Trusting outcomes

Every birth is a unique journey

IF only we knew exactly how a birth would turn out before it begins…

We would know exactly which choices to make. Exactly which decisions would create more problems and which ones would get us where we wanted to go just like we thought it should be.

Unfortunately, it simply is not meant to be this way.

The choices and decisions are best made by following the signs and responding to the events with an openness and trust. When we can do this, then, our natural instincts and intuition kick in.

When we make a hard set BIRTH PLAN it often comes to pass that we have to re-evaluate the plan. Things happen along the way you can’t anticipate.

For example, your birth plan might have been to have a physiological birth. A birth that allowed for the spontaneous flow of events to unfold in order for the brain/body balance to provide all that was needed and birth occurred with ease and a bounty of joy and a peaceful entry for your newborn.

Or, perhaps your BIRTH PLAN was to arrive at your birth place as early as you could in order to receive the epidural and manage your birth medically and in the charge of your trusted professionals. Hopefully allowing some ease of mind and reducing the unpredictability of birth.

Neither of these plans is right or wrong. They are each “right” for someone and any birth plan in-between these is “right” for someone.

What I have learned about birth in my many years of attendance is this…no plan is guaranteed.

There is not a way to set yourself up for a predictable outcome. There are too many factors that come in to play. These factors include everything from your prenatal activity to the unknown forces of a new life coming in to the world. They are complicated by decisions your provider is making with you and often without you in regards to the management of your labor.

So… ‘then what’ you ask? How do I prepare for the type of birth I want? What can I expect with the preparation I have done?

I wish I could say it is easy. I won’t because it’s not. It is however simple. It comes down to trusting your instincts and intuition.

Now, I know that not everyone believes in their abilities in this way. That’s understandable. We are all different. Some more left brain and some more right.

I have learned that part of the process is to help you develop those things during birth. Along the way you are challenged to surrender to the process and the voices inside of you telling you what to do so that you will be prepared to take care of and protect this new human life.

By surrendering to the process and by taking a pause along the way to listen to what your body and your baby are communicating you find you have the answers.

The path is yours to choose. Each choice has a potential outcome and a set of consequences that matter and shape the journey. That journey belongs to you and your baby. That has helped me learn to trust the outcome.

I know that when I am at a birth I show up with an encyclopedic birth brain. I have read all the books, studied with all the teachers, and practiced what I have learned over and over to perfect my craft.

I believe women hire me for my knowledge and it helps them have trust. But that trust is often in me. Not birth. I admit it is easier for me.

When birth is your business you get an opportunity to see what is possible.

By having such an intimate window in the way a doula does you see what can go right and what can go wrong. You witness the amazing strength of women and you peer into their pain and fear. It helps you see that no matter what path they end up taking, it ends up being the path this little human needed. The one that got them here safely into their mothers’ arms.

I know not all births end well. What I trust however, is that whatever it takes to birth a human, a parent and a family lies within each birth and its outcome. It comes in what I have learned from women. To trust that even when they don’t know it, they really do have everything they need to birth their baby.

My job then becomes mirroring back to them their strength and fortitude. To support their decisions and trust that at the end of the day she did it. She went through the tunnel and came out the other side. She went in one version of herself and came out the other side somewhat changed.

As a doula one of the first mantras I learned was “not my birth” 11 years later I am even more sure of these words. Her birth. Her journey. In the incredible wise words of midwife and educator Whapio Bartlet – “it is not my privilege to know your destiny” reminding me my role with each and every birth. I am a servant. -albeit with some pretty loving hands.

When labor surprises you

When the call came in this morning at 1:00 am I wasn’t really surprised to get it. D had let me know that she had been to see her Obstetrician that morning. She was 1 day past the 40 week mark and he had stripped her membranes. In all honesty I had even prepared myself for a premature rupture to her membranes and even possibly an irritable cervix.   In my doula experience this can often lead to either of those complications.

A little background – D came to me last spring and hired me as her doula and signed up to take my classes and bought a package of massage & alignment sessions to prepare herself for birth. I love when women realize that the preparation is key to success. Along the way she let me know she was going to be strong, she wasn’t worried about the “pain” she was actually focused more on being able to birth her way, due to the fact that she was on what her OB called a “short leash.” she had some previous medical issues that made him a bit nervous. She knew getting to the hospital was going to be a very closely monitored and limiting experience. So, she would tell me that the baby was going to come early and it would also come really fast. I admit, I do hear comments like this often. I call it a birth wish. But, as a doula of many years I knew that as a first time birther the likely hood of her having a long and drawn out labor was much greater. Statistics.

In the months of bodywork that we did I felt confident that her anatomy and her baby were well aligned for an optimal birth experience. She was mentally prepared and showing a lot less signs of stress and fear then when I first met her. I wouldn’t say her confidence was greater, although maybe it was. I would say her determination was stronger. That was for sure.

Back to the 1:00 am phone call. I sat on the phone with D and her husband R. Contractions had started around 11 ish and were about 10 minutes or so apart, not lasting very long and were not that uncomfortable. In the course of 2 hours she had  jumped to having them every 2-3 minutes, still not lasting very long. My doula brain was processing all the “data”. First time birther, stripped membranes, her voice was several octaves higher than Brittney Spears. Sounds like she is in her “adrenaline brain” and mind and body are in different places….She seemed stressed and no coping very well. On he other hand..she was saying things like…I don’t think I can do this. Are they all going to be like this? I want the needle, there is so much pressure!!!! Well, those aren’t really things a woman in early labor says. Not someone who has been in labor for only 2 hours. Especially.

It’s important as a doula not to make too many assumptions. I sat on the phone with this couple for about an hour. Dad and I did our best to support her to get calm and relaxed. We used positions and water and calming techniques to help her feel grounded and safe. Contractions actually spread out to abut 4 minutes apart but were well over a minute long. Her birth plan including laboring at home as long as possible. We knew between their location and mine that the hospital was about the same distance between us, so we were planning on meeting there, if all went well with them laboring at home. More and more I heard the red flags. From her sounds and tones to the words she was using. I felt it was important to get her OB on the phone and head in to her birth location.

When they arrived at the hospital she began to feel the urge to push in the Emergency Room. She was moved to triage, which became her birth room. As I entered the room they were already pushing with her. A very directed and organized pushing. We new we would be facing that, due to provider and location. A healthy 7 1/2 lb boy was born in to the world just past 4 am.

It’s called precipitous labor. The cervix softens and ripens quickly and dilation occurs rapidly. I admit. I did not see this one coming. She told me she thought it would be that way. And I tucked it away as a possibility. But it was not what I expected. We had joked a time or two about baby sliding right out. He was being very cooperative with the body work. I am certified in Arvigo Maya Abdominal Therapy and as a Spinning Babies Aware Practitioner. I know alignment is crucial to baby being born with ease. I know mama’s anatomy plays a really big role. I also know that in spite of those things sometimes birth is still harder than we hope for. It doesn’t always happen like this.

I give so much credit to this mama. She made the commitment to preparation. She was inwardly determined to birth with ease. She navigated those very intense few hours with grace. It’s hard to prepare for how birth will turn out. We can only prepare for a variety of possibility. Then we, as a birth team rise up to meet whatever the challenge is. Yes, there is challenge when a birth goes quickly. Mama and Baby feel a little in shock afterwards. There is additional repair that can occur and sometimes Baby isn’t very anxious to latch on. That isn’t always the case. It can be though. So there are a few post partum issues this mama is facing. However, I don’t doubt she will face them with the same strength that it took to make the long difficult car ride during transition.

I asked her how she felt about this birth. She was happy. It was what she had hoped for even though it was her wish, It came as a surprise to us all.

Doula lesson #197.(Pretty sure it was also like Doula Lesson #3, but its worth revisiting)  Never underestimate what a woman’s body can do. Don’t assume because its a first baby that it can’t happen in a flash.  A 5 hour labor for a first time Mama IS possible. Listen to mamas’ intuition as well as your own. When it feels like things are not “adding up” follow your instincts. Moving beyond the doubt of….well….it is your first baby, this could be a false or quirky start….and opening up to listening to what the baby is telling us. I am out of here! I have so much to do! Let’s not waste our time here!

Quite sure this little guy has a lot planned for life and he is ready to dive in!

Charlotte Scott

August 28, 2018


A mother’s home birth story

I have had the pleasure to be with this couple for both of their births. They in there own way were each enchanting. It was a joy to witness them as a couple bring their children into the world. -Charlotte

photo 1

Patience was my lesson for both the pregnancy and birth of R; it was a theme that ran the entire nine months and even related to one of the positive affirmations I had affixed to our refrigerator in the weeks leading up to our planned home birth: “I welcome my coming labor and birth as the perfect one for my baby and me.”

Unlike during my pregnancy with first daughter, F. , when I felt I could have happily stayed pregnant for 10 months or more, I felt ready to bring R. into the world. I often told my husband and friends, “I know this [adding a child to the family] has to and is going to happen, so I feel like I’m just ready to get it on!” As my due date approached, my desire to hold my baby outside my body grew and my struggle with patience came to the forefront.

The day before I went into labor I was 39 weeks pregnant. I was supposed to go to Atlanta to spend the day with friends at a coffee shop while F. was in preschool, but I felt really tired so I decided to cancel and stay home. Instead, I took a brisk walk up and down our driveway in a light rain while listening to music and taking some time to meditate on my connection to the baby inside me. Then I took a morning nap until our patio furniture delivery arrived just before lunch. I then spent two hours outside in the sunshine removing the packaging from the furniture, lifting a heavy umbrella into its hole in the table, and just setting things up. I ate lunch, took a shower, and then did a yoga nidra for pregnancy that was sent to me by my doula.

I had told my doula earlier that week that I was struggling with patience and she suggested the yoga nidra practice to me as a way to connect to this baby and this pregnancy before giving birth. I wasn’t familiar with yoga nidra and was confused about why I felt like I was sleeping during the meditation, especially when I had just woken from a nap a couple hours before. It wasn’t until later that I googled yoga nidra and learned that it is a “nap meditation” or “yoga sleep” that puts your brainwaves into a sleep-like state for meditation. I certainly felt that I entered that state during that meditative time before I picked up F.  from school.

Later that evening after dinner I began to notice what I thought were probably Braxton Hicks contractions, although they were a little more uncomfortable than they had been the last couple months. They also seemed to consistently be about five minutes apart. I told my husband, B.  how I was feeling but didn’t make too much of it; in my mind and in all likelihood they could have abated and I could have easily spent another week or two pregnant. I was afraid to guess and be wrong, but I did think we should inflate the birth tub…just in case. So that evening before bed we inflated the tub. I texted my midwife and doula to let them know how I was feeling and to let them know that we would be going to sleep soon after. The contractions did enter my dreams and mildly wake me up during the night until about 1 or 2 am, but then they stopped and I slept through until we woke up with F. at 7 the next morning.

As soon as we woke up the contractions began again. B. decided to go to work and I didn’t encourage him otherwise. I had plans for a good friend of mine to visit with her daughter (who is F.’s  age) and newborn son. I told her I was having uncomfortable Braxton Hicks that I wanted to distract myself from and that I would welcome her company. In the hour it took her to drive up to our home in rural northwest Atlanta, however, the contractions began to change. They were just a little more intense, and a little closer together. Again, I began communicating with my doula and midwife to let them know how things were going. I also gave my mom a heads up that she might have to come pick up F. that day.

My friend arrived at around 10 that morning, and soon after she arrived I was starting to have to breathe and focus through my contractions. I texted again with my doula and midwife to let them know the contractions were lasting about 45 seconds and were about 3.5 minutes apart, and that I was starting to have to cope through them. They began to head my way. I also called my mom to pick up Fiona and texted my husband to let him know he should come home. By that point I was fairly certain we were going to have a baby that day!

B. and our wonderful midwife arrived at about 11. My friend and her children left, and soon after the midwife’s apprentice arrived and then my parents arrived and scooped up Fiona to spend the day with them. The midwife suggested to B. just before Fiona left that she felt things would probably progress quickly once F. was out of the house. She also suggested he bring the tub upstairs (we set it up in our living room) and begin to fill it. I was open to a water birth, and at least desired to labor in the tub for this birth.

Just before noon,  my doula arrived. I was feeling just a touch “pushy” – but none of the uncontrollable urges to push I felt with F.  The contractions so far had felt intense to some degree but not overwhelming at all; I felt much more mentally present than I had at my first birth. I began to feel like I might cry, and my midwife suggested I was going through transition, but it was hard for me to believe that the mild feelings I felt could be transition. Although my first birth had felt fairly mild until the pushing phase I also felt much more “out of body” that time than I did this. At that point I requested to be checked and my midwife found my cervix to be about 9+ centimeters. A little after 1:30 I began to feel the urge to push, but it still wasn’t that uncontrollable urge I felt with F.  For about an hour and a half I worked on pushing little R. out into the world.

I pushed some in the tub, but then became hot and decided to walk around. I tried different squatting positions around the house and eventually made my way into the tub again. A couple times I felt with my hand to see if I could feel her head but it wasn’t in or really even near the birth canal at all. I began to feel really discouraged. With F., the pushing phase took 30 minutes. At one point, my doula reminded me that it was time to let go of my birth of F. and focus on this birth in all its uniqueness. I began to focus my energy and mind on the new baby inside me and on our experience. Every time my mind began to wander back to my first birth or to flare with impatience, I acknowledged the feeling but then tried to refocus it back to the present. Still, I was discouraged at times. Part of me felt like she would never come and that I just wanted to give up. I was so thankful for the encouragement and support of everyone there.

I loved my midwives’ hands off approach. They were encouraging and always present, but for the most part just allowed the labor and birth process to unfold. But at this point it felt like being in the tub wasn’t working anymore; I felt I needed another suggestion to help bring the baby down, and I asked the midwife for something I could try. She suggested taking some time to push while sitting on the toilet, as that’s often a place that a woman’s body can help a baby come down since we are all so accustomed to opening up and pushing on a toilet already. I went with B.  into the bathroom and the midwives and doula were close by. I pushed through several contractions there and while she still wasn’t in the birth canal I could sense that things were changing. I think I wanted to make sure she wasn’t born on the toilet, so I told B. I wanted to do one more contraction there and then move. As soon as the next contraction ended, I decided I wanted to kneel on the floor at the foot of our bed. Our doula followed us in there, and as my pushing sounds began to change my midwife quickly joined her; she knew the baby was coming soon.

Pushing, once again, was the hardest part of labor for me, this time both because of my lesson with patience and also because it’s such an intense feeling for me. Some women describe pushing as a relief and the best part of labor for them; I am in the opposite camp. As she entered the birth canal I could again feel so vividly that feeling that I can only describe as something akin to bone against bone; although her head is designed to mold its way through the birth canal the intensity of it is almost unbelievable to me. I screamed that she was coming, and I began to scream, “help.” I’m not sure what I thought anyone could do! In fact, B (who was my constant, loving supporter and companion through this entire process) asked me how he could help and I think I shrieked back, “I don’t know! Just touch me!” So he pressed his hand against me as she came down through me, and then he positioned his hands below my body and prepared to catch his baby girl as she came into the world.

“Her head is RIGHT here, sweetie!” he said. Those words were so encouraging to me. “I have her head!”

Another push, two, and she was out, into his hands, covered in vernix. Her cord was looped loosely around her shoulders, which probably had something to do with her slow descent. Everyone helped me sit down so I was sitting back against Bill’s legs and I pulled her up against my chest. A towel was laid over us. Little R. started rooting and sucking on her hand right away, so I nursed her even before the placenta was delivered. After the placenta came out, the midwife helped us into a beautiful “celebration bath” full of flowers. She and B took pictures as I sat floating the baby atop the warm water. Then B held the baby while I showered, and we all crawled into 4

The midwives did a thorough exam on me and on the baby. She was 7 pounds, 10 ounces, 19.5 inches long, and perfectly healthy. A couple hours after she was born, the midwives left us to settle in with our new daughter. They came back for another exam the next day, did a phone check-up three days later, and another exam at one week postpartum. We weren’t without the postpartum support we needed, and our daughter’s birth was treated as the safe, joyous event that it was.

B and I marveled at how calm we felt about our home birth. I was considered a very low risk patient and we were aware of the risks of both hospital and home birth. For us, choosing a home birth was what we believed was the safest option forus and our baby, and now we see what a low-anxiety, spiritual, joyous experience it can truly be. I would never suggest home birth for every woman, but for many women it is a safe option for birth. For us, it was the option that made the most sense and is one we would choose again. Regardless of the location – hospital for F or home for R – I believe my soulmate and I enter the birth experience as if it is a spiritual practice we share with each other, and I believe that’s an experience you can achieve no matter where your story unfolds, if you seek it.

A very special birth

As I come to this page I realize that a lot has occurred for me since the last time I blogged here. I have attended 30 births since I recorded the last birth here. Having increased my doula workload has left me a lot less time to record the journey in this way…this birth however, deserves my words. This is the birth of my grandson Isaiah, to my only daughter Roxy. It is a powerful story and I need to tell it.

Roxy began having signs of early labor on 3/31/13. Contractions quickly picked up to the recommended 4 minutes lasting a minute and she stayed with that for several hours. She was experiencing a great deal of pain that seemed intense for early labor. We made a trip to the hospital and discovered she was not dilated and these contractions were effacing her only and not too much at that. I was concerned that she was in so much pain, an unusual amount for where she was.

Let me preface the rest of this post with the knowledge that my daughter has a pretty high pain tolerance. She has 11 tattoos and several of them in places I wouldn’t want a scratch let alone an engraving. She has never been one to take aspirin for headaches or pain relievers. She has been un-medicated for the majority of her life, as well as un-immunized. Any introduction of pharmaceuticals usually led to reactions. When she was complaining about severe pain I was listening. It did not seem that her uterus was contracting hard enough for active labor…but there was concern about what was happening.

After coming back home from the hospital, she contracted very similarly for about 24 hours and then it subsided. We call this predomal labor. Labor that is likely softening and moving the cervix but not necessarily dilating it. It can feel very much like labor to moms but doesn’t qualify for the hospital.

A week later – to the hour almost-…Friday morning April 5th at 4 am we headed back to the hospital. This time she had been having contractions for several hours consistently 3 minutes apart and lasting a minute. Being a little shy about going back she had tried to hold on until she felt like she needed to make the trip back to the hospital. She arrived to find she was definitely effacing but not much was happening with her dilation. Another trip back home left her feeling defeated and doubting her understanding of her body. She sent me home so that she could be alone. A common way she finds her strength has always been to go within and seek privacy.

She continued to have contractions throughout the next 28 hours very similar, very consistent and increasing in strength more and more. Without any sleep, she was exhausted and stressed over the uncertainty of her labor. it was beginning to feel to me that something was out of place. A procedure she had done at 18 was beginning to be the suspicious cause. We went back to the hospital with the understanding, that regardless of the “numbers” she was going to stay. They attempted “therapeutic sleep” A combination of Morphine and Vistaril to hopefully knock her out for a few hours to allow her to relax enough to attempt a manual dilation of her cervix to move through a band of scar tissue that was keeping it from opening. She slept for about 2 hours, it should have had her deep asleep for 6-8.  It was as if she had not been given anything. She was contracting regularly at 3-1 and continued to do so for the next 3 days.

There were two attempts to manually dilate her cervix, the first dilated her from 2-4 and the second to almost 6. The hope was that once she got to 6 she would push through the scar tissue and dilate on her own. We did all kinds of things to assist this, walking, moving, repositioning. Somewhere in the 2nd or 3rd day I realized I had to take off my doula hat and was simply Mama. I watched my daughter go through the torture of manual dilation, constant contractions without change and feeling defeated and losing faith in herself and her body. As a doula I can remain objective and detached to a certain extent. Not so with my daughter. I am very connected to her, sometimes much more so than either of us wishes. I can feel when she is troubled or in distress even when she is miles away. This was taking a toll on her and yanking at my heart strings.

We had been through the gamet of midwives, I felt that each one walked away believing that she was headed for the OR. Our favorite midwife had been on the phone with me and guiding us along the way and now at the end was on call…Anjili would come in the room and you could feel Roxy relax and connect to her with trust. So when on day 5 we started pitocin to see if we could get dilation to occur I knew, and I believe Roxy knew that it was the next right move, she was trusting her midwife and feeling like this was the best decision.

With just a small dose of pitocin she was climbing out of her skin. With scar tissue involved it can feel like tearing instead of the normal feeling of a cervix opening. Granted it is always an uncomfortable feeling, but it shouldn’t be quite this painful…with pitocin she was feeling as if she was being ripped apart. We talked about it and she realized that she would not be able to handle the pitocin without an epidural and it looked like she would need it to get her to further dilate.

Again, the next right move for her. She came in to this believing she would do this drug free. There was a great deal of disappointment in her with every choice to medicate. But as often is the case, we have to take the cue of the baby and the birth to guide our choices.

The therapeutic sleep had felt like nothing to her. She had not slept hardly in days and had been having constant and intense contractions. I was hopeful that an epidural would allow her time to sleep and rest, knowing the work of bringing her baby into the world was still ahead of her. The epidural began to wear off on one side of her body immediately, within a couple of hours she was only numb in one leg. They came back twice to redose her with similar outcomes. It just would not ever alleviate her pain completely. In a few hours they came back and re-did the epidural completely. It too only lasted 2 hours. The midwife asked the anesthesiologist to come back and talk to her, to see if they could do anything else.

He came into the room in a very condescending way, telling her that she was feeling pressure, not pain and that was normal. I could see she did not feel anything like “normal” and dismissed him promptly from the room. I could see her getting angry and defiant. Can’t say that I blamed her at this point…In fact, I think it was just what needed to happen. She had been feeling like pushing for some time already, but the checks to her cervix showed that she was not dilating, her cervix was swelling and the baby had a “capet” which is the baby’s head swelling up through the cervix. So there was little to encourage her. I kept reassuring her she could and would do this, that she was the strongest person I knew. I knew she wasn’t buying it…but… I believed in her.

Her water broke on its own, she was restless and a agitated and she needed to move. She ripped off whatever wasn’t hanging out of her vagina at this point (day 5 in the hospital) and turned herself over in the bed and was squatting over the top of the  bed. I felt something shift inside of her at this point…like no one is going to help me so I have to get this baby out.  roxy

I felt like she had taken charge of her birth, she was bringing her baby down and even after two epidurals was feeling like she was in charge of her birth. She was overcoming the pain of the pitocin contractions on her own, dealing with a furious need to push even though everyone was saying her body wasn’t ready and she got in this position on her own and except for her partner and I massaging her feet to keep the circulation flowing in them she was totally in control of herself… At this point a nurse came in for shift change. She was negative from the moment she walked in the room. She said…”well, we will do that position for a little while” , in a very doubtful tone…as if she was going to direct how things were going to go… Roxy said to the nurse that had been with us. “I don’t want her.” A charge nurse came in and Roxy also said to her…I don’t want her, she has a very negative attitude and I don’t want her in my room.”     ( My daughter is usually the type of person to not make waves, to make sure everyone else is okay with things…it was a true moment of her finding and using her voice!)

Her midwife walked in and said…WELL! We are back to a natural birth! I know all of us in the room felt that way….However, I after so much time with no real progress, her midwife had come to the same conclusion that every nurse and previous midwife had come to…she would not birth her baby…she was headed for the OR. She asked me to come talk to her and DR. B.

So we called in the man I consider the Super Hero of birth. I have worked by his side on many occasions and seen him change the scene in an instant.  Plus, I knew that if she did need surgery this was the person I trusted the most to do it.  I also trusted the staff of Intown Midwifery to give her the time she needed and not default to a surgical birth. In ANY other hospital I know of locally she would have had surgery days before.

Dr. Brad Bootstaylor looked at me, asked me about Roxy’s state of mind to which I said currently she feels empowered, she has taken charge of her body back. So in his gentle and wise way he says…”we see what we see, right?” I know when he walked into the room Roxy must have realized that she was at the end of her choices. But I also know she trusted everyone in the room. Her dream team was there. Anjili, Dr. B, her partner and her mom… and that whatever she had to face was something she could handle…

Dr. B asked her to roll over on her back and let him check her. He reached out to her child’s father and brought him in close and said we all bring our positive energy in. I felt such a powerful wave of support from him. He had her push about 3 times while gently moving the cervix out of the way. Had Anjili check her and the cervix was gone. Roxy pushed for just under an hour and brought her son into the world. I got to catch him, with the help of Anjili. Through a fully intact perinium, 22 inches long weighing 8lbs and 5 ounces our little Isaiah came into the world as calm and peaceful as you can possibly imagine. Roxy and Zay cropped

The side stories that I can no way go into here are also amazing. The bonding between his parents, the growing up of a woman becoming a mother, the support of families, the overcoming of the doubt of a hospital staff and a midwife practice and the respect my future son in law had for Dr. B that just might change his life…and a little boy that changed all of our lives, and the letting go this mother is doing more and more every day. My daughter became a mother and in a way released a tether we had always had. She doesn’t need me in the same way she always has. She proved to herself and many others that she has incredible strength, tremendous fortitude and an undeniable will.  From the moment he was born she has felt fantastic. She was up and out of bed immediately and surprising the nurses.

I know she feels like she had a “natural” birth…in the sense that she felt unmedicated and in control at the end, even though she had to keep choosing over and over the interventions that would take her to the next phase. Both mama and baby are doing fabulous and I learned more than you can imagine!

A gift of thanksgiving…

Fernanda shared with me that she had been having light contractions off and on for several hours and was kept awake with some pretty strong ones at 3 am. She felt it was likely early labor still, but wanted me to know. As they increased she found that she was able to handle them pretty well as long as she could stay in the shower. She did pick up pretty quickly and appeared to be moving through the early stages of labor with ease. In talking to her she was calm and focused. Being in the shower was so helpful but of course the hot water heater was challenged to keep up. She began  imagining the endless hot water at the hospital. I believe the choice to go to the hospital was perhaps even inspired by this.

As it turned out her timing was pretty good. She arrived at the hospital in early active labor.  She was planning a water birth and had to wait to get in the tub until she was 7cm.  Once they ran through the preliminaries of paperwork and monitoring she was able to get back in the shower where she had already been finding lots of comfort. I felt she was handling things very well. She had found a good vocalization that was working well for her and when it was time for her to get into the tub it brought even greater relief,  her contractions were running very close and getting stronger and stronger. She moved to 9 1/2 cm pretty quickly. It seemed to all of us that baby would be here very soon.

And…the unpredictable way that babies arrive into the world left us through the next hours facing wave after wave of surrender. Fernanda stayed strong and focused, allowing the water and her vocalizations to keep her calm. Her husband and mother both too had to find that place of surrender, trusting, waiting…. Contractions slowed down, exams were showing an anterior lip, just a small one, but enough to keep baby from descending far enough down.

We thought of lots of ways to help her move in the water to open things up. Fernanda moved through different positions, swaying her hips in the water,  listening to her body and moving to help the baby move. It can be frustrating to be so close and yet feel that you are still so far away. After several hours she made the decision to let the midwife break her water, in hopes that would create additional movement and allow her to stay in the water without  additional monitoring. The midwife was hoping to keep her from having to get out of the tub, due to the rules of 4 hour monitoring required. Breaking her water brought on much more intense contractions.

I watched Fernanda constantly dip into her internal well of strength and keep moving, helping her baby labor down, letting the water, movement and voice be her pain relief.  When she felt enough pressure to start a focused pushing she pushed for 2 hours. Concentration and focus seemed to be her greatest gifts. Even when I know she was feeling like she couldn’t go another step I watched her let go a little more and keep her focus.

Fernanda shared with me during her prenatal visit that through out her pregnancy her body just continued to surprise her. She felt strong and healthy and one of her top 5 desires for her birth was that her body continue to surprise  her. I believe that is exactly what happened. She demonstrated a calm and powerful woman, moving and listening to her body with little need of intervention. She trusted her body that it knew just what to do…and of course…it did. Even in the difficult challenging moments, it seemed obvious to me that she remained true to that trust.

We watched the hours tick by in the end. A waiting game that is never easy on anyone…especially mamas. This little guy wanted to be born on Thanksgiving and so…he was…at 1:03 a.m. Of course we were all in grand celebration at his emergence. The gratitude and relief spilling over  everyone as we greeted this little new person into the world. When I left them they were wrapped in a bubble of bliss. I drove a very elated Grandma home for some rest.

A mother’s story

I wanted to let you know that we welcomed our sweet little boy, Nikhil, on Saturday, October 29th (on his due date) at 5:35pm weighing in at 6lbs, 13.7oz and a length of 19.5 inches.

I plan to write the complete birthing story when I get more time but thought I would give you a summary of how it all happened.

I woke up on Saturday morning and spent the morning hanging out with my older son.  Around 1pm, I went to the restroom and noticed what I suspected was my mucous plug so I called Anjli (Intown Midwifery) and she confirmed that it was the mucous plug.  She asked how I was feeling and I told her I felt just fine with no cramping or contractions.  She said that it could be a few hours to a few days before I went into labor but that it’s coming.  After getting off the phone, I went downstairs and had lunch with the family but then I wasn’t feeling well so after lunch (around 2:15pm) I came upstairs to take a nap but instead realized that I was having contractions.  I decided to take a bath thinking that if it wasn’t true labor then things would die down but in the tub, my contractions continued to get stronger.  I told my husband to pack the car because we were probably headed to the hospital in a few hours.  When I got out of the tub, my contractions were only 2.5 minutes apart but they were only lasting 30 seconds.  We called Charlotte and Anjli again and they both agreed that I could either wait a couple more hours or I could go on in.  I decided to go in because I wasn’t sure if I could sit through the 45 minute car ride with even more intense contractions if I waited.  So around 4:15pm we started our journey to AMC.  I continued to breathing deeply with each contraction and yell at my husband between contractions criticizing his driving.  We reached AMC  little after 5 and I opted to go through the main entrance and not the ER because I didn’t want to sit any longer.  After getting into cat/cow position in the lobby to get through a contraction (reminded me of Emily during that exercise when she pushed the baby put), we made our way up to the 7th floor.  When we got into the triage room, I asked the nurse if needed to change into a gown and she said not yet because she wanted to check me to see if we were going to stay or leave so I slipped off my pants only.  Lying down for them to check the fetal heart rate was the hardest thing ever and then when she went to check me, all I could think is that I better be more than 3cm and that 6cm would be ideal because during my prenatal appointment with Charlotte we set 6cm as a goal to reach before asking for the epidural.  Yep, my birthing plan included getting the epidural.  I never wanted to have a completely natural birth, I just wanted to get to a point where the epidural didn’t slow down labor to the point I needed pitocin.  My goal was to avoid pitocin.  Well, it turns out I was completely dilated and the baby was on his way out so the nurse ran out yelling for Anjli.  Anjli came in and I begged for pain medication and she said it was too late.  Being a Pharmacist, I started naming EVERY pain medication I could think of and she looked me in the eyes and said, “you can do this”.  I was screaming, “I can’t do this”, “I need my mommy”, ” Why can’t you give me something” and then somewhere between pushing I came to gripes with the fact that the baby was coming and that’s when I started to think of things we went over in class.  I went into silence and closed my eyes and only listened to Charlotte’s voice (she was my doula) as we did during the yoga nidras in class.  I felt each contraction was a step closer to meeting my baby and within minutes, I was holding my baby.  A few minutes later, Charlotte asked if I wanted to take my shirt off so we could have skin to skin contact…..I then came back to reality and realized I delivered in the triage room and never did change into a hospital gown, I was still wearing the t-shirt I come in with. I did it…not only did I make it past 6cm, I gave birth the way I was meant to all along!!!

As far as my experience at AMC, I couldn’t have asked for anything better.  I remember during the tour I thought that AMC doesn’t look as comfortable and definitely not as nice as Northside.  What I learned is the view makes up for any additional features Northside provides and the nursing staff actually gets to know you during their shift….so my experience was so much better than Northside.  Everyone said the food isn’t the best as AMC so I made sure I just ordered food that I wanted and thought was safe….I ate a lot of peanut butter and jelly sandwiches and had family bring in food for other meals.

 For those of you who haven’t taken a Breastfeeding Class, I highly recommend the couple’s class through A Labor of Love.  Also, instead of a boppy, we went with “My Brestfriend Pillow” which was recommended by Teresa and it has made breastfeeding easier.  I did have a 2nd degree tear so the boppy is great to sit on for me:)  As far as other things, Anjli gave me a list of things they suggest for different postpartum symptoms- from herbal remedies for sitz baths to homeopathic medication for soreness and pain relief.

Divine timing….

It’s nice to think we are in control. But, alas we learn, life is actually somewhat unpredictable and uncontrollable. I’ve come to learn that control is an illusion. We can plan and dream, but the outcome has to happen in trust. Trust Birth. Trust women. Trust the something more that guides us behind the scenes. I will forever be changed by the events of September 25th, 2011. Any perception that I might think I am in control…I surrender that now.

Carrie called me at 8:30 pm, having just left church where she was beginning to have some serious contractions. I listened carefully to her voice and it sounded as if she was in early labor, she was calm , but wanted to let me know she was going home and pack and head to the hospital.  We had several conversations about the speed with which her last child entered the world and we didn’t want to risk the 45 minute drive to the hospital.

I was drumming outdoors with my drum group and decided to finish up and take the drums home.  I was able to go home, change clothes, pack and get on the road  before I heard from Carrie’s husband that they were headed to the hospital.

We decided I would meet them there. It was 10:17 pm. By 11:00 I arrived at the hospital to find the two of them walking the halls…Carrie looks at me and says “we got some work to do…” Her cervix had been checked, contractions had stopped for the most part and she was found to be 3 centimeters. We walked the halls and gave her a chance to tune in with her body and see if we could get things moving again. It is not uncommon for labor to slow down once woman get into the hospital environment. But it is unpredictable how long it can take to move back into a good rhythm.

As we walked contractions picked up, but were erratic. We had about an hour before they checked her again and when they did they found no changes to her cervix. The mid wife suggested Ambien so that she might go home and sleep for  a few hours. She was happy and chatty and still a bit modest and those are signs  usually indicative of early, not active.. labor. Later I was very grateful that Carrie chose not to take anything to sleep. She promised to try to rest on her own.

The level of pain isn’t usually  the best monitor for where a labor has progressed. It’s usually the attitude and atmosphere of the mother.  Carrie was relaxed, coping well with her discomfort and still very much engaged in what was going on around her. Perhaps she was feeling nervous, but it didn’t show.

However, once we got to the exit and it was time for her to get in the car  she gave me a very serious look and asked me to come back to her house with her. I was very relieved she asked.  After all…birth is unpredictable.

Once home I encouraged her to shower and try to sleep. I could tell from the sounds I was hearing that she wasn’t going to rest much…I decided to squeeze in a power nap while she tried.

Her husband reports from the balcony down to me in the living room…Carrie felt the baby move significantly while in the shower, thinking perhaps she changed positions, she had been feeling a good deal of back labor and we had been trying to guide the baby in to a better position.

NO naps for any of us, they came downstairs pretty quickly.   Things still appeared as before but seeming to intensify.   By all indications she was moving in to active labor.  I did mention…the hospital was 45 minutes away…I say to her husband…time to get ready to go…well….no….maybe not…


suddenly, in a quick turn of events that had us all in a prayerful moment little Olivia insisted it was her time.


She arrived very quickly at 4:55 a.m into the world,  in her home, into her parents arms…pretty and pink…just like we like them to be.  It’s mind boggling to think that a mere two hours before we were standing in the lobby of the hospital contemplating our next step.

There were 5 things that I asked Carrie to list for me that were the most important things for her to have for her birth. I think they deserve to be repeated here…I believe she had them all.

  1. Healthy baby
  2. Fast labor process
  3. Immediate connection with baby and parents.
  4. Medication free
  5. Plenty of love, less “clinical” introduction for baby to the world.

I especially love number 5. I know that it wasn’t planned to happen in the living room of her home and being transported to the hospital holding her baby…but I have no doubt that this little girl got exactly what her mother hoped for. Fast…oh my yes….she was born with an immediate connection to her parents, into a beautiful space of devotion and love, yes…medication free and certainly…no clinical birth for this little girl for sure.

As for me…the doula… well, let’s just say I will never be the same. I am grateful for the love and guidance that takes me through life and places me exactly where I am meant to be with divine timing. I am grateful for the 37 years of motherhood that prepared me in the ways of handling crisis…act now…freak out later 🙂 and I thank little Olivia for the inspiration to embark on taking some midwife classes. Who knows where that might lead…

An amazing transformation and turn of events.

If I were going to make a film depicting a woman’s true power and the use of  her clear voice, showing her ability to birth with inate wisdom and trust…I would have simply filmed this woman’s birth….

This was a long week for Anna, we had several conversations in the middle of the night, texts and emails throughout her days as she felt each and every contraction that began gently and slowly, but very much getting her attention.

According to her midwife she was 2cm and only partially effaced on  the 20th,  she was extremely positive and staying very busy,  moving into her wonderful new home and chasing after her very precocious and active 2 year old daughter. Amongst the busy-ness though her body began to demand her attention. Easy contractions  were making themselves known, even possibly present due to needing water or over doing. We talked and she would remind herself about the slowing down, about drinking water.  As the days progressed, especially the nights she would have contractions picking up…getting closer together, feeling stronger and then a shower or some sleep would slow them back down.

On Thursday, the 28th (6 days prior to birth) we talked about how she could use some of the things we talked about in her prenatal. Sitting on the ball, using the ball for child’s pose, a yoga move called pigeon…ball supported, doing some hip circles and “Dancing for Birth (TM)” moves I had shown her. Hip circles are a wonderful asset to oncoming labor. She made a plan to start moving inward and listen to the needs of her…water…

Another midwife appointment revealed nothing had changed, still the same, 2 cm and only 50% effaced. She was told to go home, eat some chocolate, she WAS NOT in labor. These are never words a mom wants to hear, especially one that has been contracting already and hoping for progress. But Anna stayed very positive and feeling as if everything was happening just as it should. She was enjoying the chance to feel her way through her labor, something she missed out on due to an induced and medicated birth the first time around.

On Friday Anna began to notice a change in her contractions. Her back was beginning to ache a lot with each one, the cramping was getting more intense and she talked about new sensations that were moving through her belly. Contractions were still erratic but more intense. I was beginning to notice how they were consistently lasting at least a minute. Something I don”t usually see until later in labor. Something was beginning to nag at me, a feeling that this baby was not quite positioned optimally for birth. Although erratic and inconsistent contractions don’t necessarily mean that, I was feeling a need to perhaps make a visit to Anna’s and see if we couldn’t do some things to help if that was the case.

Upon looking at Anna it appeared to me that her baby was lying transverse, side to side alignment. Upon closer inspection it seemed that her baby’s  bottom was up in Anna’s right rib cage and her head was up against her left hip bone. We spent about an hour or so on Saturday doing moving to help things along.  Dancing for Birth (TM) has given me a lot of moves that can help realign and position a baby not quite in its birthing place. We also did some yoga, on the ball and on the floor. I encouraged her to use these things regularly. I suggested even time spent sitting on the ball would help.

When she stood up from our time together and we did some walking around the room I took a look at her belly, it looked much different. Although baby was still predominantly on the right side, she seemed much more vertical. What  I could now do was go home and trust mother nature to do her job.

I received a couple of calls through the night from Anna, some mucousy fluid and bloody show were followed by stronger contractions. It was morning though before her contractions were consistently 5 minutes apart and lasting a minute each. She made a decision to go to the hospital, feeling concerned that the distance would be too great if she got much more uncomfortable. After arrival though, as often can happen, contractions slowed down and during the whole paperwork process almost stopped.

Finally, left alone to labor, at least for a little while…walking, moving and taking  some time in an effort to get things back to the pre-chaotic hospital state.  Time gave way to contractions, although erratic, but steadily getting stronger. Anna was handling each change very well. A few trips around the halls would get them going pretty good, but when tethered to the fetal monitor things would slow down and decrease. Something was going on, we weren’t certain of what it was, but trusted the possibility that my suspicions of fetal positioning problems might be slowing things down we kept moving, adjusting her body in an attempt to move the contractions away from her back. We did  lots of  hip circles and “dance” moves, specific yoga postures and Anna’s favored position of child’s pose on the ball. This is a great support for labor, we consider this as moving the baby “into the hammock” where there is plenty of room to maneuver.

The monitor was an often intruded inconvenience. Of course the insistence of every hour for at least 20 minutes was demanded. Around noon or a bit after the monitor was picking up Sarah on the opposite side, the left side. She had been lying on the right the whole time, they had always picked up her heartbeat just above Anna’s right hip. They left her for quite some time on the monitors this time, the midwife was directing that the monitors stay on. Even indicating that she would not be able to continue unmonitored. There was growing concern about a low base line, picking up mom and baby’s heart rate together, decels with contractions. My concern was that she was pinching her chord and was doing so after she made the “flip” from one side to the other. The concern of the staff was also chord compression.

This was a huge turning point for the Midwife. She started talking in an aggressive approach kind of way. She mentioned C-section. There were plans within the couple to get a second opinion, to call the physician of the practice..they were considering whatever option they had to take to make sure the right decision for them and their baby was being made. I noticed Anna’s calm. It was wonderful for me to see a woman moving through these mysterious waters so calmly. I am sure there was great concern for the safety of her daughter. But what I saw was calmness, and her entire focus on…what do we do next?

While the midwife was away we went on the assumption that if we move the mother we move the baby. We got a very tired Anna up on her feet and moving around. On her hands and knees on the bed seemed to be the best position when it came to Sarah’s response to her contractions. The midwife wanted to break Anna’s water to insert internal monitoring to make sure exactly how the baby was doing. Upon exam though it was determined that Anna’s water had already broken, a fact that we suspected but weren’t focusing on. The nurse had earlier used an amniotic swab to determine if it had and it came back negative. A fact that felt as if the birthing goddesses were looking over us. Ruptured membranes gets a very harsh treatment, constant fetal monitoring and an ever impending time limit. When the midwife found there to be no membranes the decision to have the internal monitors put in place seemed like a good one in Anna’s mind. She was so tired of the belts that just seemed to create more stress and was not helping. There was also a decision to allow for amniotic infusion and an iv for fluids for Anna. The infusion was to assist in case there was chord compression somewhere, it was believed that it would help float the chord.

Whether it was the fluids, the movement or just the natural progression of labor there was a turning point. Little Sarah began have great accelerations. She eventually settled in to an acceptable pattern and both Mom and baby got a little rest. But…with another visit from the midwife came another round of unwelcomed news. She was discouraged by the slow labor. She had checked Anna and found her to be 5 cm, which was no change from hours before. She was suggesting the introduction of pitocin. The midwife mistakenly said 6 hours, but it was closer to 3. It did seem a bit premature, since most of those 3 hours was spent repositioning for the baby, clearing the chord issue we assumed and some resting. Anna and her husband insisted on more time. Give me an hour she said. And gladly, the room emptied and the three of us went to work. Anna’s attitude was that she had an hour to make a big change and no matter what..she would make that change.

We did a combination of things that had worked up to this point but I had something tucked in my “tool bag” that I had been feeling it was time to use. We did what is called a “pelvic floor release”  for three contractions, we then had her turn over on her back and I did a technique called diaphragmatic release. , Anna remembered the suggestion of the nurse to try nipple stimulation, it releases hormones into the body that stimulate labor and she added that to the release. In moments her body shook in a wave, something completely different was taking over. We were planning on getting up and moving to some of her favorite music after that but she decided she needed to stand up and go to the bathroom instead. She and David went into the bathroom together and had some time to focus with just each other. Very quickly she began making the sounds of a woman in transition, her body convulsing as the pushing urge took over her.

The nurse and midwife came into the room just at their one hour promised time to find Anna, deep into transition. They ushered her to the bed where they checked her cervix to find her fully dilated and baby’s head reachable. To their amazement they had to hop to it to get themselves ready. Anna was able to push on her hands and knees for just a few pushes, pushing her baby out with relative ease. It was a beautiful site and a wondrous feeling. I could see the joy on the couples’  face. It was not just the arrival of this baby girl, but the feeling of having conquered the impossible. Joyful tears filled the room. Mine were included.

Dilating 5cm in 1 hour is pretty amazing.  It reminds me how all things are possible. There was so much negativity and doubt being delivered by their care provider, but all I saw on the face of these parents was a determined focus. They banded together and faced each moment together, urging their daughter into the world, through love. If fear was present…it wasn’t here in the room. It might have been hanging outside the door…but here, just open welcoming arms for a safe passage.

I walked away impressed, imbued with hope and a deeper sense of belief in things I already held true. I took a look at this little one’s astrology as I always do on my arrival home and the thing that stood out the most was the power of transformation that will no doubt follow this delightful girl throughout her life. She sure arrived in one of the most profound transformations I have seen in some time.