Desiree and Jackson welcomed their baby boy after epic induction. I remember when I first met Desiree and how much she wanted options and preferred not to be induced. She and Jackson attended my 7-week childbirth class to learn all they could about the process and their options so they would have tools to help navigate labor in the hospital setting. In the final weeks before her due date she began to feel some pressure about induction for various reasons. Her blood pressure began to creep up, and while she advocated for more time, by the following appointment, the decision was made to move forward with an induction.

With two weeks before her actual estimated due date, Desiree’s cervix would need some coaxing before any labor. Desiree went to the hospital on a Thursday evening, and they began ripening her cervix with cervadil overnight. She felt mild and inconsistent contractions and was able to have some breakfast before the next steps.

Just past noon they inserted a foley balloon and Desiree ate some lunch. She was having irregular contractions that required some focus, but she was able to breathe calmly through them. The balloon can be quite uncomfortable, and it was a good opportunity for Desiree to stay focused on her breath through the discomfort.

Since Desiree had done her homework, she requested an enema in the hopes it might stir up some labor. She was not eager to have her water broken especially since she tested positive for GBS and was leery of any potential timeline. The balloon remained in her cervix and produced consistent contractions every 2 ½ minutes that lasted 30 seconds. She stood and sat upon the toilet to find the most comfort, but she was starting to feel fatigue set in and she was not yet in active labor. Finally, by 4:00 pm the balloon came out and that alone helped a bit with the pain.

Desiree asked to use a breast pump to stir up contractions and hopefully some labor. But between the pump and the enema she felt contractions for a limited time that eventually dissipated. It was around 1:00 am on Saturday by this time and Desiree had already been at the hospital well over 24 hours. The road for her labor was looming large and long and it hadn’t even begun yet. Thankfully, she was able to advocate for a night of rest, or as much rest as possible before trying to start things up in the morning.

Desiree got some sleep and a full plate of breakfast. Pitocin was next. They started at the lowest dose and raised it incrementally over the course of the day. Desiree wasn’t sure whether to rest or move around. It was wise to rest until her body required more of her but that’s easier said than done when you’ve been staring at the same four walls for over two days!

Just prior to 3:00 pm an exam confirmed that Desiree’s cervix had still not changed much from when the balloon came out. She was feeling regular contractions every 2.5-3 minutes that lasted 60 seconds, but she could still talk and breathe calmly through them. After some discussion, Desiree and Jackson agreed that the most reasonable next step was to break her water and hope labor ensued. They did the AROM (artificial rupture of membranes) just before 5:30 pm on Saturday and Desiree was dilated 4 cm, 60% effaced, and her baby was at -3 station. And breaking the water was a game changer! Desiree’s contractions intensified almost immediately.

This was around when I got to the hospital in the hopes, we could keep that momentum going. Desiree was vocalizing with her contractions and according to her nurse she was sounding more laborish. Jackson’s mantra to Desiree was, “You’re going to get huge!” (Look up Ina May Gaskin.) And Desiree’s nurse started to get goose bumps to see Desiree’s body respond. The contractions had jumped to 2-2.5 minutes apart and required all of Desiree’s focus.

Jackson wiped her face with a wet cloth and placed a heating pad on her lower abdomen. We put Desiree in the flying cowgirl position using the peanut ball in the hopes her baby would descend even further. This is not an easy position to maintain but Desiree was such a trooper.

After about 30 minutes it was time for the shower. Yes, Desiree was getting pitocin, but remember the pitocin pump was on the iv pole that has wheels. The wireless monitor gave Desiree the freedom of the shower, not to mention some distance from the monitor and bed. Desiree labored under the water flow with Jackson right there telling her she was strong and how much he loved her. “You’re a freaking badass,” also came out. Some citrus essential oil on a washcloth in the shower helped to give Desiree the feeling of more energy and clarity.

Just past 8:00 pm Desiree got out of the shower and draped herself over the cub birthing chair upon the bed. Jackson did double hip squeezes on her lower back and then a short while later Desiree did alternating lunges. Her hands and knees position also gave us easy access to her back, so we placed a heating pad there. Desiree’s nurse contorted herself to adjust the monitor while Desiree lunged. She was extremely supportive of facilitating Desiree’s labor process and for that we were all so appreciative.

Around 9:00 pm Desiree told us she felt constant pressure “down there.” We were hopeful for significant cervical change, but an exam had her dilated at 5 cm, 50% effaced and her baby at -2 station. It was not the big change she was hoping for. The pitocin was at 18 mu with not a lot more to go, and Desiree was wondering how much longer she could endure labor without relief. She had been at it off and on for over 48 hours.

In an effort to minimize intrusion to her process, internal monitors were proposed so Desiree could avoid so many hands on her belly to find baby and contractions. She was comfortable with that and once they were inserted, she labored on her side a bit. She was feeling very tired. She rolled to her hands and knees on the cub again, then sat upon the birth ball beside the bed and rested her head on a pillow between.

By 11:00 pm, with the pitocin at 22 mu and her contractions stronger than ever, Desiree mentioned for the first time that she needed relief. Jackson encouraged her to soldier on longer though, as she labored on, even trying Froggy Walchers to help her baby come down. This is another very uncomfortable position! She straddled the peanut ball on the bed while Jackson squeezed her hips, and even lay in the left runner’s position.

But as the clock neared 1:00 am, Desiree knew the best thing to do was rest. And the surest way for that to happen was to move forward with an epidural. Making the decision was the hardest part. But once decided it didn’t take long for it to be in place and for Desiree to have relief. It was in by 1:00 am and she was comfortable and eating jello soon after. And by 2:00 am everyone got some sleep.

But as the clock neared 1:00 am, Desiree knew the best thing to do was rest. And the surest way for that to happen was to move forward with an epidural. Making the decision was the hardest part. But once decided it didn’t take long for it to be in place and for Desiree to have relief. It was in by 1:00 am and she was comfortable and eating jello soon after. And by 2:00 am everyone got some sleep.

The sleep was interrupted by a cervical check around 2:45 am, only to reveal that Desiree’s cervix was still 5 cm. it was much thinner at 90% and her baby was at -1 station, two very important points of encouragement. Her baby’s heart rate was showing some variables, so they did an amnio-infusion to float the cord in case the decels were positional. And her baby’s heart rate stabilized over time.

Pitocin was bumped up again, this time to 28 mu. There wasn’t much more left to go! But it seemed to be the magic amount for Desiree’s uterus because at 6:54 am Desiree was fully dilated! Her baby was at 0 station, so technically a bit high, but still much lower than the days preceding. Desiree was so relieved she cried, and the rest of us might have teared up a bit too.

They decided to have Desiree give pushing a whirl. I think there was a strong suspicion she would be an excellent pusher due to her natural strength and because she could finally actually push! And that’s exactly what happened! With a mirror to watch her progress, and her original OB and nurse back on shift, Desiree gave birth to her baby at 7:22 am after less than 30 minutes of pushing!!

They did not know the gender, so Jackson made the announcement that it was a boy, Bridger Rowan. He was latched in the first hour and weighed 7 lb. 12 oz. and measured 20 in. long. He was a good size for 2 weeks early.

Desiree was dilated 5 cm for 36 hours! Remember, she was admitted on Thursday night and didn’t welcome her son until Sunday morning. While that may sound like something no one would want, it goes to show how patient her providers were and how well Desiree and Jackson advocated for their options. They were informed and prepared and knew what to ask for, thanks in part to their childbirth education and having a doula to help them navigate hospital options. But Desiree stayed positive and patient the whole way through and that at the core is what had the biggest impact on her experience. The steadfast support of Jackson was another important part of it.

I wish I could say that once Bridger was born, Desiree’s preeclampsia was cured, but I can’t. She was admitted again a few days postpartum. At the time of our postpartum visit, they were home and recovering well, fine-tuning their diapering skills and interpreting Bridger’s various cries. They are joyfully and sleepily taking it day by day and I couldn’t be prouder of them.

Christina and Sam welcomed their second daughter, Tatum Ellis, on June 11! After giving birth to her first daughter, Stevie, Christina had a good idea of her goals in this birth as well as postpartum. Having journeyed through a challenging first experience, Christina knew to remain open-minded and to use what worked last time. And I really think this freed her up to have a very positive birth experience.

Her body made some gradual changes as her due date approached. An exam around 38 weeks showed she was already 2 cm dilated. This was exciting news since she received the call that same day that the induction was scheduled for the weekend. But when Christina called at the appointed time, they told her there were no beds available. She waited through the night and finally the following morning she got the call to come in. Inductions can be a lot of hurry up and wait!

Around 11:30 am Sam sent an update that the foley bulb had been placed but just an hour later it came out  and Christina was 3 cm dilated. Christina wanted to delay (or even avoid) pitocin so she used a breast pump first for a bit. She also tried to rest as long as she could as she waited for labor. Eventually they began Pitocin at 3:00 pm and raised it slowly in the hopes her body would respond with labor contractions.

By 5:00 she was contracting every 3 minutes but still able to talk through them. But since this was her second baby it seemed a good time to head in. I arrived to find Christina  coping well and Sam a steadfast support to her. There was an exam soon after I arrived at 6:45 pm. Christina was about the same: 3 cm, 50% effaced, and her baby as at -3 station. It was time to use some techniques to help bring baby down. So I used the rebozo to “shake the apple tree” and did the jiggle from Spinning Babies to help get her baby situated.

Just past shift change at 7:15 pm we helped Christina into the flying cowgirl with the peanut ball. She took all of the maneuvers and positions in stride knowing they were all to help bring Tatum earthside. A cherry popsicle was a godsend and so was my jumbo heating pad as her hips ached from labor.

Christina lay on her right side for some contractions and then moved to her hands and knees at 8:30. After a bathroom trip she wanted to sit upright  in the bed to use gravity to brig her baby down. She preferred that position since it helped her feel like she could better cope with her contractions. It also gave Sam a good opportunity to rub her feet.

Christina was feeling her labor take a turn and was curious about her progress. But at 9:30 pm she was dilated 3-4 cm, and not farther like she had hoped. Her cervix was softer but it had a good deal of effacement left before big dilation could happen.  Christina decided to get  an epidural at that point since her labor was taking longer to get established than she expected and the night loomed long.

She was comfortable by 11:00 pm and did her best to sleep. Pitocin was still flowing at 8 mu and at 1:00 am an exam confirmed she was  dilated 4 cm, 70% effaced, and her baby was still high at -3. They broke her water at that point since Christina was on board with it. And we all hoped it would put her into active labor.

We used the peanut ball to keep her hips asymmetric and kept her body rotating from side to side as well. Sam got some sleep and Christina tried, but it can be hard to rest when you are meeting your baby soon. Plus busy hospitals aren’t very conducive to sleep. We sat Christina up in the bed in the throne position again and she was soon feeling nauseous and shaking. We were excited because this was an encouraging sign of progress! Even with an epidural, the body knows. They set up the delivery table taking this as a strong sign baby was coming soon!

Just before 5:00 am Christina had a lip on the right side but she was 100% effaced and her baby had moved down to 0 station! Christina labored down another 1 ½ hours so that lip could melt away and her baby could descend even further. She spent a lot of time on her right side along with a heating pad on her back and hip and peppermint close by for nausea.

And feeling lots of pressure at 6:25 am, the doctor checked to discover Christina’s baby was “right there”! She began pushing at 6:32 and her baby girl arrived at 6:36, after just one or two contractions! Tatum Ellis was welcomed with such love and joy! Christina scooped her up and in that moment the long induction journey was already the last thing on her mind. It was all worth it to have her second baby girl in her arms.

And even though her baby came in just a couple of pushes there were no stitches needed! Kudos to Christina for having control as she pushed and the benefit of warm compresses and oil from the doctor. Tatum weighed in at 7 lb. 3 oz.

Tatum was a very chill baby who hardly cried. But her nursery nurse was content with hearing breath sounds and seeing her pink up before her eyes. She snuggled with her mom right away and before long Christina was presented with a pancakes, sausage, and egg breakfast!

This couple was a joy to serve. They partnered beautifully and kept a sense of humor through the entire process. Christina knew an induction wouldn’t be an easier way, but she was prepared and knew her options every step of the journey. She had agency and was respected and supported. And that makes for a strong start to motherhood.

Christene and Rickey are parents! They welcomed their sweet baby girl, Azalea Faith, on March 5, after an adventurous induction. This baby was conceived with IVF after wanting a child for so long, so this would be an especially momentous experience for Christene and Rickey. As her due date neared, Christene had some higher-than-normal blood pressures that had her providers concerned. Then she woke up with some bleeding that had her go in to get checked out. With multiple issues going on, she agreed with her providers that an induction was the safest route rather than waiting to see if things might get worse. There was a lot of waiting involved but eventually she got into a room.

The first step was to do cervical ripening with a balloon. Christene was already dilated 1-2 cm so that was a start. She felt contractions soon after the balloon but focused on breathing through them. After a few hours had passed Pitocin was started. Christene felt a lot of cramps in her back, but I reminded her of the importance of sleep, especially with an induction that would likely take some time. I recommended some positions that might give her back a break (hands and knees) and Christene said she’d give them a try.

The pain grew to be so intense for Christene that she decided to get an epidural. She was still rather early in the labor process and knew she had a long road ahead of her. Sleep became her plan and she hoped she might dilate as she slept. (So did her doctors!) By 3:20 am a cervical exam revealed that Christene was dilated 5 cm and her baby was at -2 station. Thought largely from the balloon, it was very encouraging to hear such a number. They broke her water next in the hopes it would catapult the process. But four hours later, at 7:15 am she was still dilated 5 cm. So, Cervadil was inserted to continue to ripen and encourage cervical change.

To make sure her contractions were strong enough, they inserted an IUPC to measure them. Christene was laboring in all sorts of positions with the peanut ball thanks to her nurse and doula (). She leaned over the CUB birthing chair around 11:30 am and soon felt nauseous from all the moving. Peppermint essential oil helped, but it also didn’t hurt that she was able to drape herself over the CUB and rest a bit from all the activity.

Shortly after noon they inserted a FSE to make sure baby was handling the contractions okay. There were some concerning dips, so they wanted to cover all their bases. A cervical exam showed Christene to still be dilated to a 5 and her baby was still high at -2 station. There were murmurs of a possible c-section, but they were willing to give it more time. Technically Christene was not yet in labor, and they wanted to give her body every chance for it. But she also developed a slight fever that they kept an eye on. This was not helping matters and only had them more concerned.

We continued to rotate Christine from one side to the other using the peanut ball strategically to encourage her baby’s descent. We even did the flying cowgirl position, all while the Pitocin was raised bit by bit. Christene was such a good sport through it all. I know she worried about the possibility of a c-section, and she had voiced to me that was the one thing she didn’t want. But as the hours passed it looked more and more like the way her baby would be born. And as the hours passed, Christene seemed more at peace with it.

Just past 2:30 pm we used some lavender aromatherapy to help with relaxation. Christene felt more pain on her left side, so she pressed the PCA button. We couldn’t move her to the other side to remedy it because her baby’s heart rate would dip in a worrisome way. They cautiously increased Pitocin to bring stronger contractions while constantly watching for baby’s response. This can be a stressful situation for parents, but Christene and Rickey tried their best to stay focused on the end result—their baby in their arms. And they did not know the gender so that was an added element of surprise!

We dimmed the lights and finally we heard Christene snoring. At last! She was getting some sleep. A short time later though, the doctor came in to have a chat. There were concerns about her baby’s lack of variability on the strip, so it was looking more and more like a c-section. Christene and Ricky asked to wait until the next exam which was expected in a few hours, and they would make a decision at that time. 

When 8:00 rolled around, the doctor checked and discovered Christene was dilated to 6 cm, was 90% effaced, and her baby was a little lower at -1 station. These were changes and were a glimmer of hope for proceeding forward for a vaginal birth. They would reassess in a couple of hours and go from there. In the meantime, we continued to move Christene from one side to the other, as her baby tolerated.

At 10:10 pm it was the moment of truth. The exam results were in: Christine was still dilated to 6 cm, 90% effaced, and her baby was still at -1 station. Looking at the past 30 hours and what had transpired—concerning decels in baby’s heart rate and lack of variability, her high position, and Christine’s body’s lack of cervical change—it felt right to Christene and Rickey to proceed with a c-section. They had worked hard to meet their baby and wanted to be cautious.

Within the hour Christene was wheeled back, and Rickey waited in the PACU to join her. When they were reunited in the OR, moments later they welcomed their baby into the world. And to Rickey’s dismay and excitement it was a girl! He had confessed how worried he would be if it was a girl and that’s exactly what he got! He would have a baby girl to protect always. Azalea Faith was her name and seemed the perfect name for their journey to meet her. It took a lot of faith, and she was born on the dawn of spring when the azaleas bloom so lovely, at 11:31 pm.

Azalea was not a little one. She tipped the scales at 9 lb. 6 oz. which made Christene and Rickey feel a little better about the c-section. But mostly they were just relieved she was earthside safe and sound. She has the most amazing head of hair. It’s so full it looks like a toupee! They are settling in nicely at home at the time of this writing. They wear parenthood well and adore their daughter to pieces. They only wish they could get a bit more sleep. Sounds like things are going well then, right?

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! 

Every birth is different, and Kristin and Justin have learned this firsthand with the birth of their second child, Daniel Justin, on May 25, 2021. They welcomed their first child in a spontaneous labor free of interventions and had plans to do the same with baby #2. But in the last weeks of Kristin’s pregnancy, her blood pressure crept up to concerning levels. In fact, it rose so high at her 36-week prenatal appointment, that her midwife recommended she head to the hospital for induction that day. This unforeseen development had Kristin and Justin scrambling to adjust their plans for the birth as well as big sister’s care. But they made it work and were able to check-in to the hospital as directed.

Kristin and her providers talked a lot about options and various ways to get labor going. Since it was still early, her cervix was dilated just 1 cm, and not showing signs of imminent labor, they would need to ripen her cervix first. But with her blood pressure remaining alarmingly high, it was also important to make certain it remained in safe levels before any sign of contractions, let alone active labor contractions. Magnesium sulfate was the chosen medication to treat her high blood pressure, but it brought with it certain complications that made labor more of a challenge than expected. 

Contractions had hardly begun when Kristin did some soul searching. She was already feeling awful from the magnesium and was bed-ridden from it, not to mention the catheter and leg cuffs that were part of the package deal. She was in pain from the bed and felt sick from the blood pressure medicine and the contractions hadn’t even really started yet. The road ahead was most certainly a long one and she would remain on the magnesium sulfate for at least 24 hours after the birth. And there was also the question of whether her son would have the stamina for labor. Taking everything into consideration, and after a birth team pow pow, Kristin decided she would prefer to have a c-section knowing her son would be born, her blood pressure would have the opportunity to improve sooner, and she would be of the mag asap. It was by no means a decision she would have imagined making, but in this situation, there was empowerment for her in the choice. Her providers were diligent in detailing the risks, and just as thoroughly reviewed the process and how it would go. And sooner than expected, there was an OR ready. Justin and I waited while Kristin was wheeled back, but he was summoned soon after. Daniel Justin was born at 9:59 pm, less than 30 minutes from when Kristin left the room.

Sweet Daniel Justin was born very small, likely due to the blood pressure issues and the strained placenta. He weighed 4 lb. 11 oz. and was 18.5 in. long. And best of all, he was born with very strong Apgar’s of 8/9, showing everyone in the room that he might be small, but he was strong and ready. (Kind of like his mom!) Daniel’s birth just goes to show that every birth is different because every baby is different. Even Kristin’s pregnancies were different, and her babies needed different births. At the time of this writing, Daniel is getting chunkier by the day and is loved on by big sister. And Kristin is also doing much better. Hindsight only helps bring clarity to this as the best decision and there are no regrets. Kristin made the best decision for herself and her baby and I am so proud of her for it. I was honored to accompany them on this journey of birth, but also the journey of self-discovery through self-advocacy.

Brooke and Ben welcomed their son, Braxton Asher, on February 4, 2021 at 12:32 pm. When they woke up the previous morning, I don’t think they expected to head to the hospital. After all, Brooke was only 35 weeks that day, and things had seemed to be going well. But Brooke had some blurry vision and after an NST and some tests, she was admitted for induction. Her blood pressure skyrocketed and it became clear that Brooke was safer not pregnant and Braxton was far enough along to have what he needed. We hadn’t yet had our prenatal visit but at least they had finished their refresher childbirth class. The plan was to update as there was news. But that was the kicker. There wasn’t much happening for a while. Brooke’s cervix was doing its job well. It wasn’t time to open for a baby just yet. Her past pregnancies had gone beyond her due date so this was a big shift, to say the least. Brooke took it in stride and accepted that it was the safest course.

They moved quickly after making the decision to induce. In no time Brooke was on magnesium and had a foley catheter in her cervix. She was counseled to get an epidural but she desired to avoid it. This would be the first birth without one and she really wanted to keep with her plans. This would also be her second VBAC for which everyone was thankful. At least that was less of a risk than had it been her first VBAC. Her scar had already withstood the contractions of labor and birth.

By 3:30 pm Pitocin had begun to flow. And it continued that way for many hours, getting bumped up incrementally as Brooke waited for contractions. The foley bulb was removed and contractions came at a steady 4-minute interval, although Brooke hardly felt them. The biggest challenge in those hours was not getting overly frustrated with the many cords attached to the outside and inside of her body. And when she moved the monitor would lose contact with her baby’s heart rate, sending her nurse in to push and adjust the belt and monitor until the baby’s heart rhythm was once again detected. The waiting hours of an induction are the longest. And with no food and little to distract her, by the middle of the night Brooke had hit a wall. She was over it—tired of being tethered, wanting to eat, impatient with her lack of contractions, and desperate for the sleep that never came. She was in a difficult place. 

With the sunrise came a new day and a new attitude. The day staff came on, bringing a new nurse and I arrived at bedside to ride it out alongside Brooke and Ben. The Pitocin was at 24 mu/min, which was quite high, but Brooke remained unchallenged by the contractions. She had been dilated 5-6 cm at her previous exam and laying on her left side with a peanut ball between her legs. She was trying to be restful even if she couldn’t sleep. But she was ready to be more active. 

I recommended Brooke move to her hands and knees over the head of the bed. She labored that way for about 45 minutes, using gravity to her advantage. Squatting seemed the next place to go as the Pitocin continued to get bumped up. Brooke’s nurse fetched a squatting bar for us and Brooke got busy. She grabbed the top of the bar and squatted through each contraction, sitting back upon the bed in between. She squatted quite low, hoping her open pelvis would encourage her little boy to find a lower space that might bring on some labor.

And then we saw it. After about an hour of squatting, Brooke changed. She vocalized more with each contraction and she was spending more time in recovery between. It had been many hours since her last cervical exam so the doctor came in to see where she was at. Brooke’s cervix had also turned a corner. It was dilated 7 cm, 90% effaced, and her baby was at -1 station. That effacement was the biggest news of all for it meant that her cervix would melt away with less effort than getting to 7 cm had taken. And sure enough, within minutes of the doctor stepping out, Brooke exclaimed, “There’s an incredible ring of pain!” 

The next doctor on shift came in right away and it was clear that a baby was coming. The room quickly filled with people, especially since Braxton was only 35 weeks, but the doctor did the most wonderful thing. She squatted at the base of the bed, right there at Brooke’s feet for she was also squatting. And she told her to keep doing what she was doing and that she would be right there. I saw her cradle the baby’s head as it emerged and in just a contraction or two Braxton Asher was born at 12:32 pm! And he weighed 5 lb. 8 oz. and measured 19 in. long. 

He was rubbed and suctioned in an effort to bring out a cry or two. And he was then passed into his mother’s waiting arms. She had waited much longer than she expected to considering he came earlier than she had planned. She kissed him and Ben had his hand on Brooke through it all as they took in their newest son. Once the cord had stopped pulsing and Ben cut it, Braxton was taken to the warmer for a little more attention. It was determined that he would need additional support in the NICU so Brooke and Ben waved their son off as he traveled in his fancy box.

Minutes later there was good news. Braxton had figured out breathing and would be in the observation nursery instead of the NICU with the plan to return to his parents in 24 hours. This was not the same as never being separated at all, but Brooke knew full well that a 24-hour separation was not nearly what it might have been. Thankful for improved health and blood pressures, and for the simpler recovery that comes with a birth without pain medications, Brooke felt really good immediately after delivery. We would touch base a day later and she maintained her position that natural birth was a completely different recovery and she was grateful for that. 

Birth comes in many shapes and forms. But in the end, the journey to meet our babies is less about how they came into the world and more about how we were treated during the process. Brooke’s birth journey was a triumphant one in which she found her voice and her options and a provider who was respectful and patient. Congratulations on your unique journey!

Ashley and Wade welcomed their second beautiful baby girl, Jolene Renee on February 4, 2021. This birth was so different from the first, and believe it or not, was a bit more challenging for a few reasons. The biggest difference was the fact that the COVID-19 pandemic was in full swing. Initially, we weren’t even sure whether I would be providing doula services virtually or in-person. Thankfully, by the time Ashley was nearing full-term, doulas had been reinstated at her hospital as part of the birth team, not a visitor. This provided great relief to all of us. We had our prenatal visit, as is customary, and Ashley and Wade explained their rock-solid plan for big sister’s care during the birth. Grandma would be on an extended visit with them as the due date approached. Believe me, this alone helps to alleviate a huge potential stressor, and would allow Ashley to let go more easily for labor.

Still, she had weekly membrane sweeps at the end since that seemed to work for her first labor. But this baby was different and those sweeps didn’t get things going as soon as expected. In fact, Ashley remained pregnant a bit longer than her first pregnancy, making gradual movements toward labor in those final weeks. She was 1 cm dilated at 30 weeks, then 2 cm dilated on her due date. Ashley felt minor contractions that started at 2:00 am on her due date. They were erratic but persistent. By 5:20 that evening Ashley knew the contractions were regular but they were far apart at 20 minutes. So continued to ignore them and went along with her regular evening routine.

And just past 1:00 am everything had changed. Ashley’s contractions were not yet a minute long but they were very strong, requiring her full attention. They continued to intensify to just 2 minutes apart. And while they were still short, their intensity was enough to have Wade and Ashley head to the hospital. After her initial triage, she was confirmed 4 cm dilated. And while this was not as much as she had hoped, her first birth experience was a lesson in “ignore the numbers” since she zoomed from 4 cm to baby in a very short time.

 Some i.v. fluids came on board to help baby’s heart rate stabilize and it appeared to work. Wade did belly lifts to relieve Ashley of lower abdominal pressure as her baby worked to find her place in the pelvis. Something was a bit off in baby’s position since Ashley’s labor had been so protracted and erratic. So we encouraged Ashley into some positions that might help. Labor picked up quickly after arriving at the hospital, and Ashley was quickly drawn deeply into focus and listening to her body and intuition. And by 4:45 am she was dilated 5-6 cm, 70% effaced, and her baby’s head was still high at -2 station. 

And not thirty minutes later, Ashley’s body began to shake—a normal sign of the hard work and muscle fatigue that come with labor, but also a sign of transition. She thought her baby was coming soon and wanted an exam an hour after her previous one. She learned she was 6 cm and 90% effaced and it was not what she was hoping to hear. But Ashley forged ahead. And you know what she did? She lunged. She didn’t like it but she did it anyway! We thought it might encourage her sweet baby to rotate too.

But she had hit her wall and was ready for a change. Ashley asked her midwife to break her water. Yes, her midwife ended up coming on duty right as Ashley entered transition! She had her water broken at 7:00 am and her cervix opened rapidly from 8 cm to 9 cm. And with the very next contraction after that, Ashley was pushing! She pushed with such strength that she brought her baby down lightning fast. We watched as Jolene rotated one way and then the other, and got herself situated out of the OP position at the very last second! She came barreling into the midwife’s hands at 7:11 am on February 4, 2021! And she weighed 8 lb. and measured 20 in. long.

Ashley welcomed her second daughter like her first, in a birth free of pain medications. But so much of it was different! Her baby’s position likely delayed the onset of her labor and when it did, it made it take even longer. Then when the conditions were right, her body moved quickly to bring Jolene into the world, just as a veteran pelvis is known to do. Ashley hit a wall or two, and looking back she is still amazed she was able to do it, considering the added challenges she had this time. But we always knew she could. And in her wavering moments, Wade was her champion, speaking encouragement and strength to her without fail. And always having her back, literally and metaphorically. 

 Welcome to the world, Jolene Renee! May you always celebrate your birthday with a free Slurpee from 7-Eleven! And be sure your mom gets one too, why don’t ya. She certainly deserves it!!