2nd Birth

I attended my second birth on Friday! The mom has said it is Ok for me to use her name...It was Sunny! She was induced at Regions hospital. Due to Gestational Diabetes, her docs did not want her to go past her due date, so she was 39 weeks at the time of the induction. It was a great experience to watch this family grow. Their family dynamic is really neat...Sunny's husband certainly loves their daughter as his own, and has been around since her birth, but this was the first time, as he graciously put it that he became a father to an infant.

Back on track:

They went in on Thursday night. She was dilated to a one and had a soft, (maybe 70%) cervix. The original plan was to start with Cervadil, but since her cervix was already soft, they went with Cytotec instead. The Cytotec is a little more aggressive and she felt contractions throughout the night. To gain some rest, Vistrail was administered. In the morning, Pitocin was started. I spoke with the dad around 9:30am. He said that there was not much going on, and that he would keep me informed. Around 1:30pm, he called me to say that her water had broken on it's own, but she still seemed to be managing everything just fine. at that point, she was 3cm. I felt the urge to join them at this point, and next time, I probably will follow my instincts. At 3pm, the dad called me to say that she was waiting to get prepped for an epidural, and that now was as good a time as any to come down. I really felt my gears shift at this time. Thus far (in my mind), my role as a doula had been to keep the mom on top of her contractions, to move her around, get her to the bathroom...so I really had to think about what my role would be for a person who can't move so much and is fairly comfortable with pain.

I arrived around 3:30pm. This was pre-epidural. I could feel the intensity in the air. I quickly remembered the delicate dance of interjecting words back into a laboring mom's world as a contraction wanes. The mom was very internal as she managed her contractions. This made me feel 2 things. I didn't know where she was putting the energy of the contraction, so I couldn't tell if she was internalizing tension. In contrast, she also seemed very aware of her mind and body, which made me feel that she had made a decision to have the epidural from an informed standpoint. I suggested that she move around while she had the chance to. The mom did get up to use the bathroom. She tried a few contractions in some different positions, sitting on the ball and leaning into her partner, standing, leaning forward over the ball. She did not like either one. The anesthesiologist came into the room around 3:45. He did the epidural with everybody in the room. Shortly after it was placed, the mom relaxed into the bed. The electricity that had once filed the room dissipated. The mom had one on one nursing since she was high risk. The awesome thing is that her childhood friend turned out to be her nurse! She had a great team in place. Her husband, mother, father, daughter, and friend. Her father, daughter and friend were in and out of the room. The mood remained light. During this next hour, we met her doctor team, one of them being the OB she had seen every two weeks throughout her pregnancy. The baby's heartbeat kept dipping pretty low with each contraction. This concerned the docs. At 4:45, they placed an IUPC and an internal fetal monitor. They hooked a bag of saline up to the IUPC and added fluid back into her uterus. This was to create more of a cushion for the baby during the contractions. At this time, the mom was checked and was 5cm. She took a short nap and I went to pump. The doctors came in and told her that they were heading to the OR and the back up team would come in to introduce themselves shortly. Around 6pm, she was checked again. Everybody that had been keeping her company had managed to leave the room for one reason or another at this time. You can imagine our shock when the nurse told her she was complete! When the dad came back into the room, we told him the news and a look of excitement rushed over his face. The mom asked for her toothbrush and lipstick. I thought this was cute! She was preparing to meet somebody, her baby, and she wanted to be presentable! She didn't have the urge to push, so she asked for some coaching. She expressed concern that she didn't know what to do. Her previous baby had come in 4 pushes. The doctors wanted her to take some time before she started serious pushing. I grabbed some washcloths and started applying warm compresses to her perineum. We directed her to push occasionally. Her baby continued to have dips in his heartbeat especially when she would push, so the nurse wanted to give her some time to labor down. We also helped her move around to rest on all four's. The baby did much better in this position. She pushed with most contractions at this point. She felt it was difficult to know if she was doing things correctly, so I pressed into her hips. I did both the double hip squeeze and counter pressure to the area just below her sits bones. She remained in this position for about 45 min. Her daughter was very helpful and sweet during this time. She mimicked me and put on a pair of gloves. She kept herself busy by refilling the pan with hot water, updating the visitors in the waiting room, and speaking sweet words of encouragement to her mother. We helped the mom back onto her back. The nurse checked her. This is quickly becoming one of my favorite moments in birth. With a gentle opening of her fingers, the baby's head is revealed. The reality really sets in for those observing the birth. The first peek at new life. The room becomes real busy, yet everything remains so calm and smooth. It seems that everybody relaxes a bit with the realization that this birth is about to happen. The bed is broken down, the doctors called in. Additional nurses were also there, as there was a concern for shoulder dystocia. The baby crowned. The doctors said that once the head was out, they were going to take the baby right away. Well, the mom sat there for a long time, crowning. So long that the nurse actually checked the Pitocin drip to make sure that it was still working. This really gave for tissues time to stretch around the baby's head. Her next contraction came and she pushed with everything she had. The head squeezed out. Everybody burst into tears. As soon as the head came out, the medical staff worked together to pull him the rest of the way out. He was placed onto mom's chest right away. while on her chest, he started to cry. The cord was allowed to stop pulsing on it's own, and his big sister was given the honor of cutting the cord. There was no need to rush to weigh him. I later found out that he was 9lbs 4oz! Just after his birth, I looked over my shoulder, out the window to witness a beautiful sunset. I shared this with the dad. I immediately thought "What am I doing! He just witnessed the birth of his SON! Who care about some illuminated clouds!" He later shared with me that this somehow helped to make the entire experience more enriched and complete and has left him with a memory that will not soon leave him. I love watching the father truly understand the magnitude that has been unfolding before his very eyes for the past 9 months. I love watching them become immediately infatuated with this little person. I witness a mother's incredible sacrifice. Pregnancy has ended. A portion of this woman's deepest vulnerability now lives outside of her body. He exists. A child awakens, a family blooms. The baby latched beautifully right away. Such an amazing relationship. Just a few moments go by before a breast is offered, a mother's way to calmly reassure her newly born child that she is still there to nourish him. He isn't on his own just yet. The father took off his shirt and held his son skin to skin while the mom got dressed. A few short moments later, the excited family members filled the room. As the doula, I gathered up this amazing experience, packed my bag, and blended into the room. When appropriate, I congratulated the new family and was on my way.