Romina and Charles are parents! I had the privilege of getting to know them over the course of my 7-week childbirth series. Romina desired as little intervention as possible and prepared by educating herself, finding a provider who would be supportive, and last but not least, hired a doula. We met early on so the relationship was established over many months until finally Romina’s due date was looming. She was always good about reaching out to me with questions or concerns and addressed her fears as well. This was an emotionally mature thing to do and I was proud of her for it.
Professional photos courtesy of JCPenney
Romina’s body had contractions off and on in the final days which just so happened to be the week of her due date. While Romina grew accustomed to the nightly ritual of contractions in the last days, they did nothing for her sleep. It was hard to imagine how she would have the energy for labor when it happened. Romina worried about an induction, in fact it was one of her biggest (if not THE biggest) fear. So not going far past her due date was a very good thing.
Romina saw some signs of change in her body and sent me updates about them. It was an exercise in trying not to pay too much attention to things that weren’t labor but also getting excited about meeting her baby soon. But by the third night, things seemed to be more laborish. I got a text just before 3:00 am with a pattern of contractions that Romina said were getting stronger. And she also thought her water might have broken around 1:00 am. She reached out to her midwives and eventually headed in to the hospital.
After getting checked and hooked up to the monitor to assess, it seemed that Romina wasn’t quite in labor, or perhaps was in very early labor. Her cervix was very thin at 90% and her baby was at -2 station, which was good. Her midwife recommended Romina stay and get fluids and have her baby. She had already had several difficult nights and the concern turned to whether Romina would have the energy needed. They hooked her up with a wireless monitor which would give more freedom of movement. Romina breathed through her contractions but found it hard to relax. The hours passed but by that evening she had only dilated from 1 to 2 cm. Her midwife said it was time to get some labor to happen, so they agreed to starting Pitocin. This was not what Romina ever thought she would want but she also realized that it was the best next step to have her baby. She was courageous as her birth journey took a different turn.
The Pitocin was increased gradually but it didn’t take long before Romina’s contractions were overwhelming. She decided to get an epidural in the hopes it would allow for some rest, and she might relax better as well. It had also been about 24 hours since her contractions began, and she still had a ways to go. Well, unfortunately, Romina’s epidural did not perform as expected. She continued to feel pain and so we tried our best to rub her thighs and apply a rice sock and her heating pad to mitigate the pain of her contractions. With the pain still much worse than expected post-epidural, they did the epidural again. And thankfully, it worked better the second time.
And second to the pain relief, Romina (and Charles) were getting rest for the first time in a long time. We moved Romina into various positions to encourage continued progress in dilation and her diffuser helped to keep the environment relaxing. The baby’s heart rate dipped in such a way as to get our attention. Her nurse added a pillow under Romina’s hip and some fluids to her iv which seemed to help the fetal heartrate. Romina’s nurse also started gathering delivery since sometimes the baby’s heart rate can alert to big changes in the cervix.
With contractions coming steady every 3 minutes, her midwife came in to see what was happening with Romina’s cervix. And lo and behold at 11:49 pm (a short time after the second epidural was working) Romina’s cervix was completely dilated! Her baby was at -1 station. Her midwife broke her water to encourage baby’s descent and we continued to move Romina into various positions to help baby navigate the pelvis.
Romina continued to sleep (eye covers helped) and by 1:00 am her baby was at +2 station. So pushing began! Everyone was very encouraged and excited that a baby would be born soon. And Romina got started. She pushed in many positions over the hours. She pushed on one side, then the other, she sat upright in the bed, and pushed on hands and knees. We did the jiggle from Spinning Babies to help baby move down and placed cold cloths on Romina to counteract the natural heating up of her body caused by the work of labor. After pushing for 2 ½ hours Romina was tired. So she tried to rest through several contractions and then pushed on her hands and knees over the peanut. Romina tried to push with the tug of war rebozo maneuver, but her baby wasn’t descending. “I’m done,” she said.
And she really meant it. So her midwife recommended having the doctor come in and consider some assistance via vacuum. Romina was open to this if the doctor felt it might work. He came in and assessed things and thought it was a good option. But in spite of hard and consistent pushing efforts and use of the vacuum, the baby didn’t descend, and the vacuum popped off the maximum of 3 times. Her doctor shook his head disappointed that he could no longer assist Romina in this way. It was up to her to push her baby out so she continued to try. We all cheered and encouraged her. We even gave her real talk to dig deep and get her baby out. But it just wasn’t happening.
After pushing on her own for 30 more minutes with no notable progress of her baby’s head (which we could see!), the doctor recommended a c-section as the safest option at that point. He even said himself, “I don’t know why the baby isn’t coming.” After all, Romina had been pushing for over 4 hours. By all accounts Romina was doing the hard work to get her baby out. And after all the work she did, Romina embraced the option of a c-section with such courage a grace. This is a woman who was so determined to have a spontaneous unmedicated vaginal birth and she relinquished control of that idea and walked the journey of a very different birth. She was ready to meet her baby. She and Charles regrouped and came to a place of peace with the new direction. This was not an emergency. There was time to gather the team and for Romina and Charles to wrap their heads around the new plan.
Thirty minutes later they were headed to the OR and their sweet baby girl was born 25 minutes later at 6:34 am. Less than 40 minutes later they were back in the room where it started. Romina got skin to skin and so did Charles. Their baby girl, Sofia Nichole, was born at 6:34 am on August 18. She weighed 7 lb. 9 oz. and was 20 in. long. She had a head full of dark hair and she looked a lot like her daddy to me. (Most babies do.) She was latched before I left and Romina and Charles were off to a great start as parents.
Fast forward to the postpartum visit, and I was so proud of them. They had family helping in the first week or two and had come into their own with the rhythm of pumping and feeding and navigating support for tongue ties. Romina had appointments set up and was taking her postpartum time day by day. They were confident, inquisitive, united, and above all loved their baby fiercely. It was an honor to be a trusted member of their birth team and to truly see them grow into parents.
