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 body..rest…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.

Defining the warrior within

Imagine strapping on several extra weights to your body, climbing a mountain and not being able to stop to rest. The mountain as it rises above the horizon disappears into clouds and the end of your journey is not in sight.  Most of what lies ahead of you is a vast unknown, but from the first step you take you are committed to the climb. Whatever rest you might get will fall in between the strides of your step. Labor can sometimes feel like this. It is why, in my opinion, that a number of women will not choose to have a natural, un-medicated birth. It just seems too hard. It is called labor for a reason.

The choices women make during birth are often made one at a time. You walk in with a “plan” and hope to be able to stick to it as much as possible. The path to birth can often change in midstream and each leg of the journey takes delving deep into your reserves and coming forth with the next right move.

In the midst of a thunderstorm late one night Gayle’s water broke, containing meconium. The presence of meconium meant that her plan to labor at home as long as possible had been superseded by the need to be protective and safeguarding her son’s arrival. Heading out into the storm they made their way to the hospital, were admitted and discovered that she was dilated to only 1-2 cm and  contractions had not yet begun. The first hurdle to climb was surrendering to being on a full time monitor and laboring at the hospital instead of comfortably at home.And while the safety of baby trumps personal preferences, there is also the emotional hurdle of letting go of the “plan.”

My plan after their last call was to sleep, feeling that my strength would be needed by morning and I wanted to be ready to meet the challenge. I did not sleep well. Each time I feel asleep I woke up to dreaming that I was at the hospital with Gayle. About every hour or so I would wake up and realize I was still in my bed. At 5 am I awoke to a knowing. I needed to go. It was helpful that her husband later told me, he felt my timing was perfect. I was glad I listened to my intuition.

When I arrived I discovered that their night had felt productive to them. Her contractions had picked up good and strong and she was moving through them well, they had done that for several hours. However, by the time  I arrived at 6:30 am things had stalled out and not much was happening. In this situation if her water had not broken the night before they would likely have sent her home and asked her to come back later. We did not have that choice.

Gayle  asked for a “reprieve” from the constant monitoring so that she might get a shower.  Staff was able to get a strip of responsive time on baby and gave her permission. Another hurdle crossed, yes..they wanted to be in charge but she did have a voice. I know that was a very enjoyable shower for her. Between the shower, some walking around and movement  and gravity Gayle’s labor once again picked up and started moving. In fact, she moved well into contractions that were 3 minutes apart and lasting a minute or longer. There was a point, I even felt as if she might be headed towards transition. Her body language and her contractions gave every indication that she was progressing very well. The morning melted into afternoon and the hours of the day crept by one by one.

At 2:20 pm  the OB came in to check her progress and reported that she was  4-5 cm. She did an exceptionally painful exam, popping a small sac of membrane and stretching open her cervix. It created a series of very strong contractions that seemed to pick things up even more and creating a great deal of discomfort. Gayle was handling the increased sensations very well. She moved within to a quiet place and worked through them one at a time.  The intensity and the frequency were increasing and holding often at 3 minutes apart, lasting at least a minute often longer. Those long lasting contractions are the ones we want, they dilate the cervix and bring the baby down.

The next great hurdle came when the nurse came in and said that the Dr. wanted to assess her progress. She had been laboring hard for several hours, I believe they too thought things were progressing well. As it turned out she was still 5cm. All of us, Gayle, her husband Eddie and myself all expected that number to be higher. This is the fallback to vaginal exams during labor. Perhaps if we had gone with our own assumptions things might have continued to change, even if that was slow. But the news came like a weight, especially to Daddy, raising doubt and uncertainty.

Gayle was amazing though. She kept digging deep within herself to not let that rule her thoughts and push forward. She would get up and walk around to hopefully stimulate progress, and we hit walls. Sometimes small ones, sometimes big ones and Gayle kept climbing the next hurdle taking them one at a time. Up on her feet and moving she would contract strong and frequent, she would rest or lie down and her contractions would slowly move farther and farther apart and at times slow to nothing.

She was exhausted, sleep walking (or sleep dancing with hubby) or crawling into bed to sleep through just a few contractions, while she carved out the much needed time to prevent an unwanted intervention.  She received some IV fluids at 9:30 and started to have some considerable back labor. She pushed through the challenges, moving around as much as she could, dealing with her aching hips and the onset of back labor. The clock was ticking away, I know the three of us tried to avoid watching the time click by but we knew that there was a 24 hour limit to the insistence of an intervention.  As midnight rolled around we began to have the talk about what the next best thing would be. Even though I could see she wrestled with herself about having hands up inside of her yet one more time she gave in to an exam before agreeing to the introduction of pitocin. There was some wavering in both of them prior to the exam but the news of 5cm was disheartening and eventually Gayle felt the next best thing for her and her baby was to allow a small dose of pitocin.

Contractions began to ride one into the next, between each one I believe all three of us might have been dozing. Sleeping in the almost nonexistent  rest cycles and giving her pressure, support and energy to get through each contraction. I have to say at this point how amazing it is that she wasn’t even talking pain medications. Even though Eddie brought the conversation to light she moved past it and if she were debating it on the inside I never saw it.

Again they checked her at 2:25 a.m. after the pit had been nudged up each half hour. She was 8 cm. It wasn’t long before she was feeling the pressure to push, but it would be hours before she was able to push him out.  WE later learned a nuchal chord was wrapped around him once and it was making it hard for him to emerge. It was likely the stress he was experiencing in all of his attempts to push through her cervix was the interference of his chord. For nearly 3 hours Gayle gave all of her effort and then some to bringing her little guy into the world.  The heaviness of effort and weariness cloaked the room with focused intensity,and at  5:57 a.m. 30 hours after her water broke and in the middle of yet another thunderstorm little Maxwell emerged and the energy in the room was completely changed. Gayle was suddenly lively and full of energy, sparkling eyes and I believe words like “holy f….k” on her lips.

It was unfortunate that those following moments also did not meet Gayle’s plans. She had to give her new son a quick peck on the cheek while he was whisked away to NICU, to make sure he was alright after his long ordeal. It was interesting to note that upon being born he cried and squirmed and generally sounded unhappy, but when presented all bundled up to his mama he became quiet and peaceful  Just the feel of her breath on him and he was soothed instantly. He was followed by a dazed and a little bit loopy daddy to NICU. Fortunately his stay was not lasting.

We use the term “warrior women” amongst ourselves as doulas. We seem women at their most courageous, their most vulnerable and witness the incredible strength and fortitude that they have. That causes us to give them the title we bestow in awe and honor. Gayle came through her birth with all the strength of a warrior. She pushed herself past places she most likely didn’t even know she had. She held as true to her birthing beliefs and desires as she felt supported her and her baby in the moment. It takes as much strength to surrender and allow changes to your plan as  it does to ask yourself to push beyond your conceived limitations. We welcome you to a long line of warrior women Gayle and in to the welcoming circle of motherhood.

Maxwell  was born with 4 planets in Aries. Aries is the sign of the warrior, ruled by the planet Mars. It all seemed rightly fitting that he began his entry into the world and his labor journey in a thunderstorm and emerged during a thunderstorm. I am reminded by an image of Mars the Warrior God from mythology with a spear in his hand made from a lightening bolt.  May the force be with you, little man.

Inner strength and inate wisdom…gifts of a natural birth.

For several days Holly was doing what we call prodomal labor. She wasn’t officially in “active labor”  Even though she was reported to be 4cm at her midwife appointment and was experiencing mild contractions she was not considered “in labor.” and reassured to go about her day and “real labor” would start and very likely she would have her baby this week. Sometimes this stage is referred to as “false labor” but most women will tell you…it feels very real to them.

On Tuesday morning, after I heard from a very defeated and teary Holly. She was feeling strained and drained by the constant contractions…she said they had been happening all day every 2 – 3 minutes, however they weren’t very intense or lasting very long. Holly is a first time mother, never having experience labor contractions before, she did not have a point of reference about these contractions or what is to come. I could hear in her voice she was feeling stressed and tired. I reassured her by reminding her of the process her body was going through. I encouraged her to see it as “progress” it just was not “measurable” yet. But it would be. I assured her that her body and her baby were working together towards her daughter’s birth. We talked about her fears and concerns, the “what if’s”  that were on her mind. I even assured her that it was possible with the first stage of her labor going so slow and easy that perhaps the later active part would move quite quickly. That seemed to cheer her up a bit.

Early labor is a time when the uterus is being prepared for birth. The cervix must thin and the early dilation stage can be very erratic and without any defined pattern. It can start and stop, it can come on very slow and mild and sometimes last for days. Holly had been experiencing contractions for several days. I had hoped this reassurance would help her find the calm she needed to guide her body in its process of opening.

I wasn’t surprised when I got a phone call that night from her husband at 11:00 pm. Holly’s water had broken and she was experiencing much more intense contractions, quite close together. We made a plan to meet at the hospital, for them only minutes away. Over the phone I could hear Holly in the background. Her voice was high and stressed and I could tell she was having difficulty with the contractions. She wasn’t up for talking with me on the phone…I took that as a sign that things were progressing pretty fast.

By the time I made the trip downtown to the hospital, found a place to park and made my way to labor and delivery Holly was well settled in to her room. She had been told her desired water birth wasn’t going to be an option. They had discovered meconium during her exam. The good news was that she was 7 cm. and things were looking very good!

When I walked into the room and looked at Holly I saw the face of a girl. She looked scared and uncertain and a little panicky. I could see she was worried whether or not she was going to be able to handle what was to come. I know there can be those moments of overwhelm…can I do this?? Am I going to be able to handle the pain? I could also see past her concerns to the part of her that knew exactly how to do this and what I saw emerge over the next few hours was a strong and confident woman, trusting her body and believing in herself.

I always encourage mothers to find a pattern. A pattern they can focus on that helps them break each contraction down. Taking them one at a time and staying in the moment. Fear comes from focusing on the past or the future. Being in the moment, taking things as they come and not worrying about what comes next can be very empowering. Strength comes from the realization that we have what it takes to handle this moment.

Holly’s ritual of labor was sitting on the birthing ball in the shower with her husband anchoring and grounding her with his love and support and a steady flow of ice chips for her to chew on. Each wave of contraction was met with gentle reminders to relax, lower her shoulders, let her voice go deep and low into her body. Listening to her body, moving when she needed to move, rocking with each contraction and breathing with low, deep purposeful sounds she moved through the following few hours reaching for the trust and confidence she needed.  When the nurse came in for an exam at 2:00 am she reported she was fully dilated. I could see the relief in Holly as her body seemed to relax even more, she moved into her contractions with fortitude and resolution. I heard her call from the shower with new found strength.. “I’m doing this..” as if for the first time she really understood how capable she was of bringing her daughter into the world.

She pushed as her body directed her for another hour in the shower. Midwife Margaret came in and sat with her, checking on baby and finding out she was doing fine. On Margaret’s encouragement I heard Holly say…”Oh my God!” as she touched her baby’s head, she was so close.

She moved to the bed and used a variety of knee chest positions as well as using the pushing bar. I watched her face with each push and I watched something get born INSIDE of Holly. She had been gathering a sense of her strength, learning to trust her body and believing in her self …and what I saw blossom in her during her pushing phase was her wisdom and power. It emerged in the outline of her face and literally unfolded in her body as she opened her whole being.

Her beautiful daughter was born letting the world know she had a powerful set of lungs. Which was good, since there was a great deal of meconium and her crying was helping clear out her lungs.  She was born at 4:09 am. Only 6 hours after Holly’s water broke. She emerged with a roar to let the whole world know she had arrived! Holly’s emergence was no less profound…she too had found a voice within her that I know will stay with her always.

I left watching a happy family, content little girl nursing and parents blissfully smiling and I was home before sunrise, feeling that all was right with the world. A new journey had begun.