This birth was unexpected. So unexpected that I think it was nothing short of Divine intervention that brought me to it. M's original doula was in the middle of what turned out to be a 36-hour birth, her backup doula was at a long preterm birth, so she called my friend Jessica at Under My Heart Birth Services. Jessica later called me in...
M was induced on a Tuesday night, Jessica was called to her Wednesday morning and they spent all day Wednesday rocking labor. This was M's first baby and she was hoping to go natural and they were having luck getting the breast pump to bring on contractions. I was called Wednesday evening to see if I could pull an overnighter because Jessica needed to get home to her family.
I didn't know M at all and only knew a few things about her. Her husband was unable to be at the birth due to being in another country, but M had two wonderful friends that were also helping her labor. I liked her as soon as I met her and was a little jealous of her head scarf; she looked beautiful in labor!
I arrived a little before 8:00 and Jessica got me up to date and made sure that M was comfortable with me before she left. M was last checked at 6:00 and was 3cm and 70% effaced. She was using the breast pump when I got there, but contractions were coming regularly enough that we didn't keep using it for long.
I had M sit on the birth ball and lean against the bed so I had access to her back during contractions. This position allowed her to open her hips and get some rest between contractions. She had already been laboring so long! Her aunt left to eat some dinner and change clothes and after about an hour we decided to try to tub again.
The tub was smaller than I would've liked for a mom in labor and the only comfortable position was reclining back. M quickly found that contractions hurt worse like that and we soon got into a rhythm of pulling her to up to sitting position during contractions and helping her lie back between them. I could tell a difference in the intensity of contractions in the tub even though M preferred not to make a sound. She reached for my hand to help her up and would squeeze it; I would tell her how awesome she was doing and remind her to relax, but I was impressed with how well she could handle them! In between contractions we chatted to get to know each other a little better. Eventually I turned on the diffuser with some peppermint to try to counter the "hospital smell", turned off the lights, and turned on my little candles.
She stayed in the tub for about an hour and a half and decided to get out once her toes started to prune. She moved back to the birth ball and decided to try the bed on her side about 11:00. I could tell she was exhausted and thought she might be able to snooze between contractions. Her midwife came in shortly after and checked her. She was a little more than 3cm, 100% effaced, cervix more anterior, and baby lower. We were hopeful that now that the cervix was fully effaced she would dilate faster.
M talked to her midwife about her pain relief options because the pain was at a 10 in intensity and even though she was handling them beautifully she didn't think she could go much longer. She opted to try IV pain relief and got her first dose about 11:30. We tried the peanut ball on her, but it was so huge it was ridiculous. M's aunt and friend returned about this time and we sat by her bed ready to support her when she woke up in the middle of a contraction. I think she was able to rest between them, but I'm not sure if it was worth it to be caught off guard by the contractions.
She had another dose of meds about 1:30 and was checked again at 2:00. We were all pretty shocked and bummed that there was no progress after 3 hours of regular and intense contractions. At this point M opted for the epidural and we were all hopeful that letting her body fully relax would be the nudge that her cervix needed, but Pitocin was also discussed.
I was able to stay in the room and support M during her epidural. It took longer to place than usual and wasn't much fun for her, but she was a trooper. Immediately after the epidural her BP dropped and the baby's heart rate went down. Everyone in the room was busy trying to remedy that and I heard talk of a crash c-section (which made my heart drop). The midwife quickly put an internal monitor on the baby and the heart rate went right back up. The baby's heart rate had been perfect for the entire labor, and didn't give us any trouble after that scare.
Because of the scare, a couple of OBs came in to talk with M about the possibility of a c-section so that if it became an issue later she would be informed. Once things settled down she was checked again and found to be 4cm, 0 station, and 70% effaced. I know that it's possible for moms to reverse in dilation in labor when they are not comfortable with their surroundings, but I'm not sure if this was a reversal in effacement or if it was just a mis-measurement. Either way, she HAD progressed, but not much and everyone agreed to start the pitocin.
M had been itching everywhere since the epidural was placed and they were finally able to give her some Nubain at the same time they placed her catheter and started the pitocin. We all settled in for a "long winter's nap", excited about the possibly of M waking up ready to push.
I woke up about 6:45, unable to really get comfortable so I snuck out and got some food from the cafe downstairs. M was woken up about 8:00 and checked - no progress. Oh how sad those words make me! They upped the pitocin some more and decided to wait and see and check again around noon. M's water had been broken for 28 hours at this point and she had been in the hospital for almost 36 hours, but the baby was doing fine so they were okay to keep trying.
At this point I had to start thinking about getting home to my kids and what the day was going to look like. The original backup doula was available to come in, but I hated to give M another doula! Jessica and I decided that she would come back in the afternoon and that if it came to it, I would come back again that evening. We were just waiting to see what the next check would say.
At 11:00 they checked her again and she was 5cm and 70% effaced. They put an internal monitor in to measure the pressure of the contractions so that they could make sure they were giving the right dose of pitocin. (I should mention that the internal heart monitor fell off twice because the baby had a TON of hair! The midwives went back to the belly monitor after the second time). The new midwife said the baby was OP, so we found a smaller peanut ball and had her using that. I talked to the midwife about using peppermint oil on the back to help an OP baby turn and she was okay with us trying so I used some with coconut oil. Her back had a lot of tape on it from the epidural, so I'm not sure if I got it in the right spot.
We planned for Jessica to come at 2:00 and depending on how things were going one or both of us would be at the birth. M had mentioned that she was fine because she had gotten the epidural, but no way were we not going to stay until the grand finale!
We tried to let M rest as much as possible and just keep her company since there wasn't much we could do. We helped her switch sides, gave her sips of water, and I rubbed her legs with my coconut oil.
2:00 rolled around and the midwife came to check her again. I think we were all holding our breath! Sadly, there was no progress even with the pitocin being turned up every 20 minutes. Not only that but the cervix was starting to swell and the baby's head was molding (which is not common at 5cm dilation). At this point the midwife reluctantly had to recommend a c-section. She went over all of her concerns with M and then left the room to give her time to process and decide what she wanted to do. She could choose to continue laboring, but the pitocin was giving her strong contractions and it hadn't done anything in 3 hours.
Having been in this situation myself, I knew a little bit of the pain that M was feeling. Of course every mom is different, but this was hard news for M and I wanted her to know that it was okay to be sad, mad, angry; whatever emotion she was feeling. It's okay to cry - and we both did. Jessica arrived right at this time so I left the room to update her.
All the care providers were great and we got them to agree to let two of us into the OR with M. She eventually decided that she wanted her friend and myself to be in the room and so we suited up. M had not wanted any pictures of her labor, but I encouraged her to let me take pictures of this experience as it was such an emotional thing and she might not remember much.
S (M's friend) and I had to wait for a while outside of the OR while they got her all ready to go. I was a little nervous that attending a c-section might bring up stress from my son's birth, but once I got in the room I didn't even think of anything but M and her little baby.
M appeared to be sleeping, but I gave her my hand and she would occasional squeeze it. I have found more and more that my hands and my voice are what I use most at a birth and that was all I needed in the OR.
The surgery took longer than I expected, but soon they were lowering the curtain so M could see. I put my camera on continuous shutter so that I could capture as much as possible.
Since there was meconium in the water, they took her right over to the warmer to check her over - look at that hair! ♥
She took a few moments to pink up, but she sure had that pouty lip down from the beginning! Simply adorable! And she was crying real tears which I have never seen a newborn do!
S was able to stay in the OR with M until she was done being sewn up and I went back to the room with the baby where Jessica, M's aunt, and another friend were eagerly waiting.
Unfortunately, I had to leave at this time to relieve my babysitter, but Jessica was able to stay and help M get some skin to skin time and try to nurse the baby. We both went to see her on Sunday and we happy to see the baby nursing and M smiling. Even though we weren't able to develop a prenatal relationship with M, we have a great fondness for her and her sweet baby F!
3:36pm
8lbs 4oz
20 inches
