A Mother's Day VBAC

Mother's Day began slowly. A nice long sleep followed by lounging and breakfast-making. Just as I was leaving the house to go to my favorite cafe, my phone rang. It was Tom, husband of Shana, my first May client.

Tom called to tell me that Shana's contractions were about 4-6 minutes apart and he was driving her to the hospital. They lived far away and this was their second baby so they didn't want to risk staying at home too long (Tom was not all about the idea of catching his own baby en route to the hospital).

Shana's first birth experience had been traumatic, a c-section that she felt had been completely unnecessary. She felt as though she had no control over the decisions made during the birth of her first baby and was determined to have a different experience this time around. When I met Shana at the hospital an hour later, she was very controlled through her contractions. She was easily talking in between them and could breathe through every one. I was concerned that she was not very far along and that she would be disappointed when the midwife checked her cervix. In her ideal world she wanted to labor at home until late active labor but her husband was too worried that she would deliver the baby in the home if they waited.

When the midwife checked her, she was 1-2cm. Shana immediately got up and said--ok, I'm going home. The midwife suggested that Shana, Tom and I take a walk outside, grab food, and come back mid-afternoon. We thought that was a great plan but things quickly changed. The nurse took Shana's blood pressure and it was way too high. Darn. Back to the bed, no walking around until the BP went way down.

Although Shana changed positions on the bed, she was really much more comfortable when standing. When we were moved to the official L&D room, her BP had gone down enough so that she was allowed to stand and sway during contractions. I applied firm counterpressure during the contractions and her husband helped to keep the baby's heart rate on the monitor (she had continuous EFM because she was a VBAC and had high BP). This went on for a couple of hours until I suggested she get on the birth ball. After settling down on it, she really found relief from the way it was opening her up. Soon it was mid-afternoon and the midwife wanted to check her again. As the midwife checked Shana's cervix she smiled and said: "guess how many centimeters you are, Shana". Shana said 5-6 and to our delight the midwife informed us that she was 7cm, 100% effaced and the baby was nice and low. Phew. The VBAC was well on its way!

Shana went back and forth between the birthing ball and standing and swaying for the next hour or so. Soon the contractions began to intensify and although Shana was still very focused and breathing beautifully, she was definitely getting more uncomfortable. I suggested she get up onto the bed on her knees. We raised the head of the bed and she draped her arms and rested her head on the top of the bed. She was starting to contort her face during contractions and I tried to get her to relax her facial muscles and gently rubbed her head when she scrunched up.

Maybe an hour later she felt "pressure" for the first time. She said to wait to get the midwife, so we continued with our routine for another forty minutes. The midwife came in and re-checked Shana. Fully dilated! A new midwife was on-call and she was wonderful. She gave Shana great hints on how to breathe during pushing and how to rest between pushes. Shana's husband really got into gear at that point and was so sweet and supportive. He looked into her eyes and held her head gently in his hands. Shana pushed on her side for about thirty minutes until the cutest baby girl entered the world. Mom looked at baby and said "Hi beautiful" and the baby looked longingly up at mom. Soon they were beginning to breastfeed and getting to know each other. I felt so happy knowing that Shana had a wonderful, natural, empowering second birthing experience.

Spring is here!

As I biked to work this morning I couldn't help but smile. Spring is truly here and it is wonderful to be outside enjoying it.

With all of the excitement of the new season also comes the excitement of new babies. I have three clients due to deliver in May and each seem to be taking their time. Hopefully they all do not decide to deliver on the same day!

Each of these clients is so different and I am eager to see how their childbirth experiences play out. I know they will each be great moms. Two are first-time moms and one is a second-time mom. My second-time mom is going for a VBAC. She is a very strong lady and I know she can do it as long as she listens to her body. She had a traumatic first birthing experience (she has a heart condition and the Drs panicked and did an emergency c-section even though she was already 8cms and she and baby were doing fine!) I'm hoping I can help her have a much better birthing this time around. If any of you have VBAC tips, please share :)

My two first time moms are also very different. One of them wants to know everything about pregnancy and childbirth and early infant care. She and her husband have read books, articles, pamphlets, and taken the Natural Childbirth Class together. The other mom has more of the "my body will know what to do attitude" and has not opened a book (although she and her partner did take a childbirth class). Both are VERY excited to be mommas.

It should be an exciting month! Maybe this weekend one of the little ones will enter the world...

Another Beautiful Baby

One of my clients delivered her first child this weekend :)

A sweet baby boy was born via c-section after 54 hours of labor. Mom was such a trooper, completely determined throughout the whole process. Although the c/s was unplanned, everything went well and both mom and baby are doing fantastic.

there's really nothing that compares to watching a momma see her baby for the first time. amazing.

I want the epidural...NOW

Gloria called me when she was 37 weeks pregnant. When she called I was hesitant to be her doula because I had a client whose due date was very close to hers and I was afraid they would overlap. Then, I thought, what are the chances they would really deliver on the same day??

I went to Gloria's house a few days after her initial phone call and immediately liked her. She was young and full of energy and a very warm person. She had already been through a lot, having decided to keep the baby despite her boyfriend threatening to break up with her if she did. She decided that she would rather keep her baby and be single than terminate the pregnancy. Luckily she had the strong support of her family and she was at peace with her decision.

When I asked her about the pain relief techniques she wanted to employ during labor she assured me that she had an extremely high pain tolerance and would not need to use any drugs. I said, "great" and we went about discussing natural birthing methods.

Just a few days later, mere hours after my other client delivered her baby(!), Gloria called me. She thought her water had broken and she was definitely noticing mucus. I asked her if the fluid had been clear and she said it was. Although she was not experiencing any contractions, she was feeling anxious and I told her to call the midwives and chat about her options and then call me back. When she called back a couple of hours later, she was headed to the hospital but still not having any regular contractions. I told her to give me a call when she was admitted and let me know how things were progressing. A few hours later I got a call from a very different-sounding Gloria. She told me to come as soon as I could...these contractions were getting tough. Twenty minutes later (at 4:30am) I was at her bedside encouraging her to breathe. She was BEGGING for pain medication. I reminded her of her former desire for natural childbirth...she would have none of it. After much encouraging we tried getting up and walking. Then the shower. Finally the birth ball. Through all of this she was begging for pain medication...and she was only 3cm. Her midwives, her mother and I really tried but ultimately, she knew what she wanted. Because the baby's heart rate was a bit irregular, she was discouraged from using Nubain and instead opted for the epidural.

Gloria was the old Gloria again after the epidural. She was bright, enthusiastic and even cracking jokes. After a bit she fell asleep and I took her mother down to the cafeteria to get some breakfast. Gloria was in and out of sleep for the next three hours... She was a happy lady. When she awoke around 1pm we talked for awhile and she was beginning to feel pressure. When the midwife checked her shortly thereafter she was almost fully dilated. Since she had the epidural we decided to wait a bit before encouraging pushing but Gloria was told not to push the button for more pain medication so that she could regain some feeling before pushing. About an hour later the midwife came in again to survey the scene. It seemed like Gloria was really getting ready to push. Gloria's mother was on her left, I was on her right, the nurse was setting up all of the birthing supplies and the midwife wedged herself right in between all of us. It was a great group of women. We were all speaking a mixture of Spanish and English and generally having a great time. Gloria was a great pusher (and was joking around between pushes) and a half hour later Jack was born. He was ADORABLE. Just a little over 6lbs with a full head of black hair. He even latched on right away. All of us were immediately in love with the little guy...especially his grandma. She was smitten. I think she called fifty people in the next half hour. There was such a wonderful energy in the room and everyone was genuinely thrilled that the birthing had gone so well. The midwife left to take care of another patient and said "hey ladies, thanks for the party" on her way out.

The experience with Gloria taught me to really listen to my clients and realize that even if they didn't want an epidural beforehand, they may and can change their minds. And sometimes it ends up being the best thing for them. Everyone's experience is so different, and you just have to adapt to the changing needs of each person. I was also enamored with the power of an all-woman birthing room. It was really a beautiful group and I felt honored to be a part of it.

Hypnobirthing

So this Saturday evening I had a hypnobirthing session with one of my clients who is due in a couple of weeks. It was pretty darn cool and I'm hoping we can use it for this birthing. If anyone has any hypnobirthing success stories or tips, please share them! I've had one other client who wanted to go the hypnobirthing route but her baby ended up being breech so she couldn't use it.

When I talk to people (non-doulas) about hypnobirthing they are SUPER skeptical. Pain-free birth? It seems inconceivable to some but I hope it works out. People often have the wrong idea when you mention hypnosis. It's not like some weirdo guy waving a clock in front of your eyes and bringing you into a trance, it's more just eliminating fear from the birthing process and going inward...giving into the power of your labor and breathing through it. We shall see. I will be sure to report how it goes.

Hope

A story about Hope:

Hope was referred to me by her midwife at around 32 weeks gestation. I met Hope and her husband Henry at their cute apartment and immediately liked the feel of the place and of the couple. I was relieved because we had an awkward initial phone conversation and I was afraid we wouldn't have good doula-client chemistry but luckily, in person things were different. She was so excited to be pregnant and really glowed like only a pregnant woman can. She definitely spread her wonderful pregnancy energy to me and asked really good questions. Hope reminded me of my vision of a flower child, definitely a free spirit and very artistic. As we sipped herbal tea and talked birthing I took note of how much I love this job.

I met Hope and Henry another time before their birthing and we had a delicious vegetarian soup and some homemade cookies I had brought over. Hope told me that she had gained 5lbs in the past week which surprised her but we agreed it was probably just water weight. Less than a week later we were reunited, this time at the hospital where she was very clearly in active labor. Henry had called me an hour before to say that Hope had actually been in labor all day (and worked a full 8 hours at her job!) but she had been denying it to herself (and others) up to this point. She was quickly admitted to L&D and when the midwife checked her she was already 6cm. As a first time mom we knew that this did not necessarily mean the baby was going to come anytime soon and we set about making Hope as comfortable as possible.

Through her contractions I encouraged her to stay upright to work with gravity and she did a great job of swaying back and forth, back and forth, with the force of each contraction. Things got intense a couple of hours later and she began asking for pain medication. I knew from talking to her prenatally that she was SO psyched about natural childbirth and I hoped that Henry and I could remind her of that. Sure enough I convinced her to get into the shower to use warm water to alleviate some of the pain and that worked pretty well. She stayed in the shower for over an hour and I stood right by her repeatedly saying "you've got this one, Hope, you've got this one" (later she told me how helpful my words had been). After she felt done with the shower she got onto the bed and the midwife checked her--she was fully dilated! Already exhausted, Hope was a trooper trying to push and was even convinced to get up on her hands and knees for two hours to push her little boy out. But her little boy would have NONE of it. Even though his mom was trying SO hard. After 2.5 hours the OB Resident came in and began talking C-section. I cringed. Over 20 hours of Natural laboring and then a c-section...ughhh. But when we watched the monitor and saw the baby's heart rate drop during contractions, we understood it was the right thing to do.

The anesthesiologist came in to give the epidural and Hope was having so much trouble sitting still and resisting the urge to push. Finally she was able to remain still sitting cross-legged and the doctor was very impressed with her flexibility (that's what yoga can do for you!) After that Henry and I sat around and waited for a half hour while she was prepped for surgery. We were both allowed into the operating room and got to witness the birth of James, a 9lb12oz baby boy! Turns out he had been stuck! Because Hope was such a small lady, James just couldn't fit.

Although the recovery was a bit tough (When I went to the hospital to visit the next day, Hope was completely out of it) everything turned out fine and now James is a very healthy little man with two very proud parents. A month later I visited the family at their apartment and we talked about the birth experience and luckily Hope and Henry both had a positive memory of the experience. She HAD done natural childbirth up to the very last minute and that was something to be extremely proud of. And next time, she'll do it the whole time and she's already invited me to come along for birth journey number 2.

Have I mentioned that I love this couple?

New Client!

A couple of weeks ago I met a potential client and her husband at a tea shop in Harvard Square. I really liked her and was hoping that she would pick me to be her doula. I was a little concerned because it took her 2 weeks to contact me and I figured that she had picked someone else but I heard from her today and it looks like I'm going to be her doula! I'm very excited. I think she and I are going to work really well together and her husband seems super nice and laid back so that should be great. I think that my experience with her will be similar to my experience with Hope and her husband (whom I have yet to write about) and that was wonderful so I'm really looking forward to it. More to come :)