Welcome to the world, Maxson David Delano, born in the final minutes of June 2! This is my second time to serve as Jerica’s doula, so I was familiar with her understated way of laboring. But this was her third baby, and they have a reputation of being unpredictable. And this birth was a scheduled induction for postdates which also adds an extra layer of uncertainty on top of the already unpredictable nature of spontaneous labor.

It was a very busy day for birth but the staff worked diligently to get Jerica settled into a room as soon as one was available. She was dilated 2 cm, 60% effaced, and baby was -2. Jerica’s veins were a tricky stick, so getting an iv established required more than one try by more than one nurse, but eventually it was successfully established by an anesthesiologist. Working as a team they made it happen.

And over 6 hours after arrival, Jerica received her first dose of Cytotec. And then she waited. Jerica requested the breast pump to use in the hopes it would get things going as she waited for the next dose of Cytotec. Four hours later came the second dose, just past 6:00 pm. Jerica had some mild contractions that were close and short, but she could talk through them and knew they weren’t to the level of significant cervical change yet.  She sent David home to help settle the kids for bed.

By 9:00 pm, Jerica’s contractions were super close but still not very strong. She felt some pain in her lower back as well and considered walking around. I gave her some suggestions to ease the back pain and wondered if baby’s position was the cause. But within 30 minutes Jerica felt a shift in intensity that had me feel I should head to the hospital. She was worried I was coming too soon and preferred I want until she got checked so I waited.

At 10:20 pm she was checked and confirmed dilated 4 cm, still 60% effaced, and baby was still at -2 station. But even though the numbers didn’t seem like significant change had occurred, Jerica continued to feel pain in her back and thought they were getting more intense. She suspected it would be time to come soon so we felt it best I just head in. I left at 10:45 pm and arrived around 11:15.

Jerica was moaning through contractions that were close together. Of course, they had been close for hours, but had very recently turned the corner to active. She was standing by the bed, braced against it as she breathed through contractions. Her labor had taken hold in the 30 minutes since our call. She breathed and focused through each contraction and found the breaks shorter than the actual contractions.

Jerica felt like she had to use the bathroom, so she took a pit stop with David by her side. (Yes, I know this could mean a baby is coming but not even Jerica thought that was the case.) So, I went about setting up votives around the room to enhance the ambiance and didn’t hear her when she told David she was pushing, and then dismissed herself with “that’s can’t be right.” Jerica made her way out of the bathroom and back to the bed to lay on her side awhile. She requested David play her Hypnobabies scripts on the speaker, so he set that up as well. Then as she lay there, she said she felt her baby was coming but she wasn’t ready. Her nurse was casually setting up the delivery cart unaware that Jerica felt her baby coming, so we alerted her that Jerica felt the baby.

The nurse called for the doctor who was not in the building, so they had the hospitalist OB come in for delivery. Jerica was startled that she was actually pushing already, and she felt very overwhelmed. “I’m not ready,” became her mantra. And I met it with, “But your baby is ready. It’s okay to be overwhelmed by what you are feeling. It went so quickly!” The doctor came rushing in and got the deets from Jerica’s nurse. She hurriedly dressed in her paper suit and pulled the delivery cart up to the bed.

She lay on her side, and we supported her upper leg. The doctor watched as Jerica’s amniotic sac was born. She offered to break it but Jerica preferred she didn’t. With the next contraction, the sac was laying upon the bed like a water balloon cinched at the base. And it gently released fluid on its own. “I can’t do it,” Jerica insisted, right as she WAS doing it. We could see Jerica’s baby crowning in that moment and the doctor had David come to the end of the bed to help do the delivery! Jerica continued to tell us she wasn’t ready, but she pushed as if she most definitely was! The doctor patiently waited as Jerica pushed instinctively, following her body’s urges as she was ready. And once her baby’s head and shoulder was born, the doctor gestured for David to move in closer. The final push brought their baby into David’s hands, who was then instructed to place the baby onto Jerica’s belly. He was a bit shocked himself, so he paused for a moment of wonder before passing their newborn baby to his wife.

Maxon weighed in at 8 lb. 13 oz., the heaviest of his brothers, and measured 21 in. long. As Jerica processed the birth in that first hour or so, she told us she was scared and not ready. And she didn’t think she would make it for a long labor. So, her baby ended up coming the way she needed him to! David confessed that he felt like he might pass out right before the bag of waters was born, but he managed to stay upright. And Jerica tried to piece together when she was in transition. It must have happened on that bed and probably just lasted a couple of minutes!

It just goes to show that cervical dilation has no bearing on labor duration ever, but especially after the first baby. And Jerica’s intuition was far more compelling than any exam she received that day. I am so proud of her for advocating for what she needed in the waiting hours, and in the 90 minutes of active labor. She birthed with composure and grace just as I remembered from the birth of her second. And like before, she didn’t even look like she had given birth. Needless to say, Jerica is quite remarkable in more ways than one!

Amadly and Bryce met their daughter, Mila Lilliann, on June 4, after a long and patient journey. I got a text just before 9:00 am on June 3 that Amadly had been experiencing intermittent leaks since 2:00 am. She wasn’t sure if her water broke but thought it best to call her doctor, who recommended she go to the hospital and get checked to see what was going on. They confirmed that Amadly’s water did break and since it had been about 12 hours since it broke, she would be admitted. Thankfully, Amadly and Bryce stopped to get some food on their way to the hospital! This might be a long road.

Amadly had no contractions, and her cervix was not dilated. Pitocin was mentioned but she preferred to wait on that. Instead, she agreed to give oral Cytotec a try in the hopes it would ripen and help get things going. Amadly did her best to rest that night. But after several doses of the medication, by around 6:00 am the next morning her cervix was only dilated a fingertip. It was time to begin Pitocin. Amadly needed contractions if she was to have any chance for a vaginal birth. And by the time the Pitocin had begun, her water had been broken over 24 hours. We were hopeful her labor would eventually get going and were thankful for her patient doctor.

By 11:00 am, Amadly sent an update that her contractions were growing stronger and rhythmic, coming every 4-6 minutes. She was dilated 2 cm and her doctor broke the rest of her water. It was encouraging to know her cervix had dilated, and we were optimistic breaking her water all the way would continue forward momentum. Amadly continued to rest so she would have the energy necessary for active labor.

By 1:30 pm Amadly was breathing through her contractions that were coming more intensely. In fact, her contractions were requiring so much of her focus that she was at the point of requesting an epidural to help. The Pitocin was raised incrementally throughout the day. But the baby kept having decels with the contractions, so the Pitocin had to be turned down.

It became a dance between helping Amadly into positions that would encourage dilation, while also maintaining an effective level of Pitocin that baby could tolerate. It was a fine line and involved rolling to the left and the right, using the peanut ball and turning down Pitocin, and then starting it back up. By 6:20 pm, the pit had been turned down due to multiple decels, and Amadly was checked and 3 cm.

The nurses changed shifts bringing some different energy, and that nurse and I worked together to get Amadly’s baby out. It had been nearly 40 hours since her water broke and there wasn’t a lot of time left. We had her in runner’s position, and then upright in the throne position. And by 9:15 pm, her cervix was still 3 cm, but stretchy. So her nurse stretched it to 4-5 and did a membrane sweep that got her cervix to 4 cm.

We shifted Amadly to a reclined position, placing a blanket and pillow under her right leg for asymmetry, and then we helped her to the left runner’s position by 9:45 to help stabilize her baby’s heart rate. The next step was the game changer. We helped Amadly into the flying cowgirl position in the hopes it would open her pelvis and allow baby to descend. Her baby responded with decels through each contraction that popped back up after. After about 15 minutes in this position, and several sequences of decels, her nurse checked her cervix at 10:12 pm. And we were all thrilled to learn she was almost completely dilated!!

More people got involved, bringing the hospitalist OB to the room to fill the gap until Amadly’s doctor got there. The heart rate continued to dip off and on, but baby always recovered after about 3 contractions. This had been her pattern for the past day or so. Amadly breathed oxygen through a mask to give her baby a boost, and they also turned down the Pitocin. And Amadly pushed!

She pushed so well. Every push brought her baby down, and her doctor arrived around 10:20 pm with plenty of time to cheer her on with us. With Bryce by her side, and several other people as well, Amadly brought Mila into the world at 11:09 pm on June 4, 2022. She only pushed for an hour, which felt fair after how long she had been waiting, even to the point of having a c-section discussion just in case.

Mila weighed 7 lb. 1 oz. and was 21 in. long. She had Apgar’s of 7/9 and came around quickly to enjoy skin to skin with her mom. She latched for the first time at 11:40 that night, and Amadly and Bryce were smitten. And we kept talking through the amazing timeline which just goes to show how important it is for baby to be in the right position to come out!

It was a team effort for sure, but Amadly and Bryce’s openness to try new things and to even consider a c-section, validate how much their hearts wanted to meet their baby girl safely. And in the end, she was born vaginally and just perfect. I am so proud of Amadly’s courage and her confidence to advocate for her choices, all while balancing them with her doctor’s recommendations. And we are all extremely grateful for her doctor who was patient and not alarmist too. Amadly was blessed with an excellent team!

Jerica and David welcomed their second son, Whitman Keith on November 11, 2021, which also happened to be his due date! Jerica was motivated to have an unmedicated birth, even though she was birthing in a hospital that didn’t have a reputation for many births like that. She birthed her first with an epidural and it was a very long process, particularly after the epidural. This birth would be different. And advocacy and solid support would be key components in this birth experience.

The text came in at 8:50 pm on November 10: “My water just broke!!!! No doubt about it…it was A LOT.” Jerica had suspected her water might have broken several days before but the wetness subsided and well, this time there was no doubt. Jerica carried on with her evening plans and eventually went to bed in the hopes that her body would initiate contractions. But she woke up with very little happening. She approached the 12-hour post rupture mark and her providers wanted her to head to the hospital for labor induction. She was disappointed and a bit nervous since she had hoped to avoid the whole hospital intervention rigmarole. 

To do all she could before going to the hospital, Jerica walked a mile, ate a protein breakfast of eggs and sausage, pumped, and even did an enema to bring on labor, and walking some more. She had mild contractions but nothing too significant by the time they left for the hospital. 

On the way to the hospital and in triage, contractions were intensifying and growing more consistent. Jerica was dilated 4.5 cm, 90% effaced, but her baby was at -2 station. Something must have been keeping her baby high and once we figured it out, his head would drop down and her labor would take off. 

Soon after she was settled in her room, Jerica requested a breast pump to try to bring on contractions before using Pitocin. After some pumping rounds, we walked the halls of the labor and delivery unit from 2:00 to 2:30. Jerica paused with each contraction and grabbing the arm rail did posterior pelvic tilts to encourage her baby’s head to come down behind her pubic bone, should that be what was holding him up.

Back in the room, Jerica lay back in the froggy walchers position to encourage her baby to get more centered in her pelvis so he could descend. And after that she resumed a pumping regimen of 10 minutes on, 20 minutes off, and walked the halls again. And her contractions were different. She felt more discomfort in the front, and they were stronger and closer. After walking, she did another round on the breast pump. Her contractions were consistently 3 to 4 minutes apart and Jerica started to dread the pain that was yet to come.

David placed a warm pad on her back which helped, and she did another round of pumping for good measure. It seemed to be working well to bring on good solid contractions. She swayed through contractions in David’s arms as the waves grew within her. Jerica was working harder and leaned over the cub for some rest. Around 5:15 pm she felt a particularly strong and long contraction that required the most attention and focus thus far. She was tired and thought to lay on her side for a bit in an effort to conserve her energy.

At 6:00 that evening her doctor came in to see how she was doing. Jerica consented to an exam and was excited to learn that she was dilated 8 cm. There was a forebag and her doctor recommended breaking it to continue the trajectory of her labor. Then Jerica went to the shower to labor through transition. “Why doesn’t everybody get in the shower?” she asked. “I never want to get out. We should have done this with our last birth.” It was a stark reminder to Jerica of how important it was to know your options and have the support to see them through. She remained under the warm water another 25 minutes. She might have stayed in longer, but she was feeling lots of pressure in the shower and she got a little shaky.

She returned to her side in the bed, and we played some hypnobirthing tracks at her request. Counter pressure helped with the back pain she felt as her baby moved lower in her pelvis, and she labored on her hands and knees over the cub to finish her dilation. She felt pushy soon after and breathed through intensifying sensations. Cold cloths on her neck and back, and a fan nearby helped to cool her as her body heated up. 

Jerica was pushier by 7:30, and was bearing down more intensely. In fact, we saw her baby’s hair at 7:40! She pushed very calmly on her side, so calmly that her doctor kept commenting on how they never see women labor that way. She pushed with a yell, which helped to birth his head gradually. There was a tight cord around the neck so the doctor clamped and cut the cord right then, freeing things up so Jerica could push him the rest of the way out. And Whitman Keith was born at 7:52 pm! He got a lot of attention at first because he was a bit stunned, and when aggressive rubbing didn’t elicit a cry, he took a stop at the warmer. We heard him cry after a brief pause, and he was back in Jerica’s arms a few minutes later.

“That’s the craziest thing I’ve ever done,” exclaimed Jerica as the details of what happened ran through her mind. David was amazed and astounded as well, albeit a bit shocked and freaked out by the first moments of his son’s life. It can feel a bit frantic when there is any delay in that first cry. It was a different beginning than with their first son. But it was a different birth too. Whitman was nursing eagerly by the end of his first hour of life. And he weighed 8 lb. 3 oz.

Jerica gave her body what it needed to move headlong into active labor. She remained patient, rested when appropriate to do so, and was active as well. She though outside the box and used tools like breast pumps, enemas, and well thought out positions, to encourage her body and her baby to work together. She was powerful and empowered as she advocated for her wishes and was met with supportive providers who said things like, “We never see births like this.” Perhaps Jerica’s birth planted seeds that day in every person present, and maybe, just maybe, minds have been opened to consider that in birth, less can be more and usually is.

If there was ever a baby wished for, hoped for, and prayed for, this is the one. Wesley George was born on September 12, 2021, making his parents’ dreams come true. Pregnancy did not come easy to Annika and Robert. They were told it would never happen, and then through the wonders of infertility treatments and an ob who believed it would work, they were blessed with their baby boy! 

When we first met, I wanted to protect Annika. Robert’s love for her was obvious, and his strong drive to make sure she was safe and respected in her birth was admirable. Life hadn’t been easy for her and her deepest desire in becoming a mother was providing her baby with a life filled with love. But she was afraid of the birth process and knew that getting pain relief would be instrumental in preserving the experience as one that was not traumatic. We connected right away, and I left that meeting hired.

Annika texted me on September 10 just before 5:30 pm telling me her water broke. It had broken several hours earlier, and after consulting with her doctor, they went to the hospital to confirm. It had indeed broken, and Annika was 1 cm dilated. There was a plan to start Pitocin by midnight if labor had not begun. She would be ruptured 10 hours at that point. Fast forward to midnight, with Pitocin on board, Annika tried to rest.

The plan changed shortly afterward, switching to Cytotec. The night was quiet and by the next morning, her doctor confirmed her water wasn’t completely broken. They decided to move forward with breaking it all the way to see if her body would respond with contractions. And it certainly did. In just 30 minutes she was feeling them, and they were quite painful. The pain was concentrated in Annika’s back. A heating pad and counter pressure helped some, but Annika knew she was ready for some pharmacological relief. Just past 12:30 pm she had some nitrous oxide and it helped. But an hour later she was ready for the epidural.

The period of waiting for an epidural is difficult, but Robert knew how to help Annika relax by staying close and reassuring her and reminding her how much she was loved and that their baby was coming soon. Annika had frequent Facetime calls with her mom which also helped fill the time and ease her fear. By 2:15 she was more comfortable and ready to get some rest.

We moved her this way and that, punctuated by opportunities to get some sleep. It’s difficult in a hospital, but Annika tried. If it wasn’t the hospital noises and interruptions, it was her thoughts which never seemed to stop. At one point, she finally succumbed to sleep while her mom remained connected over Facetime. It was rather sweet. At 5:35 pm, Annika was dilated 4 cm, 100% effaced, and her baby’s head was low at 0/+1 station. Pitocin had been incorporated to keep her contractions strong and steady, especially after the epidural which tends to spread them apart.

After a few hours, Annika developed some nausea that overtook her. She received some medicine that helped and was able to get some real sleep. It didn’t hurt that Robert rubbed her head to help her relax! Annika was very well taken care of by her husband.

Two hours later, Annika was dilated 8 cm! She had a headache that we suspected was due to low blood sugar. Some juice helped her to feel better and 2 hours later she was fully dilated! She was still feeling some pain and anxiety so some medication in her IV helped her to relax. Her nurse called in the doctor, who had promised to come in just for her. (He was not on call!)

Annika labored down beautifully. Her baby moved to +2 station over the course of the hour. But then her nausea returned. So, we fanned her and gave her cold rags on her face. It was also just time to have a baby! Annika began pushing at 1:55 am. She had two nurses come in to help. They had grown fond of her over the shift and were excited to be present to the end.

Annika was exhausted and overwhelmed with the whole process. Her doctor came in and seeing that she was in such a state, recommended he assist with a vacuum. Annika’s baby was also in the OP position which posed an added challenge. Annika trusted her doctor and was comfortable with that decision. And after a few pushes, Wesley George was born at 3:29 am!

He had so much hair! And his parents noticed he had monkey feet too. Annika was beside herself with joy to finally hold her son in her arms. Robert was so tender with his wife and baby; you couldn’t help but smile. Even Annika’s mom was with us on FaceTime to see the whole thing unfold.

Wesley was named for Annika’s dad who passed away in 2016, and his middle name George was after Annika’s mom’s dad. The legacy in his name was a loving tribute to lost loved ones. Giving birth to Wesley made Annika a mom, but it also gave her a genetic connection to someone. You see, she was adopted, so pregnancy and birth held such promise for her! It promised that she would belong to someone, and he would belong to her. They were bonded as family genetically, in addition to bonded in love. It was a joy to be there to watch it all unfold and to stand strong for Annika every step of the way.