Sisters make our lives rich. They jump into our journeys with us, hold our hands and push us on. They celebrate our milestones and bless our transitions. The shared bond calls upon the ancient spirit in us all. It greets our maternal lineage with joy, casts aside the grief of habitual patterns and embraces something simple and divine. 
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NORA
November 25, 2010 Thanksgiving Day. I was rushing around, getting the turkey ready to be thawed…I had dragged my feet on this process for some reason (later I decided it was pure intuition.) I was planning my first thanksgiving dinner ever. My mother passed away in September and it seemed like a good time for me to start a new tradition. I was nervous about it. My mind was full and checking off things in my head…how was I going to have time for shopping for last minute items? The days menu was unraveling and emerging in my kitchen as ingredients were being organized, plans for perfect timing and hopes that I hadn’t waited too long to get started….and then came the phone call.
Marie had been to see her doctor and her fears from the previous few days had been realized. She had an episode of SVT with her heart, her blood pressure was climbing and they found high levels of protein in her urine, making preeclampsia a real concern. She made the difficult choice of letting them induce labor on Thanksgiving Day, also her own birthday.
I felt so blessed to have the support of my family that saw the change of Thanksgiving Day to Saturday perfectly fine…”no worries mom” and the turkey went onto a slower thaw as I prepared to be away from home for a day…or two.
After phoning the hospital at 5:30 am Marie was told to come on in. She called me, her doula, at 5:45 and we all made our plans to head to the hospital.
I met Marie and her husband Robert at 9:30 am. They had just begun Marie’s pitocin drip and gotten her settled in. She had been having light contractions while being monitored off and on for the past few days but nothing very strong. She was due on December 4th…still a week away.
Her contractions were quickly boosted by the effects of the pitocin. We were at North East Ga. Women”s Pavilion. Neither the Midwife nor the hospital made a routine out of “checking her” nor were any of us focused on timing between contractions. We simply moved gently into Marie’s journey, trusting the process. Monitoring was necessary due to the induction, but they hooked her up to a portable monitor giving her freedom of movement, the ability to get in the tub or walk the halls. She tried them all.
By noon her contractions had increased in strength, length and were obviously closer and closer together. By 2:00 a nurse checked her for the first time and found her to be 5 centimeters. Those next few hours as Marie’s very lighthearted mood changed to a much more serious focus so did her husbands. He really stepped into full presence to help guide his wife through this journey. One of the most beautiful things about being in the room as a child is born to a first time couple is the unfolding and emerging of a family. There is much more being born here than the baby. A family is born. A couple takes a new turn in their life together. It was beautiful watching Robert care for his wife and encouraging her to keep moving forward.
The room was filled with the beautiful aroma of the essential oil blend…”Peace and Calming”, a stream of soft music flowing from the couples’ lap top…Marie, Robert and I kept moving through positions trying to find the ones that worked best for Marie. Standing, sitting or leaning on the ball…Marie kept settling to sitting on the edge of the bed leaning into her husband. I would periodically( as I saw her discomfort levels increase and feeling progress stalling a bit) get her to stand with her arms around his neck and “dance” with him. She didn’t always appreciate this suggestion, snapping “NO” at us every once in a while…but once she was in the dance her body and baby seemed to work together to move her baby down.
I appreciated very much the staff at GWP, they honored Marie’s choice of very little intervention, they left her alone to labor, did not push for her to get an epidural when her contractions became vocal and constant. Both Marie and the baby were doing fine on the monitors and that gave the peace to the situation it needed. Even the pitocin drip was not being bumped up regularly since all was happening so smoothly. Marie was deep into her “labor land”, the place women go during the last stages of labor. That internal place where she is moving through the waves of contractions, lost in the sea of her own inner world. Learning about her strength and calling forth the warrior within.
Those last few hours were difficult for Marie, she was exhausted and like many women entering into transition she was saying things like…”I’m ready to go home. I don’t think I can stay.” I asked her if she wanted me to take her somewhere, maybe take a walk down to the cafeteria or go outside with her…she declined with a light laugh and moved back into her labor land.
During the last hour Marie was so spent she had moments of doubt and confusion. She asked for something to take the edge off, we talked about her options and she chose to let them give her something mild. The midwife checked her to see where she was and if it would be possible. There was a consensus I noticed between the midwife and the nurse, some unspoken language that I realized they were not going to give her much. It was more a placebo to give Marie the mental strength to carry on. She was so close, the midwife told me later that she knew it wouldn’t really help that much.
She had been saying to me…the only thing that gives me relief is pushing and I encouraged her to surrender to her body and let it do what it needed to do. We had some time together, her in her dance with her husband, resting as she could in between…for her to follow the instincts of her body, to allow gravity to work…
Her midwife came in, a perky young girl named Kelly… and changed the direction of things, putting Marie on the bed, checking her cervix and instructing Marie to get in a position to push…the traditional position, the “C” position was the position Marie was in. Within just a few minutes and some very focused pushing little Nora was born. Amazingly only 12 hours after induction. 9lbs, 21 1/2 inches long and a full head of hair.
She was whisked away from her mama due to some lethargy and I followed her across the room. Her daddy was not ready to leave Marie’s side and I didn’t want her to be alone. Her big dark eyes looked up at me as if she was taking me in, she even made a shape to her mouth that looked like a smile. She was awake and alert and checking everything out and holding on tight to my finger. When she finally got to go to her mommy she took to nursing as if she was an old pro.
Unfortunately her blood sugar check did not meet her pediatricians standards and she had to be taken to NICU. She had nursed and nursed well but at 9 lbs she was getting a lot of her mothers sugar from her body, to lose the source, I am told in these situations baby’s blood sugar often drops. If it isn’t high enough they will put them on IV’s. And if it still doesn’t go up they will want to introduce some formula.
An intervention Marie did not want. And so begins Marie’s journey as she learns to use her voice and stand up making decisions for her new baby. I know her to be strong and courageous. I know after having gone through her birthing experience that she too knows of the depth of her own strength, at levels before unknown.
DAnnabella
I was excited to hear that Doreen decided to have a water birth. I trusted the combination of midwives they had chosen and the location and the ease of water increased the chances they had of a smoother labor and birth. Her due date was October 12th 2010.
On October 14th Doreen called me at 10 pm to let me know that she was having contractions, they were still about 15 minutes apart she said and not very strong. She took my advise from our prenatal appointment and decided to get in the tub with a glass of wine to see if this was indeed time for baby!
The phone rang again at 3:30 a.m. and Doreen, in a very calm and relaxed voice said…they are getting stronger, but still kind of erratic. I took note of the word stronger and decided it was a good time to head to her house. When I got there, she was relaxing back into an easy chair, listening to her hypno-birthing CD and softly chanting through her contractions. She seemed relaxed and the contractions did not appear to be causing her any stress.She had prepared herself by taking a Hypno-Birth class and a water birth class, but also Doreen was bringing to her birth an already positive mindset about the spiritual aspect of birth and preparing herself to meditate through a natural labor in water.
After a few minutes of taking in the situation I suggested she maybe change her position, as she was lying back in a recliner and I knew that wasn’t the best laboring position. Although, comfy. I had her lean forward and adjust her pelvis and she understood after feeling the difference. We had talked several times about labor positions, I had shared with her some information from our Dancing for Birth classes and she easily shifted back to those earlier conversations.
The unusual thing about Doreen’s labor was the erratic-ness of the contractions. They never quite settled into a consistent rhythm of time, length, distance. As a doula we like to see a consistent 4-1-1 before heading to the hospital. Allowing early labor to occur at home can be one of the tools to avoid interventions.
I could see they were however having an increased affect on her, I noticed by the change in her facial expressions and the changing of her focus. She didn’t seem to be in a great deal of discomfort ever and she was talking and walking in between contractions. I have to admit I thought to myself…we will be at this awhile. She would stop and pause during her contractions and move within. She would find a sound deep in her throat and “OM” through each contraction. It seemed to be working really well for her.
Around 6 am Jeff called the midwife’s office and was told…come into the office in the morning, unless they get closer together and stronger. Doreen seemed relieved and focused. Her gentle “OM” with each contraction also had a soothing effect on her partner Jeff and me as well. I could feel that she was in control of her body and her journey.
Around 8 am she began to complain about pressure at her pubic bone. Her contractions still weren’t very consistent but they had begun to be much longer and getting stronger. Now lasting at least a minute…most of them anyway. It didn’t seem to be unbearable for her… just uncomfortable. She had been using the birth ball a good bit for different positions but it wasn’t relieving the stress. Doreen said to me, “this wouldn’t be bad at all if I didn’t have that pressure on my public bone.” I had a feeling Annabella was finding her mom’s pubic bone to be an obstacle. Jeff had the idea from something he had heard in class and suggested putting an ice pack on the painful point to move the baby away to another place, that combined with a position of leaning against the wall with one leg up on a chair proved to be the secret. Within moments she felt a shift and looked up at me, very calmly and said…” I feel like I want to push”
That seemed like a pretty good cue to head to the hospital.
My drive to the hospital was a bit strained. It was rush hour traffic and I was playing different scenarios in my head…a “park and push” along the way was a bit of a concern. Not the outcome I was hoping for. I was hoping we had not waited too long. I know Jeff had called the midwives and alerted them we were on our way, I guessed later that he must have been pretty clear about how quickly things were progressing.
We all arrived at the hospital and Doreen was whisked into triage very quickly. The midwife, Kay met us there and Doreen was checked by her right away. Kay looked up at me with a wide grin on her face and announced…10 cm! It seems the tub was being prepared instantly and we were all hoping that Doreen would have the water birth she desired. In a flurry of activity the nursing staff at North Fulton prepared that tub in record time (or so it seemed to me) and while Doreen and I waited in triage and Jeff parked the car and unloaded their belongings, Doreen said…I need to push! No more than a moment after those words were spoken her water burst with a whoosh and a force I had never seen. Jeff came frantically rushing into the room just in time for me to send him to rush the nurses, Kay stepped back into the room…herself seeming a bit excited and said…”we have just moved to another level.” Her actions were quick and urgent but her voice was calm and contained not a note of worry.
Making it into the room and slipping off the gurney into the tub Doreen finally had a moment to just sink back into her quiet place. Her inner rhythms came back to her easily and she began to focus on Kay and the process of pushing her baby out into the warm water. Jeff was strong at her back, gently stroking her face and hair and Kay and I each took a leg for support….we arrived at the hospital at 9 a.m. that morning, at 9:30 a.m. little Annabella was taking her first peek at the world.
She was allowed to rest on her mother, her father cut her chord and the room full of women (midwife, nurses, techs and myself) all became mesmerized by this darling little beauty. She was plump and pink with dark peering eyes that seemed to look at everyone in the room. I could see the tiny bruise over her eyebrow, the evidence that she was indeed bumping up against her mom’s pubic bone during her descention. She was nestled up to her mothers chest and I clearly heard the sound she was making…she was imitating her mothers labor sound…”OMMMM” I understand from Doreen she still likes to make that soothing sound.
Spencer
I immediately felt a great connection with Austen and her husband Steven. They were very excited about their baby coming and obviously had a strong and loving relationship. I felt they were going to make a great birth team.
Both of them were in great shape. Austen had been working out and taking good care of herself both nutritionally and physically throughout her pregnancy. During their prenatal we talked about yoga, labor positions, “dancing” moves such as powerful woman pose and comfort measures to assist her in the days to come preparing for her birth. Austen had been working on all of these things she shared with me before her “birth” day arrived.
Austen was using an OB practice that had a standard of inducing at 40 weeks. Her due date was the 21st and in her doctors assumption they were pushing it and scheduled an induction for the following Monday morning. We talked a long time about what that meant and went over several things she could do to bring her labor on naturally. The process of her baby coming in his own time was important to Austen and she wanted to do everything she could to support her baby coming in the best way possible, however she also had the added pressure of thinking about the small amount of time she would have to spend with him before she had to go back to work. It was struggle and I could hear that in her voice. We both agreed taking it one day at a time was the best relief to that stress. Perhaps nature would take its course.
The first call I got was on Friday, September 24th. Austen reported strong contractions every 5 minutes and felt it was time to go to the hospital. I agreed on her request to meet her there. We ended up doing a “dry run” as the contractions subsided while Austen rested on the monitors. She was noted to be 2cm and about 80% effaced. We headed home just before midnight, everyone in good spirits and knowing the time just wasn’t right yet.
The next call I received from Austen was a report that her water had broke on Sunday, September 26th around 5PM, she was instructed by her doctor to head to the hospital. I encouraged her to take her time, she was planning a shower and food. Often labor doesn’t start right away after water breaks, but it was the SOP of her practice to get her in to check things out. When she arrived at the hospital she was still 2cm and contractions were gentle but coming with some consistency. I know Austen and Steve thought this was going to happen soon. They were focused on a quick and easy birth without complications and had no reason to think otherwise.
The doctor came in and suggested a quick delivery to the couple. Interventions that would speed things up…she put her “thumbs up” to the idea of a nudge to make things happen quickly. Both Austen and Steve wanted an un-medicated, un-intervened birth. They weren’t up for a plunge into labor and wanting it to happen in their own time. At Gwinnett Medical Center their choices were guided by a “time map” The time allotted to allowing a woman to labor after her water had broken was 18 hours and they were intending on making sure it happened within that time frame.
Austen’s labor progressed very slowly as numbers go. She had to have a dose of antibiotics due to being Strep B+, her reaction to the antibiotics was the beginning of a chain of events that had the couple reassessing their “perfect birth plan” every step of the way. The reaction of itching and breaking out in hives was the first of many challenges they would face.
During the next hours and through the night Austen labored intently, Steve supported with a gentle nurturing. Contractions were closer but not very productive and the hospital staff began to introduce pitocin to get things moving. As the night progressed Austen was experiencing her contractions as intense. From observation on my part she appeared to be a woman moving into active labor. Each time the nurses checked her progress however there was little to “show” for the contractions she was experiencing. They weren’t even really considering her to be in “active” labor. The definition of which is contractions that are producing a change in the cervix.
Pitocin was upped on a regular basis and we began a kind of dance with the hospital staff. And a dance with Austen’s labor. The perspective of the nursing staff was to keep her monitored and the best way to do that was lying in bed. We kept finding positions to make her more comfortable, she would find the place to relieve the contractions pressing deep into her back by getting on her hands and knees. After a while the nurse would pop into the room, try to find a place to position the monitor and “suggest” again that Austen move on to her back to get a good “read”. We played this back and forth for many hours.
I could sense there was some type of obstacle to the baby in making his way down the birth canal. It appeared by Austen’s contractions that she was having good contractions to move him into position but they weren’t bringing about the anticipated progress. I noted on the monitor that every once in a while his heart rate would plummet and then pick right back up. I thought he might be pressing on his chord…knowing babies sometimes will even grab their chords and squeeze them. I kept thinking of the 3D sonagram picture they had shown me with his feet up around his chin and looking as if he had little room to move around. The consistent pain in Austen’s back indicated to me that he might also be posterior.
It is never easy to work so hard in labor and be told that you aren’t progressing. Austen tried all types of positions, her favorite feeling ones were childs pose and pigeon 
from yoga, positions that had brought her great relief during her last weeks of pregnancy. She tried as much as we could get away with to be on her hands and knees on the bed with her chest resting on pillows. She also worked with the ball. The nurse kept coming in to move and adjust the monitor, unhappy with the progression of things and the inconsistent monitoring. Austen was forced to lie down, which put more pressure on the ever increasing pain in her lower back. Her level of frustration was climbing each time she tried something new, worrying about the monitor was taking over her internal focus.
Morning rolled around and the day progressed and Austen and Steve (and myself) were operating with no sleep but we just kept moving through Austen’s contractions one at a time, we worked on many ways to guide her through her labor. Her labor intensified with each bump to the pit drip. Steve watched as his powerful wife was experiencing contraction after contraction in waves of pain he had never witnessed in her before. I could see his difficulty with seeing his beloved in so much distress. I knew he wanted to fix it for her and was frustrated because he couldn’t. We used ice packs to alleviate the pain, but as time progressed throughout the day and Austen did not open more fully the tension became greater for everyone.
As we all began to note the mark of 24 hours passing we did our best to support Austen and each other to keep focused on the “next right move” attempting to shut out the pressure of time and progress we focused hour by hour on just the “next right move” Austen gave her body and her baby every attempt to move into position. I could see her strength was waning and that was understandable. She had fought a long hard fight without the progress she had hoped for. Another bump up in the pitocin brought on a 7 minute contraction that had Austen convulsing in pain. She was already riding one contraction into another with little or no relief. Each wave of contraction required an absolute surrender on her part, giving her body over to it and riding the waves.
After much work and more than 24 hours of laboring with the report of 5cm of progress Austen made the next right choice for her… to get an epidural. She had made every choice she could along the way to give her body and her baby the chances that they needed. Along with the epidural there came some much needed sleep….for everyone.
Within a few hours of her epidural and deep into her sleep the birth team burst in to the room in response to a plummet in the baby’s heart rate. They were pulling people awake and snapping orders to the room and Austen spent several minutes pushing with all of her might. Little Spencer came into the world facing posterior and tangled in his umbilical chord, but healthy and into the arms of a loving family.
Even though this may seem to be a story of things going wrong….it is not. It is the story of a courageous and powerful woman finding her way through the journey that brings her baby into the world. We can know what we want, we can dream the perfect birth and choose our best options but when the time comes we need to know we have the strength and the power inside of us to do the next right thing. Not only in birth…but in life. To know when to hold strong and when to surrender. To trust our intuitions and choices…and certainly as a parent we will always want to have the strength to make decisions by facing the next right thing. This was two days of Austen and Steve surrendering control of what they thought “would” happen and taking each step towards bringing their son into the world with what needed to be.
I happen to know little Spencer is surrounded by waves of love every day. His parents are immersed in the joy of being his parents. His birth story is no doubt a beginning to his life in a very purposeful way, I can’t say that we can know that purpose just yet. But his astrology chart says he will no doubt be a leader. I am sure the strength it took him to get here and fight against the obstacles in his way imbued him with a powerful force. I hope to follow up this story one day down the road…with the story of Spencer, a mover and shaker and leader in his world.
