The Path Toward the Rest of My Life: Birth Story of Identical Twin Boys

by Jess Helle-Morrissey, MA, MSW, LGSW, LCCE, CLEC

23 weeks pregnant with twins!

23 weeks pregnant with twins!

Nothing about my pregnancy went according to plan. After nearly 12 years of marriage and completion of my clinical social work graduate program, my husband Mitch and I decided it was finally time for us to start thinking about a family. Part of me always knew I’d have twins and so when I began dreaming of twins in the 5th week of my pregnancy, I had a feeling then that something magical was happening. And when I would talk to “baby” in my tummy, every cell in my body said, “That’s not right!” So I always talked to “babies” instead, just in case…

Each time we had a midwife appointment, Mitch would ask, “Can you tell if there are two in there?” (We have been together a long time – long enough for him to know that my intuition isn’t usually just a fluke.) My best friend was pregnant at the same time, due the same day, and I was consistently bigger than her, and MUCH sicker than her. I remember one day shopping for maternity clothes together – the two of us standing in front of the dressing room mirror and seeing how much bigger I was. I told her, “Look at my belly compared to yours. I think there are two babies in there.” She said, “Oh my god, can you imagine?!” In retrospect, I also started feeling movement around 12 weeks – like little ping pong balls bouncing around my belly – what my midwife referred to as an “early quickening”. So there were lots of signs backing up my intuition.

By the time our first ultrasound came around at 20 weeks, I told Mitch I was pretty sure they would find two babies. But I didn’t completely believe it yet – my heart knew it, but my head had not quite caught on. The ultrasound technician put the wand down on my belly and two perfect circles appeared on the screen. She immediately removed the wand, looked at us, and said, “Wait, is this your first ultrasound?” Thinking this was a standard question, I told her that it was. “Ahhhh, ok,” she said. She put the wand back down on my belly. “Because here’s a head, and here’s baby number two’s head.” Mitch immediately started laughing and I screamed and said, “I knew it!” The only place my intuition was off was that in my dreams, there was one boy and one girl. Instead, there were clearly two sweet identical little boys in there.

twins sonogram

Our first glimpse of the babies! Two beautiful heads…

This was the first of many changes to how I imagined my birth would go. I’d been planning a home birth or a birth center birth and had been getting my care through a local birth center. My midwife told us they could not birth twins at the center due to their license. (No twins, no breech). She recommended an amazing OB in just over the border in Wisconsin. Kind of a drive, but totally worth it. Dr. H has the heart of a midwife, and I felt totally calmed to be working with him. He had a lot of experience with twins and was regarded as an expert on vaginal breech delivery – something that is fairly common with twins. “Breech is a perfectly valid way to come into the world,” he told me. I have never been afraid of unmedicated childbirth, but the idea of a hospital birth always scared me. Dr. H and this small community hospital were as close to a birth center as I would get this time around, and I knew it was the right place to get my care.

We certainly experienced some major “twinshock” – I spent the day after our ultrasound alternately laughing hysterically and crying hysterically. But once the news sunk in, we began to realize what an amazing miracle was taking place. Feeling the boys grow and move in my belly over the next few months was something I’ll never forget. As the months went by, I got bigger and bigger. I was measuring 40 weeks by 28 weeks pregnant, so… that was fun.

pregnant with twins

One of my final belly pictures, at 34 weeks…

Fast-forward to 34 weeks: I’d been feeling restless the past few days. I’d gotten up at 2 in the morning and taken a shower one night because I just had to. Mitch later told me that the late-night shower was when he started to think that the babies would be coming sooner than we thought – I’d never done anything like that. On a Thursday, I took a nap on the couch and woke up to a feeling that wasn’t quite right. Turns out I’d lost my mucus plug. I saw Dr. H the next day and he said not to worry – losing the mucus plug was a “nonspecific” sign. For the next few days, I started passing mucus regularly. Again, not necessarily anything to be concerned about. Still, we scheduled our second meeting with our doulas for that Monday just in case we were closer to the big show than we’d thought. Tuesday morning, I woke up with another feeling that a change had happened and found that I’d had some decent bloody show. We drove in to the L&D unit at our hospital and they put me on the fetal monitors, found that both babies looked good and saw that I was having some mild Braxton-Hicks contractions (which I’d been having since about 20 weeks). I was 80% effaced and 1-2 cm dilated, (within normal range for twins at my gestation) so they again weren’t worried. That was the first cervical check of my pregnancy.

34 weeksThat night, some friends came over for a visit. In retrospect, I was having a low “restless” backache, and some intermittent crampiness in my thighs, but I chalked it up to the fact that I’d been laying on that hospital bed all day. I was in denial that I would go anything less than 40 weeks, so why would I think that labor would begin any time soon?

1:45 am, Wednesday 1/12/11: I was asleep and heard/felt a slight “pop!” and felt what seemed like a tidal wave of amniotic fluid rush out. (Good thing we’d just put the waterproof mattress pad down). Our joke now is that Mitch and half our bedroom furniture went rushing down the hall on the gigantic wave of amniotic fluid. Mitch woke to me saying, “Oh shit oh shit oh shit oh shit.” There was no mistaking what had just happened and it was too early. Just as Mitch asked me what was wrong, he started getting drenched and realized what was going on. He tells me now that he’ll never forget the sound of my voice when I woke him up that night.

Because I was 34 weeks and 4 days, it meant we couldn’t have the delivery at our Wisconsin hospital that we’d wanted, but my wonderful OB could catch our babies at a local hospital in the Twin Cities (ha!) with a NICU attached. Already one of my biggest labor fears was being realized: I’d be delivering in the most medicalized possible environment. Quite the change from my initial dream of a water birth at home. But I knew it was best for my early boys.

We called one of our doulas, who told me to take a shower, have a little meal, and take some time to breathe and reflect on the fact that I would meet my babies soon. She told me, “Check in with your babies, and let them know that it’s okay that they decided to be born today.” Until the day I die, I will remember those as some of the most powerful words ever spoken to me.

Mitch printed out my birth plan, put my labor playlist on my iPod, and made me some oatmeal. I sat on the couch in the dark and cried some tears – both happy and scared, and listened to a favorite song from my labor playlist,Djorolen, by Bela Fleck and Oumou Sangare. I hummed quietly to my boys and connected with them, and let them know that yes, it was okay that they decided to come earthside today. I didn’t remember it at the time but the translation of the lyrics to this song are, “The worried songbird cries out in the forest. Her thoughts go far away. For those of us who have no parents, her thoughts go to them.” I don’t think I fully understood the profundity and the sanctity of that moment at the time. In that moment, I was that worried songbird whose thoughts were far away. I felt worried, lost, happy, excited, calm – all at the same time. But from that moment on, there was no fear. I knew somehow that it would all be okay, that I would push both these babies out of my vagina with little problem, that my body knew how to do what needed to be done that day. Despite the fact that they were coming early, I knew deep down that they had chosen their birth day. I had total faith in my body and my babies.

About two hours from when my water broke, we were on our way to the hospital. By the time I got there at 4 AM (on all fours in the backseat, which felt GREAT), I’d begun having some mild contractions – nothing worse than period cramps. Our doulas Sarah and Amber met us in our labor room and we met Lori, our nurse for the day. Much to my pleasant surprise, she was totally accommodating of my natural birth plan – not wanting pain meds, epidural, or continuous fetal monitoring, etc. It really was the luck of the draw because depending on the nurse, she could have required continuous fetal monitoring due to hospital twin policy. She checked me and I was dilated to 4 cm. I couldn’t believe it – I’d barely felt a thing at that point.

I spent the morning in the early labor phase doing lots of hip circles on the birth ball, doing squats and lunges, and yoga led by Sarah. This was where I was sooooo glad I’d gone to prenatal yoga classes during my pregnancy. I felt so strong and powerful. I was able to moan through contractions and recover my sense of humor and ability to converse in between. Both my doulas and Mitch had their hands on me almost all the time, which was exactly what I wanted – I felt so supported. I had my labor play list playing which was also tremendously comforting – it helped the small, sterile hospital space feel more like home.

Early labor contractions

Early labor contractions

Sometime around 10 or 11am, a distinct shift in my labor occurred. We’d been to a parent topic night at The Childbirth Collective called “The Natural Rhythm of Labor” where the presenter, an experienced doula, acted out the stages of labor in a very realistic manner. This proved to be one of the most helpful things throughout my labor because I sort of knew based on how I was acting where I was in the labor, and that how I was behaving was normal. I moaned, vocalized, and moved my body in a rhythm that came from deep within. Once I felt this shift, I knew we’d moved to the next level. I was beginning to feel tremendous downward pressure in my bottom and a need to bear down. The contractions were intense and I could no longer talk between them. I needed lots of help to not tense up with each contraction. Again, my doulas and Mitch were amazing in helping me to relax as best I could. Because of the urge to bear down, my favorite place for the rest of my labor was on the toilet in the dark bathroom. I spent some time in the tub, but it wasn’t very deep and didn’t provide the relief I’d hoped it would. While I was in the tub, our nurse checked me again and even though I was sure I was at about 28 centimeters dilated at that point, I was instead at 6.

We went back to the labor room and this was when I was beginning to tell my support team, “You guys, I don’t think I can do this anymore.” Again, I remembered from the Childbirth Collective class that this was a good sign because it meant I was getting closer to the end. “You ARE doing this!”, my support team reminded me. Eventually I began begging for an epidural – supposedly another sign that things were progressing. Sarah, Amber, and Mitch knew I didn’t want the epidural so they helped me through more contractions. All the while, I was saying I couldn’t do this anymore. I was so exhausted – I couldn’t understand why they wouldn’t just let me lay down in the bed! It was hard not to tense up so much, but Amber helped me do a low roar through my contractions. I also threw up several times at this point (sorry Amber!) – I again remembered from our Lamaze class that this was a “good sign”. Even deep in laborland, I was somehow able to remember that barfing was often an indicator of transition.

partner and doula

Amber and Mitch, helping me through a contraction…

The nurse checked me again because I was doing so much grunting in my contractions that she felt sure I was ready to push. She discovered that I was still at 6 cm, had a slight fever, and that my cervix was beginning to swell from all the downward pressure over the hours. Sarah and Amber had me switch my breathing technique so that I wouldn’t bear down so much, but it was nearly impossible not to. The nurse said, “Okay, I know you don’t want an epidural, but I think we need to do something to take the swelling out of your cervix.” There was part of me that wanted to look at my labor support team and say, “See!? I won! Epidural!” Even though I didn’t want it, the idea of relieving the intense pressure of the contractions had taken over. The anesthesiologist came in and as he was prepping me, he said, “I see you have some acne on your back. That can increase the potential for infection which can lead to paralysis and death.” I was like, “Yep, paralysis, death, got it. Sounds good. Let’s get that epidural now, please!”

After the epidural was placed, it took only about 10 minutes for a powerful realization to sink in: I was one of the small percentage of women the anesthesiologist mentioned during the informed consent for whom epidurals don’t work. The intensity of the contractions had only increased and I had full feeling and movement from the tips of my toes to the top of my head. I could have stood up and tap-danced, no problem. (If I knew how to tap-dance. Also, I did not feel like tap-dancing). Sarah and Amber sent Mitch to go get something to eat thinking that we’d have some time now that the epidural was in. Wrong – nurse checked me again since I was still vocalizing loudly, involuntarily bearing down, and clearly feeling the increasing intensity of each contraction. In retrospect, this was the final part of transition. The nurse informed me that I was at 10 centimeters – fully dilated and obviously pushing already.

Sarah called Mitch and told him to get back upstairs quickly. The nurse got scrubs for everyone (Twins automatically have to be delivered in the OR at most hospitals. Bummer.) And even though I was in a deep internal place, I knew we were at the end of my labor and the birth was near. I have never felt so fully in my body in my life – it was the most profound physical experience I think I’ll ever have. Sarah told me it would be okay if I started working with the pushes when my body felt like it. My OB was on his way from Wisconsin (at about 4pm – rush hour!) and I could tell the nurse was beginning to get a little nervous about who was going to catch these babies.  Luckily, we rolled past Dr. H as they were wheeling me to the OR. Seeing his smile and thumbs-up was very reassuring. “You’re amazing!”, he called to me. “I’ll meet you in there!”

There were about 15 people in the OR – a team of NICU nurses for each baby plus the NICU resuscitation team, and some nurses for me. Mitch was at one side, my nurse at the other, and Sarah was at my head. Amber was taking pictures and videotaping. Side note: I’m SO glad my delivery was videotaped. I tell everyone to video their birth if possible. It was very healing for me to be able to watch what I did during the birth of my sons. It was tremendously empowering to be able to see the whole experience from a different vantage point. In the time since the birth, I’ve watched the video countless times, and I will show it to anyone who will watch it so they know the amazing things I am capable of. UPS guy? Thanks for the package, want to watch when I pushed two babies through my vagina without the aid of any pain medication?

A doula’s support during pushing.

So anyway, pushing. I didn’t realize how much pushing a baby out feels like the exact same sensation as pooping. My pushing wasn’t super productive at first, but once Sarah started telling me to push into my bottom, it made all the difference. No wonder I’d wanted to sit on the toilet for the last several hours. At one point, I reached down and felt my little baby A’s head as I was pushing. That really helped me focus as well – there really and truly was a baby coming out of me! All this pushing wasn’t for nothing – I was moving that baby!

I was in such a deep internal place – a place I’ve never been before. Most everything just melted away and I had a singular focus that I wasn’t in control of. My body was doing the pushing and I was just along for the ride. My eyes were closed. I was aware of Sarah at my ear. I was aware of Dr. H’s kind and gentle encouragement. I was certainly aware of the intensity of the physical sensation. What I was most aware of, though, was my sweet Mitch at my left side. With each push I could hear his words of excitement, telling me I was amazing and telling me how each push got us a little closer to the end. I could hear the smile in his voice. I could tell he could see the progress I was making – our first baby’s head making more and more of an appearance with each push. I didn’t hear a trace of worry in his voice – only joy and amazement, and that more than anything else got me through.

After what felt like an eternity, but what was actually less than 40 minutes, Oskar Jeffrey was born at 5:09 pm, coming in at 4lb, 14oz and 18 inches long. O had a tough time at first – he was gray and floppy and did not cry for quite some time. They whisked him off to the NICU team as soon as Mitch cut the cord. Mitch went to Oskar, and Sarah told me to talk to him so he could hear my voice. He had to be intubated because he was having trouble breathing on his own. For whatever reason, I wasn’t able to do anything but watch – I could not find my voice in that moment. I’ll always be grateful to Sarah for being my voice when I could not speak, saying, “Oskar, honey! Hi, baby! You’re doing such a good job! We’re so glad you’re here!”

All of the sudden, I began to feel the urge to push again. I’d sort of forgotten that I had another baby in me. I heard Dr. H say, “There’s another bag of waters” and as he was saying that, my second bag of waters broke. When that happened, I heard him say, “And there’s a head!” Those were some of the sweetest words I’ve ever heard. My second little boy, who’d been breech the whole time in utero, had somehow managed to turn after his brother was born. I was honestly thinking, “I don’t know how I’m going to do this a second time.” But one contraction and about 3 pushes later, Henry Christopher entered the world head-first at 5:13pm, wriggling and crying. I barely felt him come out – all 5lb and 18 inches of him. They were able to put him on my chest for about 15 seconds and it was amazing – the biggest high of my life. I cried out, “Baby, baby, baby, baby, sweet baby! I’m your mom!” I felt an almost primal urge to lick him, and I wanted to kiss him nonstop. But he had to be intubated as well, so he was taken off pretty quickly also. “Just give a little push,” I heard Dr. H. say. And so I did, barely noticing I was delivering the enormous placenta that my boys had shared over the last eight months.

I did it

Moments after the boys were born. We did it.

Meanwhile they’d stabilized the boys and were able to bring them to me briefly before transporting them to the NICU. I couldn’t believe how much I loved them. I kept saying over and over, “Mommy loves you so much.” It was scary seeing them with their ventilators in, but I had the feeling that everything would be alright. I knew they were in good hands. The same deep part of me that had known that I had twins in my belly from practically the moment the fertilized egg split into two also knew that they would be okay.

I was on such a high after the delivery. They wheeled me back to my room and right away I asked for the room service menu. I ordered grilled cheese and chocolate pudding and cole slaw and V8 and nothing ever tasted so good. Mitch was shocked to hear me say, “You know, that wasn’t so bad. I’m really already starting to forget how much that hurt!” About an hour after that, I started to feel like I’d been put through the ringer, and was so ready to go see my boys. It was such a strange and empty feeling to have given birth so triumphantly but to be without my babies in my arms.

A few hours later, I was allowed to go to the NICU to see my boys. I could not hold them, but I held their hands and stroked their heads and marveled that they had come out of my amazing body. I sang to each of them – “Beautiful Boy,” by John Lennon. Before you go to sleep, say a little prayer, every day in every way, it’s getting better, better, better. Beautiful, beautiful, beautiful, beautiful boy. I’ll never forget Oskar’s little eyes popping open at the sound of my voice.

twin boys

The first picture of the four of us, in the NICU at St. Paul Children’s Hospital.

When it was all said and done, even though almost nothing went according to plan, it worked out exactly like it was supposed to. I had what I can only describe as an amazing, magical labor and birth. Because of my experience, I also feel strongly that beautiful, sacred, soulful birth can happen anywhere: I have had two truly transcendent, at-one-with-the-universe, experiences in my life, and one of them occurred in a brightly lit, sterile OR, on my back, in stirrups, with a literal crowd of people looking on. I felt every second of each passing sensation and now I wouldn’t have wanted it any other way. I ended up getting my “unmedicated” childbirth after all, and I’m really glad now that the epidural didn’t work. In the difficult days after the birth when my boys spent a few weeks growing and getting stronger in the NICU, I thought over and over about how strong and amazing and powerful I was during their birth. If I could do that, then I am capable of anything.

In the time since my boys’ birth, I have become a doula and a childbirth educator. For me, one of the most powerful and important parts of being a birth worker stems from the phrase, “When a baby is born, so is a mother.” I love it so much because that phrase, maybe more than any other, defines who I am now.  I was re-born when my boys were born.  I’d spent most of my life feeling like I was not very strong, and I’d always been one to give up when something didn’t come easily to me. But our birth – my boys’ and mine – showed me a strength I could never have dreamed I had in me. The experience of giving birth changed me down to my core, and I am forever grateful to those two little souls who illuminated the path toward the rest of my life.

Jess Helle-Morrissey is a doula, a Lamaze-Certified Childbirth Educator, a psychotherapist, a wife, and a mama. She teaches several childbirth education classes at Blooma, including one for families expecting twins, and lives in St. Paul, Minnesota with her three dudes: Mitch, Oskar, and Henry. 

Editor’s Note: A version of this story originally appeared on Birth Without Fear.

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Filed under Birth story, Doula, multiples, Twins

Waiting for this moment to arise: A healing VBAC induction

by Ashley Ashbacher, MSW, CD(DONA)

The birth of my first child was not what I expected. A lot of what happened was traumatic for me and several days of labor ended when my daughter was born surgically.  It took me a long time to heal both physically and emotionally following her birth. I knew that when I had another child wanted to have a VBAC and I wanted it to be a waterbirth. I decided to see Dr. Hartung with Hudson Physicians for my prenatal care and was planning on having a water birth. At 30 weeks pregnant I was diagnosed with gestational diabetes and because my fasting numbers were consistently high I ended up on insulin. Unfortunately due to changes in policy at the hospital, going on insulin meant I could no longer attempt a waterbirth. I was pretty bummed about that. I had a good cry and then I decided that I wouldn’t let this setback spoil my my plans for a VBAC and more importantly, a positive birth experience.

I had hyperemesis gravidarum (HG) my entire pregnancy. Toward the end of my pregnancy my HG started getting bad again and anything I could eat to and not vomit back up would spike my blood sugar. I was concerned about the risk for baby with my blood sugar running high. At my 39 week appointment my doctor and I had a conversation about my options. We discussed the risks vs. benefits of inducing. This was a surprise for me to even have this option as many VBAC moms would likely be faced with another c-section if the benefits of ending the pregnancy before the onset of spontaneous labor outweighed the risks. We discussed a foley bulb induction but it turns out I was too dilated to even consider that so we talked about doing a light pitocin induction and artificial rupture of membranes. We discussed how that would increase my risk of uterine rupture and it was only a small increase and a risk I was willing to take. I felt (based on our conversation and my own research) that inducing was less of a risk than a repeat c-section for me and less of a risk of low birth sugars for baby if we waited for spontaneous labor. I was very favorable for induction and my doctor said he felt like it would go smoothly but he also didn’t feel that it was necessary and he suggested we wait a week and reevaluate.

That week my HG got really bad and I called my doctor and told him that I was ready to induce. On 6am on Thursday May 30th, we dropped my daughter off at my parents’ house and headed to the hospital. When we got there the first thing that the nurses did was attempt to put in an IV. It took three people and four painful attempts to get an IV in and the only place they were able to get one in was in my right hand, which was the absolute last place I wanted it. It was pretty rough start to my birth experience and I considered just going home. I took some time to think about it and I decided to stay and move past that bad emotional spot I was in. Thankfully that was actually the worst part of my birth experience.

They started me a low dose of pitocin and got the monitors on. When I was first planning for my birth I didn’t want continuous monitoring but because I was a VBAC mom on pitocin and because I knew it would make my interactions with medical staff easier, this was a trade off that I chose to make in order to have a positive birth experience. I don’t advocate making decisions just to please medical staff if you truly don’t want it, but in my case I was fine with it and I felt like it made both sides more comfortable. I settled in with my snacks and pulled out my movies, expecting we had a long day in front of us, and found that there was no DVD player in the room. I’d had plenty of hospital visits during my pregnancies and I’ve doulaed a fair amount of births, and I’d never been at a hospital where there was no DVD player. I was a little bummed (daytime TV is awful) but my awesome nurse snuck into the staff breakroom and stole the DVD player for me. So Tony and I watched Les Mis and snacked while I bounced on the birth ball. My contractions were annoying but not unbearable.

When Dr. Hartung found out I was ready he came to break my water. I was 3cm dilated, close to fully effaced, and my cervix was in good position. He said I was extremely favorable and he felt it would possibly go quickly. Once he broke my water things intensified quickly and I decided to get into the tub. I was doualing myself through my husband and telling him what I needed him to do. Once my water was broken I got really bad back labor. I taught him how to do counterpressure and had him call our doula. It was crazy how fast I went from feeling totally fine to feeling a fair amount of pain and having a difficult time managing it.

Doula note: Instances like that are a good example as to why it is important to call your doula when you feel like you might need them in the next hour or so instead of waiting to call until you really need them and then you’ll have to wait while they travel to you and they also may need to drop their kids off or wait for a babysitter to arrive.

It was really difficult but I was managing with being in the tub and my husband doing counterpressure. Unfortunately right when things got really intense , the batteries on the wireless telemetry unit died and I had to get out of the tub as it wasn’t safe to plug it in when I was sitting in a big pool of water. That was rough for me. I lost all the benefits of the water for pain relief and I started feeling the back labor very intensely. I felt like I was going to break in half. At this point I felt myself losing control (not in the good way, but more in the way that I couldn’t bring myself to a good place and starting tensing and freaking out whenever I had a contraction building. Holding tension is counter productive in birth and it often leads to greater feelings of pain.

I was feeling a lot of fear/stress, I’d tense, and then I’d feel more pain. It would continue to cycle and get worse. I very much wanted a birth that was as low intervention as possible but my number one goal was a vaginal birth. Despite my best efforts and the fantastic support from my husband and doula, I couldn’t pull myself out of that cycle. At this point I started to consider and epidural. My husband and doula talked to me about my preferences and encouraged me to keep working through contractions one at a time. My husband kept pushing back when I said I wanted one and he voiced that he was afraid that I would feel like he let me down if he didn’t prevent me from getting an epidural. I assured him that I wouldn’t be angry with him and that was important was that he was supporting me. I did request to get checked before I got it to make sure that I wasn’t nearing 10 cm. I was at 4-5 cm so I decided to go forward. I know that dilation doesn’t always follow the expected one cm an hour so just because I was around 5 didn’t mean that I had at least 5 hours left but I also knew that since I couldn’t pull myself out of that bad place my labor was likely to go slower or possibly stall, which is not something I wanted when working toward my VBAC.

I got the epidural and holding still for that was one of the hardest things I’ve ever done. The nurse asked to check me once the epidural has taken effect and I consented. I was at 10 cm. One I was finally able to let go of all that fear and tension, my body zoomed through the rest of dilation. I didn’t feel the urge to push so the doctor was fine with letting me labor down for a while. I kept having the anesthesiologist come in to turn down the epidural in hopes that I would feel the urge to push. I took this time to catch up with my doula and photographer who are also my friends and also to eat and drink.

Doula, mama, husband, nurseAround 2 hrs after I was complete, I still had no urge to push and my doctor suggested that even though I didn’t feel it, maybe it was time to try some pushing. So we started doing directed pushing. I was having a really hard time pushing because I couldn’t feel it. I was pushing toward what I thought I should be but it was hard to know exactly what I was doing. I had the anesthesiologist come in several more times to turn down my epidural. After a couple times of having the epidural turned down, I could feel and move my legs but I still felt no urge to push. I was a little worried at the point. I got to 10 with my daughter, I pushed with her, and after pushing for an hour my former OB told me that she wasn’t going to be born vaginally and I ended up going in for a c-section.

Pushing on hands and knees with an epidural.

Pushing on hands and knees with an epidural.

I decided to try some different positions to see if that would help me progress or feel the urge to push. I started doing some lunges in the bed and I scared the daylights out of the nurse who said she’d never seen anyone with an epidural do something like that before.

Tug of war with a bed sheet and squat bar.

Tug of war with a bed sheet and squat bar.

I tried a variety of different positions (lunges, hands and knees, leaning over the top of the bed) and although I was making slow progress I never got the urge to push. Dr. Hartung came in and suggested we try a squat bar (which is awesome to have an OB suggest when you have an epidural) I did some squats with that and some tug o war with a bed sheet.

Using a squat bar for pushing with an epidural.

Using a squat bar for pushing with an epidural.

I continued to make slow progress. My OB was in there for most of it even though I was pushing for several hours. He had a very calming presence. He would take his shoes off when he entered the room to minimize noise, and used a flashlight to watch my progress so he didn’t have to turn any additional lights on. After hours like this, my doctor asked me to remind him of why I had my c-section with my daughter and when I told him he said based on his observations of me pushing, he felt like she likely would have been born vaginally if I had been given more time to push. It was extremely validating to me to have a medical professional say the same thing that I have felt about her birth. When I brought up my feelings that my c-section was unnecessary to my former OB, she very much brushed me off. This affirmation of my feelings was very healing to me.

squat bar epiduralDuring all of this we turned on my ipod to see if music could help me turn off my head a little bit. We started off with some upbeat stuff to see if it would energize me. It didn’t work so much but it did entertain me. Jump (for my love) by the Pointer Sisters came on. It’s the song from Love Actually that Hugh Grant dances to after he tells off the American president. Whenever it comes on, my husband starts doing that dance.

Hubby dancingWe switched the music to my mellow playlist and it was much better in helping me relax and enjoy the experience.

We were getting closer and I really wanted to get out of the bed but I was still hooked to the epidural. I often encourage my clients to try pushing on the toilet when they are struggling to push because it’s an area where we are used to relaxing our bottoms and pushing. That sounded really appealing to me. I told my doctor my thoughts and he suggested we try a birthing stool. So with my epidural, I got out of bed and sat on a birthing stool.

Pushing on a birth stool with an epidural!

Pushing on a birth stool with an epidural!

I started making a lot more progress and it finally got to the point where I could feel everything. I could feel my baby right there but I still had a little bit left to go. By this point though I had totally petered out and I wasn’t pushing effectively. I started to get desperate and I was begging my doctor to try the vacuum or anything to get him out. He told me that based on the baby’s position he wouldn’t be able to do the vacuum; that he could use the forceps, but he didn’t need to. He said I could do this, that I was strong, and to trust in my body. I got to the spot where a couple good pushes could get him out but he wasn’t going anywhere. I felt completely unable to push. I tried and nothing was there. I completely lost it at this point and starting crying that I couldn’t do it and that I was never going to be able to push him out. I felt totally irrational and nothing anyone said seemed to help. My doctor interjected into my moment of doubt and exhaustion. He told me that I could do it but the little pushes I was giving weren’t good enough. I was almost there and I had to try a little harder. I decided to climb back on the bed to try hands and knees. My husband  got right in my face and keep telling me that I could do this and I was almost there and really encouraged me to give it everything.

birth partnersI was right about there and at that point a new song came on and my doctor commented on what a great song it was and how appropriate it was. The song that came on was the cover of Blackbird by the Beatles from the Across the Universe soundtrack.

Blackbird singing in the dead of night
Take these broken wings and learn to fly
All your life
You were only waiting for this moment to arise.

Blackbird singing in the dead of night
Take these sunken eyes and learn to see
All your life
You were only waiting for this moment to be free.

Blackbird fly
Blackbird fly
Into the light of the dark black night.

Blackbird fly Blackbird fly
Into the light of the dark black night.

Blackbird singing in the dead of night
Take these broken wings and learn to fly
All your life
You were only waiting for this moment to arise
You were only waiting for this moment to arise
You were only waiting for this moment to arise.

Finally, thankfully, that moment I was waiting for came and I was able to push my son’s head out. One more short push and the rest of him came too. The doctor caught him and placed him under me so I could see him.

new familiyIt was the most amazing and crazy thing. I couldn’t believe it actually happened. I remember saying “oh my god” over and over again. He was underneath me and still attached to his cord. I wanted to lay down with him on my chest but I couldn’t figure out how to make it happened with him attached and all of my IV and epidural tubing. My repeated “oh my god” was then followed by “what do I do, what do I do?” They helped me get on my back and hold him then it all really sunk in and I felt such amazing joy, relief, and awe that I was able to do this and I was holding my little boy and I never set foot inside an OR.

healing VBACI needed one stitch and I was able to nurse him right away. I held him for over an hour before I chose to have him be weighed and measured. He was 9 pounds, 1 ounce and had a 15 inch head. He was almost a pound bigger than my daughter.

baby cI made some trade offs in my labor. But being able to VBAC was worth it all. My son’s birth was tremendously healing for me. I felt respected. I felt heard. I felt like everything the happened (with the exception of having to get out of the tub) was my choice. I never felt rushed or like I was on a clock. I actually expressed concern about that during my labor and my doctor said there is no clock and no need to worry about that. My son was born at 9:05 pm. I was complete around 2pm. I was pushed for a c-section after an hour of pushing with my daughter. I pushed for 7 hours with my son and the word c-section or any fragment of doubt that I could do it was never uttered by anyone on my care team. I felt so loved, respected, and honored in this process.

Ashley is a certified birth doula and is completing her master’s degree in social work. She has a 3 year old and a 10 month old.

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Cesarean Awareness: A Doula’s Humble Reflection

by Erin Stertz-Follett, CLD, LCCE, HBCE

 

My journey into birth began 10 years ago after the birth of my first nephew, Micah. I wouldn’t fully embrace birth as my calling until many years later, after the birth of my own two girls and the ‘birth’ of the passion inside me to bring services of meaning to pregnant women and their families.
I will never forget that moment. After an induction that lasted more than 24 hours, and “arrest of descent” of the baby during pushing, my sister was told that she would need a cesarean section. I watched as her face turned from determination, to disappointment, to resignation, and to sorrow. As my mom and I left the room while they began the surgical prep, I said to Mom, “That’s not what we wanted.” With tears trickling down her cheeks, she shook her head, “No.” The grief for what Sarah so badly wanted – a vaginal birth with minimal interventions – was palpable.

A few years later, as I was pregnant with my first child and wanting to learn as much as I could to avoid my own surgical birth, Sarah invited me to an ICAN (International Cesarean Awareness Network) meeting. At that time, the group was small and had just begun reforming here in the Twin Cities. I happened to attend on a night when a wise midwife named Gail Tully was on hand to provide information and practice in ‘optimal fetal positioning’ for birth. I didn’t know anything about birth halls or Rebozos, or the side-lying release. I just knew that it felt so good (and kind of funny!) as I was used as the ‘pregnant model’ for Rebozo belly sifting.

Two babies later, both of which included my sister’s attendance and support, I began the true path to birth work as a Lamaze Certified Childbirth Educatordoula, and HypnoBirthing Certified Educator. Again, my journey was largely inspired not only by Sarah’s first birth, but also by her successful HBAC (home birth after cesarean) her second time around.

To offer full disclosure, I dreaded as a doula the first time I would need to step into the surgical suite and witness a mama experience a cesarean birth. In some small way, I was traumatized by my sister’s experience. Now with several under my belt, I can say that my perspective has changed. Yes, it is still difficult. But, with my doula hat on, I enter the experience with an open heart and an open mind, with nothing but how I can best support that mama in that moment as my focus. It is at that time that we turn our trust over to the trained surgeon whose job now is to safely bring the baby forth from the mother’s womb. I offer a grounding hand on the forehead, an explanation of what to expect and what is happening, sounds and smells that calm the mother, words of reassurance to the partner, and pictures if mama desires.

I have seen mothers who view their surgical births in many different ways: From full-on acceptance (even requesting one at the end of a long, stalled labor); to complete devastation (offering my doula hands to wipe away tears); to somewhere in the middle (perhaps with resignation and a resolve to process the experience later).  I have seen cesareans that are completely medically necessary, and those that fall in a grey area.

Look, the cesarean rate in this country (32.8%) is too high. There’s no way around that. We can do better. For women, for babies, and for their families. It may feel daunting to tackle this subject on a grander scale and I know many of us birth workers often feel at a loss. But here is what we can do:

  • Approach the subject with mamas (clients, patients, friends, family) with gentleness, understanding, an open heart; and, when needed, the statistics.
  • Remember and value the fact that not all mamas view their cesarean as traumatic or unnecessary. Don’t assume that all mamas do and meet them where they are, especially as they plan a subsequent birth.
  • Educate. Educate. Educate. Knowledge truly is power. Whether it is ways to more optimally position baby for birth, or methods for deep relaxation, or just knowing all options and all places of referral. Education is key. The ability to ask questions and have them honestly answered is tantamount.
  • Refer to birth providers who offer options for mamas in pregnancy and labor; and who understand normal, physiologic birth… Those whose rates of cesarean birth are on the lower end (including out-of-hospital options if the mother desires).
  • Refer mamas who have experienced cesarean birth, especially those that view their births as traumatic, to resources such as ICAN and Homebirth Cesarean groups.
  • When a surgical birth becomes truly medically necessary either before the birth or during the laboring process, we can offer support and guidance for having a more family-centered experience.
  • Put our time, our money, and our voices behind organizations that support mamas in having births with low interventions.

And finally, as doulas and as friends or family, we can hold hands. Wipe tears. Validate fears. Lift them up. Walk down to the lowest lows with them. Remind every mama how strong they are… that they brought their baby into the world; that they can do it again with love.

cesarean awareness

Erin Stertz-Follett owns Flutterby Birth Services, located in Burnsville, MN. In addition to doula services, she offers HypnoBirthing, Lamaze, and Breastfeeding classes as well as other workshops and events. She is the mother to two lovely and lively little girls.

Editor’s Note: This post first appeared on the Flutterby Birth blog. Photos credited to Stephanie Ryan Photography.  All birth stories used with the permission of the mothers. 

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Eat, Pray, Doula: A Doula’s Journey in Bali

by Karen Bruce, AAHCC

I am writing from a hotel room in Ho Chi Minh City, Vietnam, awestruck by the experiences of the past 10 days, still overcome with emotion at the intense connections formed among a group of strangers in that time, and brimming with anticipation for my future birth work.  I just attended Eat Pray Doula 2014 in Ubud, Bali Indonesia with 27 of the most beautiful birth keepers you have ever met.

 

What better place to celebrate World Doula Week than in SouthEast Asia with such a diverse group of women?  We represented at least 11 countries and spoke numerous languages.  We included midwives and teachers, translators and nurses, small business owners, and, of course, doulas. Some brought their families on this adventure, some traveled alone.  All of us converged in this beautiful land they call the Island of the Gods for a DONA Birth Doula Workshop taught by Debra Pascali-Bonaro, chair of the International MotherBaby Childbirth Organization and creator and director of the film Orgasmic Birth, Ibu Robin Lim of Bumi Sehat International and CNN’s Hero of the Year 2011, and Katherine Bramhall, co-founder of Bumi Sehat and homebirth midwife.
Katherine Bramhall, Karen Bruce, Debra Pascali-Bonaro, Ibu Robin Lim

Katherine Bramhall, Karen Bruce, Debra Pascali-Bonaro, Ibu Robin Lim

I traveled with my partner from Minneapolis along with two fellow Childbirth Collective members, Angie Posine and Angie Sonrode and their families.  We all knew this was something special and were eager to share and learn with so many experienced doulas and world-famous birth gurus. Our Twin Cities contingent had much to offer by way of practical suggestions for natural pain relief, position changes, communication with families and staff, etc.  I am proud to say that the Childbirth Collective was a shining example to our peers of how birth keepers can work together to support one another and provide best practices with an evidence-based model of doula care.  We loved sharing how Minnesota is at the leading edge of a revolution in well-supported birth thanks to the many legislative efforts of Susan Lane and the Minnesota Better Birth Coalition.  Our community enjoys many options in childbirth that are sadly not widely available.

 

But Eat Pray Doula challenged me in many ways to move beyond the comfort zone I have created in my doula work – I know very well the culture of birth in the Twin Cities and my place in it, and my toolbox is filled with ideas to support the physical and emotional needs of the birthing families I serve.  However, I may not have been fully prepared for the deeply spiritual transformation I experienced at this workshop.  Our facilitators were skilled at creating the conditions that allow true connection with other people, and they lit a spark within me that has inspired me to create sacred space in birth, to preserve and protect the spiritual as well as the physical and emotional.

Karen Bruce, Ari Fatun of Indonesia

My first DONA Birth Doula Workshop with Gail Tully in 2006 prepared me in very practical ways to be a birth doula, and she certainly speaks to the spiritual, but I may not have been ready to hear it.  The 8 years of experience at over 200 births in between have prepared me to receive this new perspective in order to develop that part of my practice which is so critical to the mystery of life and love on this planet.

 

Not to be confused with religious expression, the spiritual aspects of creating life in our womb and birthing our babies into this world are simply related to the human spirit or soul.  Simply by choosing my words or silence more carefully, by being fully open to the MotherBaby mystery as it unfolds, and, when I have my activist hat on, by educating and encouraging gentle birth practices by other doulas and care providers – I know I am making a difference.  I remind myself that it is not necessary to understand this mystery in order to honor it and create space for its expression during this profound transition from pregnant to parent, from MotherBaby to mother and child.

 

Eat Pray Doula workshops are appropriate for new/aspiring birth doulas, but even the most experienced will learn many new ideas to breath new life into their important work.  I would especially encourage nurses, midwives, and obstetricians to consider registering for a future workshop as a gift to yourself and all birthing families you will hold sacred in the future!

Pujiastatuti Sindhu of Indonesia, Karen Bruce, and Ari Fatun

Karen Bruce is a certified Bradley Method(r) Instructor and Birth and Postpartum Doula in the Twin Cities.  She serves as the Vice President of the board of the Childbirth Collective. Her website is karenbrucedoula.com.

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Celebrate and Share World Doula Week 2014!

March 22-28 is World Doula Week! Did you know that just recently, ACOG and SMFM (American Congress of Obstetricians and Gynecologists & the Society for Maternal Fetal Medicine) named doula support as one of the most important and most underutilized tools in preventing cesareans in first-time mothers? This is just one of the amazing, research-based benefits of doula support.

So if you are a doula, used and loved a doula, or just want to shout the doula love from the rooftops, feel free to comment here and share these graphics on social media! We here at The Childbirth Collective are so proud to do what we do. Happy World Doula Week!
Doulas Rock!

I-Love-Doulas

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proud doula profile pic

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The Intention + Creation of Sacred Pregnancy

by Brittany Bushaw

Editor’s Note: A version of this post first appeared HERE. 

When I became pregnant with my first baby, I felt a powerful shift begin to happen – not just within my physical body, but also within my heart. I desired to experience my pregnancy with intention, present moment awareness, and trust for my body, baby, and birth. I desired a sacred pregnancy in hopes that it would flow into creating a sacred birth experience.

Already a yoga instructor and massage therapist, I was familiar with the connection between mind, body, and self awareness. I was imperfect and practicing the art of listening to my heart and inner desires, and then choosing to communicate them honestly with family and close friends. Numerous struggles arose because I had to break through the barriers of my own conditioned belief systems in order to recognize and work through insecurities. Pregnancy was a big step forward for me in the process of open and honest communication. I chose to openly share my faith and trust for my entire pregnancy and birth process without allowing other’s fears become my own. You bet this was going to be my first lesson in mothering.
When announcing my pregnancy, I also announced that my husband and I chose to have a home birth. Our announcement was met in a variety of ways: short questions, awkward silence, fear, and support. I was very open about our choice and loved answering questions and engaging in discussion. During each interaction, I reminded myself that each person’s experiences have shaped the lens through which they see the world. Knowing this helped me to stay in my truth and to communicate honestly without taking their responses or reactions personally. This allowed for beautiful dialogue and understandings to take place, and for there to be space for my family and close friends to process our choice. Most importantly, my honest communication reflected confidence, openness, and a meaningful process. I was communicating that this was sacred for me – that my body was an extension of nature – and as much as I trust the process of a seed being planted, growing, and blooming, I trust the process of pregnancy and birth. To me they are all synonymous.

Moving forward into my pregnancy, I expanded my yoga practice, and I wanted to learn more about the pregnant woman’s body. I had a desire to take space for myself and to be engulfed by a community of women and learning. That’s when I discovered Blooma. I enrolled in their prenatal yoga teacher training in October 2011 and loved every moment of my experience there. I dove into myself in every yoga class, experienced the power of being surrounded by other pregnant mamas, and felt the bliss of truly feeling supported without judgment. My confidence in myself, my choices, and my communication was emanating out of me in response to all of the inspiration and abundance. I was actively recognizing my needs and desires and manifesting them!

As I openly shared my inspiration about pregnancy and birth with those around me, naturally, some of my closest friends became inspired to contribute to my journey. My dear friend, Sandie Fish, held a three part circle ceremony:
I. Welcoming a new mother
II. Welcoming for baby
III. Welcoming a new father.

With the greatest of intention and communication, we created a circle with the wiser and older women in my life whom could share their journeys as women and mothers. We created quilt squares and tied the quilt together to wrap the baby in our wisdom and love, they brought me beads to assemble a necklace to surround me in their energy, power, and wisdom during labor and mothering, and they showered me with intentional gifts for my birthing alter. Every time we gathered I experienced a shedding and releasing of old thoughts, beliefs, and stories that were no longer serving me. The circle ceremony allowed all of us space to let go of our egos and to become present with our deeper selves. We felt connected, alive, and valuable in our life journey, struggles and all. I felt (and still feel) from these women and ceremonies an incredible amount support, love, and laughter that will forever stay with me. I was indeed experiencing a sacred pregnancy. Like a flower gently rooted into the earth, I was feeling vulnerable yet strong in my process of growth.

My spirit sister Amy and good friend Steph were inspired not just by pregnancy but by life itself. They planned and created a Celebration of Life gathering for our close group of friends to be intentional in their support for my process. Everyone brought a blessing, poem, song lyrics, or their own writing to share what life means to them. We lit candles and gathered around the table. So much giggling, love, and intentional conversation was happening. Celebrating with delicious, wholesome food along with beautiful energy of acceptance and understanding. It made my heart sing.
We created artful affirmation signs for me to hang on my wall for the labor and birth. Words like flow, breathe, power, trust, exist, now, rest, and focus were created. It was a peaceful, calm time in the evening as everyone allowed for an opening for creativity to flow. Through art, we cultivated our intentions and love.

The affirmations were a powerful addition to the energy of our home as we began to make active preparations in creating the sacred birth that I knew in my heart was possible. These affirmations still exist within my home to remind me in my mothering (and in life) to flow like water, to breathe, exist, and to trust the process of struggle and inner work.

At the end of pregnancy when the baby showers began to take place (I had four of them), it was very apparent that my desires were being heard. The women throwing these baby showers made them bright, fun, and filled with life. My gifts were hand made, bought with intention, or things that I truly needed (cloth diapers). Like the Minnesota River after the snow has melted, I was bursting at the banks and over flowing with abundance and gratitude. Feeling the deepest connection I had ever felt with those closest to me, and to myself, I was ready whenever the BABY was to move into the next phase of sacredness and connection. I was ready to give birth.

After the birth of my daughter Abyl, I spent time reflecting on the power that exists within us, not just as women, but as human beings. Abyl was part of this entire process and was taking my lead the entire time. By inviting beautiful energy, support, and trust into my experience, I also shared it with her in the womb. The sacred pregnancy I set the intention for, sought out, and actively manifested (with the help of my loved ones) flowed beautifully into experiencing a sacred birth. My amazing friend Amy, supportive husband Adam, and attentive midwife Rachel all supported me gracefully while I experienced a labor full of struggle, opening,shedding, letting go, peace, and in the end, pure joy and love.

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What Babies Need

by Angie Sonrode

Walking into any baby store or paging through oImagene of the numerous magazines aimed at parents, one is bound to find a list of “must haves” for every baby. These are usually things that are meant to help you parent your baby “best”. While no one can tell you what your individual family’s needs are, what we do know is that at its most basic, babies’ needs are quite simple. The most important things your baby needs are things you already have.

Warmth

Babies are born learning how to maintain a normal body temperature, and immediate skin-to-skin contact with mama is ideal. Studies have shown that a mother’s chest is able to lower or raise an entire degree based on her baby’s temperature needs (and on either side independently if she is mothering twins!).

Getting your baby right to your chest immediately following delivery will also help both of you connect after birth. It helps baby to regulate their breathing as they feel your chest rise and fall and you are bathed in your newborn’s intoxicating smell as you establish your bond as mother and child. This shows them where home is as they take in your mama scent.

Comfort

Your baby has spent three seasons growing in an environment where his needs were immediately met. Baby was kept at the right temperature and could hear your heartbeat and voice at all times. Keeping your baby close after birth helps to maintain and strengthen his sense of security and safety while helping you to learn his cues and respond to his needs quickly.

Wearing your baby is a wonderful way for both mom and partner to help baby recreate that environment and provide this comfort for him. It keeps baby close and secure, providing opportunities for attachment and affection at all times. Babies can sleep, eat and play all while staying connected to you, and you are able to get basic tasks accomplished without having to put them down – a win/win situation!

Food

Humans are well-designed down to the last detail. While pregnant, your breasts begin to produce colostrum which is the first food your baby will get in the few days it takes for your milk volume to increase. Colostrum is packed with energy, vitamins, and antibodies, and it lines babies’ intestines with beneficial bacteria and flora that stay with them for life. It also acts as a natural laxative, helping babies to pass their first stool, known as meconium.

Colostrum and breastmilk provide all the nutrition your baby needs – there is no need to supplement with anything else. Breastmilk is tailored to your baby’s needs at every stage of development; as baby grows and changes, so does your milk. As an added bounus, babies whose mothers eat a varied diet while nursing typically grow up to be more adventurous eaters later in life, enjoying more diverse flavors and tastes.

Parenting a newborn is all about following his cues and responding with what he needs. Your instincts as a parent are strong and if you listen to them and to your baby, you will quickly learn that what your baby needs most is you.

Angie Sonrode is a DONA-trained Doula and a Lactation Support Provider serving clients in the Twin Cities Metro area.  She  lives in Minneapolis with her supportive husband and 4 amazing kiddos. 

Editor’s Note: A version of this article originally appeared in the Winter 2011 print version of Collective Thoughts.

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