Daddy ran down to the cafeteria for some breakfast, so Mommy and I had some time to work together. At 8:45 I instructed Mommy on applying acupressure on her Hoku point on her hand. She tried this for a few cycles, but didn’t notice any increase in intensity with contractions. So I moved on to trying acupressure at her Spleen 6 point on her legs. I kept up with this for quite some time. While contractions were longer and closer together, they still just didn’t seem strong enough. At 9:00, I alternated the acupressure with belly lifts using the rebozo. Mommy said these felt really good. We watched the EFM to make sure the lifts weren’t affected the baby’s heartbeat. Everything looked good. While doing this, one of the nurses visited and commented that we were doing something right, because the contractions were getting closer together. She looked confused at seeing Mommy wrapped in the rebozo with me down on the floor pressing on her legs. It made me chuckle…she probably really wondered what the crazy doula was doing to her labor patient.

The midwife came in to break Mommy’s water, but Daddy was still gone and then she got a page, so the AROM was temporarily held off. This was a blessing in a way, as it gave us one last hour to try all our tricks and to focus on powerful contractions. We continued the acupressure, belly lifts, lunges, rocking, standing, and leaning on the bed. Once Daddy returned, I retreated to the bathroom to pump (something I’d done every 3-6 hours all night). While in the bathroom, I could hear that the midwife returned and was ready to check Mommy. Bad news. There was no change in dilation. So Mommy consented to AROM. Thankfully, the fluid was clear. Mommy was moved to an upright sitting position in the bed. The way the bed was cranked up, Mommy looked like a Queen up on her pedestal. Immediately afterwards, she didn’t seem to notice any difference with the AROM. But things changed quickly. The midwife had suggested that Mommy needed to dilate 1.5-2 cm/hour now to avoid a cesarean, which seemed really fast to me. Little did I know Mommy would have NO problem with this.

Within 5 minutes, things were ramping up. The contractions seemed to be overwhelming her. They were now less than 2 minutes apart and 75-90 seconds long. Within minutes, Mommy started verbalizing doubt that she could not do this. I recognized this as transition and told Mommy I thought she was there. She didn’t believe me. She thought it was too soon. The contractions were just killing her in this sitting position, so she asked me to get the nurse so she could be hooked back up to the telemetry unit so she could move around again. I walked out the nurses station and got the nurse’s attention and she acknowledged that Mommy was really getting slammed (she’d been watching the monitor). The midwife was also at the station, so she came in the room too.

By 10:10, Mommy was getting hooked back to the telemetry unit. The midwife suggested IV fluids. She said she often saw this response to AROM because of dehydration, and that the fluids may make the contractions more manageable and a little more spaced. Mommy declined at first, but after getting hit by another couple of contractions, agreed. By now she was off the bed. I held her in a standing position through a couple of contractions, and then eased her back onto the birth ball. Contractions were just coming strong and hard, and after just a minute on the birth ball, Mommy let out a tell-tale grunt. The nurse, the midwife and I all looked up at each other and smiled. Mommy’s body was bearing down. It was 10:15 am.

The midwife and the nurse checked in with Mommy and asked her what she was feeling. Mommy wasn’t sure, but it was strong! Mommy’s sounds were pushing grunts. I looked to Daddy and mouthed that Mommy was doing great, and that things were moving fast. At about the same time, the baby’s heart rate dipped a bit. It was enough of a drop to concern the midwife, and Mommy was just getting overwhelmed by the contractions, so the midwife told Mommy she wanted to get her back on the bed to check what was happening. Mommy didn’t want to move. She didn’t think she COULD move. But with help, they got her up to standing and discovered bloody show. This was a very good sign!

By 10:20, Mommy was up on the bed on her right (preferred) side and continued bearing down with each contraction. Daddy was by her side, holding her and whispering in her ear words of love and support. It was obvious how strong his support was to Mommy during this time. The midwife checked and found she was almost fully dilated, with just a lip of cervix remaining and baby was at 0 station! Mommy had FLOWN right by transition. Unfortunately, the baby’s heart rate was dropping down under 90 bpm and remaining low for extended periods after each contraction. The midwife and nurse worked with Mommy to turn her to her left side, which Mommy resisted, but they got her turned rather quickly. At the same time, the nurse prepared an oxygen mask and put it on Mommy to try and give the baby as much oxygen as possible. I could tell this position was not very comfortable for Mommy, but she knew it was important for her baby.

At 10:35 the midwife checked Mommy again and she was fully dilated. The heart decels started to improve, so Mommy was able to remove the mask shortly. Pushing now begins in earnest. Mommy started pushing with her legs pulled up and rolled slightly to her left. She pushed in this position for a while, and the baby was bulging low in her bottom with each push. She didn’t believe us when we said she was DOING IT. I asked her if she thought we were lying, and she said yes! She was doing a fabulous job, putting all her energy in each push. In between contractions, which were now between 1.5 and 3 minutes apart, she appeared to drift off to sleep. By 11:00, it seemed a position change might help bring the baby down further. So the midwife and nurse got the squat bar set up for Mommy to try. In transitioning to the squat, Mommy was hit by a contraction and collapsed into a kneeling position, where she remained for a contraction or two. She then got up and prepared to use the squat bar. This seemed to be a very powerful position for her, as she continued to bring the baby down.

At 11:10 am, the midwife checked again and felt the baby was at about a +2 station, but that a caput (swelling) was forming on his head. She suggested Mommy lay back into a reclined position and prop her feet on the squat bar for support. Mommy then used the bar to push off of, and then was sometimes encouraged to grab her legs and pull them up high against her in an exaggerated lithotomy position. At times the midwife said she could even see the baby’s hair. I was so excited. It seemed Mommy was really going to do this!

Thirty minutes later, nothing had changed and Mommy was not only tired, but really starting to doubt. The midwife, nurse, Daddy, and myself were continuing to give her support and encouragement. Mommy continued to ask though, “Is the baby going to come out?” The midwife was honest and said the baby hadn’t come down much anymore, and it was obvious Mommy was pushing very hard. She needed the OB for a second opinion now that they’d been pushing for over an hour. Mommy voiced her dislike for this OB, but there was no one else available and it was clear another opinion was necessary. So the OB was called. Meanwhile, Mommy continued to push. At 11:45 am, the OB arrives and examines Mommy. She said the presenting part was all caput, and that the head was actually at around a +1. This meant in about 90 minutes of pushing and bearing down, the baby had only moved from a 0 to a +1 station. This was difficult news. Mommy was trying so hard. She was changing positions and trying all kinds of different pushes. She was doing everything right. But the baby wasn’t coming down past the pubic bone. And Mommy was DONE. Because the presenting part was all caput, the OB said she could not do an assisted (forceps or vacuum) delivery. She said the baby wasn’t coming out, and that Mommy had tried very hard, but that it was time to go get the baby out. The cesarean was recommended, and Mommy agreed.

For the next 15 minutes, people were rushing around getting Mommy ready for surgery. Mommy immediately requested pain medication, so the anesthesiologist came in very shortly. There was some discussion over whether the surgery would happen immediately or later, but once it was resolved Mommy was informed of the risks of her impending spinal. The OB discussed the risks of the repeat cesarean, and Mommy signed her consent. Daddy rushed around and tried to pack up the room, then suited up for the operating room. Mommy, Daddy and I had previously discussed me accompanying them in the operating room, but the nurse told me they do not allow that in this hospital. So I stayed behind and packed up the room. At 12 noon, Mommy was wheeled away. After packing the bags, I retreated to the waiting room, expecting to hear something in an hour or so.

The waiting room was an uncomfortable place. There was a television which blasted Scooby Doo cartoons, and there were several families waiting for their own exciting news – and they all seemed to speak a different language. I was tired, needed more caffeine, and needed to pump, but I didn’t want to leave the waiting room in case I missed Daddy coming to tell me about the birth. So I stayed and tried to relax, making a few phone calls to check in at home. I also found two messages from friends – Lauren and Kendra – who’d called to hear how things were going.

By 1:30, I still hadn’t heard anything, so I decided to ask the receptionist. She called recovery and said Mommy had just arrived there, and it would be at least another 2 hours before anyone was allowed in. I couldn’t believe it! Nearly 4 hours of isolation for a cesarean? I had no idea. I knew I couldn’t stay that long. I was so tired, and every hour I stayed at the hospital was making it harder for me to drive home safely. So I asked the receptionist if I could get a message to Daddy. He said he would come out and speak to me. So finally, I got the word that Mommy and baby Baby Boy LK were fine. Baby Boy LK was born at 12:40 pm and weighed 9 lbs 13 oz! What a big boy! I was so delighted to hear they were well. Daddy confirmed for me that after Mommy received her spinal, she was content and happy with the decision to move to a cesarean. He said she talked about having tried everything to get him out, and that this was how Baby Boy LK was choosing to be born. I was happy to hear her feelings about this. I really wanted to talk with her, but this was not the time. So I gave Daddy a big hug, congratulated him on the birth of his son, and took my leave.

In my 90 minute drive home, I started having a hard time staying awake, so had to stop and stand in the cold air to make it all the way. I collapsed into my bed at 3:45 pm, but my mind couldn’t shut off for a while. I thought about all the things we did during the labor and felt good about all our efforts. Still, I couldn’t help but wonder what was holding little (big) Baby Boy LK up. When I spoke to Mommy the next day, I learned that he was posterior afterall! I couldn’t believe it! Mommy said the midwife discussed this with her, and suggested that perhaps there was something about Mommy’s hip structure that encouraged babies to swing posterior as they descended, because Baby Boy LK had been anterior earlier in the labor. Still, I couldn’t help but kick myself, wishing we’d spent some quality time in hands-and-knees, just in case.

As a doula, this was a great experience for me because we got to try so many things during the labor. It was my first all-night birth, and my first cesarean. This was also my first experience walking away and wondering if we just tried one or two more things, if that would have changed the outacome. I know that we all did our best, and that is what I should remember. And Mommy is really happy with the outcome, having made it all the way to pushing and getting to try that in several positions. Mommy later said she felt this even healed her some from her first birth, because she realized the transition feelings she had at the end of her first birth were really about as hard as it would get, so she no longer felt she’d wimped out. And having her second baby choose the “side door” as Mommy puts it, despite multiple tricks to invite him out the “front door”, validated the necessity of her first cesarean too. Overall, it was an incredible experience for all of us. I feel blessed to have been a part of this event, and only wish I could have seen Mommy and Baby Boy LK after the birth. I’m so proud of Mommy for working with her body and allowing her baby to receive all those precious squeezes. And Daddy was an amazing partner, always supportive and attentive to Mommy.

Congratulations to the Family! Thank you for allowing me to be with you on this important day. And welcome Baby Boy LK!

Baby Boy L's Birth

The Birth of Baby Boy L

Saturday, March 1oth, 2007 at 11:42 pm

7 lbs 10 oz and 20 inches

Original due date: March 16th

2nd baby, hospital birth

Mommy L is my good friend and I have felt so honored to be invited into her pregnancy and her birth. Because this was her second baby and Daddy S wished to provide most of her support, we had previously discussed my role as being one of back-seat support as long as things were going well. As Mommy L’s due date neared, I anxiously awaited that phone call. With a 90+ minute drive to her house, I hoped to have enough time to get there. Turns out that wasn’t a problem…

At 3:30 am on Saturday, March 10th, I received a phone call. It was Mommy L’s personalized ring, so I jumped up to get it. She was 39+ weeks pregnant now and had been feeling increasingly regular Braxton-hicks contractions all week. Mommy L wasted no time on the phone – she said she thought this was it. She sounded positive and excited. Her contractions had woken her up at 2:30 am and were immediately 5 minutes apart and quite intense. We discussed the plan for the next couple of hours. She and Daddy S were going to pack their bags, shower, eat a little something, and then try to relax. I was going to leave for the long drive right away. We decided to touch base again in about an hour so I could tell her where I was on the drive, and she could update me on what she was feeling. I grabbed some food and left immediately.

At 4:45 am I called Mommy L and she indicated things were still going strong. They were now showered, dressed, and fed. There were about to settle in and focus on relaxation and timing the contractions again. I was about 50 minutes away and they did not feel it was time to leave for the hospital yet, so we agreed I would meet them at their house.

At 5:30 am I arrived at Mommy L and Daddy S’s house. Mommy L answered the door and she looked just radiant! I could definitely see the birth hormone glow in her face. After big greeting hugs, we checked in. Mommy L said they had been timing contractions for a bit using an online program and things seemed to still be mostly the same. She showed me the program – I made a mental note to find it for myself later because it was very cool! Scanning the record of her contractions, it appeared things were coming somewhat erratically. Some contractions were 2-3 minutes apart and as short as 20-30 seconds, and others were 5-7 minutes apart and closer to 1 minute. Mommy L told me those that were closer together were a bit weaker, and that was often when she was up and getting things packed. Those contractions that were further apart were more intense and often required her to stop and focus on breathing and relaxing. She did not feel it was time to go to the hospital yet, so we decided to just settle in and visit for a bit. Daddy S returned to bed for a bit more sleep, so Mommy L and I just relaxed on the couch and talked about the new baby and how exciting this day was.
From a doula perspective, I was interested in just observing Mommy L as she handled things for a bit. We popped a movie in and I quietly continued to time some contractions. Sometimes it was hard to tell when she was having one because she was taking them so calmly. Part of me had some concern about this, leading me to wonder if perhaps this was very early labor or even a false-start. But I’d learned in previous births that some mothers are able to keep walking and talking through contractions straight up until transition, so I tried to focus on what Mommy L was telling me about the intensity of the contractions. We checked in about the contractions after about an hour or so, and Mommy L said they seemed to be slightly less intense now. In fact, it seemed the intensity had dropped off as soon as I’d arrived. But they were still consistent at approximately 4-6 minutes apart, so we continued to relax (since it was still the middle of the night) and see where things went.

A bit after 7 am, Sister A woke up. Mommy L attended to her. Sister A came out and joined us on the couch for a bit. She was content to just sit in Mom’s lap and Mommy L seemed quite comfortable with this. Sister A’s presence did not seem to be difficult for Mommy L to handle at all, so again I was feeling a little concern over where things were going. Soon Sister A was asking for breakfast, and Mommy L happily got up to prepare it for her. Daddy S woke up before too long and joined us for a nice group pancake breakfast. While Mommy L was cooking (I offered to help, but she said it was fine and that she felt good), I observed again for a while. Her contractions had spaced out even more – now to around 10 minutes – and seemed to bother her very little. Every once in a while, however, a hard one would hit that made her pause and breath. We discussed the situation. By 9 am, Mommy L’s contractions were still 10+ minutes apart and were losing intensity. Plus, Mommy L was really starting to show some fatigue from lack of sleep. We discussed going for a walk to see what happened, but Mommy L looked like she needed a nap more than a walk. J We also talked about running a bath to see if that changed her labor pattern at all. We decided that I would head over to a friend’s house for a bit and run some errands in the Portland area while Mommy L tried to nap. After the nap, we would touch base and see where things were headed from there. So at around 9:30 am I headed out…and wound up crashing for my own nap on my friend’s couch.

At around noon I called and spoke to Mommy L again. She sounded more rested, but said she’d been unable to do more than doze because she’s a bad napper. Her contractions were spacing out even more and now seemed to be 10-15 minutes apart. Mommy L said she was just going about her normal day at home and that Sister A would be going to visit Daddy S’s parents a bit later so they could relax and have some time as an expectant couple. I suggested I take care of my errands and then call her once more before driving back to Corvallis. So at 1:30 pm, I called Mommy L and she said little had changed. She and Daddy S were hanging out with a movie. Her contractions were still coming at around 15-20 minutes apart, but that they were mostly quite mild. She felt things could go on for hours, days, or perhaps even stop. Mommy L said she felt right with being restful right now, but that they might try and take a walk later in the afternoon. We decided it was probably best if I headed back to Corvallis for the afternoon. The plan was to see how things went, and if they stayed the same Mommy L would probably have no trouble sleeping through the night. Then, if the contractions were still coming in the morning, we would try some active approaches to get things moving. So back to Corvallis I went.

While back at home, I helped Keith prepare dinner for some doula friends who were coming over for dinner at our house. I hadn’t been sure if I would be there for the dinner or not, but these friends were coming over no matter what and they would certainly understand if I had to rush back to a birth. The friends were coming over at 6 pm. At 5:30 pm, Mommy L called to give me an update. She said things had picked back up again when they went to get Sister A from Daddy S’s parent’s house and hit the grocery store. Her contractions were now 4-6 minutes apart and stronger than they had been during the morning. She’d already had Daddy S’s parents come back and get Sister A again. She’d also talked with the midwife and told her about what happened that morning. The midwife suggested they spend a few more hours at home before coming to the hospital. Mommy L later told me this really forced her to get some perspective on the labor – and realize that she probably had several hard and long hours ahead of her. Mommy L suggested I stay home a bit longer, but she’d call me in another hour with an update. An hour later, things were still moving strong, so they planned to leave for the hospital around 8 pm. Mommy L suggested that would be a good time for me to leave my house. I asked Mommy L how she was feeling about all this right now. She said she was getting a little anxious about it and wondering how intense it was going to get, but that she was feeling in better control now and that she’d probably try taking a bath. So we hung up again and planned to check in when she left for the hospital.

At 7:40 pm, Mommy L called back again and said she felt ready to go so they were headed to the hospital. She suggested I wait until they’d gotten checked in since the hospital was so close – she didn’t want to bring me back up there again if her cervix was still closed and this was another false start. I told her that sounded good, but that if I got really anxious and felt like I should leave, I just would. She still sounded upbeat to me on the phone, so I was definitely curious what was going on in there. I hoped to hear good news that she was progressing and that active labor was well underway.

A little before 9 pm, Mommy L called back. She sounded downright happy when she announced she was 7 cm! WAHOO!!! I was so excited to hear this. And then I remembered – I have a 90+ minute drive! Mommy L said things were picking up in intensity quite a bit and that they’d probably get in the labor tub shortly. She said again that she was feeling pretty good and in control. I packed my bags and left immediately. I wasn’t intentionally speeding, but there was one moment where I nearly thought I was going to get a ticket.

At 10:30 pm, I arrived at the hospital. I made my way through the emergency room entrance, passed security (who had to call up and confirm that Mommy L was a patient in maternity), up the green elevators, and to the nurses desk. With my name tag (that read only Mommy L’s room #, not my name), I was quickly shown to her room. Mommy L’s room was empty, though I could see I was in the right place. For a brief second, I was worried that something had gone wrong and perhaps Mommy L was in surgery. And then I remembered the labor tubs were down the hall, and I felt certain I’d find them there. So I returned to the nurses desk and Mommy L’s nurse brought me down the hall to find her. In the tiny tub room I found Mommy L, Daddy S, and one of the student midwives in quiet conversation. Mommy L looked like she was working hard now. I could see a tiny ounce of worry on her face, possibly from not knowing how much worse it was going to get, but her body was telling me she was still totally relaxed. The midwife soon left us and Daddy S and Mommy L filled me in. At check-in, Mommy L’s water bag was bulging, but it still hadn’t broken yet. She had not had any bloody show yet either. But Mommy L said things were really kicking up now and that she was having a much harder time handling things. She found sitting upright to be the most comfortable position and so was simply sitting in the tub with her legs bent in front of her. I scanned around quickly and saw that they had water, towels, and a gown. I sat down next to Daddy S to be a simple presence of comfort for both of them and intended to observe for a few minutes before making any suggestions. Mommy L said again that things were getting tough and I reminded her that this might be a good time to try vocalizing during her contractions. We had talked about this in our prenatal meetings and it was something Mommy L was interested in trying, but was afraid she might feel funny. I suggested I would vocalize with her and she said that was a good idea. So with her next contractions, we (all 3) sat and took our breath simultaneously and softly moaned into the quiet air.

Before I could say anything else, Mommy L indicated that she felt it was time to get out. She wasn’t feeling pushy or anything, she just felt it was time to get out of the tub since she was going to have to eventually anyway. After a brief miscommunication about whether we needed a nurse and who would towel Mommy L off, Daddy S and I assisted getting Mommy L dressed and ready for the brief walk to her room. It became apparent that Mommy L’s contractions were really coming quickly now. She was physically shaking a bit. During contractions, Mommy L really focused and turned inside herself, and appeared to almost fall asleep. I didn’t get the chance to really time anything at this point because things were happening to quickly, but I estimate Mommy L’s contractions were only a couple of minutes apart and just over 1 minute long at this point. It was now around 10:55 pm. We started the walk down the hall towards her room, and the contractions seemed to only give her about 30 seconds break in between. When a contraction hit, Mommy L would lean into Daddy S with her arms against her chest, and together they would stand and moan softly. It was such a beautiful embrace to see this young couple supporting each other as they worked together to bring their child into this world. As we headed down the hall, the student and attending midwife joined us. The midwife asked me how things were going and I said that Mommy L was doing fantastic, but that the contractions were coming REALLY close together now. She stayed to watch for a moment.

After 2 back-to-back contractions, the midwife asked Mommy L if she felt like she was going to have a baby here in the hallway. Mommy L said no, but that the contractions were just so close together it was crazy. The two midwives, two nurses (shift change), Mommy L, Daddy S and I moved into her room. For a moment, I felt this sense of uncertainty. Mommy L was doing her best to handle things, but suddenly she had quite an audience. Thankfully, this birth team was very supportive with their wishes and offered only encouraging words. The midwife asked Mommy L some questions about what she was feeling. Her questions led me to think she thought Mommy L was completely dilated. The midwife suggested Mommy L try sitting on the birth ball or on the bed, but Mommy L was hesitant because she felt it was just unbearable. After further questioning from the midwife, we all realized it was the incredible pressure of the baby’s head that was making these positions difficult. The midwife suggested that she could check Mommy L’s dilation. Mommy L was hesitant, but when the midwife suggested she was probably fully dilated, Mommy L consented. The baby’s heartbeat was checked at the same time. The contractions were really coming quickly during this time, so the midwife had to be very fast. She announced that there was no cervix left – Mommy L was fully dilated!

This realization started the conversation about whether she should try pushing. The primary midwife suggested that Mommy L could probably begin pushing and that this birth could be over very quickly. She also suggested perhaps that because her bag of water hadn’t broken yet, that this could be why she wasn’t feeling the urge to push yet. When asked if Mommy L wanted her waters broken, she said she was a bit afraid of how much more difficult it would make the pressure. The student midwife also reminded us that she could just wait. Mommy L contemplated these ideas as she settled into the bed. A discussion of pushing positions was also started, ranging from hands-and-knees, to lying back, to squatting. Mommy L decided to try moving into a squatting position and see if that brought the baby any lower, so the squat bar was attached to the bed. But as Mommy L moved into this position, her contractions came on very powerfully and she was obviously extremely uncomfortable. She began to vomit. Daddy S was right at her side to provide comfort, and the nurse assisted. As the contraction ended, Mommy L shifted back into the reclined position and propped her feet on the edge of the squat bar for support. This seemed like a good position that she could rest in during her breaks. After much deliberation, Mommy L decided to try pushing and see what it felt like.

At around 11:10 pm while surrounded by supportive people, Mommy L gave a few gentle pushes with the next contraction. It seemed to be Mommy L’s instinct to hold her breath with each push, but when she announced after the contraction ended that pushing was relieving her of the pain, I figured it best she continue doing what worked! Daddy S continued to offer Mommy L close support as I stayed back with the water cups and cameras. Supportive, encouraging words were flowing from every mouth in the room. After a handful of gentler pushes, the primary midwife encouraged Mommy L to really give a good, full-body push. She suggested that Mommy L really could have this birth over in a matter of minutes. Though Mommy L was hesitant because she had not yet felt an urge to push, the idea of finishing this birth was visibly enchanting on her face. Mommy L decided to give it her all.

With the next push, progress was made! Mommy L’s bottom began to swell and it wasn’t long before the midwives said they could see a tiny square of the baby’s head. A mirror was brought in so Mommy L could watch. The midwife kept strong verbal guidance up during this time, keeping Mommy L pushing for a good, solid 3 shots during each contraction. During all this time, the contractions remained very close together and in the ballpark of 1 minute long. In between contractions, Mommy L would now relax back and appeared to nearly fall asleep as she gathered strength for the next effort. Roaring as she pushed, Mommy L was really gathering her energy from within. It was amazing to witness the power she was drawing from every inch of her body. As the baby’s head really started to stretch her skin, Mommy L struggled a bit with this sensation. Suddenly with a pop, Mommy L’s water broke and a tiny bubble shot across the room, startling everyone. It was just after 11:30 pm now. The new sensation of crowning continued to challenge Mommy L, but she just took every second as it was handed to her. It was obviously quite a difficult time, but there never seemed to be doubt that she could and would do this.

Just after her water broke, Mommy L’s body took over. Pushing became more than just an urge, it became an uncontrollable necessity. Mommy L did her best to handle this change. As the baby’s head fully crowned, Mommy L was given great direction from the midwives, who were both supporting her perineum to stretch. Mommy L was told to try shallow breaths and keep from pushing for a moment so that her skin could stretch. I could tell this was really hard for her – I suspected her body was on automatic dump and just wanted to get that baby out. Gathering strength between contractions, an air of excitement built in the room. It seemed the baby would be born in the next contraction. We all just sat silently during that brief break, as if every person in the room was gathering energy for Mommy L to use with the next big push. As the next contraction started, Mommy L let out a yell as the baby’s head popped through. I managed to get a photo of the baby’s head just emerging from his mother’s body. She took another deep breath and then worked on the shoulders. Once the shoulder’s were out, Daddy S reached down at the midwife’s encouragement and grabbed the baby, placing him right on Mommy L’s best. At 11:42 pm, the baby was here!

Because they didn’t know if the baby was a boy or a girl, one of the first things to do was take a peak. It was a boy! Baby Boy L was welcomed into the world. A little bit of gurgling brought on some brief suctioning, but little Baby Boy L was perfect. After a minute or two of strong cries, he settled quietly into his mother’s arms. Daddy S was all grin. Mommy L was herself again – the discomfort of her experience melted away by the little gift wiggling in her arms. I took pictures as quickly as I could of the new, expanded family. Because Baby Boy L’s cord continued to pulse for several minutes, the cord clamping was delayed considerably. Finally, once it had stopped pumping, Daddy S was handed the scissors to cut his son’s cord. A short time after that, Mommy L gave a push and out popped the healthy placenta.

In the clean-up time right after the birth, Mommy L got nothing but praise from everyone in the room. The student midwife said it was absolutely an inspirational birth. Mommy L had made it appear so peaceful and natural. The staff immediately asked her about food and Mommy L requested a vanilla milkshake. The new family continued to cuddle as Mommy L received 3 tiny stitches for a small tear. Baby Boy L just soaked in his new surroundings. He was then weighed and measured (7 lbs 10 oz, 20 inches), given a tiny little diaper, and wrapped in a swaddle. Daddy S cradled his new son as I brushed the hair from Mommy L’s head and talked with her about this amazing experience. She was simply glowing with pride – pride for her new son, pride for her amazing birth experience, and I think a little pride for having made a bit of noise. As the clean-up quieted down, Mommy L held little Baby Boy L to her breast and he latched on like a pro. After a little more discussion, picture-taking, and just enjoying this new family, I gave them big hugs and was on my way.

Baby Boy J's Birth

The Birth of Baby Boy J

Friday, November 24th, 2006 at 10:55 pm

7 lbs 14 oz and 20 inches

Original due date: November 26th

2nd baby, hospital birth

Mommy J had been on-edge for a while. At her 37-week appointment, she had a scare when the baby was breech, though he righted himself before her external version was scheduled the next day. She also learned at that appointment she was 3 cm dilated. She’d been having some contractions sporadically that were getting increasingly uncomfortable, but they always stopped within a couple of hours. Since her first son was born at 38 weeks, we were all prepared for something to happen soon. At the same time, we all reminded ourselves that with a second baby, you can be 3 cm dilated for WEEKS. So we waited.

Mommy J and Daddy M were really open during our prenatal discussions – this baby was a surprise for them and while bringing this family together, it was also a very stressful time. I felt very comfortable with both parents-to-be during our talks – I felt strongly they would both be onboard with the birth and ready to support each other.

At 39 weeks and 5 days, Mommy J called me at 8 pm just to let me know she’d been having contractions about 15 minutes apart for an hour or two. She said they were painful and that she really had to focus and breathe through them. She wasn’t convinced this was labor yet because this had happened before, but just to be sure, she (smartly!) sent Daddy M out to pick up a few last minute details. Mommy J and I spoke briefly. For the time-being, she was going to make sure her bags were packed and then go lie down and try to rest as much as possible. At 15 minutes apart, rest was the best thing for her to work on, especially when labor was just getting started at night. I asked her to call me back anytime, but if she was still awake in 2 hours, to just give me a quick update before we all headed to bed. Little did we know…

I thought of a few more things I wanted to say, so I called her back at around 8:20 pm. I wanted to make sure she’d eaten dinner, and that she was working on getting fluids in right now. Daddy M was still at the store at this point. Mommy J told me her contractions were now about 6 minutes apart and definitely stepping up in intensity. I listened to her through a couple of them – they seemed to be around 40-50 seconds, and they were definitely hard work. Mommy J was still not completely convinced, so I asked her to keep resting and have Daddy M help her time them for a bit when he returned from the store. She didn’t feel like I was needed yet, though when I hung up the phone with her, I had a strong feeling this was it so I packed my bags and waited for another call.

At 9 pm, Daddy M called and said Mommy J wanted me to come over. She still wasn’t sure if this was labor, but she wanted me to come see what I thought. Her contractions were now about 4 minutes apart, but still not terribly long. I felt pretty certain this was it, so I took all my bags with me. I arrived at approximately 9:15 pm.

Mommy J was kneeling on the couch with her body draped over the arm of the couch. Daddy M was sitting beside her and comforting her as contractions hit. From the look on Mommy J’s face, this was definitely it. The contractions were coming on pretty hard and fast. I sat with them, stroked her back, gave her a comb to grasp, and began timing contractions. They were about 3 minutes apart and a minute long, and they were very hard work. Mommy J was beginning to make some noise with them which was really good, as it often is a nice release to moan with contractions. She was just riding them as they came.

We talked for a bit and visited the bathroom before too long. In between, Mommy J was very lucid. This made it tough for me to read – 3 minutes apart is quite serious, but still being emotionally present in between contractions means it could have even been early labor. Mommy J was working very hard though. Since she was already 3 cm dilated before this even began, she rocked right into active labor very quickly with very little warm-up. Daddy M and I did our best to embrace her and support her as each wave hit.

Before too long, we had the discussion about when it was the right time to leave. Mommy J felt it was time to call the doctor and let her know what was happening, so Daddy M took care of that while I sat with her for a bit. Mommy J’s normal doctor, Dr. M, was not on call tonight. Dr. C was the doctor who called back – another very nice doctor that Mommy J had seen once before. I was glad to hear it was this doctor on call.

Daddy M filled the doctor in on her current status. At this point, I noticed Mommy J was beginning to lose her ability to make sense in between the contractions – she was loooong past the point of doing anything during them. Mommy J instructed Daddy M to tell the doctor we would head to the hospital within the hour, and the doctor did not instruct anything different during the conversation. Mommy J expressed some doubt about when was the right time to go in – she didn’t want to wait so long that it would be a horrible ride and first 30 minutes with the EFM. But she didn’t want to get there too early either. Her first birth was about 24 hours long and she definitely felt they went to the hospital too soon, so she wanted to avoid that this time. I felt Mommy J’s intuition was the best judge at this point. I agreed we should leave within the hour, but also added that Mommy J should just make the call when it felt right. That moment wasn’t very far away…

Daddy M returned from the phone calls (family called a couple of times) and rubbed Mommy J’s lower back in a way that was great relief for her. I thought at the moment it was wonderful he was so in-tuned with what might work at that moment – he knew exactly where to touch her and she was obviously comforted by his touch. I felt my best role right now was to breath with her through contractions, and remind her with verbal cues about what was happening and to keep her breathing slow and deep.

Shortly before 10 pm, Mommy J’s contractions were about 2.5 minutes apart and at least 1 minute long. At almost exactly the same moment I felt it was time to leave, Mommy J got up from the couch and announced it was time! We gathered our bags and headed out. I followed in my car – Mommy J felt she would be okay to ride without me in the back of her wagon with Daddy M at the wheel. I could see her while we drove – she was really thrashing about. I sensed things were really picking up for her and I was glad we were on our way.

I parked my car and came in to find Mommy J and Daddy M with the ER registration clerk. It was 10:23 pm. The clerk was really great – she patiently waited while Mommy J had a contraction and worked efficiently during the brief breaks she had. While sitting at the registration desk, Daddy M ran outside to move their car into a parking space, and Mommy J began to moan again and voice that she didn’t think she couldn’t do this. This was a big cue for us all – I knew Mommy J was at or near transition now, and the registration clerk knew we needed to go upstairs ASAP. She got a nurse with a wheelchair right away.

Mommy J and I were wheeled upstairs. Mommy J was uncomfortable in the chair, but at this point, I sensed she’d have been really uncomfortable in any position. The intensity was really high now. We were taken to a birthing room and a nurse asked Mommy J to change and try to pee for them. I don’t think the nurse had an idea of how intense things were right now. It was moving very fast. I assisted Mommy J in the bathroom with her clothes and we quickly realized – there was no more peeing at this point. For some reason, the hospital gown was a crazy puzzle of snaps and ties and we couldn’t figure it out, so we called the nurse in to help. It was at this point that the nurse really got to hear how hard Mommy J was working with her contractions and how quickly they were coming on. Mommy J would just collapse into me as each one hit, but it was so intense she couldn’t help but writhe just a little bit. The nurse also asked Mommy J what her intentions were for pain medication, and Mommy J answered “None.” I knew Mommy J was really struggling right now, but I was so proud of her for answering without hesitation. I knew she could do it.

Daddy M made it up to the room right around when we moved Mommy J back over to the bed. The nurse wanted to get her started on the required 30 minutes of EFM. This meant Mommy J had to sit in the bed, which was really uncomfortable. Once she was hooked up, the nurse felt she should check on Mommy J’s dilation to get a sense of where she was. All the while Mommy J was just trying to survive each contraction while occasionally telling us that she just couldn’t do this anymore. Thankfully, the nurse came back with good news.

“Would you like to know that you are 9 cm dilated right now?” The nurse said with a big smile. J Rock on! That was amazing news. Her bag of waters was also bulging, and once that broke, the nurse knew the baby would be on its way out. The nurse let us know that she knew how to deliver a baby, but that they really wanted to give the doctor time to get here. The nurse left briefly to get assistance. Daddy M stepped away to call Mommy J’s sister and ask her to pick up Brother A and bring him to the hospital ASAP.

At this point, Mommy J was working so so hard. Daddy M was right there providing her intimate support by holding her arms and looking into her eyes. I sensed this was one of the most intense moments of their lives, and they were looking to each other beautifully. I was really impressed with how Daddy M was able to be very present during such a crazy time. Mommy J kept asking us how soon this would be over. I knew it was going to only be a matter of minutes, but just couldn’t say that for fear that it might take longer.

The nurse returned with reinforcements. For the remainder of the birth, there were between 2 and 5 (or 6?) nurses in the room at all times. Dr. C was on her way, but they’d also requested another doctor who was in the building to stand in just in case this baby forced his way out. I did not catch this doctor’s name – she just stood back with gloves on and let me, Daddy M, and the nurses work with Mommy J. I assume she was an ER doc – who else would be in the hospital at this time of night? It was at about this point Mommy J’s contractions suddenly spaced out a bit, giving her more rest in between. Mommy J noticed this and asked what was happening – I let her know this was normal and that it was her body’s way of taking a little rest before she started pushing. I knew we had at most 1 or 2 more contractions before Mommy J couldn’t help but push.

At 10:43 pm, only 20 minutes after arriving at the hospital, Mommy J’s body took over. The intensity was beyond Mommy J’s wildest dreams – you could see it in her eyes. Mommy J was grabbing onto Daddy M and I and almost seemed to want to crawl away from what was happening to her. The nurses were a wonderful help here – they were really able to keep Mommy J focused with a firm voice. They instructed her to breath through the pushes in a way that I sensed they were still trying to stall – I hoped this didn’t last long.

After this first pushing contraction, Dr. C walked in. She was suited up and ready to go. As Mommy J rode out each push, the doctor and nurses got the equipment and the bed all set up. Mommy J had wanted to push in a squatting position, but at this point I did not see how we could make that happen. It was just happening to fast and didn’t think Mommy J would be able to move at this point. Dr. C was ready and in place right about when Mommy J’s bottom began to bulge. The baby was coming down! As I was positioned closer to her bottom, I asked Daddy M if he wanted to switch places with me so he could see his son be born. Daddy M felt like he was in the right place where he could be close to Mommy J’s face, so we stayed where we were.

The birth was nearly over – Mommy J was pushing HARD with each contraction. Dr. C was in place and just as she reached in to check that Mommy J was fully dilated (she was), her water broke. There was light meconium in the water, which caused a bit of buzz among the doctor and nurses. I was hoping this didn’t mean the baby might be whisked away after the birth.

Daddy M and I were on Mommy J’s left, and The nurse and another nurse (who is also a doula) were at her right. Daddy M was attentively wiping Mommy J’s brow with a wet cloth. Mommy J was in the standard lithotomy position, though she did have a really good amount of incline in her back. I know that isn’t what she had wanted, but it was happening, and now it was almost over. The doctor used some massage to try and stretch Mommy J’s tissues as the nurse applied antiseptic and warm fluids. This really shocked Mommy J – I wish they’d warned her before they’d done it. Within just a minute or two, the baby’s head was crowning and with one more push and loud ROAR from Mommy J, the baby’s head was out! At this point, Mommy J had a break from the contraction and I tried to get her to touch her baby’s head, but she wasn’t quite ready. The doctor was suctioning the baby while she had this short rest-break.

With the next contraction, Mommy J was pushing really hard again. The doctor and nurses were continuously talking to her and giving her instruction – Daddy M and I were just holding on to her and whispering encouraging words when we could. Mommy J’s instinct was the arch her back and crawl away, so the doctor really helped her try to curl around the baby and look down. The doctor eased the baby’s neck out and saw that a hand was coming beside the shoulder – making it hard to fit. Mommy J screeched a little as she felt herself tear, but that was the widest part and with another half a push, the baby was here!

Baby Boy J was born at 10:55 pm after just 12 minutes of pushing and only being in the hospital for 32 minutes. Right as the baby was placed on Mommy J’s belly, Brother A and Mommy J’s sister walked in. It was all perfectly timed – Mommy J had wanted Brother A there AS SOON as the baby was born, and they had just arrived in time to hear that last ROAR from the hallway. Mommy J was instantly present with her baby – she was grabbing at him and crying. I could see total relief in her eyes. Daddy M was just instantly in awe at his son. I couldn’t help but tear up. It was just perfect.

Over the next 20-30 minutes, Mommy J delivered the placenta and received a couple of stitches. The doctor clamped the cord very quickly and offered for Daddy M to cut it, but he declined, so I was given the honor. Mommy J’s after-pains were really hitting hard, so hard she had to focus and breathe through them. After having lots of time in Mom’s arms, Baby Baby Boy J spent a bit of time in the warmer as Mommy J was stitched. Daddy M and Brother A kept a careful watch over their new son and brother. I stayed beside Mommy J and continued to hold her hand and brush the hair from her eyes. It took a little bit of time, but before too long, the bed was back together and Mommy J could stretch her legs again. Her Dad arrived shortly after. Mommy J said she felt really good, though understandably sore. She had done it!

Within about 45 minutes, the room was quiet again with just family and myself. The baby indicated he was ready to nurse, so I encouraged Mommy J to give it a go. Another nurse was here and helped Mommy J get that first latch. This baby didn’t need much help though – he knew what he was doing! I stayed with the new family for about another hour, offering lots of smiles and help taking pictures. Baby Boy J received his first bath with lots of help from Brother A. Mommy J and Baby Boy J both seemed to be in great health. The meconium turned into a non-issue. At about 20 minutes till 1 am, I left the happy new family. It was such an honor and blessing to be there and support these wonderful people through the birth of their son.

A note about Birth Stories

I've decided to post all my family-friendly birth stories here on my blog. They are "family-friendly" because they are written for the parents. I always write my version of the birth story (with details that perhaps the laboring mom has missed or forgotten) and give it to the parents at a postpartum meeting. So you won't find me being picky or criticizing decisions here. That isn't my job as a doula. I try to preserve the birth memory and make it a positive experience (no matter what happened) the parents will want to relive over and over again.

Obviously, the two birth stories that use names are my own birth stories, written from my memory in the days following those births. The stories that don't use names are those written for my clients. If you happen to know who I'm writing about and you decide to leave a comment about the story, please don't use real names.

The Birth of Baby Boy M

The Birth of Baby Boy M

Wednesday, October 4th, 2006 at 9:00 pm

7 lbs 6 oz and 20.5 inches

Original due date: October 10th

2nd baby, home waterbirth

While having dinner with Mommy U, Daddy N, Sister E, my husband, and my daughter on Tuesday, October 3rd, I noticed Mommy U had “the look” – the look that meant the end was near. She was exactly 39 weeks pregnant and during her prenatal appointment with her midwife earlier that day, she learned she was 3 centimeters dilated, 30% effaced, and the baby was at -1 station. Mommy U’s belly appeared lower to me. She was waddling pretty badly too and had several painful Braxton-Hicks contractions while we were there. I just had a feeling…the action was going to start in a few hours. This seemed so natural that we would have dinner with them on the eve of their baby’s birth because on the eve of my daughter’s birth, we’d had pizza with them. They later told us that after that dinner, Daddy N mentioned to Mommy U that he thought I would have my baby that night and my labor did start just a few hours later.

At around 10:45 am on Wednesday, October 4th, Mommy U called me sounding very excited. She said she was having regular contractions around 10 minutes apart and that she believed she was in early labor. She indicated her contractions had really started at around 9 am, but that she felt some on-and-off throughout the night. Mommy U felt comfortable on her own for the time-being – Sister E (13 months) was down for a nap, so she could relax and see where things went. We decided she would call me back when she wanted me to come over. At this point, Mommy U gave Midwife C a heads-up as well, and called her husband (at work) and told him today was the day.

I took this time to go home (I was at school) and collect my bag and arrange the car-juggle so my husband could get home from work with our daughter. I returned to school and waited for Mommy U’s call. Just before noon, Mommy U called back and sounded a bit more serious. She said things were getting uncomfortable and that she didn’t want to be alone anymore. I told her I’d be over as soon as I could, and she told me not to rush.

I hopped in the car, went back to my house quickly because I forgot a few papers (and I STILL forgot the birth ball!), and headed towards work. This was the very first birth I would ever attend, and I was a little nervous. Keith (my husband) drove me over to her house and dropped me off and I ate lunch along the way. I arrived a little before 12:45 pm.

Mommy U looked relieved to see me. Sister E was still napping (hooray!) so Mommy U and I had the chance to relax together, get situated, and talk things over. I observed several contractions, and it was obvious they required her full attention. She was relaxing well through them in an extended child’s pose and found relief when I pressed on the center of her lower back. I got Mommy U set up with water and juice, and asked about what she’d eaten so far. She had a bowl of cereal and yogurt shortly before I arrived, so I felt comfortable that she was fed (for the moment). I also encouraged a bathroom visit shortly after I arrived.

Mommy U had been estimating when she said her contractions were 10 minutes apart, so after we were settled, I decided we should time a few. We tried a Movie for distraction, but it wasn’t long before Mommy U said she didn’t like the stimulation. We switched to some calming music. After timing contractions for a while, it was apparent they were about 5 minutes apart and 1 minute long. Mommy U couldn’t talk or walk during contractions, but she was still capable of smiling in between. She was also having mild shakes at times. I estimated she was moving into active labor, but wanted to keep watching for a bit. We tried contractions in standing positions and rear-facing in a chair. The chair worked well, so we stayed with that for a while. I also gave her a comb to grasp firmly in her hand, hitting accupressure points that are supposed to relief labor pains. This comb turned into a magic item that Mommy U clutched for the remainder of the birth.

A little before 2 pm, Sister E woke up so I attended to her briefly while Mommy U relaxed on her own. Sister E needed lunch, so I set her up with a bowl of pasta and returned to Mommy U. Daddy N arrived home at around this time, and began many of the house preparations for the birth. He also took over the care of Sister E. Mommy U continued to work with her contractions, sip water and juice, nibble on banana, and change positions. Shortly after 2 pm, I suggested we call Midwife C to give her an update. I made the call and informed her Mommy U’s contractions had been 5 minutes apart and 1 minute long for over an hour, and that they were requiring her absolute concentration and she could not talk through them. I also let her know they were varying a bit in intensity – some far worse than others. Midwife C indicated they would finish up the current appointment she and her assistant (Apprentice V) were at, they would cancel the remaining two appointments, and they would head our way.

At around 3:15 pm, Mommy U vomited. She vomited a lot, from one contraction straight into the next one. All our hard work with the water and food were now in the bucket! Daddy N and I both worked together to support her during this low point. Immediately afterwards, Mommy U was feeling a little better. Her contractions spaced out a bit more, stretching to about 6-8 minutes apart and as short as 30 seconds long. She was enjoying this break. A comfortable position at this point was kneeling and leaning on the couch because she could completely relax into the soft cushions. At times she almost appeared asleep in between…it was very peaceful. By 4:00 pm her contractions were intensifying again to around 4 minutes apart and about 1 minute long. Mommy U began to shake again. I felt at this point she was strongly in active labor.

Midwife C and Apprentice V arrived at around 4:45 pm just as Mommy U’s contractions hit 3 minutes apart and 60-90 seconds long. Mommy U was rear-facing on the toilet at the time, though she was no longer able to urinate. She was working very hard and required constant firm pressure on her back during every contraction. She was starting to moan softly and at some point whispered to me she didn’t think she could do this. I reassured her that she WAS doing it, that she was doing an excellent job, that she had made so much progress, and that she would be meeting her baby very soon. At this point, I felt she was nearing transition.

Daddy N assisted the midwives in setting up. Luckily, Sister E had been a doll and was content to play on her own for much of the afternoon. The midwives rearranged the kitchen, brought in the birth tub, set up equipment, moved things around, and began sterilizing their tools. At around 5:00 pm, Daddy N and I traded places for a while – I took over care of Sister E and he attended to Mommy U. I needed to call Keith and check in with him about our own daughter, and I desperately needed to grab a bite to eat. Sister E and I visited with each other, played for a while, and tried to stay out of the way. Of course, Sister E’s favorite place to play at the moment was the middle of the kitchen floor – not exactly out of the way! I downed some food and prepared to feed Sister E at the same time.

Shortly after we switched, Mommy U vomited very violently again. At 5:45 pm, Mommy U requested a vaginal exam (her first) from Midwife C. Midwife C had just finished telling her she could visibly tell she was in very active labor, and she thought she was at least 5 centimeters. I could see the disappointment on Mommy U’s face at this number, and I admit I thought she was farther along than that. We were all very excited to hear Mommy U was in fact 7.5 centimeters and 90% effaced! She was progressing very well! When asked if she wanted to get in the tub, she exclaimed, YES!

From here on out, I’m not aware of anyone timing Mommy U’s contractions anymore. We just watched her behavior to determine where she was. Mommy U climbed into the tub with Daddy N, Midwife C, and Apprentice V assisting. Daddy N was in the tub with her at times, providing strong physical and emotional support. I continued to care for Sister E while providing some verbal support when Sister E was calm enough for us to be in the room. By 6:30 pm, Sister E was ready for dinner and bed, so Daddy N and I switched roles again – he took over Sister E and I attended to Mommy U. Mommy U was listening to her body and changing positions in the tub frequently. I worked with Apprentice V, switching between being the front person (holding hands and arms, making eye contact, providing verbal support) and back person (applying back pressure). At approximately 7:00 pm, Mommy U said she wanted out of the tub. Apprentice V and I assisted her out, and I guided Mommy U very slowly through the house. In our walk, I was backwards, she was forwards, and she would collapse into me whenever a contraction hit. It was slow but steady progress towards the couch in the living area. Once nearly there, Mommy U suggested she should visit the bathroom again, so we turned around and headed that way.

Once finally in the bathroom, she took up her rear-facing position and things really seemed to get intense for her. Contractions were very close together with little break, and even the breaks appeared painful. Mommy U was also experiencing violent shakes at times. She needed constant touch, and very strong pressure on her back during contractions. Mommy U was really handling everything extremely well – she let each contraction take over and just flowed with it. Her strength was amazing, even when she began to have doubts. The midwives continued to check in and offer encouragement, but for the most part Daddy N and I were supporting her during this time. We continued (always!) to offer sips of energy drink and water. Mommy U never let go of her magic comb either.

After some time on the toilet, Mommy U was expressing self-doubt and Daddy N was giving her encouragement, and she began asking if she could push yet. I’m not sure of the time anymore, perhaps 7:45 pm? I went to Midwife C and Apprentice V with Mommy U’s status – violent shakes and a request to push. Midwife C said she felt Mommy U was getting very close, but she wanted her to breathe through a few more contractions on the toilet and wait for the NEED to push. She felt it would be soon. Midwife C also wanted to know where Mommy U wished to birth, but at this point Mommy U couldn’t really tell us, so they prepared the couch and the birth tub to the correct temperature.

By 8:15 pm (??), Mommy U got up from the toilet and noticed blood. Midwife C said it was a very good sign, and that it meant her cervix was making important changes. We helped Mommy U make her way back to the birth tub. In the tub, Mommy U continued to change positions as we all waited for to feel the urge to push. Daddy N and Midwife C accompanied Mommy U, while Apprentice V and I took a short break in the other room. After just a few minutes however, I could look to Mommy U and see in her eyes – she needed me. As I came back into the room, Daddy N (who was also in the tub) told me Mommy U was asking for my help. I took up position in front of her so I could hold her hands and arms, lock eyes with her, give her verbal encouragement, and be a firm rock. Mommy U was working for every second now. She clutched the comb, squeezing it in her hands, biting it, and running it through her hair in between contractions. It seemed to give her strength. After some time, she requested I switch to press on her back, so Daddy N took up position in the front.

Midwife C suggested Mommy U try a squatting position with the next contraction. She suggested it would move the baby down lower in her pelvis. For the next series of contractions, Daddy N pulled Mommy U up into the squat as I pushed from behind. Getting a good angle on Mommy U’s lower back was difficult with her in a squat, but it was still very important to her comfort so I kept it up. At one point, Midwife C tried to take Mommy U’s comb away so she could grab on to the side of the tub, but Mommy U whimpered and wouldn’t let it go. The comb had to stay! In between contractions, Mommy U would relax back against the side of the tub and I would run my fingers through her hair. She was doing such a fantastic job and we all knew she was soooo close! At one point, Midwife C suggested Mommy U reach down and feel the baby’s head. Mommy U could feel it, and it was very close, but she felt something was in the way. Midwife C decided to come in to check.

At 8:47 pm, Midwife C confirmed Mommy U was 10 centimeters, but that she had a lip of cervix still near the baby’s head. A cervical lip had held up Mommy U during the birth of her daughter, so this wasn’t great news for her. Midwife C suggested that after another contraction, she would try holding the cervix back to see if it would slip out of the way. We prepared Mommy U for a contraction where Midwife C would be able to reach. I was concerned this may hurt, but once the contraction began, Mommy U did not signal it was any worse than the others. Midwife C said the cervix just melted away from her fingers, and just as that happened, Mommy U’s water popped. It was clear. With that, Mommy U was 10 centimeters and ready to push. For the next contraction, Daddy N climbed back into the tub and sat on the side. He supported Mommy U from behind in a dangling position, so Mommy U was vertical and ready to push.

At about 8:55 pm, the next contraction came and Mommy U could not help but push. She showed so much power and strength, it was really amazing to witness. With that very first push, she could feel burning and you could visibly see her perineal region begin to bulge. It all happened very quickly at this point – Daddy N was supporting from behind, I was in the front, and Midwife C and Apprentice V were on the sides with gloves on. It was literally only a couple of minutes before the baby’s head was completely crowning. Mommy U instinctively reached down and touched it and if I remember correctly, said “My baby.” For me to see this in person was a first. I could see the head with lots of hair and a bit of bloody mucus across the top.

Mommy U continued to push with deep growling sounds, and with a slight heightening of pitch, the head popped out. Midwife C reached in to check for a cord around the neck. Mommy U continued pushing, but it seemed the baby wasn’t progressing out. Mommy U pushed, and she pushed HARD! Midwife C grasped the neck region – I suppose she was checking to see if the shoulders were stuck. For perhaps a minute, the baby was stuck in this position while Mommy U pushed with all her might. It was difficult to watch – I knew the baby should have been at least bobbing with her pushes, but it was stuck like a rock. During this time, the head did rotate ¼ turn so I could see an ear and I told Mommy U I could see this. With the next push, Mommy U really pulled everything out – 110%, and the shoulders both popped out at the same time. My sense from Midwife C’s actions and Mommy U’s hard work was that the shoulders were stuck, but it was Mommy U’s strength that got them out. It was only but one or two more pushes, when a little baby boy was born. Mommy U was immediately reaching as Midwife C brought him up out of the water to her. All the pain and work in Mommy U’s face immediately melted to a mother’s glee. And with that, we heard the first cry.

Welcome Baby Boy M! Born 10/4/06, at 9:00 pm, weighing in at 7 pounds, 6 ounces, and 20.5 inches long.

The rest of the evening was all about little Baby Boy M. He was absolutely perfect. Mommy U bounced back in 2 seconds flat and was her old self again. The placenta came within about 3 minutes and Daddy N cut the cord shortly after that. For a good period of time, Daddy N and Mommy U stayed in the tub and cradled Little Baby Boy M while Midwife C and Apprentice V prepared her bed for the next 24 hours. I manned the video camera and got little Baby Boy M beginning at about 1 minute old. Little Baby Boy M seemed interested in breastfeeding, but wasn’t quite ready yet. The placenta was perfect, and when things were ready, we all made our way upstairs. I assisted the family with settling in by bringing up beverages, making sandwiches, and delivering Mommy U’s first request – cookies! Mommy U snuggled Little Baby Boy M to her breast while Midwife C checked for tears – all clear! Little Baby Boy M received his exam and let out some impressive screams, but settled quickly afterwards once expertly burrito wrapped by Dad. Finally, the new family was settled. Sister E never woke up, despite all the commotion. I said my goodbyes and made plans to visit again in a few days. I walked away exhausted, but on cloud nine because of the beautiful event I had just witnessed. Not only had I seen a new life be born, I’d also seen a mother go to the edge and back during her birth, and I’d seen a father give his all to his family. It left me in awe of birth in a totally new way, and really looking forward to my own.

The Birth of Baby Boy C

The Birth of Baby Boy C

Monday, August 20th at 2:17 am

2 lbs 14 oz

Original due date: October 30th

1st baby, premature (pre-30 wks) hospital birth

It had been about four weeks since I’d met Mommy M. We had our initial interview consultation at the Mall in Salem, since neither of us were terribly familiar with the area. Mommy M and Daddy P had just moved to Salem, and I had never attended a birth in the area yet. Our meeting went very well. Mommy M was a music therapy major and has plans to be a music therapy doula in the future. We found a number of crazy similarities between us, and felt we’d make a good match during the birth. I looked forward to our prenatal meetings and to meeting her husband, Daddy P. Little did I know I’d be meeting him in the operating room at Salem Hospital…

It was a Sunday night when my phone rang at around 9:15. A glance at the number told me it was someone in Salem. I wasn’t expecting anyone, but since I knew Mommy M had a similar phone number, I figured I better answer. I was glad I did. It was Daddy P, Mommy M’s husband. Mommy M was in the hospital, in labor, and she wasn’t even 30 weeks pregnant yet. Daddy P filled me in on some of the details. Her day started with a little bit of pink discharge, and progressed to more pink discharge that was darker in color and a low feeling in her belly. The doctor asked her to come in and get checked, so her neighbor took her to the hospital at around 5:30 pm. She was found to be around 3 centimeters dilated and 90-100% effaced with contractions getting started, so it appeared labor was here. She was given steroids to help develop the baby’s lungs, and magnesium sulfate to try and stop the contractions, but things seemed to still be moving forward. When he called me at 9:15, Daddy P said she was 4 centimeters dilated, contractions were 3 minutes apart and quite painful, and Mommy M was doing well. Daddy P asked me if I could come up. I briefly spoke with my husband and decided I could do it. I hadn’t planned on attending any births until October, when my newborn would be 5 months old. But it just so happened that my son (barely 3 months old and still nursing 24-7) had just gone to sleep for the night, so I figured I could disappear for quite a while and he would perhaps only need one bottle from my husband. So I called back and got Mommy M and Daddy P’s neighbor on the phone and told her to tell them I’d be there by 11. She shortly called me back and said the nurse indicated the baby might be here by 11, so I hurried to leave as fast as I could.

I rushed around, gathering all my doula gear, and jumped in the car. On the drive, I called a friend of mine who works in a NICU and asked what I could expect from a pre-30-weeker. She gave me good info, and I raced my way up to Salem, arriving at around 10:45 pm. The hospital was easy enough to negotiate, despite major construction. I arrived and was buzzed in quickly, and then told to wait in the hospital room where I found Daddy P and Mommy M’s neighbor. She got me caught up on everything, and we just waited for news. I’d been told at the nurses’ station that Mommy M had not delivered yet. At times, we could hear some moaning and were pretty certain it was Mommy M. It was so frustrating to be so close and not able to help!

At around 11:10, a nurse came in and got me suited up with the booties, hair cap, and full-body apron. Mommy M was in the operating room, which the nurse explained to me was standard for any births pre-34 weeks. I walked in to find Mommy M flat on her back with tubes and hoses and belts everywhere, Daddy P at her side, two nurses assisting with paperwork, and Dr. H doing a cervical check. Mommy M was 9 centimeters and feeling pushy when I walked in the room. Wow!

I expect this will be one of the most restrictive births I will ever attend. With the baby being so premature, it was very important for Mommy M to keep pressure off her cervix to protect the baby’s head. It was also medically the best choice for her to avoid pain medications, as any medication could interfere with the baby’s alertness and ability to breath after the birth. Mommy M needed continuous fetal monitoring because of her early gestation, and because the baby began having more difficulty with maintaining his heart rate towards the end of the birth. Mommy M also had an IV and a catheter, again, to keep pressure off the baby, ease his passage down the birth canal, and keep her prepped for surgery if it was needed in an emergency situation. So here she was, basically strapped down to the bed in the worst position to labor. Mommy M had a back injury too, so this was really a bad place for her. Many of the things we had discussed using during labor were not available – no birth ball or Jacuzzi tub, she couldn’t be mobile, she didn’t have her music with her, and changing positions was not really possible with all the attachments (and it was vetoed by the doctor too). As the doula, I was left with only verbal encouragements and hand-holds as the tools I could use to help her. That said, Mommy M did an ABSOLUTELY AMAZING job.

I immediately took up position at Mommy M’s left side. Daddy P was on her right. Together we held her hands, gave her verbal encouragement, and fanned her or applied cool cloths when she would tolerate. I realized I forgot my camera, and Mommy M and Daddy P didn’t have one either since they had no idea they’d be having their baby today. I checked in with the nurses about bringing my cell phone in the operating room to use it to take pictures. I’d been told I could not bring my bag of doula tricks (most of which were not helpful given Mommy M’s position anyway), but bringing my cell phone was okay. So I briefly left to retrieve it. Mommy M and Daddy P said they wanted pictures, and I wanted to give that to them if at all possible. I knew the baby would be taken away almost immediately, so a few snapshots with my cell phone might be all they got to see for a few hours.

Arriving at the peak of transition was tough. Mommy M was really struggling. I could tell things were happening very quickly in her body, because her sensations were changing and overwhelming her right-and-left. At times she would ask for a cool cloth because she was too hot, but then she could throw it across the room when it annoyed her. Mommy M tore her hospital gown off at the top when she had a hot flash. Both Daddy P and I were chastised for having bad breath. J She berated the doctor (when he was not in the room) for not doing his job and taking the baby out. It was all the classic signs of an intense transition. Despite the lashing out, Mommy M really was doing great. The contractions were taking their toll, but she took them head-on. There were a few times that she seemed to be trying to crawl away from them, but after I reminded her that staying relaxed instead of tensing up and trying to crawl away would make them more manageable, she welcomed them more openly.

By 11:45 pm, Mommy M was completely dilated during contractions with only a lip of cervix left. My midnight, she was completely dilated. Now, in a normal hospital birth, I would have expected the doctor to suggest she start pushing at this point. But because this was a premature birth and Dr. H was so gentle, he encouraged her to keep breathing through contractions and allow her body to move the baby down more before pushing. Mommy M’s water still had not broken either, and the doctor refused to break it at that time because it was giving the baby’s head a nice cushion. When Mommy M begged for them to please do something, the doctor and nurses calmly told her the best thing for her baby right now was to avoid pain medications and breaking her water. She was doing a great job and her baby needed her to be strong. Knowing this was the attitude of the hospital staff, I adopted this reminder to keep telling her when things got really tough again.

Now that she was fully dilated, Mommy M really found her rhythm. The next 90 minutes passed relatively quickly and peacefully. Daddy P and I maintained our positions, holding her hand. I made a makeshift fan out of a paper handout Daddy P had been given, and Daddy P and I took turns fanning Mommy M to keep her cool. Something visibly changed in Mommy M during this time. She was no longer crawling away and struggling with the contractions. She was welcoming them fully and breathing beautifully through them. I wish I’d had a video of how she was during this time – it was an amazing example of a naturally laboring mom at the very end of stage one. We were mostly quiet during this time too, as Mommy M had retreated into herself and was taking things on inside. She later told us that holding our hands and maintaining our vigil at her side was giving her immense strength, as she could feel the circle of love and support surrounding her. Daddy P was amazing as well, keeping a constant presence as his wife’s side. There were a few tender moments they shared during this late transition time where they kissed and exchanged I-love-yous and mini-hugs.

During this extended time at full dilation, the nurses and doctor kept checking in. Baby was moving slowly down, but was still not ready for pushing and the waters were still intact. Finally, at around 1:45 am, after observing some shifts in the baby’s heart rate, the doctor suited up and prepared for catching the baby. At 1:50 am, the doctor had Mommy M do some practice pushes to see if she would be effective at bringing the baby down. She must have been great, because he then told her to breathe through a few more and be ready to have her baby. Meanwhile, the doctor got all the equipment out and within reach. They also notified the NICU team to be prepared. The NICU nurse with warm blankets arrived and stood ready to catch the tiny baby.

At around 2 am, the doctor broke Mommy M’s water and it came out clear. Mommy M immediately felt more pressure from the baby’s head and was in more pain. Despite this, she was great at listening to exactly what the doctor’s and nurses instructed her to do. She continued to breathe through several more contractions. At around 2:10, the real pushing began. I held Mommy M’s left leg, and a nurse held the right. Mommy M was great at pushing! She curled up just like the nurse suggested, and brought the baby down with each push. The doctor was instructing her to hold her breath and push for long periods, and she did exactly as she was told. As the baby moved down, his heart rate really started to fluctuate a lot with the contractions. Sometimes it was around 160 beats per minute, sometimes it was under 80. This was an obvious concern for everyone in the room. It became imperative the baby be born soon.

Mommy M pushed and pushed and soon felt burning in her perineum. This sensation really shocked her and challenged her coping skills. But she pushed right through it. I could see the baby’s head as it slowly emerged. It was the most distinct cone shape I’d ever seen – almost pointed really. It was also very blue. Very quickly, the baby’s head was out, and with a quick motion the rest of the baby was born. It was 2:17 am and Baby Boy C was here!!

Most of the amniotic fluid came splashing out after the baby, and there was quite a bit of blood in it. I got splashed a bit too – my first time getting splashed with fluid. J Mommy M showed immediate relief from the pain. She and Daddy P hugged and kissed and cried at the little tiny sounds coming from their baby’s mouth. I snapped pictures as quickly as my camera could, but still only got three because the doctor moved even faster. He cradled the baby in one arm while clamping and cutting the short cord with the other arm before handing the baby off to the NICU nurse. And within a minute, the baby was gone. This was a very odd time for me. A beautiful baby boy had just been born, but here we were – the doctor, nurses, mom, dad, and doula, just standing around without any baby nearby. I showed Mommy M and Baby Boy C the pictures I was able to snap. Mommy M had not seen the baby before he was taken away, so this was her first glimpse. She laughed and smiled and seemed to be instantly in love. We were all so hopeful he was going to be okay. From my totally uneducated eyes, it seemed to be a good sign that he was born making noises and moving around frantically.

Dr. H’s attention turned to check Mommy M for tears. She had a small one inside her vagina, so he prepared to repair it. Unfortunately for Mommy M, she and I are similar in that lidocaine doesn’t seem to do the trick for pain relief when getting stitched. She could feel much of the repair. It was over quickly though. The doctor waited a bit on the placenta, and then used traction to extract it. The placenta was tiny and showed evidence of a very large clot. The doctor posited that labor had started because of this partial placental abruption. The blood that came out after the baby was also a big clue. So while the early birth was a challenge in many respects, continuing the pregnancy may have been an even bigger challenge to Baby Boy C’s survival. The catheter was removed, also with incredible discomfort for Mommy M. Mommy M, Daddy P and I chatted about the baby and what he looked like. The doctor said he guessed he might be around 3 lbs or so. Mommy M got cold (the operating room was freezing, but she’d been too hot for the entire labor) so we covered her in blankets. The nurses prepared to move us all back into her regular delivery room. It was around 2:45 or so when we got back in the room. By now, Mommy M and Daddy P was both feeling worry over the health of their son.

The neonatologist came to report on the baby fairly quickly. He said he was doing okay, fairly well actually. They had immediately inserted a breathing tube because of the late-delivery heart decelerations. With the breathing tube in place, they administered a surfactant to help further develop his lungs. Shortly after that, they removed the tube and put him on CPAP (continuous positive airway pressure). This machine controlled the pressure, oxygen, and moisture of the air he was receiving, but meant baby Baby Boy C was breathing on his own. What great news! Mommy M and Daddy P made calls to family, announcing the arrival of their little boy. After a couple more brief visits, the doctor finally reported Baby Boy C’s weight – 2 lbs 14 oz – just about right for a baby shy of 30 weeks.

Mommy M and Daddy P had just been through one of life’s greatest roller coasters, and it was beginning to take its toll. They were concerned about their boy and anxious to see him. Sometime around 3:30, Daddy P was taken back to see him. He took my phone so he could snap another picture and bring it back to show Mommy M. Mommy M and I stayed and talked a bit about the birth. She was obviously so proud of accomplishing it without medication, and I was very proud of her too. She overcame so many obstacles, but stayed her course and made the best choices for her little tiny boy. The picture of Baby Boy C that Daddy P brought back brought tears out from all of us.

Finally, at around 4 am, a nurse arrived and asked Mommy M if she’d like to go see her son. I assisted with getting Mommy M in her fancy postpartum panties and pads, and settled into her wheelchair. Somehow the nurse had been informed Mommy M had received an epidural, and when she learned that was not true, she was visibly impressed. We all walked over to the NICU and Mommy M and Daddy P were given instruction on how to enter. After scrubbing our hands several times, we walked back to Baby Boy C. He was attended by NICU Nurse C.

All I can say is wow. He was TINY. I was prepared to see him with the wires and hoses attached. His eyes were taped shut to protect them from light. His chest heaved with each breath. It looked so violent, but the nurse said without any fat, it was just very visible. There were a few moments where he let out some tiny gurgles and moved his hands and feet. Mommy M and Daddy P spoke to their son, both in English and Chinese. It was impossible not to be swept up in the love they felt for him. I found myself crying too. NICU Nurse C explained many of the wires and tubes, and how his care would be handled over the next few months. I was encouraged to hear what a central role the parents play in his care. It sounded like Mommy M and Daddy P would be practically moving into the NICU. Finally, at the end of the visit, Mommy M and Daddy P were encouraged to touch their little boy. It was a beautiful moment. I got pictures as best I could.

After we returned to the regular hospital room, there were many tears shed. We talked a bit about his features, and how he obviously had Daddy P’s full lips. The nurse gave more information on Baby Boy C’s care, and they prepared to move Mommy M up to her recovery room. Once there was a lull in the action, I took my time to say goodnight. It was around 4:30 am, and time for me to depart. We all exchanged hugs and information on when we would talk again. I desperately hoped it would be good news. As I walked out to my car, I couldn’t help but reflect on the beautiful event I had just participated in. If only it had been 2 months later…