Thursday, March 19, 2015

Freshly Baked!

Did you know that a woman is really not "over due" until she is 42 weeks pregnant?!  Most people assume 40 weeks is an EXPIRATION date, but science tells us that some babies will need to the full 42 weeks.  HOWEVER, waiting that long can be difficult.  And for women choosing to have their babies at a freestanding birth center, they know that making it past 42 weeks means transferring to the hospital for an induction.  So I was pretty excited to get the call yesterday that my client, at 41 1/2 weeks, was in labor!


I arrived at their home shortly before 7 pm.  Mom was coping extremely well with her contractions, and dad was busy supporting her and whipping up some fresh bread.  The house smelled AMAZING, and we enjoyed chatting and contracting all evening.  :)



By 10 pm, we had made it to the birth center, and mom eagerly entered the tub.  
This is what it looks like to be in the zone!
We listened to so much great music!


Mom spent the next 6 1/2 hours laboring in the tub.  
She was unbelievable.  
So focused.  So relaxed.  So inspiring.  
Her contractions were unceasing for hours, but progress was a little slow.  She listened to her body, and was so instinctual.  


Pushing was definitely tiring, and lasted for quite some time.  That big boy had to really squeeze through!  But he finally slipped into his mother's arms at 4:43 am, March 19th, 2015.


Seriously, look at that face!
Totally worth it.


Grandma was able to quickly sneak in and see her first grandbaby!  
It was such a beautiful moment to see her watch her son become a father.


This little guy is so loved.  

Monday, January 5, 2015

En-caul


After laboring for 3 days with her first child, this mom was really hoping for a quicker labor this time around!  She texted me last night around 8:30 saying she was having contractions.  I quickly jumped into bed assuming I would spend at least a portion of the night with her.  I was pretty surprised when I woke up at EIGHT AM!  I frantically checked my phone for messages, but there weren't any.  We touched base around 9:00 am, and contractions were picking up again.  At 11:00 she headed to the Midwife's office, and was 6 cm!  

I joined them around 12:30 at the hospital.  Mom was coping beautifully, and dad was offering physical and emotional support.  They were both in good spirits, and we were all excited to see where the day would take us.  


We walked the halls quite a bit at first.  Mom liked looking out the windows at the beautiful, snowy day.  She also needed someone to hold her hand during each contraction.  This was her most used ritual.  Around 4:30, things began to intensify, and we started utilizing more coping mechanisms.  Mom used the jacuzzi several times, we listened to music, did deep breathing, and massage.  

By 6;00 pm I was pretty sure that mom was in transition.  At 6:30 she was checked, and was 9 cm!  Nerves began to kick in a bit, which is pretty common, and is almost always a sure sign that birth is imminent.  

Mom continued to remain calm during contractions, even though they were lasting much longer and were very intense.  She asked for nitrous oxide, but someone else was using it!  The nitrous finally arrived about 20 minutes before the baby did!  

Pushing was very intense, as it often is.  Mom pushed for about 20 to 25 minutes.  
And at 8:13 pm, on January 5th, 2015, this sweet, little boy slipped into the world.


This baby was born "en caul", meaning he was delivered entirely inside the amniotic sac.  I was pretty excited to not only witness this, (it only happens in 1 out of every 80,000 births!) but was happy to snap a quick picture of it, too!



Cutting the cord.  That thing was thick!


These two were such a great team.  What an honor to support them.


Telling Grandma about the birth!  And already nursing like a champ.


I couldn't resist taking a quick photo of the beautiful night as I walked to my car.  Full moon, winter fog, and Christmas lights.  :)  Happy New Year!

Monday, October 6, 2014

Monday Miracles


I got a call last night around 9:30 pm, saying that mom was in early labor.  I quickly jumped into bed hoping to clock an hour or two of sleep.  I got almost a full night's rest, as I didn't hear from my clients again until 5:00 am!  Her contractions were lasting between 1 and 2 minutes and were about 6 minutes apart.

I met mom and dad at the hospital at 7:30 am.  The nurse was grumpy and wouldn't let me back into triage.  (She got grumpy later on when mom said "no" to a heploc, too.  Thankfully, she cheered up by delivery time.)  By 8:00 we were settled into the delivery room.  Mom was coping great!  She was so controlled and extremely relaxed.  Her husband was very supportive, offering massage and imagery prompts.  At this point, mom was dilated somewhere between 5 and 6 cm.

This mom's contraction pattern was really unique.  Her contractions were about 10 minutes apart, but would last around 3 minutes long!  That's a long contraction!  But the long breaks were nice, and mom was able to rest and even snooze a bit in between.

Around 10:00 mom got in the jacuzzi.  She loved the way it felt and said it helped her relax.  Things started to really progress and at 10:30 her water broke.  I knew we wouldn't have much time since this was baby #4.  We quickly got mom over to the bed.  Things were very intense to say the least!  This woman worked so hard and was able to maintain control during some very long and strong contractions.  She was 8 cm dilated, but I knew we were minutes away from birth.  

The urge to push soon followed, but there was no doctor yet!  So mom had to continue breathing deeply.  As hard as this is, it's actually a great way to deliver.  It gives your skin time to slowly stretch, which helps avoid tearing.  And it paid off!  


Love at first sight.


Tipping the scale at a whopping 9 pounds 8 oz!
10:58 am, Monday, October 6th




This baby snuggled right into his mama.  


Cute, little, old-man face.  I love it!




The perfect way to start off the week!  



Thursday, August 21, 2014

What Constitutes an Emergency?!


This lovely lady is one of my all time favorite people.  (Doesn't she look great resting her belly on my countertop?!)  Our husbands have been best friends since grade school, so when we all got married, the 4 of us quickly became inseparable.  I was able to support Emily during the birth of her 4th child a little over 5 years ago.  Even though her son had spina bifida, she was able to have a completely intervention-free birth.  We were planning on the same for this baby....

We were a little wrong.  

Due to low amniotic fluid, Emily was scheduled for an induction early in the morning on August 20th.  But when she arrived, they discovered that her baby was breech!  The doctor immediately suggest an emergency cesarean.  Wait, what?

Emergency?

This baby was not in distress, nor was this woman in labor.  I'm really struggling to see the emergency in this scenario, so I'm going to say this doctor either really over reacted, or just really loves doing cesareans....

Thankfully, the anesthesiologist would not allow the cesarean for 6 hours because Emily had eaten breakfast.  So since this wasn't a really emergency, and there was quite a bit of risk involved in doing a cesarean after a meal, Emily and her husband were given til 1:00 pm to turn their baby.  When the doctor came back at 1:00, their little guy was soooooo close to being head down.  Reluctantly, the doctor helped her baby get in head down position.  

It took about 45 seconds.  
FORTY-FIVE seconds determined the type of birth she would have.  Wow.

Pitocin was administered immediately, and we all did everything we could think of to keep that little boy head down.  Contractions were very mild at first, and didn't start becoming difficult until about 4:00 pm.  The contractions were 2 to 3 minutes apart the entire time.  That doesn't give mom much time to rest, but Emily was handling them wonderfully!  

 At 5:20, Emily was dilated 3 cm, which was progress from the 1 cm she was at that morning.  But her baby was still not engaging in the pelvis.  She labored on the ball, walked, and squatted throughout.  

8:00 pm, 5 cm!  Definitely progress, but baby was still high.




Emily utilized music and relaxation throughout her birth.  She swayed in tempo, and tapped her fingers to the beat.  


Around 9:00 pm Emily's contractions were very intense.  I rolled a rolling pin filled with ice water up and down her back.  This trick is a dream come true.  I use it all the time, and had it used on me during my births.  


At 11:00 pm, Emily was still only 5 cm, and head was still not engaged.  This is when discouragement really kicks in for moms.  Contractions that are strong but not doing anything are super hard to cope with!  
At 11:30 Emily received an epidural, and we all settled in for a nap.  I assumed she would sleep all night, but I was so wrong!
By 1:45 Emily was dilated to 7 cm and her baby's head had finally descended into the birth canal!  Throw in a little vomit, a few pushes, a cord wrapped around his neck, and one tug from the vacuum, and this little cutie was finally born!


Thursday, August 21st, 2014
2:15 am
7 pounds 13 ounces

Sunday, May 18, 2014

Shoulder Dystocia


My phone rang at 3:20 this morning, and I knew I needed to hurry.  Baby #2 for my client was on his way, and her first birth went fairly quickly.  I arrived at the hospital shortly before 4:00 am and found mom laboring beautifully.  I couldn't even tell when she was having contractions, but she was already dilated 6 cm!  I knew she would progress quickly, and after about 30 minutes I could tell when she was contracting only because she would breath a little louder!  She was so relaxed and focused.  

She began to have the urge to push around 5:10 am.  The midwife checked her cervix and she was complete.  The midwife decided to break the bag of waters, and the urge to push subsided for several contractions.  By 5:30, mom was pushing, and pushing, and pushing.  But baby boy was coming down the birth canal slowly, and after a few minutes it was clear to see that he had shoulder dystocia.  


Situations like these can feel very stressful at the time.  Though in reality, it only took about 15 minutes for this baby to be delivered, each minute feels long when you don't see the progress you expect.  Mom had to work incredibly hard at the end to expel enough strength and energy to deliver her child.  And once he was out just enough, we could see that he was also very wrapped in the umbilical cord.  He was pretty shell shocked, and was quickly whisked to the baby nurses to help him with his crying and newborn reflexes.  


Daddy went over to talk to his new son, and this little guy pinked right up and was opening his eyes.  There was initial concern that there could be some nerve damage in his neck (from the shoulder dystocia during the delivery) since we wasn't moving his right arm at all.  But after several minutes, both arms were moving and he looked great!


What a cutie!


Welcome Reuben!
Born May 18th, 2014
5:41 am
7 pounds 14 ounces



At 6:10 am, mom and baby were finally able to snuggle.  



Little Reuben snuggled right into his mom, and you could tell that he was right where he wanted to be.  


Thank you for sharing your birth!

Monday, March 17, 2014

St. Patty's Day Baby!

When I first interviewed with this couple, they mentioned how fun it would be to have a St. Patrick's Day baby, and they got one!  (We'll see if green cupcakes are as fun as green beer....)  :)

Shortly before I went to bed on Saturday night, I received a text saying that mom was having mild contractions.  I woke up early Sunday morning to a text saying contractions had been going steady since 3:00 am, and by 10:00 am, mom was admitted to the hospital at 4 cm dilated and 95% effaced.

Knowing that first time moms often have long labors, I settled in for the long day, but was still optimistic that things would progress quickly.  They didn't.  I am totally blown away by how strong this couple, and their "Little" guy were!

This mom was not only in control-focused- and relaxed, but she was willing to try anything.  We walked the halls (in her super-cute labor robe), labored in the tub, and swayed on the birth ball.  The hours clicked away and her sense of humor and optimism stayed in tact almost as long as her bag of waters did!


At 5:00 pm mom was dilated to 6 cm.  Slow progress... but progress is progress!  We kept going with walking, swaying, squatting, listening to music, and massage.  Mom even mentioned that she felt like a queen as I rubbed her feed and her husband fed her ice chips.  At 7:30, her own mother stopped by to offer encouragement.  The feelings of love were so intense, that all of us teared up!  Giving birth sure brings out the emotions, and it was great to see the support this woman had in her life.

The hours continued, and at 11:00 pm, mom was still dilated to 6 cm.  News like this is incredibly frustrating and discouraging, especially once night time rolls around and exhaustion sets in.  This mom was visibly upset, as any woman would be.  But instead of giving up, she opted to allow the doctor to break her bag of waters, and we were all more determined than ever to get this baby out.


Mom's back began to hurt pretty intensely, and we all suspected that her baby was posterior (facing the wrong way in the pelvis).  This causes extra discomfort, and slows down labor (and for some reason, about 80% of my clients have had posterior babies in the last year!).  We added in the ice rolling pin for comfort, and mom started squatting and changing position often to encourage her baby to descend.  Dad offered physical support, encouragement, and always knew what to say.  They were an amazing team.

Finally, at 1:00 am we got news of progress; almost 8 cm dilated!  Mom was tired, but now had the encouraging news of progress.  She opted for nitreous oxide as a form of pain relief.  This is a new option at St. Lukes downtown, and this is the first time I have seen it be used.  It appears too good to be true, as the medical staff claimed it had zero risks and side effects.  But it worked!  Mom liked it because it was just enough to get her over the edge and make things manageable.  I liked it because it didn't affect the baby, and mom was still able to talk and change positions.  I can think of many women over the years who would have loved a pain management tool like this.  Women who desired to stay away from the well-known risks of epidurals, but also struggled with long labors.  I'll definitely be doing my homework on this new option.

 At 2:35 am mom was complete and ready to push.  Pushing can take a while with a first time mom, and this mom really found her inner strength.  Her endurance was amazing.  By now she had been up and laboring for 23 1/2 hours!


 At 4:45 am, "Little" Leprechaun Liam slipped in to the world, 
and almost broke the scale at a whopping 9 pounds, 15 ounces!  HELLO!







Dad was so proud, and I think he smiled for about an hour straight.  I just love to see dads like this.  (Partly because they remind me of my awesome husband, and partly because I can tell that they really understand the importance of family.)  These two love-birds sure are lucky to have found each other!




This birth had a great outcome, but it wasn't easy.  There were times that even I began to wonder if it would end in a vaginal birth.  I have seen many births with slow progress, and often they end in cesarean.  This birth was a great reminder to me to always trust a woman's ability to birth her child.  It was long.  It was hard.  But it was doable.  Women are capable and babies are resilient.

Wednesday, February 5, 2014

Fear vs. Faith

Since birth is unpredictable, there will always be some amount of fear concerning it.  But lately I have really noticed how so few care providers actually have faith in birth.  This lack of faith makes parents feel more fearful; and often, more willing to accept interventions that are offered to them without true medical need.  It's a cycle that desperately needs to stop.  

My latest client was expecting her third child.  She had been induced for medical reasons with both of her previous births, and was thrilled when this pregnancy had no medical issues.  For once, she was going to be able to go into labor all on her own!  

However, several weeks before her due date, her care provider kept finding things to fear.  The baby wasn't descended in the pelvis yet, or the heart rate was a few beats too low.  She talked often of the size of the baby, and worried it would be too large to be delivered vaginally (even though this mom had already vaginally delivered a baby barely under TEN pounds!).  The topic of cesarean came up at every appointment during the last 4 weeks of this woman's pregnancy.  

Where was the faith in this woman's ability to give birth?
She had already proven that she could, TWICE!  

Yesterday she was getting serious pressure to induce.  She and I spoke on the phone about the pros and cons.  This is a hard place for a doula, since we can't let our opinions sway the way we talk to our clients about their own agency.  But personally, I didn't see any true need to induce.  However, many couples agree to inductions because they feel that once the provider has mentioned it, that it is something they have to do.  Thankfully, this couple decided to go home and think about it.  And wouldn't you know, she went into labor that night!  

I received a text at 5:40 am, saying that contractions had just gotten intense.  Mom and dad arrive shortly before 6:00, and I got there shortly before 6:30.  I could hear mom vocalizing as I was walking into the maternity center, and I could tell she was about to have a baby within minutes!  

A fast labor is mainly a blessing, but can feel like a curse while you are experiencing it.  There are literally NO breaks.  Moms feel very overwhelmed, and often hyperventilate because it is so hard to find time to breath.  I quickly started helping mom find her focus, and use her breath purposely.  

Before the first official push, mom expressed her fear that the baby was too big.  Hmm... I wonder why she worried that.  Oh wait, it's because her provider planted that seed of fear weeks ago....



But there was nothing to fear, as her son was quickly born after just a few pushes!  
He came out a little blue, and a little lethargic; but had pinked up within a few minutes.  



No Name Baby Boy :)
Born February 5th, 2014
6: 47 am
9 pounds 5 ounces



Dad was able to hold baby while mom recovered.  
I could hear him talking and humming, and it was beyond sweet!  


Congratulations to a wonderful family, who truly had nothing to fear.  :)