I hear statements like these often at births:

“Mama, I’m going to ask you a few questions.”

“You got this, Mama!”

“Mama, you are going to meet your baby soon!”

While I don’t think these comments are meant to be negative or derogatory, they are directed at a watered-down version of the person being addressed. There is no use of a person’s name in these interactions, only the new label as mother/mama/mom.

Let’s think about this though. Pregnancy, let alone birth, is a life-changing experience. It is one in which women struggle to maintain an identity for themselves despite being a mother. It starts from the very beginning. As their body is overtaken by the growing baby, everyone, even complete strangers, feel compelled to reach out and touch the swollen abdomen, an act that one would never consider doing on an unpregnant belly!

Consider these unpopular truths that are the reality for some. What if the person giving birth is not excited about motherhood? What if she is petrified of her new role? Perhaps her relationship with her partner is not the best, or it may be that the partner is not eager to welcome a baby. Is might be possible that she never wanted to be pregnant in the first place, and she is still trying to wrap her head around it. Birth is not always a joyful occasion. Would she want to be called, “Mama?”

But even if the woman is thrilled to meet her baby, shouldn’t we address her by name? For in the event of giving birth and meeting her baby, she will also be reacquainted with herself. She may be a little different than before, but she will still be herself. She is so much more than a mama. And she may have years of struggling to see that and convey that to a world that pigeonholes her into the motherhood identity.

I recognize that in the hospital setting it can be particularly difficult to recall the names of several patients in your care. But I also see the dry erase boards in every room with names listed. And when the computer screen is opened the patient’s name is visible. There are ways to find out on the sly. Or simply ask her if you don’t know or remember. So you can address her by her name.

Empowerment can be found in giving birth. But it can also be lost in it. Please don’t initiate the loss of self by calling her mama. Call her by her name.

Camron and Bryce welcomed their second child, Eleanor Blake, on November 18, a baby sister for big brother, Theo. The birth of Ellie also happened to be the 1,000th birth for me so this was an extra special birth journey for that reason and because they were repeat clients!

Camron’s first birth began when her water broke at her prenatal appointment and proceeded to take about 29 hours, requiring some interventions for labor’s progress as well as antibiotics since her water was broken for so long. This time around, she developed preeclampsia, so an induction was the topic of conversation over a month out. Camron was no stranger to an induction since that was the path her first birth had taken. And she trusted her doctors’ recommendations for the safest outcome for her and her baby. In fact, she had some concerning symptoms that had her going to get monitored at the hospital. Thankfully she made it to her scheduled induction at 37 weeks.

Camron went into the hospital for cervical ripening after having to wait a few extra hours due to no available beds. She received Cytotec orally as well as in the suppository form. The following morning, they inserted a Cook Balloon and began low dose pitocin. Camron tried to rest through that first night and stay chill during the day until contractions picked up. The biggest challenge during an induction is not letting the same four walls drive you crazy! Bryce was a wonderful partner, keeping things light and loving her through every step.

I arrived around 2:30 pm as things were starting to pick up. Camron was still chatty and pleasant, doing some catching up between contractions. I tied the rebozo to the squat bar on the bed to give her an alternative position that was upright. The contractions were growing more consistent but still just every 4:30 minutes apart and on the shorter side.

By 4:25pm her doctor came in to assess and recommended breaking her water to move things forward. Camron was dilated 5 cm, 50% effaced, and her baby was at -3 station. Due to some concerns with tracing baby’s heart rate, they used internal monitors to get a more accurate read on things. Camron soon felt more pain in her lower back, so we used the heating pad.

Just thirty minutes later, around 5:00 pm, Camron was vocalizing with her contractions. We stepped up the positions using the CUB so she could remain upright. An hour later, Camron felt a lot of pressure like she might need to push her baby out. This brought her back to her first birth however, when she felt pushy, but it was too soon. She tightened up in response to the contraction for fear history might be repeating itself. And when her doctor did an exam, Camron was dilated to 6 cm, 80% effaced, and her baby was at -2. While she had made some change in the right direction, it was not time to push.

Camron labored out of bed in the hopes she might bring her baby down upon her cervix and open it. But she couldn’t help but feel the anxiety creep in about pushing too soon. She clenched in response and told us she thought an epidural might be a wise decision if things weren’t progressing. It had been over an hour, and this WAS her second baby, so perhaps it was time to push. However, a check confirmed she was still 6 cm, so Camron knew what she wanted to do. She requested an epidural in the hopes it would keep her from pushing too soon and possibly swelling her cervix.

By 8:00 pm they were finishing up the epidural, made a little more complicated due to a rod Camron had placed in her back. But she was comfortable soon after. Her baby’s heart rate took a surprising tumble around 8:30 pm with each contraction. We suspected this could mean big changes and when Camron’s doctor did a check, she confirmed just that! Camron was dilated 10 cm, 100% effaced, and her baby was at 0 station!

They turned down the pitocin to give baby a break. And then had Camron give a push. She was a very good pusher! It didn’t take long. Her doctor got suited up and then Camron really pushed, and she pushed Ellie into the world at 9:02 pm, exactly an hour after the epidural test dose went in! Looking back, Camron felt confident that getting the epidural when she did helped keep things moving forward so nicely.

Camron and Bryce took in their baby girl from head to toe, comparing her to big brother while also seeing how she was her own unique person. With her baby in her arms, Camron looked up at her husband who leaned down to kiss her forehead. Ellie got skin to skin with mom and then with dad, getting so much love in her first hour. Ellie weighed 6 lb. 8 oz. and measured 19.5 in. long. She was a little gal, but perfectly healthy.

The love overflowed to the next level when big brother Theo met little sis, and mom and dad watched it all. That moment comes very close to the moment of birth as one of the best. These sweet parents are gentle and kind, and I have no doubt their two children will benefit from their nature as they guide them in this life.

Devin and Ben welcomed their third baby girl, Austin Elizabeth, on November 15. Davin’s births were all very different. Her first was a c-section, the second was a VBAC (and she arrived at the hospital ready to push!), and this was a second VBAC! However, it wasn’t without its challenges. This time around, Devin’s placenta had a velamentous cord insertion which can leave the vessels more vulnerable. There is not a lot that can be done except possibly induce a little early to protect baby from an incident, albeit a rare one.

But Devin’s baby was also measuring smaller, and her growth had dropped to an alarming threshold, which had her providers recommending induction. Her baby remained steady in growth and even had a little growth spurt, but between the VCI and her baby falling low on the growth chart, an induction was the decision agreed upon. It was scheduled for 39 weeks, so not terribly early.

Devin was dilated 2 cm at the start of the process. She was no stranger to unmedicated birth, but this would be her first time with pitocin, so it would still be a new experience. They got situated that morning and once she was admitted, the plan discussed, and everything began, it was later in the morning. There was not much of an update since nothing much was happening initially. It took awhile for Devin’s body to respond with contractions and when it did, she was dilated 3 cm, so she went into the shower.

In fact, Ben’s first update came at 2:47 pm saying “the contractions were more intense, and he was helping to squeeze hips for help on the contractions.” When I asked how far apart and how long they were, he responded that they weren’t long and two minutes apart. It soon became clear that it was time for me to head in.

Devin didn’t know if it was quite time, but she was breathing through the contractions. The pitocin was at 12 mu and by the last text, Ben confirmed the contractions were close to 60 seconds and 2 minutes apart. I was dressed and packed so left the house shortly. I arrived 20 minutes later at 3:37 pm. And Devin had emerged from the shower a short time before I arrived. She had dilated from 3 cm to 8 cm in a very short time!

When I walked in, it was evident that Devin had turned a corner quickly. Her midwife was present, and she was struggling to stay on top of her contractions. She had asked for an epidural, but the simple fact of the matter was that she didn’t have time. Plus, it was not what she initially wanted. Ben pressed on her hips during contractions, and I took my place beside them to offer encouragement to Devin.

We kept her focused on one contraction at a time and she breathed through her contractions courageously. Her cervix was changing rapidly. She was already dilated 8 cm and it was only a matter of time before her body would lurch her into a push. In the meantime, she was wavering and not sure how much more stamina she had. She agreed to have her midwife break her water in the hopes that the last bit of cervix would melt away as baby came down. But it didn’t go quite like that.

Devin had a rim of cervix that remained through several contractions. Her midwife offered to push the cervix aside during a contraction to help Devin with dilation to complete and she was game. This is not a pleasant thing to go through, but Devin faced it head on and like a champ. And she was fully dilated as a result. Devin labored upright in the bed, pulling on the rebozo tied to the squat bar, and she soon felt the familiar sensations of a baby coming.

Devin pushed on her hands and knees over the CUB. She pushed quietly and with great strength and it didn’t take long at all for us to see her baby’s head. Austin Elizabeth was born at 4:26 pm with a full set of eye lashes! The midwife passed her through Devin’s legs and up into her arms. Devin hugged her close and cried with joy to know her littlest girl was safely born.

The placenta was a sight to see, and we took many pictures of the rare velamentous cord insertion. Austin snuggled with her mommy and soon got skin to skin with her daddy. She was small, weighing just 6 lb. 2 oz. but it wouldn’t be long before she got chunky on her mom’s milk.

Devin’s labor was such a joy. She welcomed her baby with glee and had a wonderfully flexible approach to the birth. And when induction became the plan, she rolled with that too. Pitocin is no joke, but Devin rode those rocky waves with such courage. I’m very proud of her as should she! And now she is a member of the 2VBAC club!

Elyse and Tony welcomed their second daughter, a second surprise gender, in their second homebirth on Saturday, October 14. Repeat clients are a wonderful opportunity for me to develop an even deeper relationship through multiple births. And Elyse and Tony were no different. The text of the pregnancy was the foray through which our second journey began, and I didn’t hear much from Elyse until we were coordinating our prenatal visit many months (and two seasons) later! The team would be the same – same midwife and same doula We were excited for the reunion that would occur when their newest little love entered the world.

Elyse welcomed her first baby a couple of weeks before her due date so when she approached her due date with this one she felt overdue. Thankfully, the text came through on October 14 at 7:15 am that Elyse’s water broke at 5:30 am! Her water broke at the start of her first labor so it was a conveniently obvious way to signal her baby was coming at some point that day. It was especially helpful considering they had a toddler to contend with and eventually have picked up so as not to be underfoot.

Elyse would update as things developed but she did feel crampy soon after her water broke. Three hours later by 10:30 am, she sent the text, “Ok things are getting a little spicy. Contractions are 3 mins apart.” She didn’t have to tell me anything more. I knew that meant it was time for me to head over.

When I arrived, Elyse was laboring on her hands and knees against the couch and her daughter was milling about while Tony took care of details, including getting their firstborn settled for a nap and reaching out to a friend to pick her up later. Elyse sipped on a smoothie between contractions. Then when a contraction rolled through she swayed on her hands and knees against the couch. In her unassuming way, Elyse greeted the intensifying cotractions with an, “Oh sheesh,” right before closing her eyes to focus.

Tony disappeared with big sister to try and settle her down for a nap but it wasn’t happening. Something about having a visitor with a large inflatable created enough of a distraction for her not to miss anything. Elyse went to the back to give it a try and managed success for a little while. Big sister was asleep by noon. Elyse continued to breathe through her contractions and add a heating pad to her lower back. She continued to coordinate momming details with Tony like making sure their daughter had food packed for when she was picked up by a friend. Tony had it all taken care of.

As labor intensified, Elyse moved to a back room to ease the transition when their friend came to pick up their toddler who was still asleep herself. Her midwife called to check on things around 1:00, asking questions about what Elyse was feeling during contractions Rectal pressure was one of the questions to which Elyse didn’t really feel. But 10 minutes later she did feel rectal pressure through a particularly strong contraction so she called her midwife to head on over. She was only 5 minutes away, it turns out, so she was on her doorstep momentarily.

Elyse rested in bed and reached for Tony’s hand at the start of a strong one, and by the next contraction there was a knock on the door. Tony roused their toddler who was on her way to an adventure at a friend’s house. And like clockwork Elyse’s labor kicked up a notch. The midwife arrived a couple of minutes later and the contractions became strong enough to require counter pressure on her lower back.

Elyse’s legs shook and her contractions moved from 3-4 minutes apart to 3 minutes apart and lasting 90 seconds. Elyse labored over the cub and lunged to one side through a contraction and then to the other. This is a woman who is not afraid to do physical work. Every one in a while they would lean in a listen to baby on the doppler. The heart rate was always sure and steady.

By 2:00 Elyse was exhaling more audibly through the contractions. We could tell that she was working harder. Her baby was also tracking lower in her abdomen, another good sign of labor’s progress. There was no need to check a cervix. The signs were there. As labor picked up so did the rain outside, providing a wonderful backdrop of white noise for Elyse. She continued to lunge through contractions and asked Tony to push even harder on her back.

She moved to stand up at 2:30 and continued to ask Tony to push harder. We knew Elyse was getting close. She took a trip to the bathroom and saw more evidence of cervical change. And 10 minutes later her vocalizations became louder and lower through contractions. Her midwife and the assistant moved into the room quietly. Five minutes later, Elyse had a contraction that brought on the recognizable guttural sound of pushing. Her midwife asked, “Did you feel like you were pushing?” To which Elyse responded, “Yes.” Her midwife excited but calmly said, “Cool!”

Elyse was already on the bed with Tony, so she eased onto her side and gave a push at 2:54 pm. It didn’t take long, maybe 4 contractions before her baby was born at 3:07 pm. It was a remarkable sight to see her child born because the eyes were wide open as the baby emerged to the chest and then flopped out! It wasn’t until Elyse had her baby in her arms and took a look at the undercarriage that Tony and Elyse confirmed it was another girl! After plenty of bonding and skin to skin, Revel Monroe would be weighed and measured at 7 lb. 6 oz. and 20 in. long.

There was so much vernix! Elyse dabbed it on her face like war paint. As their baby cried out, Elyse said, “It’s ok. We’re nice.” We stepped out of the room so Elyse and Tony could bond with their newest one. And after about 1 ½ hours the newborn exam ensued. Elyse also finished her smoothie, and within 2 ½ hours, big sister was home to meet her sister.  Soon after that, we served up a bowl of soup and rice with chicken for Elyse to enjoy, thanks to Tony putting it on the stove a bit earlier. We all were able to get fed that evening. Oh, the comforts of homebirth.

Revel was contentedly nursing and napping, as Tony and Elyse rested and took in their little family. We cleaned up our things and left once they were settled. All in all, it was a beautiful way to spend a rainy Saturday afternoon. And how lovely that behind their front door they welcomed a miracle. The ordinary location of an extraordinary process like giving birth elevates the home in a way like nothing else, if you ask me.

Alyson and Chris welcomed their second child, this time a son, in a very surprising birth on October 9. Since their daughter ended up coming about 2 weeks late by induction, baby’s arrival any time before the due date was not even on the radar. Alyson was very adept at ignoring the twinges and discomforts of late pregnancy that seem to come on stronger with subsequent pregnancies. She even requested a book from me to brush up on labor and I had been driving it around in the back of my car to bring to her a couple of weeks prior to the full-term 37-week mark. Worst case I could bring it to our prenatal that was scheduled around then.

The week Clifton was born, Alyson shared that she had been feeling weird all week. That Friday she thought her water had broken but a trip to the hospital and a spent nitrazine paper later, it was confirmed that it hadn’t. She was sent home. It was chocked up to typical last trimester discomforts and left at just that.

But baby Clifton had very different plans! We had scheduled our prenatal for Sunday, October 8 and as I was walking out of church Alyson called to tell me she was pretty sure her water broke, and we would not be having our prenatal visit scheduled an hour later. She was headed to the hospital instead since she was just 34w6. She didn’t expect a baby to come for another 6 weeks!

Turns out Alyson’s water did break. But she was only 1 cm dilated. She texted around noon to update that she would receive steroid injections to help baby’s lungs mature and if labor didn’t happen overnight, they would work on starting things the following afternoon. We covered some birth details via text, including Alyson’s desire to have an unmedicated birth. She labored on pitocin previously and while she hoped to avoid it, she was willing to give it a try again since she labored many hours before an epidural. Alyson would send updates in the meantime.

Sitting in a hospital room waiting for labor can be a daunting task. Alyson was permitted some meals which was a godsend, and Chris helped to keep the mood light. She had excellent staff taking care of her the whole time, easing her mind, and keeping things positive. Alyson tried to stay relaxed and “not freak out” (her words), and even thought she might watch some YouTube videos to reacquaint herself with birth. After all, she had expected to have another month or so to do all of the prepping.

As the date turned to night, Alyson requested some Benadryl to help her get much needed rest. The day had been emotionally eventful even if she wasn’t in labor yet. I went to bed, not expecting to hear about much labor that night based on the day’s lack of action. I didn’t get an update for a few hours, but in the meantime, Alyson sensed some contractions starting up at 3:30 am. She had been napping through the contractions prior to that but wasn’t able to get back to sleep after that.

Chris sent me a text around 5:15 am telling me Alyson was dilated 4 cm and 90% effaced. It was very exciting because Alyson’s body had begun the labor process on its own. We were all hopeful she could avoid pitocin. Alyson added that her contractions were 5 minutes apart and lasting a minute but there wasn’t a rush for me to come yet. Chris was doing counter pressure, and she was managing the pain fine. Her midwife mentioned reaching out so I was aware and would have some time. I asked her to reach out when she gets to the point of needing support and I would head over. Alyson anticipated in an hour would be a good time for me to come but would let me know if things changed before then. It was 5:30 am.

Just 45 minutes later, as I was waking up to head to the hospital, Alyson sent an update that she was in a lot of pain and feeling exhausted. She was thinking she would go ahead and get an epidural. At that point, I told her I should be there if she felt like she needed an epidural and she planned to hold off until I got there. Once I gathered my things and changed, I was on my way. I texted my eta to the hospital of 6:57 am.

The CRNA came into the room to administer the epidural, but Alyson asked her to leave. She was waiting and didn’t really want it. As her contractions continued to roll on through, Alyson moved into positions that would help ease the pain. She found herself on hands and knees on the bed and felt the surprising urge to push. And that’s exactly what was happening! Alyson had gone from 4 cm to pushing a baby out in 1 ½ hours!

Clifton James was born at 6:57 am, which happened to be the same time I texted my ETA. I walked on the unit to the news Alyson had given birth. I could hardly believe it! But sure enough, I walked into a scene of a baby born, but not yet the placenta. Alyson looked exhilarated and Chris was jazzed. They had done it! She clutched her little guy who was crying quite well (thanks to the miracle steroids!). She was given the gift of skin to skin with him right away. He was a strong little guy.

Alyson played over the details and the time frames, and it was mind boggling. Her midwife didn’t even receive a page until 5:00 am so everyone came together in a short time. Alyson was thrilled she gave birth without an epidural and said just knowing I was on my way helped her to hold off on getting it. I was thrilled I was able to help, even if virtually. We helped Alyson get settled and we marveled at her little guy, who weighed in at a surprisingly small 4 lb. 7 oz. He was 17.5 in. long.

Birth is never scripted, and we can’t know how it will unfold even if we think we know. Alyson’s birth was a perfect example of this. I am so proud of how she met the unique challenges thrown her way and kept herself grounded and centered during a very different journey. And ultimately, she did have her unmedicated birth even if for her higher risk labor that required continuous monitoring and elevated concerns for her baby. Alyson rode the tidal waves of her labor with finesse!

Rachel and Steven welcomed their fourth child on October 9 in a 2VBA2C! (Second VBAC after 2 c-sections!) Rachel’s road to meet each of her babies had unique challenges so she was prepared for every possible outcome, even a c-section. I admired her willingness to be flexible but hoped very much for her sake that she wouldn’t have to. Well, as any experienced mother would tell you, Rachel’s body was gearing up in those final weeks. Her uterus was full of baby and her house was bustling with 3 busy kids. There was no rest for the weary! But she managed those last weeks well, resting in the fleeting moments she could, and stayed grateful for another baby on the way.

At her 38-week appointment she was curious for a cervical check and learned she was dilated 2 cm. It was encouraging to know things were starting to change but Rachel also knew that it could still be weeks before meeting her baby. In the meantime, though, and for the remaining couple of weeks, she had bouts of contractions that caught her attention and her imagination. She breathed through them and even did some positional things to help ease them. The contractions became a regular feature of each day and night and Rachel greeted them with patience. I was proud of her ability to face them and roll with them. In fact, Rachel thought it was the real deal at one point, but the contractions ended up petering off. With so much activity, I hoped when the time came, she would have the advantage of at least some sleep.

Steven sent me a text three days later on October 8 just past 10:00 am telling me Rachel’s water had broken. She was having contractions and thought to err on the safe side of getting to the hospital so she could get settled. It was also a relief to have her children taken care of and no longer under foot. She was dilated 3 cm, 80% effaced, and baby was at -2 station. It was a good start to her labor. Once settled, she labored with the peanut ball on her side. Cold cloths helped on Rachel’s face and Steven applied light strokes to help her relax. Counter pressure on her lower back also helped. She was in significant pain at this point which had me wondering about her baby’s position.

Sure enough, it was conveyed to us that baby was tilted a bit to the right. With all of her prodromal labor we weren’t surprised her baby was a little off kilter in there. We got busy trying some Spinning Babies things to help him find a more direct position. Fighting nausea, Rachel was willing to do it all – the jiggle, even the forward leaning inversion, and finally the side-lying release (on each side). She threw up soon after and around 2:00 pm got an epidural. It didn’t work perfectly at first, however. Rachel struggled with a window of pain on her left. It resolved after some time and adjusting the medication and I recall hearing her breathe deeply in slumber just past 3:35 pm.

The sleep was fleeting though because the window was not 100% gone. The nurse did a check and Rachel was dilated 4-5 cm but stretchable to 6. We worked on shifting Rachel into positions that would improve the pain management as well as help coax her baby boy more midline. Rachel was game for all of the positions we tried, even though the window remained. She used the PCA button when she could, and a heating pad and strategically placed pillow gave some comfort.

Rachel’s contractions were steady at 3 minutes apart and we were hopeful for cervical change. The biggest struggle was the pain management though, as the window remained a challenge. She labored in a variety of positions with the peanut ball under one leg and then the other, laying on one side and then the other, and even using the stirrup to hold her top leg in the runner’s position. By 6:30 pm she felt the pressure lower and more central which got us all hopeful that her baby had moved.

At 7:00 pm she was dilated 8 cm! Her cervix was 90% effaced and her baby was lower at -1 station. These were good changes, and we continued our repertoire of positions to help him find his way out. At 7:19 pm Rachel felt more pressure and her baby seemed lower. By 8:30 pm we positioned her bed in the throne position to make use of gravity to help.

Steven continued his gentle support in light touches and loving words. He told Rachel how proud he was of her and that he loved her. You could see the love reflected back from Rachel and it was a beautiful framework for them to welcome their fourth child. And by 9:27 pm, Rachel’s baby was at +1 station! She still had a bit of cervix, but we were very excited to know that her baby was on his way out of the pelvis!

She returned to an upright position, and we shifted her knees together to make more space in the lower part of her pelvis and rubbed her shoulders with Stress Away essential oil blend to help her release tension there. She lay back on her left side and the window of pain had returned. She received a second bolus from the CRNA, and it seemed to help some. And by 10:45 pm her cervix was gone! Her baby was still lingering around 0 station though and needed to come back down. So, we encouraged Rachel to rest as she labored her baby down.

Thankfully, the latest bolus of medicine really helped to manage the pain from the lingering window and Rachel was relaxed and comfortable enough to sing with the worship music that was playing. She remarked on how wonderful her team was and how well they listened to her. It was important that she feel heard and supported and every single person was very attentive to her needs.

By 12:25 am on October 9, her baby was very low, so she was encouraged to give a push and see what happened. Well, Rachel was a good pusher because one try had her nurse assembling the team. Her midwife was in the room by 12:35 am. Rachel wanted some oxygen to help give her extra stamina through pushing and it kept her mind clear. And she pushed for about 20 minutes or so and welcomed her not so little baby boy at 12:52 am! He weighed in at 8 lb. 11 oz.

Landric Steven didn’t cry out loudly at first, so he got some support at the warmer with some CPAP to open his lungs. There was meconium in the amniotic fluid as well and it was an added precaution to set him up for a good transition. He was back in his mom’s arms a little while later.

When the room was less crowded and quiet again, Rachel and Steven took in their son and reflected on the road to meet him. Rachel is so very patient and mild, and I admired her quiet hope for a positive birth. Rachel held her baby lovingly and enjoyed her first meal of pizza and a cranberry juice and ginger ale mocktail! It was a beautiful celebration of life and love as we welcomed this new person into the world. And it was also a healing birth for Rachel in many ways and reassured her that she could indeed have a VBAC…twice!

Meredith and Brett welcomed their second baby on October 3! It was an incredible confluence of perfect timing that allowed for Brett to be at the birth. He was deployed for the majority of the pregnancy and due to return a couple of weeks before Meredith’s due date. It was cutting it close, but it seemed a realistic expectation. I got a text from Meredith that was an update from her appointment. She was frustrated she tested positive for GBS, but she was excited that Brett was flying home that evening. They were in the clear!

Then three hours later I got a text from Meredith that her water broke. “What time does Brett’s plane land??” I asked first thing. It mattered. At least it would matter if her birth unfolded as it did the first time – with everything moving along at a breakneck pace once her water broke. He was due to land in a few hours, so we crossed our fingers and Meredith crossed her legs and hoped for the timing to work out.

Since Meredith had tested positive for GBS she was headed to the hospital soon after her water broke so she could receive antibiotics as soon as possible. We also thought her labor might capitulate and wanted her to have as much time to get treated as possible. She settled in at the hospital without much labor happening and Brett landed and went home to hug his firstborn and MIL and pack a quick go bag and turned around back for the hospital. Brett was severely jetlagged. And since Meredith was not in labor yet he tried to catch some sleep on the hospital couch. After all, he had been up for 48 hours at that point. He came off deployment and fell right back into life, whether he was ready to or not.

Since Meredith arrived at the hospital the first time completely dilated, we hedged out bets and I got to the hospital on the early side. Probably too early looking back. But you just never know how things will go with birth. Meredith bemoaned the fact that she was supposed to greet Brett at the airport looking pretty in a nice dress and here she was in a hospital gown wearing a diaper as she dripped. Brett’s sense of humor (and Meredith’s) shone throughout this labor. It was entertaining and a joy to witness.

Since Meredith’s labor was poky to start, we did the Three Balances to help it out. Meredith had already done the Miles Circuit. Next, she did three cycles with the breast pump and walking the halls, 10 minutes each, in an effort to start up some contractions. It wasn’t doing much for her labor yet, so she did hip swirls on the ball and even consented to an enema to rile things up, to no avail.

Meredith did some standing lunges and another round of pumping and walking. But it wasn’t doing all that much for her labor. She was tired so she rested during the next course of antibiotics, and when her midwife returned, she was ready to try something else. Suspecting Meredith might have a high leak in her amniotic sac which didn’t really push her into labor, the midwife recommended breaking her water completely. At 4:00 am Meredith’s water was broken all the way. And Meredith was on the move walking again.

Her body was still slow to come around to labor. She rested in bed with Brett and at 7:45 am (after a long night), she was dilated just 2 cm with no labor. We did the Three Balances again and she rested on her hands and knees over the CUB, but it was becoming clear that it would soon be time to start pitocin. Meredith had already relinquished her expectations about this birth being anything like her first. And that included accepting pitocin as a tool. They started it at the lowest level and raised it incrementally.

By 11:00 am the pitocin was at 10 mu. Meredith moved into the shower to labor. She emerged and with Brett’s help did some abdominal lifts and tucks to help her baby get positioned better. By 12:45 pm while on her hands and knees on the bed, Meredith felt more pressure in her butt which was an encouraging sign that her baby had moved. She lay on her side with the peanut ball between her legs and we watched the tremors of active labor take hold. The contractions were painful, and we used a heating pad to help ease the discomfort.

At 1:50 pm her baby was noticeably lower, and she was dilated 4-5cm/100% effaced. We turned on some birth affirmations which garnered some giggles at first, but the mood quickly turned more serious as Meredith descended into active labor. In fact, her body had taken hold so well, they turned down the pitocin a bit to spread out the contractions.

Meredith breathed through intensifying contractions and labored in a variety of positions. We applied counter pressure on her back and a wet cloth on her forehead. She sat upon the edge of the bed and then slow danced with Brett thorugh some contractions. And by 3:20 pm, just 1 ½ hours later she was dilated 8-9 cm!

Meredith returned to her hands and knees, a position she felt intuitively, and 15 minutes later she was pushing involuntarily. I tied the rebozo to the head of the bed so she could grab hold through contractions as she pushed. Then Meredith rolled to her back to try pushing that way. This baby was taking a lot more work to come out, so it became necessary to change positions. Meredith was so patient even though she was working way harder than anyone expected. And after pushing with her knees closed and then open again, her baby was crowning. And at 4:38 pm Kyla Christine was born!

It was soon obvious why it took so much work to bring Kyla down: her cord was wrapped twice around her neck! Kyla suffered no ill effects and her heart rate only dipped once or twice. And she came out and gave a big cry that pinked her up right away. It was an emotional moment, and a huge sigh of relief was heard all around. Kyla weighed 7 lb. 5 oz. and was 19.5 in. long. Big brother was able to meet little sister in the hospital and before discharge Kyla had actually gained weight! Suffice it to say, they were off to a fantastic start as a family of four.

Meredith’s journey to meet her second baby was not at all how she expected. She completely flipped the script with the timing. She arrived at the hospital fully dilated the first time and took nearly 24 hours in the hospital to welcome her second. But honestly, is it ever? She was grateful for small mercies though like the timing that allowed Brett to get home for the birth, and plenty of time to receive antibiotics to treat for GBS. She might have been okay with it not taking all night and into the following day, but she could also look back and see just how strong and patient she was. I am so proud of this couple and their positive attitude and love for each other through it all.

Shereen and Saxton are parents! They welcomed their son, Loren James, on October 1. They attended my childbirth class and had strong intentions of a birth without pain medications and minimal interventions. But as her due date came and went the thought of an induction did occur to her. The hope was to avoid it but she also knew there would be a deadline of 41w5d with her providers. Thankfully, her baby was on board with spontaneous labor because her body started having regular contractions towards the end of her 40th week.

Shereen’s labor began at 7:00 am on Friday, September 29. The contractions weren’t too strong or long, but they were definitely on her radar. They weren’t in touch with me just yet either. Then Saxton sent an update just before 2:00 am on September 30 that Shereen’s contractions were coming every 8-10 minutes. She continued to labor through the night and by just before 9:00 am the contractions were ranging from 4-8 minutes apart but rather inconsistent. She was not yet in active labor and so the prescription was to rest, hydrate, and eat as she was able to.

By 2:00 that afternoon the contractions were getting stronger but spaced farther apart. I gave some positional suggestions for Shereen to try in case her baby needed to tweak his position and after doing them they saw a marked change in the labor. After having regular long and closer contractions for a decent amount of time, it felt like the right point to head to the hospital. That text came at 6:00 pm. They were headed in! The contractions were regular at 5 minutes apart and Shereen had just projectile vomited – a good sign! She had been feeling contractions for nearly 36 hours at that point.

Good work had been accomplished though because Shereen was dilated 5 cm, 80% effaced, and her baby was at 0 station. She and Saxton credit the positions I suggested to them as what changed the tide of the labor. They got to the hospital at a really good time. Shereen clenched her comb through contractions and the Office played in the background on the TV in the room. Contractions were lasting 1 to 1 ½ minutes at that point and coming steadily at 3-4 minutes apart. With every contraction, Saxton pressed a Theragun against Shereen’s lower back. She couldn’t imagine laboring without that tool as things became more intense.

Shereen was feeling tired, so we used some peppermint to give her some more energy. She leaned over the CUB around 8:30 that night and we placed a cold cloth on her forehead to ward off nausea. The peppermint oil helped with that too. Her contractions soon moved to 2-3 minutes apart.

To change her position and bring her more upright, Shereen tried sitting on the birth ball at the end of the bed. She burped which was a sign of good labor. She also shared with us around 10:00 pm that she felt like the baby was in her vagina. She was feeling so much pressure, we figured her water was probably trying to break or she may have felt a bulging bag.

At 10:13 pm Shereen asked us if we were just waiting for the water to break. I told her sometimes it doesn’t break until the end, so she was waiting for her body to tell her it’s time to push. She looked up at me and said she thought it was getting close to that. And her nurse agreed as she placed the doppler way lower on her belly to get the baby’s heartrate. It wouldn’t be long.

At 10:45 pm Shereen thought her water might have broken. There was a mucus blob but a quick check confirmed it wasn’t yet her water. Her midwife stopped in about 5 minutes later to check on Shereen and to be present. And at 11:13 pm Shereen told us, “I want to push now.” She asked for an exam with the hope of good news, and she was dilated 9.5 cm with a bulging bag, as we suspected! It was 11:22 pm at the time of the exam and by 11:30 Shereen was giving little pushes as her body led her.

She returned to her hands and knees over the CUB, and we watched as she birthed the sac! Or at least the bulging bag before baby’s head. Saxton continued to apply the Theragun to Shereen’s lower back, her most valuable comfort measure for sure. She chose to stay out of the shower since she knew she wouldn’t have access to the Theragun in there!

She returned to her hands and knees over the CUB, and we watched as she birthed the sac! Or at least the bulging bag before baby’s head. Saxton continued to apply the Theragun to Shereen’s lower back, her most valuable comfort measure for sure. She chose to stay out of the shower since she knew she wouldn’t have access to the Theragun in there!

After pushing on hands and knees, Shereen rotated to push on her side. She rested between contractions and then gave it her all with strong pushes during them. And at 12:17 am she reached down to feel her baby’s head with her hand. It’s always such an exciting sight to watch a mother’s face light up at the first touch!

Soon her baby’s head was visible and that forebag continued to sit right outside her vagina. Shereen pushed consistently with each contraction and her baby’s head crowned gradually. It is difficult sensation to feel the ring of fire grow and last through many contractions, but Shereen was strong. It almost looked like she might need some help, but her body stretched, and her baby was born at 12:49 pm! The cord was around the neck but did not cause any concern in her labor.

Loren James cried right away and had so much dark hair! He even had dark eyebrows and lashes. He didn’t take too long to latch but he was equally interested in his fingers. After all, that’s what he had to suck on in utero. He weighed 8 lb. 7 oz. and was 22 in. long. Saxton enveloped his family with love, looking into the eyes of her newborn son with wonder. Loren was wide-eyed taking in the faces of his mother and father, transfixed on his parents.

Shereen rested in those first moments, holding Loren against her chest, taking in what she had just accomplished. It was long and arduous, but she minimized her early labor and arrived at the hospital at the perfect time. All told, she was only there 6 hours before her baby was born.

Labor is always a mystery, but that mystery looms greater with the first baby. Shereen and Saxton filled in the gaps of the unknowns with a strong partnership, and balance between rest and work. The (Theragun didn’t hurt either.) I’m so proud of them and will be forever grateful to have been part of their team.

Jessica and Nathan welcomed their son, Waylon, on September 25. He is their first son after three daughters! I had the honor of serving as their doula for a previous birth, so it was especially exciting when Jessica reached out to work with me again. Jessica was hopeful for a different experience since her third child was born right at the beginning of COVID when hospitals were trying to figure out safest practices during a pandemic. We were all looking forward to a more “normal” birth experience.

Jessica developed some mild polyhydramnios late in pregnancy and her son was measuring large. While she wasn’t eager for an induction, she was worried about pushing out an 11-pound baby, as she says. She was also wanting to give birth without pain medication as she had when we worked together before, and she knew the longer she waited the larger her fear would grow. And she didn’t want that fear present in her birth.

She reported to her hospital in the evening for cervical ripening in her 39th week. She also had low dose pitocin through the night to help nudge her cervix along. After 12 hours she was dilated 6 cm which was exciting, however, her contractions were still far apart and not too painful yet.

Several hours passed with no update so I checked in. Jessica was still 6 cm dilated, and while her cervix was thin at 80%, her baby was still high at -3 station. Her midwife was able to break her water though and the hope was that her labor would pick up. After an hour had passed, Jessica reported that her contractions were varying between 3-5 minutes apart, but they were more intense, but no longer than 20 seconds or so. Since Jessica was a multip, I felt it was a good time to head in just to be on the safe side.

When I walked in the room at 3:15 pm I could see that Jessica was still comfortable. She breathed through her contractions, but they didn’t require a lot of focus from her. The feel in the room was light with the anticipation of a baby at some point. But the birth did not appear to be imminent. Knowing her water had been broken and the pitocin had been running since the night, it was time for some labor. It was time for some Spinning Babies. We got started 30 minutes after I arrived.

Jessica was game for it all! I explained that we would do the Three Balances in case Waylon’s position was the reason her labor had not yet become active. That was my strong hunch, anyway. And I told her they would each occur during contractions to maximize their effectiveness, and it would be uncomfortable. And she was ready to do it. Nathan handed Jessica her comfort blanket for support. We started with the jiggle through 3 contractions to help loosen her pelvic floor and maybe jiggle enough to make space for her baby to chance his position. The second step was 2 forward leaning inversions which Jessica did like a champ. The third movement was the side-lying release done twice on each side through two contractions. Nathan rubbed Jessica through it to help her relax and feel encouraged (and loved!).

I could hear Jessica moan through contractions during the three maneuvers and was hopeful they would impact her labor. We finished the Three Balances around 4:00 pm or so and Jessica labored through a few contractions on her hands and knees over the CUB in bed. Nathan was a constant presence, stroking her face and her arm, reassuring her and loving her.

The contractions were instantly longer and stronger. I recommended Jessica do lunges over the cub to make more lateral space for baby. She did them without complaint and we could hear in her breath that her labor kicked up another notch. She labored standing beside the bed through a few and the plan became to move her labor to the shower.

I prepared the bathroom with votives and started the water running to let it heat up. Jessica felt like she had to go to the bathroom so the made her way to the toilet, pulling the iv pole beside her. But when she sat down, she felt the urge to push her baby out. It quickly became obvious the shower would not be the next stop. In fact, Jessica needed to make her way back to the bed and the simple act of walking in that moment felt impossible to her. But we walked beside her and one step and a time she got there.

Jessica climbed back up into the bed and rested on her hands and knees. Her nurse checked her and she was “complete and plus two!” It was time to have a baby! The midwife was called, and the nursery nurse was in the room momentarily. We put a cold wet cloth on her back, and she had her comfort blanket nearby.

No sooner did the midwife put on her paper garb and pull the delivery cart to the bed, did Jessica push her baby’s head into view. He moved but the midwife could tell he was a bigger baby than her others. She had Jessica stand in the fire hydrant position (aka a side lunge) and push that way, and her son came barreling out! He coughed and sputtered out fluids and cried out just fine. Waylon was born at 5:06 pm!

He was passed into Jessica’s waiting arms, and I think she was in shock to already have him! Although she had been there nearly 24 hours before meeting him, her active labor was just about an hour long! She clutched her son and tried to let it all sink in as we helped reposition her to sitting in the bed and her midwife waited for the placenta. Nathan cut the cord and was reeling with how fast everything went too.

Jessica’s sister-in-law happened to have left to pick up the girls from school, right as Jessica’s labor began to pick up. And it went so quickly, when she returned with the girls around 5:25, Waylon had already been in the world 20 minutes. The timing was perfect for their pickup and arrival to meet baby brother, although not so perfect for being present at the birth. They were gushing over his cuteness, and I just knew there would be some helpers in those big sisters.

Waylon was indeed Jessica’s heaviest baby weighing 9 lb. 2 oz. He was 21.5 in. long. But Jessica did not let fear affect her labor and pushed out her heaviest baby was all the confidence of her smaller ones. I was so proud of her and how she labored. It was quick and intense, but it was by no means easy. It just goes to show how much baby’s position can impact the way labor unfolds. And I’m very glad what we did worked! (And so is Jessica!)

Jordan and Mike are new parents for the second time! Jordan’s first birth was a very early induction for a medical reason that resulted in her baby in the NICU and some additional challenges with breastfeeding as a result. Jordan wanted a healing birth this time, and she wanted it to be a positive experience. She was not committed to avoiding pain medication but desired to feel strong and capable and like she had choices. Ultimately, she wanted to feel present and hoped for a less dramatic pregnancy and birth this time, and thankfully that’s just what she got!

Jordan was healthy for her entire pregnancy and relished her appointments with the midwives she was also fortunate to work alongside as a labor and delivery nurse. That trust relationship had been built long before the pregnancy and it was very reassuring. Jordan went all the way to her due date with no induction on the books yet. It did have her growing a bit impatient for when and how labor might unfold but she was able to keep herself in check with some reassurance.

And on her due date she sent out an update that she was contracting more painfully than she had been and wondered if things might be percolating. She had some bloody show and fluid which had her alert up as well. But she wasn’t timing anything and wasn’t leaking so she stayed even keel. We talked about how it likely wasn’t labor since it was her actual due date and babies don’t ever choose that day. And we left it at that. (I even went to the beach!)

By that evening the contractions had intensified further and had Jordan reaching out again. She was not timing yet, just trying to ignore them as she continued about her day. Her contractions had her stopping and breathing and focusing though, and she was no longer talking. It was a good time to check the intervals. They were closer than 5 minutes apart and within that hour they were consistently 2-3 minutes apart. They made arrangements for the care of their firstborn, and we were on their way to the hospital. I met them there.

We met up at the hospital around 7:30 pm. And Jordan had minimized and ignored her labor all the way to 5 cm, and nearly 6! She had done brilliantly with spontaneous labor after only experiencing pitocin contractions with her first.  She had a bulging bag and her baby was at -2 station, but once the waters broke we suspected her baby would move right on down.

Jordan got herself situated in a room and Mike and I got busy with labor support. Counter pressure during contractions and a heating pad between them helped. By 8:30 pm the contractions were steady at 2:30 apart and lasting a full minute. They were stronger than when she arrived too.

Just before 9:00 pm was a good time for Jordan to move into the shower. Citrus fresh oil blend on a washcloth in the shower made for a spa feel, along with the battery votives. Jordan labored in there about 30 minutes and when she emerged, she was ready to get an epidural.

She was dilated 8 cm, baby was at 0 station, and her cervix was effaced 90%! Thankfully, the CRNA was fast and effective, and Jordan was comfortable in a short amount of time. At 10:30 she was still dilated 8 cm so we helped her into side-lying positions with the peanut ball to dilate the last bit of cervix. Jordan hoped to get a nap in as well before pushing.

Just before midnight Jordan’s water broke which had us wondering if she’d get much rest. It wasn’t a huge amount of fluid, so she tried to rest after we helped her into the left runner’s position. But thirty minutes later Jordan felt her water break A LOT. So we called in her nurse to confirm and then helped her into the upright throne position at 12:48 am for the last bit of dilation.

Jordan felt the pressure of her contractions so much so that she was blowing through them. So, at 1:38 am we helped her into the flying cowgirl position on her left side. She still had a 9 cm lip of cervix in the front through, so we switched it up and had her go on her hands and knees over the CUB. The nurse on duty had some Spinning Babies knowledge so she got to work doing the jiggle while Jordan was in the hands and knees position. She was completely dilated 10 minutes later at 2:00 am and her baby was at +2 station!

Jordan tried pushing and as we expected it didn’t take long! Her baby was born after just 3 contractions at 2:10 am and Mike and Jordan announced the gender. It was a surprise! And they had another girl! “We have another baby!” Jordan exclaimed. And yes, they did! This baby was much bigger than her sister though! The immediate postpartum was so different and very healing! Jordan had her baby in her arms from the start and she didn’t leave for over an hour. And she latched in the first 20 minutes, another very different journey than her first. The name took some time, but they chose Chloe Mae. (I love the first name especially since my third baby is a Chloe!)

Mike had Jordan’s parents on Facetime for lots of oohs and aahs. This baby didn’t cry right away, just made enough sounds to assure everyone she was just fine. She was content to lay against her mom and gently adjust to being born.

A fun fact about this birth is Chloe was born on her parents’ anniversary! So she dodged her due date but found another significant day. Jordan also had no tears which was extra wonderful given that her first baby was so tiny. Chloe was an overachiever from birth, already trying to catch up to her big sister. She had latched well and nursed on both sides in her first 45 minutes of life.

Jordan had friends in the hospital that came to congratulate her and felt blessed to have been at work when she was in labor. The entire experience was a positive one and very healing for Jordan. She was all smiles, as was Mike, and it was such a joy to accompany them on such a different birth journey.