Dulce and Joshua welcomed their third child on December 22, 2021! This was my third time to serve as their doula and it has been such a wonderful gift to watch them grow as parents with each new addition. When they reached out to tell of their pregnancy, they were in California with plans to return to Hampton Roads in the later half. I was so excited at the opportunity to serve them again! Dulce’s birth history is varied in some ways, and consistent in others. She has had recurrent high blood pressure that resulted in inductions for every birth. However, they unfolded differently. Her first child was born by c-section, her second by a VBAC. And then came Charles Duke, born by a second VBAC!
In this third pregnancy, Dulce’s blood pressure was actually very good almost the whole way through. It was a nice change and left open the possibility of spontaneous labor. That is until the very end. Dulce’s blood pressure was high at her appointment on December 21, just one week shy of her December 28 EDD. She was sent to triage for evaluation, but they soon made the call to keep her for induction. Dulce and Joshua were happy with the decision given her history.
Dulce’s biggest hope for this birth, behind healthy baby and mom, of course, was to not feel frantic. Her first birth got scary when her water was broken and her baby’s heart rate took a turn, making the call for a c-section for her baby’s sake. Likewise, in her second labor things got crazy when her water was broken and then things ramped up so quickly, she hardly had time to get an epidural. This third birth she hoped to feel less frantic and calmer. And that meant being a bit more strategic about things.
Dulce’s initial exam had her cervix dilated 2 cm, 50% effaced, baby at -3, with a posterior cervix. There was some ripening to do. They began with a Foley bulb and Pitocin together and just an hour later, Dulce was feeling contractions. They were short and erratic, but they were contractions, nonetheless. And the Foley bulb was out in just 1 ½ hours. The plan was to gradually increase Pitocin and do another exam in a couple of hours around 9:00 pm.
An hour later, her contractions were coming at a steady pattern of every 2 ½ minutes and lasting 30 seconds. They planned on getting the epidural in place before breaking her water this time, to help guard against the crazy experience she had previously at that point. In the meantime, Dulce walked and paced and sat upon the birth ball, moving in ways that helped with the contraction pain, and also brought her baby deeper in her pelvis.
They broke her water shortly after the epidural and she was dilated 3 cm, but Dulce’s body shook in a way that hinted to active labor getting established. We had her lay over the cub birthing chair for some rest but to also help bring baby down to dilate her cervix. It was 10:40 pm.
Shortly before midnight, her nurse noticed some variables in the baby’s heart rate. Dulce was also feeling some pain in her vagina, so it seemed a good time to investigate. Her cervix was a stretchy 5 cm, so we tried a new position to encourage descent called Froggy Walchers. I loved how eager Dulce’s nurse was to learn and collaborate with me with positions to encourage the birth!
The doctor came in and inserted an IUPC to make sure contractions were strong enough and also to add fluid to help float the cord to help stabilize baby’s heart rate. They also turned off the Pitocin to see if Dulce’s body might continue dilating on its own.
Someone drifted in to setup the delivery table and we helped Dulce roll to her side and placed a peanut ball between her legs. She felt more pain in her vagina and a check at 12:15 revealed Dulce was fully dilated, and her baby was at 0 station. The turned Pitocin back on at the lowest level to help bring baby down. But I doubt it was necessary really, because when Dulce gave her first push after they removed the foley at 12:30, we could already see her baby’s head!
Dulce pushed a total of 3 minutes, so I guess that was 2 contractions. And Charles Duke was born at 12:34 am on December 22, 2021! The cord was loosely around his neck and easy to move aside at delivery. His face was so purple from bruising as he navigated his way through his mom’s pelvis. And he was a little slow to perk up, so he took a 5-minute detour to the warmer for some extra attention. Joshua was never far from his son, and I was never far from Dulce. And he was soon back in her arms. Charles weighed 7 lb. 10 oz. and measured 21 in., the same length as his brother and sister at birth. Dulce birthed her son without a tear too, by the way. And he was latched not too long after birth.
Dulce had the calm and gentle experience she envisioned for Charles. She had a hand in the decisions and was reassured by her providers every step of the way. They even worked collaboratively with her chosen birth support, going so far as asking whether I was going to “coach” her in pushing or they were. Honestly, I don’t think Dulce needed any coaching from any of us, but it was so nice of them to ask. It was a truly lovely birth and I think there was a lot of good cross training happening too!
