Mary's Gift

I met Mary through a past client (http://www.bestocdoula.com/Blog/files/Alicia%20Taylor.html) who is now also a doula. She lives quite far and wanted to partner with a surrogate mom in my area. Of course I was excited! I loved attending her surrogate birth. It is such an amazing gift to someone. Anyway, Mary just had such a huge heart for carrying a baby for someone that couldn't carry her own. I loved our conversations. Unfortunately, we assumed Alicia was going to be the one attending her birth as I was supposed to be on call for just a few days and if Mary's water broke, I would get there sooner. However due to unforeseen circumstances, I was on-call the first week and luckily for me, Mary went into labor. 

It started slowly with contractions often, but not often enough on Friday, April 18th. Instead of getting closer together, they spaced out. Again all weekend, it went like this until, Monday night / Tuesday morning. About 2 am Tuesday morning, we received a text that Mary had been having contractions about 5 minutes apart. She was ready for some help. When I arrived, her contractions were about 7 minutes. The IM was also going to join us for labor. I waited a bit to see what was going on, we took a walk around the neighborhood and it just seemed like she was in early labor. I told Mary to get some rest, she didn't quite need me yet and that I would go home and rest also. I told her to call me if there was any change. That was about 5:30 am. 

At 6:30 I received a text from Mary saying she was going to head to the hospital to ask them to break her water. (With her previous labors, once her water broke, the labor dramatically sped up.) I decided to go ahead and meet her at the hospital. The doctor came in to check her and she was 4 cm. She did not want to break her water because she was a VBAC (last pregnancy was a surrogate with twins by c-section). Also, the doctor looked at the monitor and she had had 2 contractions in 4 minutes, so she thought she was contracting regularly. In actuality, Mary was contracting every 10 minutes while lying down and 5 minutes while walking. We spend as much of the day walking as we could between getting monitored. Finally, at around 3 the doctor came into see her and she was only 5 cm. The doctor thought that Mary's contractions had slowed down and told her she could go home or have her bag of water broken. Mary decided to have it broken after wanting that originally and being tired from laboring 1/2 the night and all day. With in 1/2 an hour, contractions picked up to about 2-4 minutes apart.

Around 4:30 Mary decided on an epidural so she could get some rest. Unfortunately, the epidural didn't work at all. This is a very difficult thing. Mary had 2 previous natural delivery's in the past, but once you have decided on an epidural are expecting relief, when it doesn't work, it is worse then if you never tried the epidural. The other difficult part was because she had an epidural, she was not allowed off the bed or even on her hands and knees.
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We had to deal with the pain she was having with very limited positions. We basically spent the next 2.5 hours with me squeezing her hips while laying on her side and sometimes sitting in bed. This was the only relief she got. Multiple times the anesthesiologist came in to up the medication. When she was about 9 cm, he gave her the c-section dose to see if the epidural was in the right position. It made a little bit of a difference, but not much. But finally, she was able to push which only took 11 minutes and the relief was finally there! Mary gave birth to a beautiful, healthy baby girl at 7:15, April 22. She was 8 lbs, 14 oz.

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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.

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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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.