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!

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.

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.

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.

That 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

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.

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.

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.

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.

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.

Around 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.

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.

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.

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.

During 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.

We 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!

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.

I 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.

It 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.

I 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.

I 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.

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 Educator, doula, 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.

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. 

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

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.

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!

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.

Driving Home From a Birth: A Tale of Triumph, Whimsy, and the St. Paul Police

by Mary Norby, CD(DONA)

As a birth doula, the drive home from a birth is meditative: replaying the birth, most often reliving the joy, sometimes a bit of regret. Driving home from Lori and Paul’s birth was pure joy—distracted joy.

Lori had, in her words, rocked her VBAC. It doesn’t get better than that for a doula. It is so rewarding when a birthing mom understands what a birthing rock star she was, how powerful she is, how forever awesome she will be.

Lori got it. She rocked her VBAC.

I was giddy as I drove home from St. John’s Hospital at 4:30 in the morning. Part of me realized that my euphoria was clouding my driving ability.
For those of us who have seen Bridesmaids, you may recall Annie driving home from Lillian’s shower, bemoaning the loss of her best friend to Helen: Annie’s car swerves all over the road as she chants, “Hi, I’m Helen. I’m Lillie’s new best friend, even though I’ve known her for 10 seconds.”

I believe my car was swerving, not because I’d lost a best friend, but because I just saw a woman do an amazing thing—and she gets it! She knows how amazing she is!

Wouldn’t it be funny if I got pulled over?

Whoa! Those are bright lights in my review mirror. Are those red and blue lights too?

I’m getting pulled over.
I actually smiled–did I have a story for the St. Paul Police.
The lights were so bright I covered my face. Would the officer think I was trying to hide my identity? A doula in the witness protection program, perhaps?

As I readied for the “Good morning, ma’am, a little distracted this morning?” I said a prayer, “Please God, please give me a female officer. Oh, while you’re at it, make her in her “childbearing years.”

Bingo.
“Good morning. A little distracted this morning?”
“Yes, officer. I’m a birth doula, and I’ve been up all night at a birth.”
“Is that why you ran that stop sign back there?”
I did?
“I did? Oh, I’m sorry.”
“License and registration, please.”
This is where I used some Doula Magic. Reaching into my bag, I made sure to send some lavender scent Officer Childbearing’s way. Calming to birthing moms. Calming to ticketing police officers.

She returned to my car a few minutes later, saying, “OK. Drive home safely, and get some sleep.”

“Thank you officer. Don’t you want to know how the birth was?”
A voice was saying, “Quit while you’re ahead.” But really, I was on a roll. “Yes. Is everybody OK?”
“Everybody is awesome! A beautiful baby girl.”
“Great, have a nice night.”
“Thank you, officer.”

Birth Story: “I did it! I did it!” – Katie and Carter’s HBAC

by Katie Champ

My journey to Carter’s homebirth after cesarean (HBAC) began when my daughter Kaylee was born on September 1, 2011.  I was induced at 38 weeks for pre-eclampsia with cytotec, pitocin, and an epidural which led to a cesarean section under general anesthesia.  After her birth, I was determined to do things differently the next time.  I needed to be the first person to see and hold my baby.  I joined the Twin Cities chapter of ICAN (International Cesarean Awareness Network) and learned that I was not alone.  That other women had traumatic births as well, but they went on to have beautiful vaginal births after their cesarean.  This is when we decided that when we had another child, they would be born at home.

 

We spent a lot of time doing our research on natural birth, homebirth, birthing classes, midwives, and more!  On October 31st, 2012, we found out we were expecting our second child.  We went on the hunt for the perfect homebirth midwife, doula, and childbirth class.  We quickly found our midwives and decided to use Hypnobabies for this birth.  We couldn’t attend in person classes due to scheduling conflicts, but we were able to do the home study course.  We went back and forth on hiring a doula.  One thing I really regretted in my daughter’s birth was not hiring a doula.  Even though I had 2 wonderful midwives attending my birth, I didn’t want to have any regrets this time, so we went ahead with finding a doula and are beyond thankful we did.

 

I spent my pregnancy preparing myself for this birth.  I needed to make sure I did not get pre-eclampsia and I needed to stay healthy.  I completely changed my outlook on pregnancy and birth.  I ate healthy, stayed active, went to prenatal yoga, received chiropractic care, bodywork, and massage, did my daily spinning babies, listened to my Hypnobabies tracks and practiced my Hypnobabies techniques, read more birth books, attended ICAN meetings (and joined the board), met more homebirth families, and really took an active roll in preparing for this birth.  I wasn’t going to let anything get in my way of having a successful HBAC!

 

Fast forward to July 2013.  My guess date was July 13th, 2013.  This day came and went with no baby.  So did 41 weeks and 42 weeks!  I was growing impatient, but my husband kept reassuring me that I would not be pregnant forever and that babies come when they are ready.  Thankfully, my doula had gone to 43 weeks herself and assured me that I would go into labor.  At 42 weeks we started trying all to old wives tales to get labor started.  This little guy must not have been ready, because none of them worked!  At 42 weeks 4 days, we went in for a biophysical profile (BPP).  This showed low fluid, but nothing my back up OB said was urgent.  He encouraged us to keep trying to get labor moving and come back in 2 days for a follow up BPP and we would go from there.  He was pretty confident that labor would happen soon and was not concerned that I was nearing 43 weeks.  We were very lucky to have fabulous, supportive midwives, and a wonderful back up OB!

 

I cried lots of tears that day wondering when my baby was going to decide to make his appearance, but also accepted that he would come when he was truly ready.  Earlier in the week, we tried some herbs with our midwives, but that did not encourage labor to begin.  We decided to try them again that night and see what would happen.  That night, we had a wonderful dinner and put our daughter to bed before the midwives arrived.  I must have had a gut feeling something was going to happen.  We read extra books and had lots of extra snuggles, hugs, and kisses before bed that night.  I think deep down, I knew this would be our last bedtime as a family of three.

 

The midwives arrived around 8:00.  I spent the next hour bouncing on my yoga ball, hanging out with our midwives, and trying the herbs.  Around 9:00, I started getting a little crampy and a few waves here and there.  By 10:00, waves had begun to get regular.  I started listening to my Hypnobabies Birthing Day Affirmations while bouncing on my yoga ball. I texted my doula to let her know that labor had possibly begun.  I told her that we may have a baby the next day and that the midwives were still at our house.  I honestly thought I wasn’t in real labor.  I thought the midwives would go home to rest and come back in the morning.  Being almost 43 weeks, I was in complete denial that labor was actually going to happen!

 

Shortly after texting my doula, our midwives decided to time the waves.  They were already 2 minutes apart.  I kept moving on my yoga ball for awhile, then went to take a shower.  I went upstairs and by the time I got up there, I could barely move through a wave.  I asked my husband, Jon, to come help me.  I leaned on him during the waves while I was trying to move into the shower.  I listened to my Hypnobabies Deepening track and kept going between waves on the toilet and waves leaning on Jon.  I finally got in the shower.  The water felt great but standing was a challenge.  I got out and got on the toilet again.  I started getting vocal through the waves.  Deep moaning helped me make it through them.

 

I have no idea how far apart they were, but they felt very close.  I told Jon that I needed them to set the pool up because I needed to get in it now.  By this time, my midwives were setting everything up for the birth.  I texted my doula a little before 11:00 to come now.  She asked if the midwives were there and all I said was yes.  She asked if she should let the birth photographer know to come, and I said yes.  That was the last I looked at my phone.

 

My doula got to our house at about 11:45 and my photographer got there at about 12:00.  I was sitting on my yoga ball in our bedroom while everyone scrambled to get the birth pool set up.  My doula used the relax cue with her hand on my shoulder and said lots of wonderful, positive Hypnobabies birthing affirmations which kept me calm and relaxed.  The midwives and Jon were trying to get the pool filled fast.  The hose was not quick enough!  They brought up pots and pitchers of water from the kitchen to the nursery upstairs where we had the pool set up.  Shortly after, the pool was full and ready for me to get in. I climbed in the pool before another wave hit me.

 

The water felt amazing!  The only position I was comfortable in was kneeling and leaning over the edge of the pool.  Jon held my hand pretty much the entire time.  He was truly my rock through all of this.  My doula helped me with Hypnobabies affirmations, staying relaxed, and breathing my baby out.  My moaning got louder and deeper and the pressure waves more intense.  I can’t say it wasn’t painful, but I was able to keep my body relaxed and not tense up.  I thank Hypnobabies for being able to keep me calm and my body relaxed through this stage.  I spent awhile on my knees hanging over the edge letting my body push.  I never believed people when they said your body will start pushing when you are ready, but it is absolutely true!  As baby moved down, I needed to move to open my pelvis.  I alternated between one knee down and the other knee up in a lunge and then the same thing on the other side.  It was uncomfortable but its what baby and my body needed.  My midwives also wanted me to sit up so gravity would help bring baby down.  This was incredibly hard to do.  I certainly tried my best to stay upright, but I couldn’t do it every wave.

 

I said many times “this baby needs to come out!”  I was getting close to crowning when they brought my husband an elastic band with handles on it that he wrapped around his body and I held onto the handles to keep myself upright.  This is when the intense pushing began where I really gave it my all.  Shortly after, I remember saying it burned and they said that was good and to take it easy and his head was almost out.  A couple pushes later and his head was out.  His shoulder was a little sticky so my midwife helped loosen his shoulder and shortly after, the rest of his body slid out.  I remember hearing everyone tell me to reach down and pick up my baby.  I reached down and grabbed him into my arms and said “I did it!”.  I think a repeated “I did it” over and over again!  I was the first person to see and hold my baby!  Carter was born at 2:14 am.  He certainly waited until the last minute to be born, but once labor started, he was in a hurry!  His whole labor was about 4 hours long!  He was 9 pounds, 9 ounces and 22.5 inches long.

 

Carter’s birth was absolutely perfect and everything I dreamed of.  It was the healing birth I needed and it brought our beautiful baby boy into this world!

“Incredibly healing and an absolute gift”: An HBA2C birth story

by Joyce Geving

My first of three sons was born December 21st, 2004.  We labored for hours and I was given an epidural followed by Pitocin. His cord was wrapped around his forehead, so with each contraction his heart rate would fall. So I was rushed into the operating room. I remember feeling so scared and helpless.  I am not sure if a cesarean could have been avoided with his birth. Afterward, I really mourned not being pregnant any longer, and I think it was the safe feeling of my pregnancy that I missed. I no longer had my baby safe and warm in me but had this scary birth story. I also left feeling like my body had been violated in some way. All of these feelings I shared with others and my doctor but were dismissed or hardly acknowledged so I thought I just needed to get over it and move on.

My second, July 6th, 2007, was a scheduled repeat cesarean. The hospital had a no VBAC policy in place and my doctor convinced me that a cesarean would be the safest option, and I went along with it.  It wasn’t until a couple years later, after watching the “Business of Being Born” that I began questioning the necessity of my cesareans and how I and my babies missed out on the natural experience and all the benefits that happen with that.

When I became pregnant with my third I knew I wanted to give birth, to do what my body was meant to do, even with a scar. I was so happy to hear the nearby hospital was doing VBACs again but was told it was not for me because I had had two previous cesareans and the risk was too high…so now what? I felt defeated.

I contacted the ICAN Minneapolis chapter and was informed of hospitals in the metro that would do VBA2C. I began making appointments and looking into a couple that were within reasonable driving distance. After each appointment I left feeling like they were setting me up for another cesarean, and more interested in adding my birth to their statistics – good or bad.  I began questioning what my birth was going to look like at the hospital with all their policies and protocols. 

Mean while, we had hired a doula because we had read the statistics supporting reduced risk of cesarean when doulas are present. I also knew I would need someone to help us make informed decisions in a hospital. Right from the start, we had a connection with our doula, Ashley; she gave us so much support and information that we needed. 

While doing my research online, home births always came up as an option or in success stories, but my husband and I were both really scared of the idea thinking, “what if something goes wrong” and “what would we do with the dogs and my dad during labor, how are we going to come up with the money?”

Our doula encouraged me to just meet with homebirth midwives to rule it out, if nothing else, and at 30 weeks my husband and I made an appointment to do so. After our first meeting, we knew this was our path and had a sigh of relief. We left feeling excited again and validated, instead of stressed about the birth and our plans. We could really enjoy the pregnancy and the preparing for our birth. 

My prenatal appointments were always at least 45 minutes long, usually longer. We talked about the importance of eating well and drinking water and my tea.  The care I experienced during our appointments was amazing, they always made me feel comfortable and that I could do this.  Nothing like what I experienced in any of my clinic visits.

On January 21st, my contractions began at 10:40 at night. I was so excited, we were up timing contractions all night and called our doula so excited at 4am. She convinced us to get some rest. I slept a couple hours and my water broke at 7:35the next morning. Then I called everyone, because I felt like now’s the real deal, but contractions were still steady and not increasing or getting stronger. I was in constant contact with our doula and midwives. One of the midwives came to check on our progress and things were moving so slow we were urged to get some rest that evening and labor would hopefully pick up after some sleep. Just as soon as I laid down, contractions really began – and we had just told our doula to take her time and come that night when she wanted. One of the midwives came and hurriedly called the other to come now after she said she could see his head and then reassured me that my body was doing what it was supposed to be doing.

That night, in our family room, I gave birth to our third son.  He came out and cried “momma” (sounded like that to me) and nursed like champ all while his cord was still attached to me. My husband was so comforting and amazing while supporting me. It was so calm, comfortable, and full of love and encouragement…it was a beautiful setting for our little guy to enter the world. 

My home birth experience was incredibly healing and an absolute gift.

Birth Story: Emaline’s Home Water Birth under a Blue Moon

by Kerri Rivers

Editor’s Note: All photos in this birth story are from Megan Crown Photography. 

Kerri getting support from her partner and doula. (and doggie)

Our second pregnancy was accidental. Jason and I had been indecisive for several years about whether and when to have a second child. But we were thrilled when we saw the positive pregnancy test. We knew right away that we wanted to have this baby at home. The hospital birth of our son five years earlier was a lovely and natural water birth but we couldn’t help but feel that it had been unnecessary for us to be in the hospital. So we made calls to several home birth midwives. Our first interview was with Emme Corbeil of Trillium Midwifery and we felt an immediate connection with her. We didn’t end up interviewing anyone else.

Homebirth mama Kerri gets a hip-squeeze from her doula while her partner and son look on.

Our prenatal care was amazing. Our appointments were at Emme’s home and each one lasted an hour, giving us time to talk and get to know Emme and the midwife apprentices. We brought Eliot to each appointment and he loved being a part of the process (and playing with Emme’s great toys). Having our appointments at Emme’s home, always with a warm cup of tea, where there was intimacy and comfort,  was a blessing and wonderful preparation for birth. As I approached 40 weeks, I felt completely at peace and ready to meet the sweet baby in my belly.

Happy Birth Day, baby Emaline!

My water broke on Monday night a little after midnight. It was 2 days before my due date. I hadn’t yet gone to bed, but after a quick talk with Emme, I laid down to try to get some sleep. Jason stayed up and filled the birth tub. I had intermittent contractions throughout the night and didn’t sleep well, mostly due to anticipation. Neither of us got much sleep. The next morning I got up early and went for a long walk with a friend, hoping that it would get things moving along, but there was no change. Emme and Julie, a midwife apprentice, came over around 10am to check on me and the baby. Everything was great. Emme commented that her head was so low that she couldn’t really feel it. We agreed to touch base later in the day. Emme called while we were eating lunch just a few minutes later and told us that she couldn’t shake the feeling that maybe the baby was breech. She asked if we would be willing to go for a positional ultrasound and we agreed. I promised myself I wasn’t going to worry about the possibilities, but  it was difficult to keep my mind off the idea of not being able to have a home birth. The ultrasound took less than three minutes and the ultrasound technician was able to confirm immediately that the baby was head down. We were incredibly relieved.

After dinner that evening, Jason, Eliot and I took another walk. My contractions were becoming more regular and I was pretty tired. We talked with Emme and let her know that it was still stop and go. After making sure that our house was tidied up and everything was ready for the birth, we went to bed around 10pm. Around midnight, I felt like I couldn’t lay in bed anymore and I got up. I knew at that point that my labor had started in earnest. My contractions were still between 6-10 minutes apart but they were definitely getting stronger. I took a long shower and mentally prepared myself for whatever was to come. It was a Blue Moon that night and I spent a few minutes outside taking in the full beauty of the moon under which my daughter would be born (and getting a huge mosquito bite on my belly in the process).

A new family of four

After checking out the moon, I decided to sit on a birthing ball to see if it could help me get into a rhythm. I started my birth playlist and relaxed, while Jason and I chatted and kept track of my contractions. It felt so calm and peaceful and the birthing ball was definitely working its magic. Around 2:30am, we called our team and asked them to come over: Emme, Julie, Rebecca the second midwife, Margaret our doula, my friend Kristen who would be there for Eliot, and our birth photographer, Megan. Everyone showed up over the next forty minutes or so and we all got cozy in the living room. I was able to talk between my contractions and I continued to labor on the ball. I remember feeling incredibly comfortable, safe and surrounded in love at this point. We woke Eliot up around 4am to make sure he would have enough time to fully wake up before the baby arrived. It was important for him to see his sister’s birth. As my contractions started to intensify, Margaret suggested I try laying down in bed to rest for a couple of minutes. I agreed and we moved to the bedroom. The first contraction I had in bed felt so much more intense than all the others and I knew that I was ready to get into the tub. By this time, I was in a labor fog and had lost all sense of time. I got into the tub and remember that the water felt so warm and took the edge off the contractions, which were very intense at this point. I know that I labored in the tub for about an hour before I felt the need to start pushing, but at the time, it felt like only minutes to me. It is so incredible what birth hormones can do! I remember Margaret helping me through contractions and Jason and Eliot encouraging me. When I started pushing, I came out of the fog a bit and realized that Margaret was reading out loud a set of birth affirmations that I had written several days prior. I focused my mind on them as I allowed my body to open for my baby. After 4 or 5 good pushes, Emaline Ophelia was born at 5:55am. I distinctly remember hearing the song, The World Exploded Into Love All Around Me, playing from my birth playlist as she came into the world. Jason caught her while Eliot stood right next to him. The moment felt absolutely perfect to me, filled with so much love.

Happy big brother!

After the birth, Jason, Eliot, Emaline and I moved to our bed where we stayed while both Emaline and I were checked. She weighed 8 lbs and was 22 inches long. Emme guessed the weight exactly! By the time everyone left our home several hours later, everything was cleaned up, I had eaten, there were cold compresses in the freezer and perineal rinse in the fridge, and we were all tucked cozy into bed and ready to sleep.

Blue Moon Baby

Our home birth was everything we had hoped for and more. We were able to bring our daughter into the world in the most peaceful and loving way. Eliot was able to watch his sister’s birth. Jason was able to deliver his daughter. I was able to labor in my own home, surrounded by my family and a care team that honored and respected the normal and amazing process of birth. We feel so incredibly blessed, both to have had the birth we did and because of the precious life that joined our family that morning.

Kerri Rivers is a mama to Eliot (5) and Emaline (3 weeks) and wife to Jason. She is a Regulatory Compliance Specialist at Boston Scientific who likes to be crafty in her free time and is super passionate about natural birth.

Sweet Moments in OOH Birth: A Doula’s Perspective

by Anne Ferguson, CD(DONA), HCHI

A homebirth mama is comforted by her partner and her doula as her midwives look on.

Amazing, beautiful and empowering birth can happen anywhere, that’s for sure.  But there are some special things I’ve witnessed as a doula in out-of-hospital birth that you really don’t see in a hospital setting.  Here are just a few of the amazing things I’ve had the honor to be a part of in some of the birth center and home births I’ve attended as a birth doula.

 

• The doula waking the older children in the middle of the night just moments before their Mom pushed their new sibling out in the world so they could witness the birth, and the children announcing the sex of their new baby sibling.

 

•  The entire birth team and family enjoying chocolate cake and pink champagne at 6 am after a beautiful home birth.

 

• A strong Mom pushing her baby out into the world just as she envisioned, in the birth tub in her backyard as the sun rose on a beautiful summer morning.

 

• Enjoying Pizza Luce for lunch while sitting around the dining room table in a comfortable and cozy birth center with a Mom in early labor, waiting for her body to move into the next phase, without any expectations around timing or a need to rush the process along.

 

• A beautiful, quick birth during a power outage, because it turns out you don’t really need power to have a baby!

 

In general out of hospital birth offers the following perks:

 

• Taking a bath or shower in your own bathroom and then climbing into your own warm, comfortable bed not long after giving birth.

 

• A homemade meal made just for you, right in your own kitchen or in the birth center kitchen, made just to your needs and tastes. 

 

• Midwives who you know and trust because you’ve been meeting with the same people for months, and you know who is going to be there when the times comes for your baby to be born.  (This happens sometimes in hospital birth with small groups of care providers.)

 

• Moms being able to trust their bodies completely, knowing when it’s time to push their babies out without any cervical checks. 

 

• Control over who comes in to your postpartum space, instead of the constant flow of traffic that usually happens in the hospital setting.

 

Out of hospital birth is a safe and wonderful option for low risk mothers wanting a low-intervention birth.  In the Twin Cities we are incredibly lucky to have three free-standing birth centers and many, many wonderful, skilled home birth midwives.  If you are planning to have a low-intervention birth, it is well worth your while to consider your out-of-hospital options!

Anne Ferguson, CD(DONA), HCHI is a birth doula, Hypnobabies instructor and placenta encapsulator who has two sons, one born in the hospital and one in the comfort and safety of her own bedroom.  You can find her at www.bywaterbirth.com.

 

 

 

 

Promoting better birth through research and policy change: a doula for every mother

Editor’s note: We are excited to welcome guest blogger, Dr. Katy Kozhimannil! Dr. Kozhimannil has recently brought national attention to the importance of the doula role for positive birth outcomes, especially in under-served populations. We’re grateful to her for sharing a little about her experience and her research here on the blog. 

by Katy B. Kozhimannil, PhD MPA

A doula supports a laboring woman.

It makes sense to me that pregnant women with personal, emotional, and physical support during labor and delivery have better birth experiences. I did not have a doula when my son Paul was born in 2008.  I could not afford one at that time.  However, I had taken a newborn care class, and the instructor for that course (Teresa) was training for her certification in childbirth education and needed to observe births for her training. Teresa offered to support me during labor for free, so that she could observe my son’s birth and fulfill her training requirements.

My labor experience was best characterized by the phrase “cascade of interventions.” I was overwhelmed and frightened, but there was one moment that stopped the feeling of inertia that seemed to hover around me: when Teresa stood next to me, held my hand, and told me that I could ask whether I had time to rest before making a decision.  The medical team, standing next to me in scrubs waiting to take me to the operating room for a cesarean, confirmed that the situation was not urgent and agreed to wait an hour and reassess. The tide turned in my direction.  I felt a renewed sense of ownership and agency in the birth process.

When I felt the urge to push, I was so grateful for the chance to do something and to feel like I could participate in the birth process. I had a vaginal delivery, and – with Teresa’s help – I regained control of the decision-making during my son’s birth.  Incidentally, I also think Teresa saved my health insurance company a lot of money – approximately $4000 by my calculations (the difference between the costs of a cesarean vs. vaginal delivery).  But she never even got a thank you note.

Unfortunately, many women can’t afford to pay out-of-pocket for doula care, and most health insurance companies don’t pay for doulas.  But labor support is incredibly important.  There is good empirical evidence for this. A 2012 Cochrane review conclusively finds that continuous labor support is associated with many positive outcomes for moms and babies (more spontaneous vaginal births, fewer epidurals, shorter labors, higher infant Apgar scores, and greater satisfaction) and no known negative impacts. These effects are most consistent when labor support is provided someone who is not a friend or family member and not a member of the hospital staff – someone like a doula.

For a year and a half, I have had the pleasure of collaborating with Everyday Miracles, a Minnesota-based non-profit organization that aims to reduce health disparities by providing perinatal education and doula services to low-income women. Everyday Miracles employs a diverse group of doulas (including Somali, Latina, Hmong and African-American doulas) and attempts to match doulas to clients based on language and race/ethnicity.

Given the strong evidence base for the health benefits of doula care, we gathered and analyzed data to look at both the health and cost impacts of doula care among low-income women. In a paper published this spring in the American Journal of Public Health, we reported that cesarean rates were about 40% lower for doula-supported births, compared with similar women nationally. We also estimated potential financial impacts to states Medicaid programs associated with cesarean rate reductions of this magnitude and suggested that states investigate whether reimbursing birth doulas may result in improved birth outcomes and potentially even generate cost savings within their Medicaid programs.

Minnesota took up this challenge, and our state legislature has decided that doula care is a service worth providing to Minnesota’s mothers.  On May 23, 2013, Governor Dayton signed “the doula bill” (SF 699, HF 768) into law as part of the Omnibus health bill (SF 1644, HF1233).  Starting in July, 2014, Minnesota Statues Chapter 108, Sec. 11 will allow Medicaid payment for services from a certified doula for pregnant women in our state.  The passage of this legislation resulted from more than a decade of work by doulas, mothers, community members and led by the Minnesota Better Birth coalition.

The “doula bill” was a great policy victory for mothers, families, and doulas in our state, and as implementation unfolds, I hope that it will lay the foundation for improving birth for moms in Minnesota and beyond.  While the potential “cost savings” of offering health insurance reimbursement to birth doulas is a compelling rationale in a policy context, I think that the fundamental goodness and power of a positive birth experience and the ability of doulas to facilitate such an experience far outshine any benefits that could be measured in dollars and cents.

Dr. Kozhimannil is an assistant professor at the University of Minnesota’s School of Public Health where  she conducts research to inform the development, implementation, and evaluation of health policy that impacts reproductive-age women and their families. She is the mother of two sweet little ones.