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!