natural childbirth

Every Birth is Different

Sarah had her first baby almost 4 years ago at 40 weeks + 2 days, after 68 hours of very slow labor. Yes, active phase of labor was really that long. In fact, she went to the hospital and was check 5 centimeters, went home and came back the next day at about 6 cm! That was her first birth and this is her second:

Friday night, almost midnight on 5-23-14, Sarah’s water broke with no contractions. This time she was a little more then a week early. She decided to take a bath at that time to wait and see how things go. Her baby had already been very low and she had been doing Cross Fit her entire labor. I had told her that it can take a couple hours for contractions to start. By 4:15 am, contractions were 10-15 minutes apart and lasting about 30-45 seconds. Sarah had gotten some rest in-between contractions and was letting her husband rest. She actually felt like being along, which is really normal at this point in labor.

An hour later, I got an update that her contractions were the same, she got another hour of rest and was eating and trying to relax. Sarah did such an amazing job of following her instincts and knowing what her body needed. At this time of night and early morning, it was better to relax incase labor was really long like last. If labor was going to go fast, resting was still a good idea. We texted back and forth about drinking enough water and going to the bathroom.

Within a couple hours Sarah was in a pattern of having some big long contractions with little ones in between. She was having some blood when going to the bathroom and she was going to the bathroom a lot. Labor sounded perfect to me. I was just waiting for her to be ready for some help. I don’t like to suggest I go over too soon, so I leave it up to the mom.

At 9:15, I checked in with Sarah. I wanted to let her know I was going to the store so she knew how far I was from her. She had told me things were still the same and she was sleeping between contractions. Her ability to relax during labor was amazing, I had remembered this from last time. I had mentioned if things did change in an hour or so to try nipple stimulation. I didn’t want her to go to long after her water broke without being in active labor. From text, I couldn’t quite tell where she was in labor.

A little while later, Sarah had a 90 minute contraction. I asked how she was doing and she said “Good”. I was surprised, it seemed like it should be getting intense, but in the back of my mind I was thinking, maybe it would be like last time. She was packing and picking up between contractions. But, she did say they were way stronger this time then with Harper, her first baby. By 11:30, contractions were still consistent and, “Maybe a little more frequent.” But again, she said she was going good and had a snack. I told her I was going to take a nap. I wanted to get some rest in because my guess was I could be joining her any minute and we didn’t know how long this would last. About a ½ hour later, Sarah texted that she had a few 3 minutes or longer contractions that were 1-2 minutes apart. This time, I just said, “Are you ready for me?” To which she replied, “Yes!”

I arrived at 12:30 and just one look at Sarah told me she was in transition! (I couldn’t be 100% sure, but I was as sure as a doula could be.) I told her she looked great. I was so happy to see that. This was a little over 12 hours after her water broke! She had her first contraction with me and I did the hip squeeze. No complaints with that, yep, transition! Then we sat down on an ottoman and I had her hang while Rick squeezed her hips. Sarah’s contractions were long and strong. She couldn’t relax all the way through and broke down a little about how hard it was. I told her and Rick I thought the baby was coming and that we should get to the hospital. As she is having contractions with lots of pressure and mini pushes, I mentioned, maybe I should just took for a head and we should call 911 instead. Nope, she said they would make it to the hospital.

It took us a while to get to the car, she did feel to see if she could feel her baby’s head and it wasn’t there yet, so went to the hospital. I had Sarah sit backwards in the seat so she could be on her hands and knees. When we arrived, Rick said she had only about 2 big contractions. I told him about how many times when you reach 10 cm, there is a little break in the contractions. The next 15 minutes was like a scene from a movie. We got to the hospital just before 1:30 pm, 5-24-14; Rick was running down the hall with Sarah in the wheel chair. I ran on ahead to get the door for him and when we walked into Kaiser L&D, I told the lady at the front, “I have a mom here having a baby, now!” She opened the door to let us in. We went to triage and Angelette walked in. Yay! She is the most amazing nurse, I was with her just too weeks ago. She was so calming and asked me if I thought she was complete, I said, I can’t be sure, but I’m pretty sure she is. She said, “Ok, we are full, but we’ll just deliver this baby right here.” Then another nurse came in and said another room just got cleaned up and the midwife came in ready to check her. As we walked to the room, Ricked signed the papers and I answered the questions I could for her regarding 1
st or 2nd baby, water breaking, etc. I’m not even sure Sarah was that aware of what was going on at the moment. When we got in the room, the midwife checked her and said, “Well, your baby is right here, it’s time to push.”

With that, Sarah was in disbelief! She just kept looking at us, saying, “Really?” “I can push?” “I’m ready?” Yes! You are ready to have this baby! I was so happy for her. This was the best news every. We knew she had been working really hard while not letting herself fully believe this could go faster. By 1:46, Rick and Sarah’s second baby girl was born all natural. 8 lbs, 6 oz. Rick got to announce they had a girl, at first he thought he saw boy, so he had to double announce the sex. He got to do the big reveal twice, with just as much excitement both times. There second little girl latched onto the breast within a half hour of delivery and nursed so well. I am so happy for Rick and Sarah, it was just what they wanted for their birth.

A Beautiful Birth

At the end of Stephanie's pregnancy, she started to get a little nervous about the events leading up to her delivery. Her first birth story leads into her second birth, so I will be sharing a quick version of her first as best I remember from what she told me.

With her first baby Stephanie was induced at 43 weeks. the first time was very difficult as the midwifes and doctors were trying to force an induction on her at 42 weeks simply because she was 42 weeks. They did this by using scare tactics and being down right mean to her and her husband, Bill about their choices. A doctor even called Bill at home to tell him what a horrible husband he was to let his wife put their baby in danger. (Personally, I think he is a wonderful husband to support his wife in what they know is right.)

All the non-stress tests (NST) were perfect, there were no signs the baby was in distress. Stephanie's fluid levels were good also until 43 weeks. Everything looked healthy with mom and baby, so, there was no need to induce because of an estimated due date. She and her husband, Bill, understood the risks involved with an induction before the baby is ready and wanted to wait until her baby was ready to be born. At 43 weeks, she went in for her NST and ultra sound. During the ultra sound the midwife specifically told her she couldn't get a number for one of the pockets of fluid because the cord was in the way, so she added up all the other pockets (I think it came to a 5) and told Stephanie her baby was in danger.

Those were the key words to Stephanie and her husband. If their baby was in danger, they would induce without a second thought. That night, they induced with a foly bulb and pitocin. (She was 0 cm). Her induction went well, other then the fact that the staff was horrible to her and her husband, but the baby did extremely well and Stephanie birthed a healthy, not late baby girl covered in vernix without an epidural. Nobody was going to take that part away from her! She wanted as little interventions as possible and that was one she could control. The midwife and nurses all commented on how her baby was not late, the placenta was very healthy, the baby was covered in vernix and her due date must have been wrong.

Stephanie knew her due date was accurate then and this time around she knew her due date was accurate as well. Stephanie also knew she was likely not going to go into labor by 42 weeks. She was very concerned and there was so much prayer going into this birth by so many people surrounding her. She was very worried about how the hospital staff would treat her. As her due date approached, she noticed her specific midwife doing things to protect them from the awful doctors, like scheduling when she was there and not with doctors. Already it was turning out to be better. After her NST's when Stephanie and Bill decided to go home, they always had to sign against medical advice with the first pregnancy. This time, she didn't have to sign against medical advice until the last ultrasound. Just like the first time, the NST's were perfect. However, it kept getting harder and harder to get the fluid count. There was a lot of cord in the way.

The evening of 42 weeks, plus 2 days, she had the usual NST and ultrasound. The fluid was a 3. This time they didn't say, "Your baby is in danger." They advised induction and gave her the choice to induce and when. She accepted the induction for the second time, but this time decided to go home and sleep in her own bed, then come back in the morning to start the induction. She did have to sign against medical advice, but it was without threats and her midwife was very understanding.

In the morning, they went back to the hospital after a good night sleep, prayer, some time processing everything and a good breakfast. At 11, another midwife, Cheryl, was on. Stephanie was asking questions about monitoring and IV. Cheryl, the midwife suggested starting the induction by breaking her water so she could have the freedom she wanted. Cheryl didn’t have a problem with this method because Stephanie was already 4 cm. Bill called me to get my thoughts on that. We talked about the risks involved, but also that, it was what Stephanie really wanted. She absolutely did not want pitocin again. Bill and Stephanie decided to have Cheryl break her water. I stopped in and checked in on them at noon. They were in a good routine of walking, bathroom, drinking and snacking. There was no IV, not even saline loc and she was on the monitor for 20 minutes, off for 30 on for 1 minute, then off again for 30. I left and told them to call when they were ready for some help.

When I was gone, Cheryl had told them they could walk where ever they wanted around the hospital as long as they came back for the monitor checks. Bill and Stephanie walked all around out side and stopped off at the cafeteria for some food. Contractions were getting painful, but bearable.

At about 5:30 pm, Mother's Day, Stephanie was checked and was 4.5 cm and 90% effaced. That was some progress. I decided to go check in on them again. She was doing really well, breathing and completely relaxing through the contractions. Walking a ton and fast and going to the bathroom often. They had gotten a salad that she was eating from the cafeteria. While I was there, contractions got to 3 minutes apart so I stayed. Stephanie was in a great rhythm and was checked again at midnight. Just before the exam, I could see a shift in her, so I was anxious, thinking it was going to be good news, but not a ton of change. It ended up, she was 5 cm and very soft. Cheryl suggested pitocin and Stephanie asked if she could have a minute to talk about it. Cheryl said that was fine, she would do another exam in an hour and if no change, then she was going to strongly recommend pitocin, she did also mention nipple stimulation. When Cheryl left, Stephanie said no pitocin. I reiterated the nipple stimulation. Either that worked or she was just ready to turn that corner with her labor because it got really intense for her. We also had an amazing nurse come on at midnight. Angelette that told us she would put a bug in Cheryl's ear that Stephanie's labor was progressing and she wouldn't need pitocin.

Amazingly, Stephanie was still so calm and controlled during her contractions. She was breathing and very relaxed. She went on a few more walks and got in the shower a couple of times. All along the baby did wonderfully. After 3 am sometime, Stephanie and Bill were in the shower and I could hear Stephanie saying she couldn't do it anymore. So far, this was the birth she wanted, no medications, no IV. I went in and had a little talk with her. I told her that she could do it and she was doing it. Before her birth, Stephanie had told me absolutely no epidural. She got out of the shower, sat on the ball and hung from the rebozo. Back in her zone, close to 4 am, Stephanie was feeling a lot of pressure. She had felt she needed to go to the bathroom all along so we weren't sure if this was it. Stephanie was afraid to have an exam incase it wasn't good. But with all the signs, I didn't want her to sit there thinking she had hours to go when it was actually time to push. She decided getting checked by the nurse would be ok. At that time, she was 9 cm with a thick anterior u-shaped lip. I suggested hands and knees and the nurses in the room said either that or flat on her back. We did 5 contractions on her back, then hands and knees it was.

It wasn't long after that, that the urge to push was uncontrollable. I called the nurse back in and the lip was still there, but with Stephanie on her hands and knees, Angelette was able to slip the lip easily around the baby's head. Angelette told Stephanie to stay how she was, she could birth her baby like that. Stephanie gave her first push at 4:26 and Cheryl came in. Immediately, Cheryl told Bill, "Dad, come down here, your job is more important over here." Then she had Bill put his hand under the baby's head to catch the baby. Cheryl guided Stephanie on pushing perfectly; when she need to push hard, stop pushing or just a slow push. This gentle guidance helped Stephanie to have just the tinniest 1st degree tear. Bill got to guide his baby out, announce they had a girl and hand their child to his wife at 4:37 am on 5-12-14, just 11 minutes after that first push.

For the second time, Stephanie delivered a beautiful, healthy baby girl that was not a late baby. Healthy placenta, healthy baby covered in vernix. Their little girl, Olive Ann was 9 lbs, 9 oz, yes, in 11 minutes with a first degree tear.

After Stephanie had her baby in her hands, turned around and got comfortable the cord stopped pulsing. Cheryl had Bill cut the cord and waited till the placenta was ready to come out. There was no pulling or tugging. There was no pitocin after birth. It was the most natural, gentle, and hands free birth I have seen and it was in a hospital of all places! It was absolutely beautiful. This shows me that there really is so much hope for hospitals getting it right.

A Restorative Birth

A mom who wants a VBAC (Vaginal Birth After Cesarean) usually has a different perspective. She usually feels either the first time was unnecessary, or she wants to try to have a safer healthier birth with more control the second time (even if it was due to circumstances beyond her control). Even if the first time c-section was the first option for the baby, it doesn’t have to be with the second. The VBAC moms I have worked with have done a lot of their own research and have concluded they want a natural birth. The reasons for the natural birth are many, but mostly I have heard, they know a natural birth is their best option at a VBAC, they want to feel more in control of their body, they want to feel everything and be a part of their baby’s birth. This is exactly how Jane felt when deciding to have a VBAC. She created everything around her to have the best opportunity possible for a VBAC.

Setting everything up to give you the best possibility for a VBAC doesn’t mean you will have one and it doesn’t mean that things will go your way. Jane had to accept this when she was a week past due, was having mild contractions every night, but not full labor. She was due, Sunday, September 30
th and had a doctor appointment on October 7th where she had to schedule a c-section for October 11th, almost 2 weeks post due. She knew that in the end she would still have her healthy baby and she would accept it, but she really wanted to go into labor.

Sunday, a week post due, Jane and Kevin decided to take their little boy to Disneyland to walk all day. I had mentioned to them, if you have a baby at Disneyland, they will have a lifetime pass for free. That wasn’t the goal, but they had free passes and thought the day might help get labor going. They had a fun, tiring day. Early Monday morning, October 8
th, their little boy threw up, so Jane had to wake up She felt the usual rushes and thought it was the normal night time contractions. After taking care of her little one, she went back to bed. Around 6 am, she woke her husband up telling him she couldn’t get out of bed. He just thought he could get her out of bed, but she was having pretty strong contractions at this point. She went to sit on the toilet and hung onto the shower door while Kevin called me. I told her to take a bath because the contractions were pretty intense and about 5 minutes apart.

I arrived at their house at 6:30 and she was in the bath with the water running past the overflow spout. I sat with Jane so Kevin could eat some breakfast. During a contraction, I would turn the water off for her and turn it back on to get the level high enough. During this time, Jane still felt pretty comfortable and wanted to stay home. I think it had been about a half hour and Jane wanted to try to go to the bathroom so she labored on the toilet for another ½ hour. By this time, their little boy woke up so Kevin got him settled with grandma so she could take him to her house. As soon as Jane got off the toilet, she started to have the urge to push. I got her on her hands and it helped somewhat, but didn’t take the urge away. She had some signs of transition, but just some. So, I was thinking, “We need to get this baby turned.” I was afraid he was face up. At this point, Jane decided to go to the hospital, it was somewhere between 7 and 8am. Her contractions were coming strong and fast.

In the car, she had the urge to push through all of her contractions; we hit traffic, so Kevin took side streets to UCI. We got there a little after 8:30 am. They had someone pick up Jane in a wheelchair. Kevin wanted me to go with her while he parked the car. The wheelchair guy, (I don’t know what they call them) wanted to take her to admitting first. I told him, “We don’t have time for that, she wants to push.” But, he insisted, they have to go there first to fill out paper work. I told Jane not to worry we would get her up there soon. So, we arrived at the desk for the paperwork and the girl sitting there stapled a bunch of stuff together and starts to tell her about it and I just blurted out, “She’s pushing!” That worked! The girl says, “Oh! Go on, take her upstairs.”

As we are walking through the halls, I’m trying to coach Jane how to breathe through the pushes but the halls were so narrow, I would walk next to her for a second, then stop while we passed something, then run to catch up beside her then stop again. Finally we got to triage and they wanted her to pee in a cup. Kevin was still parking the car so I took her to the bathroom. As soon as she got in, I hear, “Kristen!” So, I put out my arms and she just fell into them. While I’m standing in a squatting position holding up another adult, I’m thinking, “Only a minute, I can do this, it’s only a minute.” It was perfect though. Jane had this amazing ability to let everything go limp while she was having a contraction. She would let her body relax while her uterus did all the work. Jane said, any time she felt pain; it was a good feeling because it was what was bringing her closer to her baby. See, that’s VBAC perspective. As the rushes intensified, the better she felt.

I kept asking someone to check Jane because she wanted to push so bad and couldn’t control the urge, so finally the 1
st year resident came in a checked her. She was about 3 months into her residency. She said, “Well, I think she is about 7 cm, but she could possibly be complete, but probably 7. Does someone want to follow this exam?” to the other nurses in the room. I don’t know if this doctor has kids or not, but 7 and 10 are a big difference! Finally they take us to a regular room and this resident is trying to do an ultra sound to make sure the baby is head down, but she can’t find the baby. So, she brings another doctor in the room to do it. Baby was fine and was head down. At this point, we are still waiting for Kevin to get back and I am trying to create as much of a bubble as I can around Jane. There were so many people coming in and out of the room and the nurse said Kevin couldn’t come back until the IV was done. Jane didn’t want me to leave to switch though.

With the lights finally out and whispers to Jane we worked on concentrating with each rush. The goal was to not push. Kevin finally was allowed in before the IV. Jane was doing wonderful, she managed tiny pushes while one of us held one leg up and put pressure on it, while the other talked her through the contractions and breathed with her. We worked like this for some time and by 9:15 she was 9 cm. Once the room was empty and dark Jane sat on her ball. She hung on the rebozo while Kevin squeezed her hips. Concentrating and breathing with each rush (Well, once she threw Kevin’s red hat aside) Those pushes came stronger and stronger.
Jane wanted to push so bad, she started to get disappointed in herself that she couldn’t control the urge and then the resident came in again to check her. Jane was 9 cm but thick and swollen. The chief resident didn’t think she could reduce it and they along with a nurse that was not who Jane’s started talking her into an epidural. Jane responded with, “Well, yeah, I guess so.” Kevin just looked at her and said, “But Honey, you didn’t want one.” So, I asked for some time alone for them. Everybody cleared the room immediately. I suggested that Jane get on her hands and knees with her head down and if that works, no need for an epidural. If it didn’t work, then we would know for sure that she needed one. Jane agreed and with her head down, the room dark again and her face buried in the pillow, she was able to concentrate. Rush after rush, she fought the urge to push. It helped, some of that pressure was gone and she could breathe better; but she still wanted to push so bad.

With her first baby, it was a very long induction a few weeks early because her water had broken after an exam. She always thought the water broke because of that exam and her baby wasn’t quite ready. After 36 hours of labor, they had her pushing at 9 cm and her cervix swelled so they took her to a c-section. With a VBAC, the hardest part is getting past that point the mom got to before. So, during this time it required a lot of concentration for Jane to relax, let go and do what her body needed her to do to get some pressure off her cervix.

By 11:15 the attendee doctor, Dr. V came to check on Jane. We asked him to check to see if the swelling had gone down and if she could push past it. Dr. V was so positive along with Jane’s regular nurse. There were some dips in the baby’s heart rate and the nurse explained to her that it was good that the baby was responding to the contractions. When Dr. V checked Jane, right away, he said, “Oh good! This is good.” He said there was a bit of swelling, but not much. Yay! I was so happy the swelling went down; I asked if he could reduce it and she could push past it. He said, “Oh yeah, I think so. Let’s try.” He got in position and had Jane push with the next rush. She did and it worked the first time! She was so happy and the nurse was so happy for her, we all were. She could finally push. She passed that point!

After about an hour of pushing a very determined Jane birthed her healthy baby boy face up! He was a tired little boy and was so happy to rest right there on his mommy’s skin and sleep. He stayed there for over an hour while his mommy cried with joy. Jane and Kevin got to touch and hold him as long as they wanted this time. Jane was so happy she did it this way and her words; she didn’t even have to have an epidural. I am so happy we tried something other then the epidural. Kevin and I knew she did not want it and I knew she could do without it. This was one strong and determined momma.

The best thing I heard from her was, this birth made up for everything that happened before, she felt like she did what her body was meant to do. The experience for a mom to get past those obsticlas is so powerful and healing. I am so blessed to be a part of it and experience a little bit of it. The joy in Jane's face and her words are something I will never forget.

Endurance

Some births are short and intense and others are long and slow. Some people have great endurace and others are sprinters. God will only give us what we can handle. This is a story of a mom who had incredible endurance and an amazing ability to relax through her contractions.

I met Tiffany and David a couple months before the birth. When I first talked with her, she told me how her sister had a natural birth with a doula and loved it, after hearing that, she also wanted to have a good positive experience for her birth. Tiffany was very cautious with all her decisions from the beginning. But, over all, she seemed very relaxed and comfortable with the upcoming birth of their child. David was just completely on board with what ever Tiffany wanted. Going into it, I had a feeling it was going to be a pretty good birth. They supported each other and had a lot of family support as well.

Tiffany went in for an appointment Tuesday morning, the day before her due date. Her doctor did a rather rough exam to feel around the baby’s head. After the exam, she noticed some leaking. The exam showed she was 2 cm and 80%, but that her water bulging below the baby’s head. Tiffany wasn’t sure if her water broke, but she called me around 1 pm Tuesday with some consistent cramping. I had told her that it is normal after an exam to have the cramping, especially an exam like that. If it just continues to progress it is probably the start of labor, if it stops, it is not labor. Throughout the day, the cramping kept up and turned more into tightness then just cramping. She asked if I could come over and see what was going on around 5, I arrived just before 5:30.

At home, Tiffany was pretty comfortable. It seemed pretty early in labor, but I thought we would take a walk to see what would happen with it. Her surges were much more frequent with the walking, but she was able to walk right through them. After our walk, we ate some dinner and rested for a bit where the surges started to get stronger. She would start to fight them, so I tried to keep her focused and not fighting the contractions. At first I thought I might go home and come back, but things started picking up. We ended up taking about 3 walks, Tiffany’s surges got more intense, so Tiffany and David had a shower. I was thinking after the shower that she labor would have been further along, but she got out all refreshed and said the shower felt great. At this point I was back to thinking I might be going home. But, Tiffany got down stairs, rested and it got much more intense again. Now, I am definitely not going home. Yay! It’s baby time.

About 11 pm, Tiffany starts to throw up. David and Tiffany decide it is time to go to the hospital so we left and arrived at 11:30. About midnight, the wonderful nurse, Lisa checks Tiffany and she is 3-4 cm, +2 station. I was so bummed for her, she had been working so hard and it is so difficult for a mom to bring her mind to where her cervix is, if she thought she was further along. But, Tiffany didn’t seem to mind at all. She was so patient and calm. She just went with it and started walking after the monitor. Through the night we walked, her and David showered and Tiffany was monitored. Lisa was very relaxed with the monitoring; Tiffany was put on maybe every hour, not even 40 minutes. Lisa also never gave Tiffany a saline loc. It was wonderful to have such a supportive nurse who was respectful of Tiffany and David’s wishes. Through the night the surges ranged from 2 minutes to 6 minutes apart.

Early on, Tiffany was fighting the surges, she would try to wiggle through them, finally in the night she settled into her groove and relaxed through them. Once she did that, she had an amazing ability to relax through them and in-between. When Tiffany did get on the monitor, her contractions would slow to about 6 minutes and we tried to let her just sleep as much as she could. All night and into the next morning, it just seemed like labor wasn’t progressing. Her hormonal symptoms were there with the throwing up every hour, but there was no bleeding to indicate dilation, there was no shaking, not change in demeanor, the back labor wasn’t moving down her back. We tried all the positions to get baby to turn and move down, but still not dilation, so it seemed.

The daytime nurse was just as great about respecting Tiffany and David’s wishes for a natural birth with no interventions. After all this time, it had been all night now, the nurse, Michelle wanted to check to see how things were going. She had talked to me first about it and we both agreed that it just didn’t seem like much dilation was happening. Just before noon she was checked and found to be 4 cm. Still, Tiffany didn’t seem to get discouraged. She just kept on going and doing what we said to do. The nurse mentioned to her about breaking her water. Tiffany, David and I discussed it, what it could possibly do for her (there are no guarantees) and what the down side was. They made the decision to go for it.

At 12:10, Dr. Gray broke her water and instead of it being an uncomfortable procedure, it was such a relief to Tiffany. She had so much water, no wonder the baby’s head wasn’t near the cervix. So, we went back to walking, shower and monitor. This time I only let her back in the bed once for the monitor, the other times she had to stand. It finally seemed like the cervix was changing.

I stepped out for the restroom and on my way back, Michelle stopped me in the hall. She wanted to see if there was any progress now that her water broke. I was curious and knew that we did need to know if this was working, because if not we had to figure out a new plan. So, she asked if we can approach Tiffany about this.

At 2:45, just 2 hours and 45 minutes later, Michelle checked Tiffany. She was very slow about her check, didn’t say anything till she was all done. Then Michelle put her hands together and with a slow sigh and a sad look on her face says, “Well… I have some good news for you.” Oh my goodness! I about jumped out of my skin and yelled something like, “What is it?!” or “Tell us!” Michelle says, you are 8 cm. Praise God!!! I had to keep from crying, I was so happy for her. After laboring for 19 hours and dilating 1 cm, she dilated 4 cm in 2 hrs and 45 minutes.

So we went back to our routine, walking around the room and the shower. Tiffany’s throwing up had subsided; she had some coconut water and naked juice. The coconut water really helped her feel more energy. During contractions, David would hold her up while I would do back pressure and have her just hang on him. David would remind her to breath deep almost every time. He really just stepped up and helped her so naturally. They were a perfect pair. Tiffany was amazing, her coping didn’t change at all, she just kept right on dealing with the contractions how she was all night. Every once and a while, she would fight it, but as soon as I reminded her not to and David told her to breath, she would sink down on him and relax.

At 6:28, just under 6 ½ hrs after her water broke, Dexton Johnathan was born. He was 7 lbs, 13 ozs. (Maybe) There was a little problem with weighting him. The doctor said something about the baby being a boy, so I said, “We didn’t see yet, David, can you check for us?” So, David got to tell Tiffany that they had a little boy. A cute one too.

The Unexpected

Audrey was having her fourth baby and did not have great experiences with her other labors, so she wanted the help of a doula to help this time go a little better. When I first met Audrey, we talked about her past 3 births. All 3 children were 2 weeks early, very long labors and jaundice. Her first was breach and she started contractions about 2 weeks early so they took her right to a cesarean. The other 2 labors were long and bad experiences with the epidural. So, we had a plan that we would try to have a natural as possible birth without pitocin and epidural not at all or very late in labor.
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Audrey followed suit and started contracting very early on. 35 weeks was the first bought of contractions. They stayed at about 3 minutes apart for a couple hours so we even went to the hospital, but they would not show up on the monitor and she had no change in dilation. It seemed about every 2 days she would have hours of contractions starting in the early evening, lasting part way through the night. By 39 weeks Audrey was completely tired and frustrated with what was going on. So, after taking everything into consideration, her due date, risks, benefits and connivence, Audrey and her husband, Devin choose to have her water broken, Thursday, Jan 12th at 1 pm. Audrey and Devin did not take this decision lightly and came to the conclusion that it was the best decision. I was very happy that she made it to 2 days before her due date because her other babies were jaundice.

We arrived at the hospital at 12 pm, Thursday. Everybody's spirits were good, Audrey had started cramping from the inside about every 10 minutes that morning. These were different then the previous contractions. The doctor came early, about 12:30 and broke her water. He was so laid back and at ease with everything. Contractions still were not reading on the monitor, but Audrey described what she was feeling as different, kind of uncomfortable and weird. Her doctor made sure with the nurse that Audurey was to be up and moving as much as possible. He also told Audrey how great it was that when he tickled the baby's head, her heart rate would go up. He left the room with us all feeling very comfortable.

As soon as monitoring was done, we went walking. We walked for almost 40 minutes. During this time she only had to stop 2 times for a contraction. We also talked about if she asks for an epidural and decided on if so, we will have her checked before making that decision.

Audrey gets back on the monitor (this is the second time on it) and she is starting to be very uncomfortable with the contractions she is feeling. Contractions that are still not picking up on the monitor, so I have her sit on the ball while she finishes the 20 minutes she is supposed to be on the monitor. That is more comfortable, but I can tell that things are changing a bit. Even though, the monitor is not picking up contractions, every time Audrey's breathing changes, the baby's heart rate also goes up a bit. I could tell, her little girl was feeling them too.

Once we get off the monitor, Audrey goes to the bathroom and we try to go for a walk, but it took about a half hour for her to get to the bathroom, out, in again, on the couch and back to the ball. She wasn't sure if she wanted to push or had to go to the bathroom. Her contractions were definitely long and strong, we just couldn't feel them externally. It was very interesting. The nurse comes in to try to get her back on the monitor and she couldn't because the contractions just weren't stopping. She leaves again and Audrey is in the bed tearing up and tells Devin she is going to need the epidural. I told her we will have the nurse give her another check first. Audrey is saying she wants to push. So, I call her in again and look at her bum to see if there is a purple line in her crack, which is an indicator of how dilated she is. As the nurse walks in, I see the line and I'm so excited and tell the nurse, "She's almost there! I see the purple line!" The nurse just kind of looks at me and checks her, then tells her ok, don't push yet, you are almost there. She calls the doctor and tries to get Audrey on her back. Audrey goes to her back and rolls right over to her other side. She is involuntarily pushing and the nurse checks her again. She is now complete at 3:22! Yep, just under 3 hours after her water is broken. I was so happy for her. No more long labor, no more horrible epidural. (She had leaking spinal fluid with the last one.)
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Audrey pushed holding onto her husband's hand for 20 minutes. Their 8 lb 15 oz baby girl was born at 3:42, after a 3 hour and 10 minute labor.

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This birth was so unexpected because Audrey's labors were all early, long (over 24 hours), needing augmentation and an epidural. The past epidurals were aweful. One didn't take and the other caused a spinal headache. This labor was so incredibly different. It was short, relatively easy, she didn't need the epidural, she won't have any side effects from it, her recovery will be so easy with just a tiny tear that needed only one stitch and her baby so far has not had any jaundice. It is so wonderful that she got what she wanted. I am so very happy for them.
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Selfless Birth / Beautifully Traumatic

When I first met Alicia, I knew I wanted to be at her birth. She is such a selfless person and she loves birth and pregnancy. She was determined to have a natural birth, one of the reasons is because she herself wants to be a doula. I thought that was awesome. I was also very excited because she was a surrogate. I think that being a surrogate is such an amazing selfless gift you can give someone.
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Alicia first started contracting at 36 weeks. She had pretty strong contractions about 5 minutes apart, but they were not a whole minute. But it looked like it might be the start of labor. So, Alicia called me. I had another post due already, so I called her and told her that I might be going to another birth that night. Turns out when I hung up the phone, that client's water broke. Since, that birth was happening, I went to that hoping that Alicia would hold off a while longer. We also wanted her to hold off because it was still very early. She was very worried about the baby's lungs. I think she felt a huge sense of responsibility to the intended parents and that little baby boy.

Luckily her labor slowed in the early morning hours, but pretty much from then on she had contractions all the time every day. More so when she would rest. It was very strange, walking and activity would weaken them and resting and bath would strengthen them. We had another tease November 18th. Contractions were 5 minutes apart that evening at 7 pm. She tried the bath and a walk and they stayed the same, walking actually didn't take them away this time. I decided to head over to her house around 10 pm. By about 1:30 she was having contractions 3 minutes apart, but they were only 45 seconds. Then it seemed like the contractions were weakening at about 2 pm, so I sent her and her husband on a walk at 2:30. I already knew this was going to stop, but I thought I'd try a few things. After the walk I told her to try to sleep in-between because they really seemed to be going away. She was able to sleep in-between and I could hear her breathing change when she would have another. At this point they were back to 10 minutes and I decided to go home.

At this point, Alicia is 4 cm and about 60% effaced. Her body is SO ready to go into labor. But, it just wouldn't keep up. We were thinking it was a position problem, so she tried the inversion, standing in a deep lung with one leg up, and side lying. She would feel that little guy move but about 10 minutes later the little stinker would move right back. At Alicia's 40 week appointment, her doctor told her if that labor starts up again, just to go into the hospital and get her water broken. But, on her next appointment 5 days later, they would schedule an induction. So, that's what she did after taking castor oil Saturday night. Contractions started up again in the early morning of Sunday, Dec. 4th. At 3 pm she went into the hospital after things started slowing down.

Alicia really didn't want pitocin, but not much was happening and the nurse wouldn't break her water since the baby still was too high, it could cause a cord prolapse. So, she got a low dose of pitocin Saturday night at about 7, it gave her some contractions, but not a great pattern still. At 9 pm the intended mom shows up in the hospital room. She was very excited, but Alicia is still in active labor where anything atmosphere change can affect her labor. The intended mom also told Alicia that there won't be a need for her to pump breast milk for her baby anymore. Alicia's contractions completely stopped and then at about 9:30 pm the doctor ordered the nurse to turn the pitocin off. This particular doctor is the only one that will deliver his patients. There is no on call doctor for him, he's it. So, basically in a round about way the nurse told us the doctor didn't want to deliver in the middle of the night.

Between the intended mom coming in, the news about not pumping and the doctor wanting to slow things down it was all very overwhelming. So, I got everybody out of the room to give her husband and her time to process everything. Later we decided the intended mom needed to wait till pushing to come back, I went to the waiting room and told her it would be a while and it would be best if they got a hotel for the night. She agreed with that suggestion, so she left. Contractions started again an hour later and Alicia was happy with pit being off. She didn't want it anyway. We figured around 11 pm, things might start up again. It did a little and she was 6 cm by midnight. That's 2 cm progress after 9 hrs. Alicia had a friend that was a photographer there to take pictures, (aren't they beautiful?!) her and I decided to take a break for some sleep at almost 1 am.
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At 4:45 I got a text from Jason, her husband, "She's 7 cm and throwing in the towel, she wants an epidural" Finally! Some really good labor going on. I rushed out the door to make it back to the hospital in time. An hour after I got there I realized I left so fast in the dark that my shirt was backwards.

Transition can go very fast and it is the hardest part. Up until this point, Alicia was handling contractions beautifully. She didn't need any help coping with them. It was almost as if they didn't bother her at all. But, when I got back to the hospital, I could see a complete shift. I knew this was finally it! I was very excited for her.
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It came to a point that Alicia was having trouble coping. She just looked to her husband, he held her close encouraging her as she wanted it all to end. He was so supportive of her and never left her side. He new this was something she wanted to do and needed to do. Jason did everything he could to help her do what she wanted so badly to do.
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I suggested the bath and she didn't want the nurse to get mad at her for getting off the monitors. So, I explained that she is allowed to go to the bathroom, basically when the nurse sees on the monitor that she has been "on the toilet" for too long she will come in and find out that she is actually using the bath. Sure enough, within 10 minutes the nurse came right in and would not let her off the monitor. About 6:45 am she stopped coping well again. There was no talk from her of pressure, so I suggested to call the nurse, I said, "Tell her you are going in the bath and if the baby needs to be monitored then bring the Doppler along." This entire time, the baby's heart rate was beautiful, he was handling everything perfectly, the only reason they wanted her on the monitor was because she was 7 cm. The nurse came in and decided to check, Alicia was complete! The nurse said, "Oh! He's right here, don't push." Side note, we were told earlier that nurses try not to deliver because if they deliver too many, they will loose their job. But, I know how impossible it is to hold that baby back without an epidural. (We called the mom and had her come back to the room.) As the nurse is telling Alicia to take short breaths and not push, I whisper to her that she can just go with her body. Try to blow out, but if you have to let your body do what it wants to. "Push if you want to." She nodded slightly and she pushed.
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This whole time I could hear the mom crying in the back ground. The nurse actually tried to push her knees together! I don't really think they understand labor without an epidural. I kept telling Alicia to go with her body and the baby boy was born at 7 am, 8 lbs, 9 oz, the doctor didn't make it. The baby was pink and healthy, tears were just streaming down his mom's face. It was so amazing. I told her to go and follow the baby, touch him, be with him. She walks over and in broken words says, "Oh, look! He has my chin." It was so beautiful.

The doctor shows up and then things take a turn. The doctor is ready to deliver the placenta, he actually tugs a bit, the placenta isn't coming out. He tugs some more and it's not coming out. I can actually see the placenta right there. Alicia is saying that it hurts, the doctor says, "Oh, it shouldn't hurt to deliver a placenta." Then he mumbles almost to himself, "Boy, this placenta is harder to deliver then the baby." I said, "Not quite!" The doctor is pulling and telling her to push. She yells, "It hurts!" I'm concerned about all this pulling so, I ask, "Is it detached yet?" The doctor sticks his fingers in and says, "I think I got it." He's tugging, telling Alicia to push. She tries to push and says it hurts again. He lets her wait for a contraction, then pulls and tells her to push, she literally screams, "It hurts on the inside" That right there is key, something is wrong. ALWAYS listen to a mom without an epidural. You will know if something is wrong, usually it is a relief to deliver the placenta. I am watching, not knowing how I can stop this and seeing what looks like a HUGE placenta come out then the doctor goes, while looking at it fascinatingly, "Oh... Well... That's something you don't see." He mumbles a few other things and tells us she pushed her uterus out. I also hear him say something along the lines of "What are we going to do about this?" My insides just dropped as Alicia is panicking. She's asking what can she do while the doc is looking at her uterus, trying to detach the placenta. Yes, the placenta is still completely attached. I'm just telling her to try to relax everything in her body, "Don't do anything, the doctor is taking care of it." While I say that, inside I am thinking, panicked thoughts knowing how serious this situation can be.

** Side note: I have a problem writing negative things surrounding birth because I don't like to scare moms. I fully believe that birth is a natural non medical process. Yes, sometimes things can go wrong, but it is a rarity if things are done with little to no intervention and if things are done properly. However, I feel that it is also important for everybody's story to be shared. On top of that, this particular story was a beautiful birth where this complication could have been avoided. The doctor rushed and pulled something that should NEVER be done. This is not something that a mom should ever just be scared of, if she is, talk to your doctor before hand and ask how much time they give the placenta to come out.

** Back to the story... The doctor finally detaches the placenta Alicia is in pain and I am asking the nurses and doctor to give her something. I asked about 3 times and her nurse says she is. Then Alicia asks what is that, the nurse says saline. We were thinking a med after the saline that would take the pain away, but she only gave her pitocin. Then, the doctor shoves it back in with his arm up in her to his elbow. Still no meds. He stitched her up with extremely shaky hands. He even missed a part, I asked him to add another stitch and he did. Then he left so quick, he didn't even sign the cord blood paperwork. The placenta was sent to the lab and Alicia is left worried about "what now." I called the next day and nobody has come to talk to her about what happened, to explain it or to talk to her about possible future risks and recovery. The staff all knows what happened, but it is such a rarity that nobody has come to talk to her about it. I am angry over this and what happened. The doctor hasn't even been back to see her. Before the delivering the placenta, she had a beautiful birth almost completely in her control.

In the end, there was a good and a bad to this story. But, by telling it I want it just to teach people about what can happen. Not at all could this mom have changed anything. It was the doctor that choose to do what he did. But we can learn from what happened to her and just have more questions to ask other care providers. Educate yourself, choose a caregiver that you trust and be firm with what you want. Of course, understand if there is an unforeseen circumstance out of anyone's control were we do need to make changes and have interventions. Thankfully, Alicia didn't end up in the OR and thankfully she is ok now. No signs of hemorrhage or retained placenta. No shock when it happened. Go back to that picture in the beginning, that was after everything. Alicia is ok and recovering wonderfully with a smile on her face.

Hands Off Birth

Alan and Amanda wanted a natural birth, but were a bit worried it might be too hard. Amanda had a previous back surgery with fused bones as a result, so an epidural was not exactly an option. It might have been possible, but it was a huge fear. Aside from that Amanda went in with some fears about labor and concerns about a narcotic. Needless to say our goal was to help her to have a natural birth. We had talked a lot about how we were going to achieve that and all kinds of different comfort measures. We had lots of preparation of what to expect as well.

Amanda's due date was October 27, however from our very 1st conversation, we both were thinking her pregnancy was going to go into November. At her prenatal appointment at 38 weeks, Amanda had her doctor, Dr. Gonzales strip her membranes. Being that the baby just wasn't ready to be born, it did nothing. So her due date rolls around and then Halloween arrives and she tells me, "It's official, I'm going to be pregnant forever!"

The evening of November 2nd, Amanda decides to take a castor oil mixed with some pineapple juice and coconut milk. At 10:15 she went to the bathroom and felt her water break. I got a call at 10:31 telling me that her water broke. I asked the normal questions, "Is it clear? Is there an odor? Is she experiencing any contractions?" I also told her to lay on her side for 20 minutes and let me know when contractions start and how it is going, I wanted to get a little rest before I needed to go over to their house. I also told Alan to try to get some rest if he can since Amanda wasn't having contractions yet.

11:06, Amanda had her first contraction. They started at about 4 minutes apart and quickly went to 3-2 minutes apart. I got another call at 11:45 asking me to come over. I arrived at 12:01 and Alan was loading the car for the hospital while Amanda was on her bed in her relaxation position timing contractions. She wasn't fully relaxing with them, so I got her to breath and relax right when the contraction started. They were coming 3-2 minutes apart. I had her drink and go to the bathroom. It was at this time that I found out about the castor oil. After that, Amanda felt that she really wanted to know where she was at in labor and we should go to the hospital. So we left for the hospital at 12:49, just 48 minutes after I got there. The hospital was a bit of a drive and we arrived at 1:30, the nurse checked her at 2:00 very quickly between contractions and she was at 6 cm. Perfect! That's right when we like to get to the hospital. The hospital was pretty busy, so we were not assigned a nurse yet and we had the charge nurse trying to get all Amanda's info in between contractions while another nurse was trying to get the hep-loc in place. They managed all that in about another 45 minutes and Amanda's contractions were getting really intense. Amanda had started asking for something to take the edge off and Alan and I reminded her that we were going to try to get through 3 contractions. She kept telling us no and was by this time screaming with contractions.

We don't know whether it was the screaming or not, but the baby's heart rate would drop dramatically with the contractions. When she first got hooked up to the monitors, his heart rate was dropping a little, but nothing of too much concern. But because the dips were in the 80 bpm range, Amanda was not able to have a narcotic. It just wouldn't be safe for the baby. We told her that and actively worked very hard to keep her focused and breathing through contractions. It was at 2:45 when the nurse checked Amanda again and she was at 7 cm, just 45 minutes later. After that she left the room. At this time, I had an Alan hold a hot pack on Amanda's back while I had her looking at me for the contractions and breathing. I was able to get her to breath for the first breath of the contraction, then she would have about 4 long loud screams, then I could get her to breath again by having her looking in my eyes and telling her how her little boy was doing. Here contractions were not completely going away and she didn't want Alan's hands anywhere on her until he made his way to her feet. It was perfect, he so calmly tried different things until he found something that worked. So he got some lotion and rubbed her feet the rest of the time.

At one point, Alan points out to me that she is having a lot of bleeding, I looked and it was definitely enough to know she was either complete or almost. I had him get the nurse and Amanda wasn't involuntarily pushing so she left again. Then, Amanda yells, "My vagina is burning!" So I told Alan once again to get the nurse. Remember I said it was 2:45 when she checked her at 7 cm? Well, it was just after 3 am at this point. So the nurse comes in and she can see the baby's head. She has another nurse call the doctor and asks Alan to clean a little of their stuff to make more room in there and the baby's head starts to crown. About a minute later, I tell Alan, he better get over here and see this. He does, snaps one picture with my phone because we all forgot our cameras, his was in the car and mine at home. Next contraction, the nurse puts her hands there and gently guides the baby out. Carter was born! It is now 3:20 am. Yep, just 35 minutes after she was 7 cm. Crazy. No doctor.

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When Carter was born, Amanda asks if they are going to clamp the cord, the nurse says, "No, you didn't want us too." They move Carter to Amanda's tummy and tell her not to pull to hard because he was still attached. Amanda held her baby till the doctor arrived, and started her stitches. At that point she passed him onto Alan who talked to Carter for the next 40 minutes until Amanda was ready to hold him again.

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Carter's temp was a little low, so the nurse said to uses skin to skin on mommy now. Amanda got him on her breast immediately and Carter pooped twice on her while nursing. We cleaned up the poop most of the way, he switched sides and pee'd on her while nursing some more.

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About 2 hours later, I left and nobody had held that little baby except for his parents. The nurse barley touched him except for guiding him out at birth. It was the most hands off birth I have ever seen. I don't know what time the nurse finally did come in to weight him. I'm still waiting on that information from Amanda, but I was so impressed with that staff and how they completely saw the importance of initial bonding. I'm guessing he was in the 7 lb range.

After the shock of how fast everything went, Amanda was so happy she didn't have any pain meds. Carter was born so alert and content. It was amazing, he let out a little sound and then the rest of the time just looked around. He never really cried.

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Just got an update as I was going to save this, Carter was 7 lbs, 5 oz and 20.5 inches long.

Completely Natural Hospital Birth

As Doulas, we never want to miss a birth of a client that we have spent time getting to know. The doula-client relationship goes both ways, in the interview the parents are deciding if they connect with the doula and the doula must feel the same. So, for us to miss a birth it can be very dissapointing. With that being said, I got to be at a birth where I was a back up for a very wonderful couple.

Holly and Wes planned to have a natural birth at Hoag Hospital with Dr. Diaz. I talked to their doula Melissa over the phone and told her I've been to Hoag and I have actually worked with Dr. Diaz. Also, in talking it became clear that we were both Christians and that the couple would love to have a will be very happy to have their back up be Christian as well. Anyway, Melissa's whole family was getting sick with the flu, she was so dissapointed to be missing the birth of Holly and Wes. They actually first met when Holly was just 7 weeks along. On my end, I was very exciting to go to a birth after taking the summer off for vacations and birthdays.

I woke early Thursday, September 22 to a text from Melissa telling me that I am needed. This was at 6:33 am. Holly woke up at 4:30 with contractions at 5 minutes apart. I called Holly to introduce myself and get a feel for what was going on. I needed to take a shower and she sounded like she might be getting close to going to the hospital and talked a bit about the pain, so I suggested the bath for pain and to hold her off a bit. I needed a shower and breakfast before I left.

I arrived at Holly's about 8 am to her and Wes outside working through contractions. Wes had just packed their car for the hospital because their doctor told them they should come in. I suggested wait till I get there. We went in their home to work on a few contractions to see how Holly was doing. I told them that she definately wasn't in transition and it would be a good idea to stay home a little longer. So, we stayed till Holly was ready to go. Her contractions were 3 minutes apart, she labored with the rebozo inbetween and on the ball. Holly was eating and drinking well. Wes was a wonderful support for her, he was there for everything and did constant massage during the contractions.

At 9 am we left for the hospital. Melissa was concerned that she wasn't bleeding yet, but Holly was ready to go. I had texted Melissa that I thought she was at about 5 cm. We arrived about 9:30 and Holly was 4-5 cm. The nurse that was in triage with us was not very friendly or receptive of a birth plan at all. So, we limited interaction with her and started walking the halls. Holly was great at walking fast and Wes was right there at her side to hold her up for her contractions. We would walk, Wes would hold her and massage while I did pressure with the tennis balls, after each contraction Holly was great about drinking coconut water or vitamin B water after every contraction.

Holly was reassigned nurses and after our walk we met her. She was awesome! She read the birth plan and instead of asking Holly if she wanted pain meds, because they do have to make it known that they are available, she said, "I won't ask you if you want any pain medication, I will just assume you will ask me if you want it." Heidi was our nurse and right off the bat she was very positive. She loved natural births and described herself as being very holistic. Heidi seemed like she just wanted to hang around and be part of the labor, but she didn't want to intrude too much. She was great! Wes and Holly were very relieved that we got this new nurse.

Heidi checked Holly after our walk and she was 6-7 cm and 100% effaced. That was very encouraging, we thought she was going to finish very quickly. At 12:30 Holly got monitored for the 3rd time since we got there. It was nice, they weren't very rigid on how often she was being monitored. Lying in the bed made it more difficult for Holly to relax through the contractions, so she sat in the bed for the monitoring.

Holly spent the rest of her laboring in the room, walking, squating, sitting on the ball, drinking eating and going to the bathroom. It was very difficult for Holly to empty her bladder, so she slowed way down on drinking. Finally, I got her to go with Wes and she emptied a ton, so the drinking picked up again. Holly was just so peaceful during her labor, she knew what had to be done and did it. When the contractions got really intense with more pressure, she prayed for strenght and support. Wes was right there by her side praying with her. It seemed like they had no worries all throughout the labor, they knew God had a plan and everything would work out. It was really beautiful.

A little before 2 pm, Holly was at 8 cm. Her membranes were still intact and there was a buldge under the baby's head. This was keeping the head up a little higher. By 3 she was 9 cm. She labored with a lot of pressure and intense contractions since 2. At 3:30 she was still at 9 cm with the bag intact. Holly was really tiring out now. She was resting well between contractions, but she had such short breaks. At 4:12 the doctor came back and broke her water. Finally at 5:28 she was complete. She pushed through a lip of cervix and got to continue pushing. Holly was exhausted but pushed with such strenght. She was at 9 cm for 2.5 hours! That was very exhausting. We could tell, Wes would have taken these contractions for her if he could. After pushing for 2 hours and 10 minutes, Dezmond Matthias Kasper was born 8 lbs 5 oz at 7:38 pm, September 22, 2011 with no interventions to him or his mommy. Dezmond was born with his cubby little hand up by his chin and a big head. That makes it very hard to push! It was so perfect. Dezmond hadn't even left his mommy by the time I left the hospital.
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Healing Birth

Cheryl was expecting her third child that was due January 1st to be early. In-fact, she was hoping for one more week when I went to see her Saturday, December 11th. Her estimate was December 15th. On Wednesday the 15th she had an appointment with her OB who was very supportive about Cheryl having a natural birth, so supportive that she told Cheryl to stay home until her contractions were 3 minutes apart lasting a minute for 2 hours. Doctor Baick wanted Cheryl to go into labor early also, because she was a VBAC, she wasn’t going to be allowed to go past her due date. After 40 weeks it would be another C. Anyway, at the appointment Cheryl was 2-3 cm and 70% effaced and Dr. Baic stripped her membranes.

I received a call at 4:30 am from Jaime, Cheryl’s husband saying that she had been having contractions 7 minutes apart for about 2 hours. He also said she couldn’t sleep through them but wanted to relax. I told him to have her get in the bath. About an hour later, Jaime texted asking if she could get in the shower. Cheryl really didn’t like the bath, but loved the shower. Her contractions at this point were about 5 minutes apart and her thoughts about them were they were uncomfortable and stronger then she expected. I thought she was progressing pretty quickly so I ate breakfast and got ready. I went outside to get stuff out of my husband’s car so I could take it and I was planning on driving over to Cheryl’s. I figured they were going to ask soon, so I’d start heading over there. I called when I went outside and Jaime said she was ready for me to come, the contractions were getting a lot harder.

When I arrived it was about 6:30, Jaime was blow drying Cheryl’s hair after the shower. She was in a pretty good rhythm with her contractions and very upbeat about everything. She was very talkative and had a lot of energy between contractions. After Jaime was done with her hair, I straightened it and then she did her make up. Cheryl’s daughter woke up about 7:30 and wanted to stay right there with her mommy. She watched while Cheryl put on her make-up and at all the grapes I got for Cheryl to eat. She was very quiet and didn’t seem to be a distraction for Cheryl at all. Jaime called his sister, Christina who was going to be at the birth also. He told her to go ahead and go to work until they called. A bit later we went down stairs, her little boy woke and the twins got ready for school with their grandma.
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Once they left, Cheryl’s contractions were about 4 minutes apart. I thought we could pass some time by baking and it seemed to be good for her labor when Cheryl would be on her feet, so we started baking pumpkin muffins.

Around this time, everything starts to get a little blurry. Things were progressing so well. Cheryl was getting tired and talking about pain with the contractions. She wanted a break and didn’t know how long she could go on. She would go to the bathroom every couple contractions, for a few of the in-betweens, she rested on the couch and at about 9:30 her contractions hit the 2-3 minute apart mark. She was on the toilet at this time and pretty much stayed there. Until we left the house. I was able to get her on her hands and knees for 2 contractions to see if that would take the pushing pressure off, but it didn’t. So I was pretty certain the baby was getting pretty close because it wasn’t a position problem causing the pressure. Every contraction on the toilet Cheryl said she need to push, but she did so amazing controlling that. She breathed out with her lips in a circle every time I reminded her. Jaime timed every contraction and stayed right there massaging her through the contractions. He had the bowl ready for when she felt like she might need it, although she never did and he finished the muffins for the nurses at the hospital. About a 1/2 hour into this toilet laboring, Cheryl said she though we should go to the hospital. I was torn at that point, but I said if you are ready, that’s what we will do. Jaime started packing the car and Cheryl told me she felt burning, it was burning bad. I asked her to point to where it was burning and she said down low like inside her vagina. At this point, I was right on board with her going to the hospital right then. But I was making plans for when we got there to avoid any IV, I told her to sneak into the shower when she was getting admitted in the room. Jaime packed the car and called his sister then we left.

It was 10:24 am Thursday, December 16th when we got in the car to go to the hospital. Jaime’s sister decided not to go to work and head straight for the hospital just incase. Boy, what a great decision that was. We arrived at the hospital at about 10:45, got to the room at 10:50 and Cheryl thought she had to go to the bathroom, the nurse handed me the gown for her while Jaime took her to the bathroom. I went in the bathroom and Cheryl said the baby is coming, I watched her feel for the baby and saw the bag of waters and the baby’s head protruding out of her. I said to the nurse, “She’s not kidding, I see him!” (At this point I am completely not aware of where Jaime and Christina are.) The nurse rushes in the room, hits the call button and someone (probably Christina) handed me gloves for the nurse then I opened them for her. The nurses station calls back and the nurse yells to the speaker, “I need some help in here, I’m delivering a baby on the toilet!” I think she and Jaime got Cheryl up and to the bed. Cheryl was lying on her side just as I was walking out of the bathroom, her water broke like a water balloon splashing across the room just as the baby’s head came out. Rylan Scott was born at 10:53 am December 16th weighing 7 lbs, 6 oz. Yes, I did say we arrived in the room at 10:50! He was born 21 minutes after we got in the car to leave to go to the hospital and only 3 minutes after we were in the room! She wasn’t even admitted yet.
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I remember looking at Christina and she was standing there frozen in shock. I have no idea where Jaime was, it was all so, so quick! Rylan was a little stunned by the quick delivery, so the nurses had to breath for him. They thought he was going to have to go to the nursery, he did pink up and slowly got his energy up. He had his eyes open before he even got to Cheryl and never needed to go to the nursery.
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Cheryl got the natural birth she wanted. No interventions, no IV or hep-loc and she did amazing. She did everything I suggested to her and went with her labor. She worked so hard before we even left the house. When I had my very first conversation with Cheryl, she said she wanted to experience the birth this time, she wanted to feel some control and wanted to feel everything pain or not. She didn’t want to go through what she did with the twins again, having everything out of their hands while being so scared about what could happen to them any minute. She also didn’t want to be monitored the whole time. So in the end, “That’s the way to have a hospital birth!” She experienced a completely natural hospital birth. She also had great instincts about when to go to the hospital.

Wende's Birth

I met Wende a few weeks before she was due. She had just moved to CA from Massachutes where her, her husband and their daughter had been living for a few years. Before that they lived in the Netherlands. I received an e-mail from her saying that she needed some help during labor because they are new to the area and don’t have any friends or family to watch their daughter so her husband will not be able to attend the birth of their second daughter. We talked and decided to meet at a restaurant to see if I could help her. Right away I loved her honesty and openness. She was very real. Wende told me she was induced with her first daughter, but didn’t have any other interventions. She didn’t want to have an epidural this time around either, she just didn’t see the point. I told her to talk with her husband and that I should meet him to, so we did that and they decided to have me as their doula.

It was November 2nd, Wende went in for her usual non-stress test (NST) that she did every Tuesday for the last couple weeks. She had been “uncomfortable” all night and couldn’t sleep. She though it possibly could have been contractions, but wasn’t sure. In the morning Wende told me she was having more discharge and at about 11 it was pink. I was pretty sure she was in early labor and was finally dilating, but I didn’t want to get her too excited, so I told her to go about her normal activities and to eat well. This was 4 days past her due date and during our first conversation she told me she was going to be early. Friday on her due date, she still was dilated to 0 cm. She wasn’t too excited about that.

The NST showed dips in the baby’s heart rate every time she had a contraction which were about 6 or 7 minutes apart. The doctor wanted to put her on pitocin to see how the baby would react to it. So Wende e-mailed me telling me they were going to induce her. I told her I’d just have to drop off my kids and I’d be at the hospital. I arrived at 3 pm and her husband was already there. Their daughter was in day care, so her husband was able to be there for part of the birth. The baby seemed to be doing good, no more dips in her heart rate and Wende was handling the contractions fine. She told us not to stop talking during a contraction at this point. Rudie, Wende’s husband had to leave to pick up their daughter, but a coworker of his said she could spend the night there, so he took her over there after they had dinner together.

While Wende’s husband was gone the contractions started to increase in intensity. Wende was still handling them beautifully, the only change was she wanted some quiet during them. A couple hours later, the monitor wasn’t getting a correct read on the baby. Her heart rate was showing 80, but when the nurse would listen by ear, it was sounding much higher. The nurse then decided to ask the doctor to rupture Wende’s membranes so they could put an internal fetal monitor in. Wende was told it would be a male doctor and she wasn’t too comfortable with this. I asked if they had a female and there wasn’t one available to do that. So the doctor comes in and breaks her water. This was probably the most difficult part of labor. Wende had a lot of trouble relaxing and it was painful to her. I think it was just a lot with the male doctor, a couple of nurses, she had to be on her back and the lights were very bright. All those sensations just lead up to a rough time for this part. After that Wende was able to get back into her rhythm with the contractions and she was doing wonderful again. But the baby’s heart rate was reading in the 250’s about 100 beats too high. There was no maternal fever and Wende’s heart rate wasn’t increased so there was really no explanation for this. They turned off the pitocin, re-did the internal monitor, used a hand held doppler to measure the heart rate and changed out the machine, but still 210 - 260. So they started talking to Wende about a possible cesarean.
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At this point I asked the nurse if they knew this happened a couple of weeks ago and they didn’t. They also couldn’t find it in her records. So now they were thinking it is just an arrhythmia in the baby’s heart. I called Rudie to tell him what was going on and there may be a c-section. At about 7:30 the doctor filling in for Wende’s OB came in to tell her the plan. This doctor was a female, that was good. Anyway, she said they need to do a c-section because they can’t monitor how the baby is doing with the contractions with her heart so high and if the baby needs medication for her heart, they can’t do it inutero. So I asked if they can wait for her husband to arrive and I also asked if the baby’s heart went back to normal if she can continue with labor. The doctor did not want to do that just incase. Rudie was about a half hour away so they said they would wait. Around 7:45 Rudie arrived and the baby’s heart was finally back to normal. So they went to have the c-section and Jill their new little girl was born at 8:42 pm, November 2, 2010. She was 8 lbs, 6 oz and 19 3/4 inches long. Her apgar scores were 9 at 1 minute and 9 at 5 minutes. Even through Jill had wonderful apgar scores and her heart was normal, the neonatal doctor wanted her monitored in the NICU for 24 hours. So Jill had to be separated from her mom for 24 hours.
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Now, 2 days later, Jill is doing wonderful, she was back with her mom just under 24 hours and she has started nursing and doing so well that Wende’s milk is in. Wende is feeling much better after her surgery, each hour she says, she feels better. It was wonderful that Rudie made it to be there for the birth of their daughter. They were both worried that he might have to miss it. Especially since it was a surgery she was able to have her husband there with her. Everything in God’s perfect timing. In the end, Wende prefers the vaginal birth because the recovery is better, but she liked that the c-section was very quick and easy. So what matters most is a healthy mom and baby.

Marathon Birth / 60 Hours of Determination; Sometimes Medical Intervention is Necessary

Sarah’s birth was unique in so many ways. There is so much to say about it, I don’t even know where to begin. You can probably see a bit of that from the title. My husband thought I should call it “Marathon Birth” I thought, 60 Hours of Determination; but I wanted something in there about the medical intervention. So I had to put them all.


Part 1: The events of labor
Sarah was planning a natural child birth using the Bradley Method. One big reason she wanted to do this was because her mom birthed her this way. There were, of course other reasons as well, but this was a big reason. Sarah’s mom had told her that her labors were fairly short and baby size was around 7 lbs. So, naturally Sarah thought she could expect a fairly short birth and a bigger baby because her husband was about 9 lbs at birth. She did however know that might not be the case, her birth could be very different then her mom’s. Little did she know it was going to be the exact opposite.

Wednesday, September 22, Sarah had her appointment with the midwife who told her it would be ok to take castor oil because her due date was Sept. 19th, 4 days prior. Being uncomfortable and ready to have her baby, she did. But there really was no effect except a slight upset stomach. Thursday morning about 1:45 am September 23rd, I received a text message from Sarah. I didn’t get it till my daughter woke a little after 2 am and I checked my phone. Normally I don’t hear a text message in the middle of the night, just a call. Anyway, she said she thought her water broke and her contractions were about 10 minutes apart. So, I messaged her back asking her some questions and telling her to do a few important things like drink water, rest, pee every hour and eat. That night she took baths, showers, and did everything else in the instructions. The contractions got a little closer together, but around 5 am, she fell asleep and the contractions slowed way down. All day on Thursday she had contractions mostly 10 minutes apart, but some 20 minutes. I suggested she and Ricky, her husband do something to take their mind off the labor like go to the movies. They watched a few at home, but didn’t go out.

Thursday night, her contractions picked up again but were inconsistent. She labored all night and tried to get the contractions stronger and more regular. It was about 12:30 when I got a call from her that she wanted me to come over for an hour or so, to help her relax while Rick was resting. I got there and gave her some suggestions. She was very uncomfortable laying down so I had her on her hands and knees doing pelvic rocks. Her back was extremely uncomfortable so we tried to get the baby off of it by doing the pelvic rocks. I ended up staying until the next day because it looked like her labor was progressing. But it would have periods of slowing down and we could not keep it consistent. Sarah kept getting so discouraged that she wasn’t progressing. I kept reminding her that things were happening in her body. Just not the expected way.

About noon on Friday, September 24th, Sarah decided to go to the hospital to have them check her progress. She went to triage and she was 5 cm dilated. The baby was doing good. She did not tell the midwife her membranes were ruptured, she didn’t want a time limit on her labor. The midwife recommended she check into the hospital, but Ricky and Sarah decided to go home. The midwife was not too happy about this. In-fact she was a little bit threatening about what would happen if they go home and don’t get back in time or can’t monitor the baby. The midwife was even more upset to hear they took Bradley classes.

Sarah and Ricky still decided to go home. She wanted to work on flipping Harper around and I went home to rest. About 3 pm I picked up Sarah to get an adjustment, which can help with the baby flipping but most importantly it helps with being aligned to minimize some pain and helps to open up the hips. After that Sarah went back home. They decided to go back to the hospital around 8 pm and I would meet them there.

When Sarah and Ricky got to the hospital, she was now 6 cm. Her contractions were still inconsistent. So we had a plan of constant nipple stimulation. Usually constant isn’t recommended, however she was able to start while on the monitor and we could see that the baby could handle it. Harper was doing great every time she was checked on. So Sarah kept that up along with walking and the shower. Her contractions were still so inconsistent, they would fluctuate from 2 or 3 minutes apart to 10 minutes apart. At 2 am, September 25th, Sarah was having a lot of pressure, so she was checked and was dilated to 7 cm. She got back to her routine of nipple stimulation (more aggressive this time), shower and walking. The midwife came in and checked her again and she was dilated to 9 cm. Wow, that was exciting! Finally, some encouraging news. This is the most progress she made in the last 2 and a half days! 2 cm in 4.5 hours. We were very excited. Sarah’s spirits were up. She was very motivated and encouraged to keep going.

Sarah kept up with her routine. However, all this time, the past 3 days, she wasn’t eating much. It was very difficult for her to eat. She was drinking tons of water, just no juice or food. She also wasn’t able to sleep. The midwife came in maybe around 7:30 to check her again before shift change and she was dilated except for a anterior lip of cervix. That was very exciting news. So now my plan was to keep her on hands and knees, walking or doing pelvic rocks. We needed to get the pressure on that lip to help it dilate.

At 8, there was a shift change and the midwife that Sarah originally saw Friday afternoon was back on. She checked Sarah and discovered she was 9 cm with an anterior swollen lip of cervix. The difference in 9 or 10 cm may be just how 2 different people checked her, however the swollen lip was defiantly going backwards. We were disappointed, but we still had a plan. Sarah was so determined to do this naturally. Now, we had to keep Sarah on her back or sides to stay off that lip. Definitely no hands and knees and no pelvic rocks. However, at the next check, Sarah was more swollen.

Now it was time for a decision. The way things are going are not good at this point. It was time for some intervention. The contractions would keep up with constant nipple stimulation. Even then, they were not regular or incredibly strong. Sarah had also been awake for 3 days now with little to no food. She needed fuel and so did the baby. After a lot of thought, Sarah decided to get pitocin so her contractions would get stronger on their own and keep up, she decided on the epidural because she definitely needed sleep and she needed to get that swollen lip to go down. They also gave her sugar water which helped both her and the baby. They needed that fuel. Sarah was administered all of this about 1:10 pm Saturday, September 25th, 59.5 hours after labor began.

After a few hours of rest and some awake relaxing time she was finally 10 centimeters. The midwife allowed her to labor down and she was finally able to push. After 1.5 hours of pushing, Harper was born just after 7 pm Saturday night, she was 9 lbs 14 oz and 21 inches long. Did I mention, Sarah is a small girl, about 5 feet 2 inches tall.

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Part 2: Thoughts on the labor
This birth was so unique and amazing all in one. The main thing that was so different about it is the contractions were the same throughout, some close together some far apart, she’d sometimes get a group of good intense contractions all at once, then a half hour with maybe 3 smaller ones. The entire time, I kept thinking there has got to be a reason this is happening. Why does God want the contractions to be like this, why does he want the labor to be so long? I knew there had to be a reason. When Harper was born, I thought maybe this was the reason, Sarah’s hips needed that time to open up enough for her little body to fit Harper through. Harper even had her hand up by her shoulder. That makes it even harder to push her out.

To me this birth was so amazing. Sarah had such determination through the entire labor. She never wanted to give up after discouraging news every time she was checked. Sarah was discouraged and disappointed at times, but she kept right on working at her labor. She wanted so badly to have a natural child birth, that she said no to the doctors when they would recommend something over and over until her and her husband felt it was necessary. They really took a stand for what they wanted. It was amazing. That is such a difficult thing to do. I am so proud of them. If Sarah had gotten the pitocin earlier, maybe (I don’t know for sure) but maybe her hips wouldn’t have had enough time to open like they did. If she had gotten an epidural without pitocin, her labor probably would have completely stopped. But in the end, both were needed to finish the birth of her little girl. She waited until it was needed, so even through the entire birth wasn’t natural, the first 59.5 hours were and she was extremely happy with the outcome. To be able to deliver her baby vaginally was such a blessing.

I loved how this birth turned out and once again I learned so much from it.
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Sarah's birth

I had my first birth as the primary doula! It was very exciting. Sarah was the mom and first I have to say she was amazing. She was having consistent labor at 5 pm Monday night with her contractions 5 minutes apart, by 1 am they got to 3 minutes apart, so her and her husband (Keith) decided to go to the hospital. They then called me and asked me to meet them there.
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When I got to the hospital, Sarah was in very good spirits, she had to stop for her contractions, but other then that everything was normal. Well, she was tired. Sarah was worried about not getting any sleep and having enough energy for the labor. When she checked in the nursed checked her progress and she was 2 1/2 centimeters! Wow, I couldn’t believe she wasn’t more dilated. Aren’t many women dilated to 3 before even feeling the labor rushes? However, Sarah didn’t seem to get discouraged. The nurse did discover that she was leaking fluid and had been for most of the day, so we were staying till the baby was born. Keith and I went right to work keeping Sarah busy, moving, drinking and going to the bathroom.

In the early morning, Sarah’s doctor came to visit and she did a vaginal check. During this check, she discovered Sarah was now 4 centimeters and firm. “What, oh no!!?” was my initial thought, but I continued with the encouragement and we kept her moving once again. We tried the birthing ball, laying down, hands and knees, squats and walking the halls. So the doctor came back in about 11:15 later that morning (Tuesday). At this time, there was no change in dilation, so Sarah was put on a pitocin drip. From then on, her contractions stayed in the same rhythm, but worked better for her body.

A few hours later Sarah was in transition and before we knew it, she was 9 3/4 centimeters. She stayed that way for about 2 hours! But still, she seemed like she was slightly uncomfortable and kept up the changing positions, drinking her water, eating her popsicles. Keith and I were amazed with how hard she worked without 1 complaint the entire time. Baby Gavin was finally born at 6:32 Tuesday night, he was 8 lbs, 6 oz.
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Kristen at Conscious Birth is serving Placentia, Yorba Linda, Fullerton, Brea, Anaheim and other Orange County, CA cities. I am also very near, some Riverside and San Bernardino County cities. If you are interested in meeting with me, please e-mail kristen@bestocdoula.com or call 714/269-0172.