Posts tagged hands and knees delivery
The Birth of Elliott Andrew 6/30/21
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Kelsey and Andrew welcomed their second baby, Elliott Andrew, on June 30, 2021! Kelsey’s body prepared for labor with cramps and contractions especially in the last week or so. She was dilated 2-3 cm at her 39-week appointment and decided to forego a membrane sweep and see what her body might do. Kelsey preferred not to introduce any risks and was curious if her midwife’s prediction of labor within 72 hours would hold true. (It would.)

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Two days later, on June 30, just before 5:00 am, Kelsey texted to tell me she thought she was up with regular contractions, she thought. Even after previously giving birth, labor can be confusing and challenging to decode. Kelsey had been up with the contractions a couple of hours, and her app recommended she go to the hospital. But Kelsey desired a birth free of medications and knew that establishing active labor at home was a wise idea. Besides, in her words, she wasn’t dying, and going to the hospital didn’t feel right yet. 

An hour and a half later she was definitely having to stop for each contraction and even felt nauseous at the peaks. It all felt a bit fast to Kelsey, but in order to avoid a extra difficult hour-long drive to the hospital, they decided to leave with the plan of a hotel room as backup should she get sent home. Suffice it to say, Kelsey was either in denial, or just very adept at minimizing her labor. Kelsey got sick in the car and then after taking time to gather herself, they made their way up to the Family Maternity Center at Sentara Leigh Hospital. 

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There were no available rooms but in triage her midwife came in to greet her and confirm that she would be staying to have a baby. She was dilated 4-5 cm, just about perfect to avoid a very unpleasant car ride. We added some pillows to the underwhelming triage bed in an effort to make it plusher like a labor and delivery bed. And if you are familiar with labor and delivery beds, the fact that we were trying to improve the condition of her bed to match a L&D bed was laughable. Kelsey breathed calmly through her contractions and got settled in the room as her nurse strapped the monitors to her belly for the initial NST. Thankfully, baby looked great so Kelsey was off the monitor 20 or so minutes later. She promptly threw up and then rolled over to her hands and knees to labor. She lay down after a while to get some rest between. She said she felt tired and week, and still a bit nauseous. Peppermint aromatherapy helped assuage the nausea, and we helped her to relax and rest with music and backrubs. 

Her nurse returned to listen to baby’s heartbeat with the doppler ever so often, but in general she tried not to disrupt Kelsey’s labor groove. Kelsey labored beautifully while her midwife and nurse tried to coordinate a room change. Finally, a larger triage room was available; one with a shower! So we moved Kelsey into it quickly and turned on the water asap. Kelsey labored an hour under the warm water and returned to the bed to rest a bit and energize with some juice. A few minutes later, just past 2:00 pm, she was 8 cm dilated and her baby was at 0 station. Her progress was great encouragement, and Kelsey continued to labor confidently. Ten minutes later her water broke, causing Kelsey to gasp in surprise. And her baby moved down bringing a lot of pressure. 

Kesley breathed her baby down, allowing the urge to push to grow naturally. Her midwife sat nearby, and the nurse shifted things around the room to make a clear path to the warmer. The fact that the warmer was already in triage, spoke to their incredible busy-ness. I noticed Kelsey holding an emesis bag in one hand, and holding Andrew’s hand with the other. It was definitely a snapshot of labor. 

 By 2:45 pm, Kelsey was pushing gradually. She blew through the end of her contractions until she couldn’t anymore. Hands and knees is where she felt led to go and she made significant changes there. In fact, her midwife saw baby’s hair almost immediately and called for nursery. Two minutes later, her baby’s head was crowning as she pushed gradually. Kelsey did an amazing job of pushing just enough to advance her baby and allow everything to stretch so she wouldn’t tear. And at 3:11 pm, Elliot Andrew made his appearance! (And yes, he was born over an intact perineum!) Elliot cried immediately at birth but quickly settled down. He had a very long cord that was wrapped loosely around his neck and caused no problems whatsoever. He snuggled with his mom as he awakened to the world outside of her, showing us the cutest dimple in his right cheek.

By 3:40, Elliot was latched, and Kelsey enjoyed a granola bar and some Oreo cookies for a snack. Peanut butter on saltines was the next snack, along with orange juice. Kelsey ate it all and was grateful for the energy and the return of full stomach capacity. She was eating snacks as if it was an ordinary day. Kelsey and Andrew got familiar with their son and spread the happy news of his arrival to loved ones. It was a lovely birth, one in which Kelsey had autonomy, support, and a team that trusted her intuition and ability. It all came together nicely in triage, and by the time Elliot was born we hardly noticed where we were. It didn’t much matter, after all. Birth can happen anywhere. Congratulations to this couple again for partnering and journeying together to welcome their second son to the family. 

The Birth of David Thomas the Third
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Avery and Davey welcomed their first child, a son, on December 17, 2020. This labor was quite the story and just goes to show that anything goes, even for a first-timer. Avery’s cervix laid some groundwork ahead of time, dilating to 2 cm by her 37-week appointment. While this can be exciting to some, Avery appreciated that it would not predict anything except that she had 2 less centimeters to dilate. And so she remained at 2 cm for the next couple of weeks, but continued effacing to 75-80% by the last week. 

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Then a few days later, on her due date, Avery reached out to tell me she was having consistent contractions. It was 2:29 am at the time of the text, which was a clue that it must be something! She first felt the pain around 4:00 that afternoon but figured it was just gas. She ate dinner, took a bath, and went to bed at 8:00. But she was awakened around 10:30 that night by more consistent waves of pain that were oscillating 5-6 minutes apart, albeit short at 30 seconds. She wasn’t feeling pain radiating from her back at all like she had assumed she would, and the pain was focused low in her uterus and not as strong as she expected. I reminded her to hydrate and rest, saying all of the doula things typical to a first-time mom in early labor. And she reached out about 45 minutes later to tell me the contractions were getting closer but staying short, and certainly not strong enough to require her to stop and focus. We left it at that and she would update as things developed.

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Around 6:45 am, over three hours later, Avery could tell that the contractions were definitely stronger and longer, lasting 55-60 seconds, and coming every 6 minutes. Rest was still a prudent plan so she would try to continue that. Then just before 11:00 am, the contractions were no longer tolerable in bed. But when she stood up they jumped close to 2-3 minutes apart and short again. What was going on? The inconsistent nature of her contractions hinted to her baby’s position being a bit off. So we thought the Miles Circuit was in order. Avery began the regimen and Davey texted to ask about when they should leave for the hospital around 11:30. That was another good sign things were progressing—Davey was the one texting, AND that he was beginning to think of the logistics for the drive to the hospital. An hour later, with contractions at the 5-1-1 range (thanks to the Miles Circuit), that quickly jumped to the 3-1-1 interval, it was time to head in. We would meet at the hospital.

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And somehow in the process of decoding contractions, resting, taking a shower, and doing the Miles Circuit, Avery arrived at the hospital dilated 9 cm!! Oh my word! Clearly, Avery had mastered the art of laboring at home. The room was swirling with activity as you probably know—they were getting the delivery table setup and turning on the baby warmer, and taking their places. But Avery did a great job laboring beside the bed as she felt led, knowing her body would soon tell her when it was time to push her baby out. She tuned into what she was feeling and did not let the flurry of activity distract her. Then her water broke as if in answer, and she was thrown headlong into pushing after that.

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As you might have guessed, Avery pushed well and was not afraid of the hard work it required. And after just about an hour of pushing, her sweet baby boy, David Thomas (the third!) was born at 3:12 pm on his due date! Avery grabbed for him between her legs and brought him instinctively to her chest. He was embraced with such love and elation, we all couldn’t help but revel in it as we watched this new mother so self-assured and grateful for the gift of birthing.

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Little Davey weighed 6 lb. 13 oz. and measured 21 ½ in. long. He was perfect and adorable and he latched eagerly and fed for 25 minutes at his first go. For a little guy, he was healthy and strong, and had a fair amount of hair, and lots of rich vernix coating his skin. He was at home in his mother’s arms. And why shouldn’t he be? It’s nature’s proven method of keeping babies warm and secure.

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Instinct was the name of the game in this birth and it translated to something quite beautiful all around. While COVID restrictions have affected some aspects of modern hospital birthing, births like this are such an important reminder of what is true and real and permanent. Women are strong. Babies know how to be born. And birth is natural. Welcome to the world and welcome to parenthood!

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