It is confirmed...I'm carrying a mini Homer Simpson

The "big" ultrasound was yesterday. For each of my kids, I've left the 20-week ultrasound feeling like the baby looked like something specific on the ultrasound screen. With my first, she looked like a turtle...it was something about the placenta resting against her back. With my second he looked like a duck. This baby looked strikingly like Homer Simpson. There was a particular shot when they measure the distance between the eyes that really brought out the Homer image with eyes bugging out and big round forehead. Anyway, I'm hoping the kid is a bit cuter in 4 months.

We don't have the official report yet, but everything looked good from my eyes. Baby was extremely uncooperative for most of the measurements. Even if we had wanted to know the gender, they would not have been able to tell. I guess that is the way it is supposed to be. We truly weren't meant to know. I still have this feeling about a boy, and my daughter is convinced it is a boy...but we'll see. We're definitely coming up with girl names too, just in case.

Otherwise, things are going well. I'm STILL gagging and vomitting on certain food items and when I brush my teeth. Almost 21 weeks...sheesh. Between the sickness and the uncooperative behavior for doppler and ultrasound, I'm still thinking this baby might be a handful when he/she emerges on the outside. Contractions are getting more regular. I've always had lots of "practice" contractions very early on, so this is nothing new for me. It is exciting though.

Last week I attended my last doula birth for probably the rest of the winter and spring, and it just got me soooo excited to be in labor again. Birth went very well, though it was long. But mom got exactly what she was hoping for - it was about as close to a homebirth in a hospital that you could hope for. And the neat thing, at least from a doula perspective, was to really see how as the baby's position changed from posterior to anterior, it really changed the contractions. Had this mother had an epidural, I feel certain she may have needed a cesarean. This baby liked to be posterior, and only turned with extended time on hands and knees (which an epidural would have prevented). Anyway, it was a beautiful experience.

Otherwise life is very busy. I'm teaching two university classes this fall, plus doing a bit of research work. I was offered a teaching position for winter term too, which I had to turn down because of the baby. And I now have one lined up for spring, as well as 2 research proposals to work on and a proposal to work on some e-courses for quite a bit of money. Though getting the PhD was a major pain in the arse, I'm sooo happy to have it now. Pay is more than quadruple what I was making before (which obviously wasn't much), and I feel this invisible measure of respect coming from the other faculty. Pretty sweet.

D-O-N-E!!

This morning I turned my final revisions into the graduate school for my dissertation. It almost required a degree just to turn it in and meet all the requirements (10x13 inch manila envelope with metal clasp with 2 flyleafs, 3 extra title pages, 1 extra signed abstract, taped title page on front, receipt for archiving fee, etc etc). My revisions were pretty simple - took about 3 days. As of this afternoon, my online transcript says "Doctor of Philosophy degree requirements met on May 8, 2008." DONE DONE DONE DONE!!!

In other news, I've attended two births in the last two weeks too. Birth stories coming soon. One was a 92-hour marathon birth (I was only present for the last 25 hours). The other was an induction with hx of embolism complications that ended well with 4 hours of pushing. Both were good. Can't believe I fit them in there with all the defense stuff going on.

So now I'm taking a little time off from school. Gonna work on relaxing and reclaiming my sanity and health, develop my childbirth classes a bit, go see a movie, and go meet some new babies...

FREEDOM!!!!!!

T-minus 6 days

Life is crazy as I prepare to defend my PhD next Thursday. I can't barely keep up with things. Plus, I attended a marathon 92-hour birth earlier this week (I was only there for 25 of those hours). And I've got another mama due tomorrow too. How did all this stuff end up happening at the same time?

Cool thing this week was picking up my cap and gown. When you become a Dr, they give you very fancy robes.

Updates

I haven't posted in a while. I know. I think my blog is going to suffer a little in the coming months as I near the end of my school career. My stress and anxiety are just overwhelming sometimes, and it leaves me wanting to lurk more than post on the internet. So I will try to speak up when I can, but know that if I'm MIA, its cause I'm buuuuuuuuusy.

So updates...

Last weekend I attended Neonatal Resuscitation Program with Karen Strange, and it was an AMAZING class. We learned far more than just resuscitation of newborns. We learned about newborn physiology and some techniques to encourage a peaceful transition from intrauterine to extrauterine life. And, I got to meet Sage Femme, someone I've admired for a while and hope to interact with more frequently.

Alder is coming up on 9 months now. He still isn't crawling, and has no teeth. He's been on the verge of crawling for about 2 months, so I'm starting to wonder if he'll skip crawling all together. He's doing okay with standing if propped up in that position.

The life-after-school question is still up in the air. A big job came up but I've decided to pass because it is: 1) in Eugene, 2) full-time, and 3) research focused, and I want none of these things. My advisor has remained noncommital about whether I can work for him after graduation, so I'm starting to assume that means no. He's sending some hints that it is no, though I think if he really KNEW it was no, he'd just tell me no. Anyway, I'm definitely not counting on that. Right now I'm excited about developing my doula and childbirth education business, and possibly getting the opportunity to do some assisting at homebirths in the near future (Pssst...any area MWs reading this...I'm available!).

School is coming along, but pissing me off too. I'm still revising my final chapter, and time just keeps passing. My advisor is being tough on some of the revisions, so we aren't setting a defense date yet. Now it looks like I may stray into spring term. If so, at least my advisor has offered to pay me (a teeny, tiny amount) for spring term too. But dammit, I gotta finish!!

What else...

We got a new tv today. (grin) Finally...my piece o' junk tv can be retired, in favor of the nice, new, CLEAR imagine of our LCD flatscreen. As a LOST junkie, I can't wait to see my favorite characters on the big screen.

I've been doing a draft of our taxes, and it looks like we're going to get quite a little refund this year. Thank goodness...cause we're shopping for a minivan this summer and need more for that downpayment.

Not much else really. Just busy...and stressed.

Busy

Sorry...I know I've been slacking about posting lately. And I feel like there has been a lot going on to post about...but I'm just not finding the time. I'm racing to finish this dissertation. I'm battling a little cold right now. I've had doula engagements right and left lately (fun meeting with doulas in neighboring town, interview, prenatal, book club, etc). Tomorrow I head to Seattle Midwifery School to take a class from Penny Simkin on working with moms who are sexual abuse and birth trauma survivors. I just decided I'm going for childbirth educator training in March. And I'm trying to figure out what happens after my last paycheck. SO yeah, just a lot going on lately. Oh, and I've been hanging out a lot with a friend who is 5 days overdue now. She's trying to be patient, but is not a happy camper at the moment.

Anyway, hope to be back to more regular posting soon. Will certainly try to blog about Seattle, cause it will be awesome.

Doula meeting

Night before last I attended our monthly doula meeting here, and it was a really great night. We alternate locations for the meetings, and this time it was at our hospital in one of the L&D rooms. We always extend the invitation to the L&D nurses, CNMs, and OBs, but have had few attend before (and no OBs). This time we had an L&D nurse (who is also a doula), a homebirth midwife and her assistant, a CNM, and an OB! It was awesome! Feedback continues to be very positive for doulas in our community, though most of us are working far less than we would like. In fact, there has been a significant lull in business lately for everyone, with some of the women having no births since early last summer. We are working on more marketing and getting ourselves out there.

In other doula news, I have one client due in April. I recently had an interview for one due in February, which I was secretly hoping I wouldn't get because it just feels like too much on my plate with finishing school and all. So I didn't get them, but they chose me as back-up. Perfect! I also had a contact about someone due in March, but referred them to other doulas because I don't want to take a birth on during the same month I think I will be defending. Beyond April, I have nothing though there are two hopefuls in May. Hoping to get some more births lined up.

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!

Almost a VBAC

She was so close. The midwife said she could see the baby's hair. It seems crazy to me that we could see the baby's hair, but he wouldn't come down anymore. I guess I don't have a very good image of the pelvis, cause I really thought that once we could see the head, there was no way he wasn't coming out. But he didn't come out.

This mom was absolutely amazing. Baby #1 was a cesarean after 15 hour labor, 5 hours of which was at 8 cm. She never got past an 8. During the stall, they tried breaking her water (and found light mec), tried an epidural (and got slight decels), and when he wouldn't drop and she didn't dilate, they went to cesarean. Turns out baby was posterior. He was a 9.5 lb baby on his due date.

With baby #2, he decided to come 4 days after his due date. We knew he would be big. One major goal was to encourage baby away from posterior. Well, mom was 4 cm before labor even started, and when checking into the hospital she was 4-5 cm. 14 hours later, she was 6 cm. Her labor pattern was still variable, and contractions really should have been stronger. Something was amiss. We tried tons of things to encourage good positioning (the midwife said baby was anterior, but I was leery of asynclitism) and to bring on stronger contractions. The OB on call started interferring and demanded either progress or a cesarean. So mom agreed to AROM at 6 cm. A few minutes later, she was getting slammed with back-to-back 90-second contractions. I knew it was transition. She didn't believe me. Twenty minutes after the AROM, she started pushing. Unfortunately, in 90 minutes of the most incredible pushing I've ever seen in a half-dozen different positions, baby had only gone from 0 to +1 station. Mom was done. She was in terrible pain. The OB came in, took one look, and said the baby wasn't coming out. So off to cesarean she goes. Baby was 9 lbs 13 oz. And he was posterior afterall.

Unfortunately, because of the long recovery after surgery, I wasn't able to see mom and baby before I really needed to head home. This was my first all-night birth. I had 90 minutes to drive home. I talked to the mom today and she sounded really happy with her experience. We tried so many different things and she got so much further than last time. Having it end this way also gives her a sense of justification for her first cesarean too. In the end, she pretty much had a complete vaginal birth, except for the ring of fire part.

As a doula, this is the first cesarean client I've had, and it is the first client who didn't achieve exactly what she was shooting for. I have mixed feelings about it. I'm THRILLED she got to push and feel that power for so long. I just can't help second-guessing what we did. Could we have tried a different position? Should she have pushed for longer? Was this going to be a cesarean no matter what? I guess it shouldn't matter as long as mom is happy.

Pins and needles

I'm just sitting here on pins and needles, waiting to get a phone call. One of my doula clients is due tomorrow (Thanksgiving!) with her second baby. Her first baby was born ON his due date. And last night she had a couple of hours of contractions that were consistently 10 minutes apart. I'm so excited! The birth time is just so magical. This client is a good friend too, and I'm so excited for her to meet her new soon. This is a VBAC too--my first--so I'm very excited to be getting this experience and happy to support my friend.

So now I've got my doula bag packed, the car tanked up (this birth is 90 minutes away), my caffeine in the fridge, my hair washed, and my teeth brushed. I'm ready. And I'm sure this mom is ready to go too.

Mega update

I've lost all sense of time. Seriously, minutes pass in seconds, days pass in minutes, and weeks pass in the blink of an eye. I remember as a kid when life passed at the slowest snail's pace, but now it is more like a rocketship. Somebody put on the brakes, will ya?

Life in our household has been continuing full-steam ahead. Nothing major has happened in the last week, except for the most minor case of the sniffles in both kids. My computer at school (where I have the most uninterrupted time to blog) doesn't like Blogger, so I've been unable to post from there and frankly, posting time at home is almost non-existent lately.

So the VBAC birth that was going on last week obviously ended. I was not called to stay the primary doula. Baby was born later that night via emergency cesarean, after a transfer from the birthing center for what the doula described as "scary" decelerations. While at the hospital, the mom was able to continue laboring all the way to 8 cm (that is 7 cm further than she got last time), but then FHT took such a serious dive a cesarean was performed immediately. Turns out there was a serious cord entanglement going on, and baby wasn't coming out without bringing the placenta with it. Healthy boy, 9.5 lbs. Mom is really happy she got to experience so much labor.

In other news, daycare woes continue. Ava is now registered for 3 afternoons a week starting after Thanksgiving, but that is not a convenient schedule for us at all. With some luck, all the right changes will take place in the next 6 weeks, and we'll get both kids in there for 2 full days/week by January 1. Cross your fingers for us. We're still on the waiting list for the campus daycare center, but it looks like that will be July before space is available.

We've been getting our wills and advanced directives together around here. We already had a will, but seeing my aunt's death and the aftermath associated with her will and assets, I've realized how important it is to have everything meticulously prepared. I've been learning about trusts. There are just so many ways to take care of your loved ones after you die. Confusing stuff. Not like we have much to leave em (and not like we plan on dieing for 50 years), but I wanna make sure they get every penny!

Potty training! I think we are officially potty-trained here. Accidents are extremely rare now and almost predictable because of the circumstances. We still haven't tackled nap or night training because Ava has no access to the potty during those times, but it is coming soon.

Night weaning! Alder has night-weaned himself. This has been going on for about 2 weeks. I can't believe it. Last night he slept for 10.5 hours STRAIGHT. And he's not even 6 months. I'm so thankful we've gotten here with absolutely no urging on our part. Franny, I hope your next one takes a cue from Alder. Granted, things were still very rough 2 months ago, but to completely sleep through the night ON HIS OWN at less than 6 months...that is just worth almost anything.

Not much else going on. Keith and I are dreaming of our new minivan that we hope to get next summer.

Oh, and 2 days ago I finished writing the final manuscript of my dissertation. It needs major editing, and I still have to write a brief introduction and brief conclusion to the whole dissertation, but that should only take a couple of days. I can't believe I'm almost there. Hopeful defense date in late January.

And one more thing! I'm on the verge of signing up for my first class towards the long path to midwifery. I'm thinking this will be a one or two classes at a time, maybe a couple of times a year thing...so the entire curriculum will take probably 5+ years (I'm thinking of going for the AS degree which includes the CPM first, then possibly the MSM if I'm still into school and all). But that sounds about right to me. I have no apprenticeship lined up anyway. It takes time to figure those things out, and until I'm done with the PhD and have earned a little money, I can't even fathom an apprenticeship with no income.

Okay, that is all now.

VBAC 2

Today I got a call from another doula who was late in the 2nd day of attending a birth. I'm her back-up doula, and things were starting to get really tough for her and the mom. She needed to just talk things out for a bit. This client is a VBAC too, and so far the labor seems to be progressing (or NOT progressing) along the same line as her first birth that ended in cesarean. And she is now 9 days overdue. It is hard to not be there, especially when given this glimpse into where things are at the moment. It sounds an aweful lot like there are some emotional hang-ups for both the mom and the midwife. I just hope things start to show progress. This mom is such a sweetheart and has worked so hard for the chance to birth naturally. She chose her doula before she chose her care provider, so I know the doula (and me as back-up) feels pressure to support her the best way possible. What a tough position overall. I'll be thinking about them until I hear a baby is born (or until I get the call to take over when doula #1 needs a break).

VBAC

Yesterday I had a prenatal doula visit with my next client who is due. She's 37.5 weeks now and gearing up for her VBAC. I can't explain how excited I am for her about that upcoming labor and birth. She is so prepared and ready to meet this challenge. I have 100% confidence that her body and her baby can do this. Granted, her baby is most definitely going to be on the large side, and if he is posterior like his big brother was, it could be a darn hard labor that just might possibly end in another c-section. But there has been so much learning for this family that has happened since the last birth, I think the entire thing will be a whole new experience. They fired their old OB who blatantly refused to entertain the idea of a VBAC. They found a midwife group that attends at a hospital (their preference was for a hospital birth) with decent support for VBACs. They hired me. They searched their souls for the best choices for their family. And they've packed their bags.

I look forward to posting a great birth story here very soon.

Doula waves

No, this isn't about a doula who waved, or waves of doulas or anything. This is about the weird phenomenon that is reaching doula clients. Months will go by and no one will call. And then suddenly I get two or three unrelated calls in a matter of days. What is up with that? And it amuses me where people get my information. SO far, no one has stumbled across my website out-of-the-blue, despite my being on the first page of google when you enter my town and "doula". I've gotten referrals from one of the Oregon midwifery sites I'm listed on, and once from someone who googled another nearby town and "doula", ended up on the Oregon midwifery site, and then still picked me despite being in another town. In my town, I'm part of our local network of doulas. I'm on their website and on their flyers. I'm also in another nearby town's network, which includes a website and flyers. And I pay for these connections. Plus, there is the hefty fee of my own website. But so far all my connections have come from the free websites. How odd. Maybe I should stop spending money on advertising. Maybe it is just a slow time for doulas. Maybe we have too many doulas in my town - 19 for a fairly small birthing population, especially considering the high number of homebirths here.

Birth Into Being

I finally shelled out the dough and bought myself some birth videos. I admit, I wanted them for myself just as much as I wanted them for my doula client library. I also knew they would come in handy for showing the kids real births in prep for the birth of their future (not yet existing) siblings. So far, only one video (of three) has arrived.

Birth As We Know It is excellent. It features 11 births, including one twin birth. Nearly all of them are waterbirths. All of them our out-of-hospital births. The birthing mothers are beautiful and very conscious of their labors. In fact, the main point of the video is promoting "conscious birth" and how wonderful it can make the entire experience for a pregnant couple. I really jived with the video and loved the scenes of moms birthing into the sea. I was a little leery of how long they kept the babies under water, but I'm sure that is because the waterbirths I've experienced in real life brought the baby immediately to the surface. There was a short clip of a circumcision. You really can't help but squirm when watching that. There was also a segment on lotus birth in the "extras" that was really neat. Lotus birth is when you keep the umilical cord and placenta attached until it dries and falls off naturally. Sounds nice, but I doubt I could handle the hassle of how immobile you are with a baby attached to the placenta. Anyway, the video is great and just has some beautiful images. I look forward to lending it out to clients.

Am I gonna be a midwife?

Maybe. The birth bug has definitely got me strong. Today I attended a training session for wanna-be midwife's assistants. It was really great - all like-minded ladies together for a day of playing with instruments, practicing techniques, and talking birth, baby, and pregnancy. The training was offered by several midwives from the Midwifery Access Project in Eugene, OR. Three other doulas from my local Corvallis group went down with me, so it was a great time had by all.

Five years ago, I never had any idea I would become this involved in birth work. I guess it started when I began planning my first pregnancy, long before I actually met the man who eventually became my husband. I just knew I wanted to have a natural, drug-free birth. Over time, I realized my vision was to have my children at home. So once I was married and we were ready to have children, my time had come. After my first homebirth, I knew the hands-off midwifery model was definitely my cup of tea. I became the uber birth nerd that I continue to be, and I got interested in doula work. I still didn't have an interest in being a primary midwife though. Eventually I started to consider being a midwife's assistant. Someday, I'd love to attend some training workshops on The Farm.

Anyway, fast foward to now. I have a handfull of births under my belt and a few more in the hopper. I've had my second child. I've realized that though I intend on a career in academia at some point, I know it isn't where I still spend the rest of my working days. And I'm starting to think about the long path to being a real, primary midwife. For me, it could be a VERY long path though. For now, I'm just thinking I'll soak up any birth experiences I can get - as a doula, as an assistant, as an apprentice, as a friend. I know I can't take an assistant/apprentice role until I finish school. But after school is done, that might be a good time for something like that. We'll see. I think I've got the sleep on this one. In the meantime, I'm gonna make an appointment with my midwife to go over my charts. Now that I've had the class, I think I can read them and understand. I'm sure I might let slip that I've attended this class and could be interested in attending births if she was ever searching for someone.

Update on Baby Boy C (preemie)

This past weekend I was honored to go visit with Baby Boy C, his mama and papa, and the NICU staff up at the hospital in Salem. Baby Boy C is doing so well! He's over 4.25 lbs now and gets most of his feedings through a bottle (they are working on getting him to nurse). He's doing so well in fact, that they think he might get to go home in about a week. That is at the equivalent of 35 weeks gestation, which is just AMAZING for a pre-30-week preemie. They were originally told he wouldn't go home until around his due date. His parents seem to be doing great and are ready to handle their son at home. I'm still in such awe of their amazing strength. I just can't imagine going to visit my child in a hospital every day.

Chiropractic care for pregnant moms and babies

Last night we had our monthly doula meeting. The guest speaker was Dr. Jenn of Hands-On Healthcare. We learned all about chiropractic care for pregnant moms and babies and let me tell you, it was fascinating! I'm a fan of chiropractic care, but to hear a presentation specifically geared for my client audience (and myself!) was great. And since I was there with my son (still under 4 months and nursing all evening), he got to be the demo doll. I'm excited to have some information that I can share with my clients about the availability of chiropractic care specifically for expectant moms, especially the Webster Technique for allowing breech babies the best opportunity to turn. I'm excited to move my care from the collection of chiropractors I've previously seen over to Dr. Jenn. And if I can convince Keith it is safe for kids, I'll be taking Ava and Alder over there too.

Birthing centers

Today I toured Sacred Waters Birthing Center in Eugene. I am back-up doula for a client due in October, so I wanted to make sure I could find the place and that I was at least minimally familiar with the facilities. It was really a pleasant place. If I didn't love birthing babies in my own home so much, I might consider driving all the way down there. It has two beautiful birthing rooms and a separate waterbirth room. It was warmly furnished yet had all the safety equipment necessary for most complications. Yep, I could really see how it would feel like home to a laboring mom. But I don't think I could ever get myself in a car during labor.

Oh, and I saw pictures of my doula on the wall there - I guess she used to assist there. It was great to see old pictures of her, like it was a former life or something.

Pics of Baby Boy C

Baby Boy C's parents (birth at 29 weeks 6 days) have given me permission to share a few pictures. These were taken with my cell phone, so please forgive the lack of clarity and the desperate need for a flash.

This first one is about 90 minutes or so after the birth. The tubes on his face are the CPAP. His eyes are taped shut. The wires monitor his breathing and heartrate. He's got more attached to his feet. And somewhere I think he had an IV. The NP tube (down to his stomach) wasn't inserted until the next day I think).
This one is really fuzzy, but I had to share it. This is both his parents getting to touch him for the first time.
And that is me, all suited up in the OR. This was taken shortly after the birth, so I'm all relaxed and happy that mom did great and baby appeared (for the 30 seconds we saw him before he headed to the NICU) good.

I spoke to Mommy M today and it sounds like they are holding up okay. Baby Boy C had a major infection one day, but has recovered and overall is doing well. He's gained around 3/4 of a pound over his birthweight! He's still on CPAP, but it is just room air and the pressure has been significantly reduced. They say he has only 1 or 2 more steps before it is removed. Mommy M is pumping 8 times a day and getting some milk, but she seems discouraged that it isn't very much. I think she's doing really great. I'm just contiuously impressed with how this family is holding together during such a stressful time. Daddy P is working hard to get the house ready for Baby Boy C's arrival home (in another month or so). I'll be visiting them next weekend at the hospital, where hopefully I'll get to see Baby Boy C again.

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.