Summer and David welcomed their second baby, this time a boy, on March 29. Summer’s first baby was very content to remain in the breech position. It didn’t matter what her mama did, she was resolute in staying head up. Summer went through all the emotions that come when a birth doesn’t go as you envisioned, and she met her baby girl in a scheduled c-section.

This time she was once again committed to giving birth vaginally if possible. She chose the same providers knowing their reputation for supporting VBACS (vaginal birth after cesarean). And time ticked on in her pregnancy much more rapidly than it had the first time. (Babies make time go faster!) Summer and David’s first child was still a baby herself and would be 16 months at the time of her brother’s birth. She was toddling and very busy, and Summer found herself busy and, on her feet, chasing her firstborn.

This baby was head down at least. Thank goodness! But this child posed a different set of challenges. He was so content inside that he wasn’t showing any signs of budging. An induction became the likely plan, but only if Summer’s body was showing signs of readiness. Her providers wanted to be sure they could encourage a gentle induction and with her recent c-section they were limited in the cervical ripeners that would be safe for her.

As Summer’s due date came and went, it was clear that her only option for a vaginal birth was an induction. But sadly, her cervix wasn’t showing any signs of getting ready. Closed, thick, and high. These were the words she heard from one appointment to the next. A final NST and ultrasound made it official. Her baby was measuring 8 lb. 13oz. and had his hand by his head. Her providers were not comfortable with an induction. So, they recommended a repeat c-section. (Spoiler alert: remember that ultrasound weight…)

Look at those rolls!

Summer mourned the change in her birth once again. She took the time she needed to process it and then gathered herself in preparation for what was to come. Her recovery would be different simply because she had a toddler roaming about. The need for rest would be even more important this time. The c-section was scheduled for 1:30 pm on March 29, but was soon changed to the first scheduled c-section of the day. Summer surmised it was probably her compassionate OB’s doing, knowing it would give her less time to stress over it.

Along those lines, Summer advocated for what she needed. And that included how I could best serve as her doula. She requested I come after the birth and provide support then as she processed everything. The c-section went well. Music played, courtesy of DJ David. Notable songs were Mama Mia by Abba and Wanna Be by Spice Girls. The music helped with Summer’s anxiety, and so did her deep breaths. At one point she breathed so deeply she lowered her heart rate into the 40s! Sage David was born at 8:21 am, but he needed more respiratory support than expected. Summer got a glimpse of him right after he was born, but soon it was a quick kiss and then he was off to the nursery. That was disheartening as it meant he wouldn’t be with Summer for skin to skin at first. David went with him to the nursery and Summer requested I come at that point.

And one more thing about Sage. He was a big boy! He weighed 11 pounds! Ultrasounds can be off by 20% when used to gauge baby’s size in the final weeks, but this ultrasound was off by 25% in the wrong direction! Suffice it to say, Summer welcomed the big number with relief as it helped her feel even more justified in the repeat c-section. I have seen several 11-pound babies born vaginally unmedicated, but Summer was content to sidestep that experience. And I was happy she got validation for the c-section through that detail of his weight! An 11-pound baby definitely wouldn’t have made labor any easier.

I was by Summer’s side soon after she called. I helped her process things but also aided in her advocacy regarding getting information about Sage and when she could go and see him. She was recovering from the c-section well and was on her way to visit him by wheelchair before I left. And he was back with her later that night.

All in all, this birth experience was less traumatic than the first one. Summer told me there were some bonuses too. She didn’t get extremely nauseous like last time since the anesthesiologist was able to adjust her meds this time to prevent that. Plus her OB was able to give her a scar revision, which she appreciated. And to top it off, her doctor did come see her later that Sage was very high in her pelvis and the VBAC may not have happened even if she had tried. This was just another validation! Summer felt the c-section was the best decision, especially in light (or heavy?) of her son’s weight. I just love when birth can be healing. And this one was.

This birth story has some backstory which is an important part of the journey. Jessica and Dan welcomed their fourth child on December 1, 2022. This was our fourth (and final) birth journey together which made it a bittersweet one for sure. Jessica’s births were a journey of self-discovery that originated with an ob practice with doctors in Newport News, then shifted to a Midwifery Center run by midwives in Norfolk. Her births were all unmedicated and showcased Jessica’s ability to stay calm through the most intense contractions. So, she was confident in her ability to birth wherever she might be, as long as she felt supported. Given her history and the fact that she would have to drive through a tunnel to get to her birthplace, Jessica felt most comfortable with a provider on her side of the water. This was a sensible consideration but was a leap of faith on Jessica’s part since they were new providers to her. They had midwives though, and that was her primary draw.

But Jessica experienced some red flags as her due date drew near. Her midwife pushed for an induction at 37 weeks that didn’t feel right to her. She went so far as to go to the hospital for monitoring and labs and still had to sign a paper leaving against her provider’s recommendation. But Jessica had always birthed past her due date, and she wasn’t eager to sign up for an early induction for a questionable reason. Then a week or two later, as Thanksgiving drew near, her midwife recommended scheduling an induction to avoid birthing near the holiday since there would be less midwives available. Jessica had chosen this ob group specifically for their midwives so to be told she might not have access to one in her labor was the last straw.

She reached out to me desperate for alternatives, feeling trapped in her 40th week of pregnancy with unsupportive providers. I mentioned homebirth and Jessica was open to considering it if she could find a midwife who would take her. Thankfully, she did and felt an immediate weight lifted and a sense of peace at their initial meeting. Jessica was at ease and ready to welcome her baby whenever she might decide to come. It didn’t take long to feel safe and protected, and unconditionally supported, which was a very strong reminder to her of the importance of assembling a team that you trust. She would have a homebirth. And just 11 days later that’s what she did!

It was just over a week past her due date when Jessica felt the familiar waves of contractions. It was around 6:30 pm when she sent the first text to me, but she had been feeling contractions soon after doing the Miles Circuit as recommended by her midwife. She was wise to have the children and dog head to her parents’ house close-by for the night, knowing she would likely be giving birth. I didn’t hear from her for nearly four hours and then a call came in from Dan telling me Jessica was breathing through strong contractions and very focused. This is significant for Jessica and meant she was in active labor, so I was out the door and got to their house by 11:30. (The drive was a long one, given the tunnel, but I was grateful to have made it!)

Her midwife was not yet there and after watching Jessica through just a couple of contractions I knew it was time to call and fill the tub. Dan was on it, and he let the midwife know it was go-time and got to work filling the tub. In the meantime, I remained with Jessica. She breathed with a sigh through her contractions, clutching the headboard of her bed, and trembling through the peaks. She looked to be in transition or very nearly there. This was moving quickly!

She tried a bathroom trip and took several contractions to get there and back. Her contractions were lasting 90 seconds and 3 minutes apart, leaving her with a very short recovery. A cold cloth on her neck and a fan nearby gave slight relief, but her sweat revealed her strong work. Her midwife arrived with her assistant by 11:50 pm, just 20 minutes after me. Jessica stood beside the bed through some contractions and immediately felt pressure down low. Her midwife got her things set up and they paid a visit upstairs to Jessica in the bedroom to greet her and check on baby.

Jessica was in labor land, looking disoriented and tired in between her contractions. Around 12:15 am she asked me, “If they don’t check you how do they know you can get in the tub?” I smiled at her innocent question and reassured her that there were other ways to know. I reminded her that if she felt stinging and burning and that would be her baby’s head. Three minutes later, Jessica felt her baby’s head there.

She made her way slowly down the stairs to the birth tub as the second birth assistant arrived, and she sank down in the water. The tub was situated beside the Christmas tree and made for a lovely backdrop for birthing a baby on December 1. While in the tub, we made sure Jessica took sips of her electrolyte drink prepared by Dan, and we kept a cold cloth and fan nearby. It was little things we did, but the significance behind it all was that we believed in her and trusted her.

Jessica lay back in the tub, eyes closed, and breathed with each contraction. She was in tune with her body and literally breathed her baby down and out. Her midwives watched in wonder, as did we, as Jessica with hardly a sound, and ever so gradually, brought her baby lower. First there was the bulging sac which had always been broken in her previous births. Her patient midwife waited until it gave way naturally, allowing Jessica’s body to ease her baby into the world and prevent a tear.

The midwife summoned Dan close, so he was poised to catch their baby. And he leaned in with complete confidence, saying all of the right things to encourage and reassure Jessica that he saw more of their baby with every breath. And then the head came, so quietly and gently. And after three minutes, another push brought the baby into Dan’s hands at 1:12 am on 12-1-22! Dan and the midwife brought the baby up into Jessica’s waiting arms and she held her to her breast.

It was a truly wondrous birth that left every person quietly in awe. And as I sat in those first minutes it occurred to me how very differently this birth might have unfolded had Jessica not taken the leap of faith and courage to switch her care providers! It was a beautiful and gentle birth by a woman who has a quiet strength about her that I have always admired.

There was no aggressive rubbing of their baby as she made subtle sounds and moved her body in a way that verified she was breathing. And she was pink from head to toe almost immediately. She transitioned in her own way with hardly any cries in the warmth and security of her mother’s arms; a far sweeter first moments in the world than those of a typical hospital-born baby. The placenta came a short while later and remained attached until it felt like the right time to cut it, yet another unique feature that is hard to come by outside of homebirth.

When Jessica felt up to it, she did the herculean task of getting out of the tub and walking back upstairs to her bedroom. Once settled, and confirmed she had NO TEARS (the first time ever!), she watched her baby’s newborn exam occur at her feet and saw as Dan did the honors of weighing her. She weighed 8 lb. 6 oz. and was 19 in. long. The name was still being debated but they would soon settle on Esme Joy. Interestingly, Esme means ‘to love’. Partnered with Joy as a middle name, it’s the perfect name for a baby born on the first day of December in the early part of advent, in which we celebrate with joy the coming of a Savior who came to the world to teach love. In true homebirth fashion, we assured Jessica had some nourishment and hydration, cleaned up any remnants of the birth, and then took our leave so she could settle in her own bed to sleep.

I can’t imagine a more perfect way for Jessica and Dan to have rounded out the births of their four children. I am so proud of Jessica for her courage in making a last-minute change in care. I am grateful for the midwife who could take her on so late. And I will forever be honored to have accompanied Jessica and Dan in all four of their births. I hope they share their story so others may know the importance of feeling safe and supported in birth, and trust the voice that speaks to their hearts is the same voice that has a right to be heard.

Candace and Jacob ushered in their third baby girl, Gabrielle Samantha, on October 23 in a birth that defied their expectations, as third births often do. This was my third time to serve them in birth and I knew that Candace tended to dilate rapidly once her labor got going. But because of this, she was especially worried about timing the drive to the hospital so she A) didn’t give birth at home or on the way, and B) so she would have some time to adjust to the hospital setting and experience her labor there, not to mention make sure her doula got there in time. ;)

Candace made her way to her due date and beyond, and as expected, the induction talk was posed. Trusting her body would go into labor on its own if given enough time, Candace advocated for the latest possible date, 41w6d and hoped she wouldn’t need it. She was also pleased when her midwife said they would not jump right to Pitocin given her history and current cervical dilation. Instead, they would consider alternatives like a membrane sweep, breaking water, and use Pitocin only as a last resort. In the meantime, her cervix began to dilate and ready itself for labor. And while there was no guarantee of when labor would start, but the good news that she had already dilated some of the way.

At 11:50 pm the same day Candace texted the induction date was confirmed, she was having contractions. She was concerned about staying home too long and wasn’t sure whether she would know when to head to the hospital. Thinking to her previous birth in which she hardly made it in time, she wanted to be sure she didn’t do a repeat of that just in the nick of time birth. Candace went into the hospital because she wanted to know what was happening. Her contractions were regular at 3-4 minutes apart and her cervix changed between two checks. She arrived 2 cm dilated and was 4 cm dilated at the next check. Her baby was also moving down slowly between checks. She was debating between options like breast pump and breaking water, as recommended by her midwife.

Around 10:45 am, Candace’s midwife suggested she call for me to head in. I arrived shortly after 11:00 to find Candace sitting comfortably. She was 3-4 cm dilated at that point, after walking some and using the pump. Breaking her water was an option but it had Candace puzzling over whether it was the best decision. She thought back to her previous births to try to predict how this one might go, but her midwife gently reminded her that each birth journey is different. After giving it enough thought, Candance decided to have her water broken. The fluid ran clear, and she dilated from 3-4 to 4-5 cm immediately. The time was 11:27 am. Surely, she would have this baby by dinner, right?

Candace’s body shivered, a sign that labor was taking hold. She positioned herself on her hands and knees but commented to us that her baby was on the lazy river and apparently in no hurry to be born. She also walked the halls for an hour to intensify her contractions, but at 1:40 pm her cervix was still dilated to 5 cm. She tried using the breast pump again, but it was too painful to be worth it. Instead, she moved her labor into the shower. I set the mood with aromatherapy and votives and after an hour Candace was dilated 6 cm, although her cervix was still tilted posterior.

She returned to the shower and positioned herself so the water might provide nipple stimulation and stronger contractions, and alternated so her back would get the relief of the warm water. Next, she swirled her hips on the birth ball, and then did some pelvic tucks with the rebozo. At this point I heard her breath sound more labored and noted that her contractions were steady at 4 minutes apart. After the pelvic tucks, Candace was game to do the flying cowgirl position. We suspected for some reason, her baby was having troubling descending enough to significantly dilate her cervix so we chose positions to open the inlet of her pelvis. The heating pad helped with the back pain she felt.

One last push before baby came!

At 5:30 pm when her midwife returned for an exam, Candace was dilated 6 cm. She had made modest change but was not quite yet in active labor. Her midwife recommended Pitocin or iv fluids at the very least, but Candace preferred some time to wait and see. They decided to powwow again after an hour.

Candace returned to the shower since she found the heat helped. She closed the curtain and closed herself off from everything—the room, the check, the machines, the expectations—everything. She wasn’t in there long, maybe 20 minutes but Candace did her best work in that short time. She cried out in frustration, and as she let those feelings wash over her, labor took hold.

Candace was out of the shower at 6:05 pm and draped herself over the peanut on the bed. She was breathing harder, and her contractions were closer. I pressed on her lower back since she no longer wanted the heating pad. Candace began to vocalize with her contractions, and I just knew her baby would be born soon. I called her nurse who joined us quickly and then summoned the midwife. I called the nurse at 6:18 and the midwife was in the room by 6:27.

Candace was dilated 8 cm at 6:27 but she wouldn’t be for long. She told us she felt like the head was there and she was drawn into a push almost immediately. Her midwife was poised and ready at the bottom end and Candace moved her baby with powerful pushing contractions. And Gabrielle Samantha was born at 6:35 pm on October 23, 2022! The midwife passed her baby through Candace’s legs into her arms, and we helped her lay back upon the bed. She was given the magic hour of skin to skin first, but after that was surprised to learn this was her biggest baby yet weighing 8 lb. 13 oz.

Candace snuggled her baby and let the events of the night and the day settle onto her heart. This was her longest labor and arguably her most challenging one too. She hit a wall and persevered, knowing deep within that she COULD and WOULD see it through. And she did just that. Three baby girls born, all three without epidurals. Candace is amazing.

Amy and Eric are three-peat clients of mine! So, they are special to me. Amy’s first labor was long and complicated, resulting in an epidural she had hoped to avoid. Her second labor was more difficult than she expected and had Amy requesting an epidural only to be pushing shortly after. So, this time was it. She was determined and knew in her heart she could give birth to her third baby girl without an epidural. Of course, I believed she could too, as did her steadfast husband, Eric. We were excited to see what her third baby, with the third baby reputation of a wild card, would throw her way.

New van purchase on 8/29 - 3 weeks before the birth

There were some concerns about position in the third trimester, and Amy’s midwife and I advised her to do some posterior pelvic tilts to get her baby more properly positioned to drop into the pelvis. Amy was diligent about the Miles Circuit as well as the posterior pelvic tilts. She had tools and she was going to use them. She was also healthier this pregnancy and gained less weight than her previous two, a difference that certainly can’t hurt. She grew comfortable with contractions, knowing there would be a difference between contractions of labor and contractions for other sorts of things. She was careful not to raise alarms for nonlabor contractions and instead kept herself busy and distracted which was easy with two busy little girls at home.

Belly shot taken 9/6 - about 2 weeks before the birth

Amy’s third baby proved the wild card reputation in many ways. The first being that Amy made it a week beyond her due date! She birthed her first two girls before her due date. There was discussion of an induction on the horizon but surely her baby wouldn’t wait that long! Amy decided to have her membranes swept at her 41w appointment to see if it might jostle up some labor. Nothing but Braxton-hicks contractions resulted from that, unfortunately. Amy had pretty much consigned herself to the fact that her third baby had her own plan. And that she did!

This photo taken the day of the membrane sweep, 9/16

Amy woke with contractions around 2:30 am on Sunday, September 18. She got up and paced around the room to get a feel for whether they were the same old Braxton-hicks contractions, or perhaps she had to go to the bathroom, or maybe, just maybe they were labor. The contractions persisted so she called me an hour later.

Big sisters meeting little sister

That call came to me at 3:33 am. Amy said, “I’m having contractions that seem close, but they are short. I think this is it but I’m not definite yet. I’m wondering if I should go to the hospital or maybe call Eric’s mom to watch the girls.” Then through one of the contractions she confessed to me, “I don’t want to do this anymore.” I reminded her that she DID want to do it, especially this time. I also reminded her to soften her jaw, shoulders, and hands, so as not to clench anywhere. She breathed through a couple of contractions during that short 5-minute phone call, and I reminded her that her midwives had advised her to call if she had three contractions that were strong and required her focus. She was on speaker phone and Eric said, “These are bringing her to her knees,” and that’s all I needed to hear. It was time to call her midwife and head in. Eric called his mom so she could come to the house to watch the girls so they could leave for the hospital. They would call me when they were on the way, and I would leave to meet them since our drives were about 10 minutes different.

At home with baby sister

That second call came from Eric at 4:12 am telling me they were in route to the hospital. I could hear Amy vocalizing LOUDLY through a contraction in the background and thought UH OH! I knew I had to hurry out the door!  That call was just 15 seconds long. I was on my way to the hospital in under 10 minutes.

My eta to the hospital was 4:36 am, this time will be significant later. I was held up by two red lights but still managed to get to the hospital in a speedy 15 minutes. However, when I turned into the parking lot, I saw a car parked in the circular drive outside the main entrance. This almost always means a laboring woman was let out as close to the door as possible and walked in with her partner because the walk from the car to the door was just too much. I knew Amy was laboring HARD.

Security Guard Mike

Then I jogged my way to the front door and paused in the foyer to hit the button to summon security to open the door. As I waited, I looked up through the glass door to see Ericka, Amy’s midwife, jogging down the stairs from the Family Maternity Center. UH OH! I felt panicked and a sense of urgency to GET IN THE DOOR. The security guard, I would later learn it was Security Guard Mike, walked up and let me in saying as he gestured to the car parked out front, “Are you here for them?” I think he knew I was because I was holding an inflatable birthing chair. I said I was, and he remarked very matter-of-factly, “Because I think she just gave birth in the lobby bathroom.”

I ran to the bathroom door, dropped my things on the floor and entered to find Eric sitting on the bathroom floor against the wall breathing hard in a bit of shock, and Amy standing outside the stall with a bright-eyed look of accomplishment on her face, surrounded by about 8 people in scrubs. She saw me and said, “Well, Amara, I did it! I got my natural birth!” I told her, “Yes you did! And you did it with flair!”

I snapped a few pictures and then took a seat beside Eric who seemed to need more attention than Amy in that moment. I praised him for getting Amy to the hospital in time, knowing that drive must have been stressful. Then so they could help Amy go from standing to sitting in the wheelchair to head upstairs, they handed Eric his baby girl. And he looked down at her and wept big daddy tears. It was priceless.

Getting upstairs was an event, from making sure the wheelchair had a pad on it, to walking in a parade formation to the elevator and then onto the unit. Amy was already the talk of labor and delivery, but that talk would continue for weeks following, if not longer. I will never think of that bathroom stall the same, that’s for sure.

Once in her labor and delivery room, Amy’s body started to shake uncontrollably. Her hormones took over, just as they had a short time earlier to birth her baby, and now were working on the placenta. Once it was out, and she was ready, Mary Rose was placed in her arms. She latched easily and Amy started to share the details she remembered. Eric sat upon the couch to continue to decompress and eventually hold Mary Rose again, this time on a proper couch and not on the floor!

Amy told us little bits that she could recall. Amy shared how counted breaths through her contractions, “just five breaths and it will be over,” she told herself. During her phone call with me the reminder to soften from head to toe also helped. In fact, it became her mantra through every subsequent contraction following our phone conversation. “Relax your hands, relax your shoulders,” is what Amy told herself. Soon even Eric was repeating it to her as he drove her to the hospital. And that reminder of “relax your hands, relax your shoulders,” is what Amy credits making the precipitous labor doable.

Once they arrived, Amy had wanted to stop in the bathroom because she wasn’t sure if she had to pee or poo. (Let me note here that had I been with them in that moment I would have discouraged the potty pit stop and insisted on a quick elevator ride upstairs to the unit first!) And when Amy wiped, she saw blood and got concerned, and then reached up to feel her baby’s head! Then there was a bit of back and forth to Eric about him catching the baby, and then Melanie got there. And when she pieced together the details by timestamps of phone calls and pictures, she was only in labor for 2 hours! And Mary Rose was born at 4:36 am, the same time I parked my car. And Amy pushed her baby out in one single push! And for the record, Mary Rose weighed in at 7 lb. 14 oz. and was 21 in. long.

Mary Rose was about as much of a third baby wild card as she could be. These are the many ways she was different: she was born after 40 weeks (8 days after her EDD!), Amy had a membrane sweep, this baby was the only one not OP, labor began in the middle of the night, Amy’s water broke during labor, not before (thank goodness!), she birthed unmedicated, and not in a labor and delivery room! Whew, that’s a lot of firsts!

Some of the first responders from the Family Maternity Center: Martina, RN, Melanie, CNM, and Stacie, RN

Everyone who assembled for the birth, went their separate ways soon after. I went on a mission to find Security Guard Mike and the Family Maternity Center staff who came to the bathroom/delivery room--Melanie, CNM, and the nurses, Stacie, and Martina. Even Ana, Amy’s nurse, made it down there. Plus, there were several extras in the bathroom from the ER too. Ericka, her midwife, did end up in the bathroom too. They all played a part in the crazy birth that unfolded that night and without a picture, Amy might not remember their faces since within minutes of meeting them, they were off.

Mary Rose’s potty

There might have been a bag or two in the car to fetch and the car that still needed to get moved. I imagine Security Guard Mike wouldn’t let their car get towed. It was a crazy sort of birth, for sure. But at the heart of it, was a woman highly motivated to have an unmedicated birth. Amy didn’t need any of us! She did it. Even Melanie didn’t have to do anything but tell Amy to push. It’s quite a story. And one that shows in a dramatic way, that it’s the woman who delivers her baby! I have never, in 20 years and over 900 births ever had a client give birth in the lobby bathroom of a hospital. And that middle stall in the lobby bathroom of Sentara Leigh Hospital will forever be Mary Rose’s potty to me.

Amy and Eric with their three adorable little girls

Katie and Will were recent clients of mine when they reached out about baby #2! Their children would be just 14 months apart, the perfect spacing for siblings as best friends and also an easy labor! Katie’s first birth had more interventions that she had wanted so she decided early on to welcome her second baby in a homebirth. However, it was discovered that her baby had an atrial defect in the heart that would require a higher level of care. Katie’s dream of a homebirth quickly shifted to a plan for an induction of labor in the busiest hospital in Hampton Roads. This was not what Katie had anticipated, but she had time to get used to the changes well before labor day.

Katie had a preterm labor scare that brought her to the hospital to get checked. Thankfully, she wasn’t in labor, however her cervix was dilated to 2 cm. so she was put on high alert. A couple of weeks later, she reached out because she suspected she might not make it through the weekend. At least she was full term at 37 weeks. She woke with horrible back pain and felt tightening and burning in her stomach along with nausea. Turns out she went to the hospital overnight fearing she might stay home too long and give birth in the tunnel. She was dilated 4 cm, however, her contractions were not changing her cervix beyond that. Katie was so ready to be done. And on top of that she felt like she wasn’t being heard. Requests for a birth ball went unanswered until she was out of triage and in a labor and delivery room, and she felt like she and her husband had been abandoned to wait and see. She was trying to figure out ways to insist on staying to be induced, but after several hours of no cervical change, and adhering to best practices, her providers told her she would have to go home and wait for active labor. And if she didn’t go into labor before, they would be in touch to schedule an induction in her 39th week. Katie was discouraged but she went home.

Surprisingly, Katie’s body held on until the induction. The date and time remained a mystery up until the last minute as she waited for a bed to open up. Finally, the call was made, and Katie and Will were on their way to the hospital for a 2:00 am induction. I got the alert text around 1:15 a on September 15 telling me so. This was a surprise, but a labor text would have been the same. So I waited for updates of regular contractions to signal it was time.

Pitocin began at 4:15 am, and with another wiggly baby, Katie’s sleep was interrupted by regular adjustments to the monitor and the belly bands. She was 4 cm on arrival, but the doctors were optimistic that they could break her water later that morning with a favorable result of labor. Katie waited through mild contractions she could hardly feel as the Pitocin was raised incrementally to 16 mu. After waiting for Will to go home and feed dogs, and get back, Katie’s water was broken just before noon. It flowed clear and her cervix opened from 4 to 5 cm immediately. I was in the car and by her side about 30 minutes later.

Katie had a large group of family present in support. Her husband, Will, was there of course, plus his mom and dad, Katie’s sister, and their firstborn daughter, just 14 months herself. I wondered if the people were distracting her from moving into labor and told her if she needed some privacy, she could have it. Katie nodded, but I think she knew she needed every person she had invited into her birth space.

The doctors returned to insert an FSE (fetal scalp electrode) because they were still having a difficult time keeping her baby’s heart rate on the monitor. Katie was open to anything that kept her baby safe and considered the loss of a belly band a bonus. Then, I recommended she get out of bed and swirl her hips on the birth ball to bring her baby’s head down upon her cervix. Next, she labored in the flying cowgirl position with the peanut to keep her baby moving down. She got up to make a bathroom trip after that and remained in there for a good while with her feet propped upon the foot stool.

Katie and Will returned to the bed, stopping through a contraction or two along the way, and then Katie returned to lean over the cub birth chair and lunge on each side. This was when I noticed her demeanor change. She felt nauseous and her breaths moved into moans. An exam confirmed she was dilated 8 cm already and it had only been an hour or so.

Katie continued to burp loud and long, and she finally vomited, which only brought her baby down further. We shifted the bed into the throne position so she could make use of gravity to dilate her cervix to complete. The rebozo tied to the squat bar provided a way for her to ground herself as she breathed through very strong contractions. The pressure in her pelvis grew until we saw and heard that she was starting to push.

I asked Katie where she wanted to push her baby and she expressed her desire to push on hands and knees. We returned the cub to the bed and she rolled over and grabbed it. Will stood at the head of the bed and that was where Katie gave her first strong pushes. The room quickly filled with hospital staff (17 to be exact!) and she focused on Will’s face and my words as she pushed. The doctor met her where she was, with no cervix check required. He simply affirmed her efforts and told her she was amazing.

Katie pushed through maybe 2 or 3 contractions before welcoming her second baby girl, Melody Belle, at 3:20 pm! Katie reached down between her legs for her baby and looked into her husband’s eyes with such joy, it was beautiful to witness! Her MIL and sister were overcome by the miracle of birth, crying as they watched, and a few minutes later, Katie’s young daughter returned in her grandpa’s arms to see that her baby sister had arrived. The room was abuzz with activity, but Katie was in her own world with her husband and newborn baby girl.

Melody went to the warmer for some minor assistance clearing fluids, and arrangements were made with the cardiac team for an echo to be done soon. Katie had a minor repair but had her baby in her arms for much of it. And once she was done, her firstborn daughter came in for a snuggle right in the hospital bed. Katie and Will welcomed their second baby in a family-centered unmedicated induction in the hospital. And while her room was filled with people, many of them medical students, I know they learned some important lessons that day. We all did. Lessons about autonomy in birth, trusting the birthing woman to know what’s best, welcoming family if it brings peace and comfort, and not disturbing the natural process when it works best. I realize Katie’s labor was induced, but once she was laboring, she was left to labor with little interference beyond the monitors. She was given space and time and wasn’t touched. She birthed her baby with nothing needed of any of us. And we were all honored to be there to see her do it.

Sasa and Tyler welcomed their second son on September 2, 2022, in a beautifully healing birth. Sasa did not emerge from her first birth feeling confident and like she was listened to. She hoped to have more agency and a voice this time, and Tyler and I were intent on helping that happen. We were by her side the first time, so we had an understanding of what that journey entailed.

Sasa’s body had bouts of warm-up contractions for weeks. She was an expert at minimizing and ignoring them, not ever reaching out to me once. In fact, the first heads up I got from Sasa was a quick text on the way to the hospital! It was 8:30 pm on Thursday, September 1, and a phone call right after the text help solidify that these contractions were different, and I should just make my way to the hospital.

Later I would learn that her contractions were different that evening around 5:00 pm, leading her to think it was the real deal. She didn’t want to trouble anyone unnecessarily by raising the alarms too soon or for nonlabor, so she waited. It was a wise decision to leave because Sasa was dilated 7 cm when she got to the hospital. Those second baby labors can really fly!

She breathed through the triage questions and the hep-loc setup which took a bit of doing and maintained her labor groove. Once she was shown to her room the call was soon made to have the tub setup for labor. Sasa felt back pain with her contractions, so I applied counter pressure and a heating pad. Tyler was always right by Sasa, encouraging her and believing in her.

By 10:15 that night the tub was blown up and filled with water, however it was a bit too hot, so some ice was dumped to tweak it to the optimal temperature. THEN Sasa was able to get in. She was feeling tired from her labor, so we gave her some coconut water and added encouragement. Labor always makes women tired but not letting it get in their head is the challenge. Sasa got out of the tub at 11:30 for something different, then labored over a chair through some contractions until she eventually found herself laying on her side in the bed.

Sasa exhaled “ooh” with her contractions as the pressure mounted at the peaks. “I don’t think I can do this,” she confessed at 11:00, but I reminded her that her baby was very close. Her voice continued to climb with the intensity and her growls were stronger. Shortly before midnight, changes in Sasa’s demeanor and voice hinted that she was pushing. Her midwife asked if she felt different, and Sasa confirmed that she was pushing. “Nothing helps anymore,” she said, and then rolled over onto her hands and knees before the next contraction hit.

Sasa’s midwife gave some verbal encouragement about how this birth was different than her first and she was doing amazing. It was important that she had a safe space in which to labor as she wished, and we all understood that. Sasa lay back down on her side and then rolled to the other, and then got up to stand at the foot of the bed. This birth seemed harder to her than her first and it might have been. It also might have been that she was in the hard spot between transition and pushing and many women give pause in that space as they wrap their heads around what is to come.

Sasa moved her hips back and forth and made the sounds she needed to make as she brought her baby down. We placed cold cloths on her neck while continuing to place the warm pack on her back. The midwife pulled the delivery cart near as Sasa pushed unmistakably just before 1:00. The midwife got dressed in the paper clothes and moments later Sasa’s water broke all over the floor. It was 1:19 and her baby was coming!

Nursery was notified as Sasa roared her baby to her perineum. She breathed and paused and was patient at the right time, and then brought her baby’s head out. The shoulders were next, but they took a little effort. But Sasa mustered all her strength and brought her baby out with the next push at 1:37 am!

Baby Lukas was passed through Sasa’s legs into her arms for her to get a look at him and take a moment to realize what she had done. Tyler was just as astounded and overjoyed as Sasa was, taking in everything as Lukas cried out. Once we helped Sasa upon the bed, Tyler cut his baby’s cord. This was not something he did the first time, so it was extra special.

Lukas weighed 8 lb. 8 oz., just 3 oz. shy of his brother’s birth weight. These boys were big for Sasa, but she did it! Lukas latched well and Sasa basked in the oxytocin that follows a particularly amazing birth. She felt different. I could tell she even looked different. Her midwife leaned in before leaving and told her what an amazing job she did. Sasa smiled to hear it and settled into to getting to know her son.

Sasa’s birth was a beautiful example of how every birth is different. Her birth journey was a healing one that allowed her to feel strong and heard, and one in which she had choices and respect, and the freedom to labor as she saw fit. She shined in that environment and under the supportive team that surrounded her that night.

Cierra and Tyler welcomed their second COVID baby on April 12, 2022. This second son served as a gentle reminder that not all babies will follow the same birthing pattern as their siblings, and not all pregnancies will run the same course. Cierra had a long labor with her first, due to a complicated position, and used an epidural to help with rest. She hoped to avoid it altogether this time, especially since she got it late in labor. She also went over a week beyond her due date the first time around so we all assumed she would do the same. It’s often the case, yes, but we were so wrong! 

Cierra texted me on Saturday, April 2, just past 5:00 am, nearly two weeks before her due date, to tell me she was bleeding and having contractions. She had managed to sleep some between and during, but it was getting more difficult. She called the midwife about an hour later who recommended they make their way to the hospital. They had quite a drive, and since this was the second baby, it was better to get to her safe place before things really took off. Later I would learn that she was awakened by her first born at 2:20 and she rocked him to sleep, went back to bed, only to wake up to contractions at 3:00 am.

In the car on the way, Cierra’s body continued to labor, and her contractions were steady at 5 minutes apart. Cierra arrived dilated 7 cm and I was by her side within 30 minutes. She breathed through each contraction as the minutes of the requisite 20-minute NST ticked by. Once the monitoring was done, Cierra made her way to the shower.

Cierra labored in the shower through just a couple of contractions and then was startled by the sensation of having to push. She got out and returned to labor upright on the bed. We tied a rebozo to the squat bar and she grabbed hold and breathed through the strongest contractions of her labor. She was feeling pain in her back so we applied counter pressure to try to ease it, knowing that ultimately birth was the best cure for it.

Twenty minutes later her water broke. It was 8:40, and Cierra labored standing in her husband’s arms and was pushing shortly therafter. Cierra climbed upon the bed and leaned over the cub where she followed her body’s instinct to bear down. She didn’t push long before welcoming her baby boy at 8:52 am! And he was so ready to sing his birthday song, he cried before his whole body was out! And his head was perfectly round since he spent such a short time low in his mom’s pelvis before being born. Sweet baby Christian Jase weighed 7 lb. 1 oz. and measured 19 in. long. (Although those stats would not be confirmed until after the magic hour he shared with his parents!)

Cierra leaned back and clutched her son to her chest. She had done it! And she labored with confidence and never even uttered a word of doubt to us. She hardly had time to, but she likely didn’t feel the doubt. Tyler was her solid partner and never wavered either, supporting her emotionally, and even physically at times, serving as her rock. And this makes my doula heart sing.

It was a privilege to bear witness to Cierra’s strength and Tyler’s steadfast support. It was also nice to see the staff give space and opportunity for Cierra’s birth to unfold unhindered. Cierra labored in whatever position she chose and birthed where and how she landed. Her midwife met her there, and the hospital support team was ready to help if needed but kept their distance. I love seeing this happen. And I hope to see it happen more.

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! 

Chelsea and Chris welcomed their second child, Daniel Charles, on November 5, 2021. I had been their doula with the birth of their first and looked forward to welcoming baby number two. But fate had other plans, or perhaps Daniel Charles did, as he made his debut on the final day of my out of town Spinning Babies Parent Educator training. Here are my written details of the events based on the notes and observations of the backup doula.

Chelsea’s body was gearing up in her last week or pregnancy. It also happened to be right around her 40th week, the same time she welcomed her first, so naturally, her radar was up. She felt a lot of pressure, as if her baby had moved deeper in her pelvis, and her exams at the end of pregnant revealed a completely thin cervix that was beginning to dilate. Her body was getting ready. In fact, on her 40-week appointment, she was checked and had a very, very thin cervix that was already dilated 4 cm. She declined a membrane sweep at that time, trusting labor would begin on its own and if it was meant to be that her son would wait for me, then he would. Turns out, Daniel was ready. And he didn’t want to wait for anybody!

Later that night around 9:22, ON her due date, by the way, Chelsea reached out to my backup doula to share that she had felt a few contractions. They were inconsistent and she didn’t think she was in labor, but she wanted to give a heads up. After all, her midwife had told her to leave for the hospital with any strong contractions that came closer than 10 minutes. The 5-1-1 guideline no longer applied. Those experienced cervixes can’t be trusted to follow guidelines and expectations! (Neither can first-time ones, come to think of it.) But even more important that that, Chelsea’s intuition as a woman and mother was telling her that this labor would be a fast one. And a mother’s intuition is a powerful force that is right almost every time.

Just over an hour later it became absolutely clear that her son was coming. It wasn’t so much from her contractions, although they were still there. Chelsea’s water broke! It wasn’t the “gee, did my water break?” sort of break, but the “oh wow! My water definitely broke sort!” They reached out to the backup doula telling her to meet them at the hospital. And they left almost immediately.

Just 40 minutes later at 11:10 pm, the doula arrived to find Chelsea being admitted. There was some meconium in the fluid but it was light and the baby’s heart rate looked stellar on the monitor. Five minutes later the midwife came in to do a cervical check and confirmed that Chelsea was dilated 7 cm! (already!) Her contractions were still inconsistent, bouncing around between 3 and 10 minutes apart. And Chelsea was the epitome of calm, resting on her side and talking casually to her husband, and with each contraction, pausing her conversation to squeeze his hand and breathe through it. You might not suspect she was as advanced in her labor, but her quiet focus was enough to hint at the hard work at hand. She was feeling significant pain in her back, which helped provide insight as she sought out labor positions that were predominantly forward leaning.

A short 20 minutes later, Chelsea’s labor had intensified. Her nurse began to prepare the room for delivery as the contractions moved to a consistent 3-4 minutes apart interval. Chelsea moaned lightly through them as Chris held her hand and offered her sips of water between. She would be meeting her son soon, but she maintained her gentle focus as the power of her contractions grew.

Just 15 minutes later at 11:45 pm, Chelsea said, “I feel like I need to push.” The nurse called for the midwife who skipped a cervical check in favor of sitting quietly on the bed and waiting for Chelsea to feel the strong urge to push her baby out. Chelsea still felt back pain, so as her urge to bear down intensified, she rolled over to her hands and knees to push. There was no counting, no direction, just trust and patience as Chelsea moved and pushed into the growing pressure within her uterus. Her body told her what to do and when. She did not require any guidance from anyone.

Chelsea began pushing in earnest, and her midwife suggested she try a side lunge. And by 11:53 pm she was pushing mightily with each contraction. The midwife gowned up and everyone took their places. Nursery was called soon after as Chelsea continued to bring her baby down to her perineum. And at 12:05 am on November 5, 2021, her baby was born after just 2 ½ hours of labor!! And just 5 minutes after the end of her due date, no less.

Chelsea grabbed for her baby as the midwife passed him between her legs, and then turned back onto her back upon the bed. It was then that she and Chris realized they had a baby boy! This baby had been a surprise gender! Daniel struggled to breathe initially, most likely due to excess fluid that can remain after a precipitous birth like his. The meconium was an added concern, so he went to the nursery for some initial close observation but was returned to his parents within a couple of hours. 

Birth always teaches us things. Chelsea’s second birth reinforced the value of a mother’s intuition and her trust in her body. It reminded us that birth workers need only stand by unless needed. And it taught me (reminded me!) that my clients don’t NEED me. They don’t NEED anyone. They only deserve steady, attentive support. I don’t use the word support to infer there is a need fulfilled, but rather in the meaning of support by simply being present and affirming Chelsea’s steps on her birth journey. For the work of birth is done by no one but the person birthing. And Chelsea did a fine job of it, regardless of who was there.

Jaclyn and Jason grew their family by two cute little feet on May 12, 2021 with the arrival of their daughter, Madison Rose. This was our second birth journey together so I had an inkling about her. She gave birth to her son a few years prior in an unmedicated, fast and furious induction. This time around the concerns centered less around coping with labor and more around getting her son taken care of so she could leave with plenty of time to get to the hospital. It would be nice to have some time to settle into labor, but the realty was that things would likely go quickly again. And true to form, Jaclyn’s cervix dilated in the weeks beforehand finding her opened 3 cm at 38 weeks. 

Her body hung on for almost two more weeks, with bouts of contractions that had her radar up. Until I got the text at 1:55 am on may 12. The text simply said, “Having some strong contractions. Talked to the midwife. Going in.” We timed our arrival to the hospital to be in sync and rendezvoused in front of the hospital and proceeded to the family maternity center together. Jaclyn was dilated 5 cm and 100% effaced but acting like she was farther along than that. Her nurse went about admitting Jaclyn, trying to time her questions between contractions. Jaclyn had a difficult time laboring in the bed on her back so we encouraged her to move as she felt led. Hands and knees was the go-to, just like last time, but it is also the most challenging to get a steady read of a baby’s heartbeat. Those monitors ended up staying strapped around Jaclyn’s belly the rest of her labor, as it turned out!

Jaclyn got nauseous and threw up, then felt like she had to use the restroom. She was working up a sweat and shaking all over. This was a woman in transition and we knew it. Jaclyn tried to use the bathroom at 3:43 and we edged in closer to the bathroom door just in case the baby came. She bore down and I asked her if she felt burning and she said that she did. Burning equals baby! So, the nurse called the midwife in as we helped Jaclyn make her way back onto the bed. 

Jason pressed on Jaclyn’s sacrum as the midwife pulled the delivery cart up to the bed. And Jaclyn pushed out her baby with great control, easing her out bit by bit from the crown. And her sweet Madison Rose was born at 3:53 am and passed into her mother’s hands. Jaclyn had only been at the hospital for an hour. And she flew from 5 cm to baby in that time.

She gathered herself as she looked down at her baby. Jason and Jaclyn were immediately taken by their daughter and expressed their love for each other and another miraculous birth. The wonder on parents’ faces upon first seeing their child is such a delight to behold. I am always honored to be there to witness those moments. 

There was a lot of snuggling before the nursery nurse returned to get Madison’s stats. She weighed 8 lb. 6.8 oz. and measured 21 ½ in. long. And she didn’t even cry during her shots! We did laugh when she cried during footprints though. Madison latched when she was ready, guided by her mother’s confidence and experience. Through patience, Madison found her way. I gathered my things once everything was settled so Jaclyn and Jason could get some rest consequently right as the sun rose. 

I left the birth thinking about what a crazy year it had been. We were on the verge of some changes in pandemic protocols and lowering of social distancing and mask-wearing restrictions. And they couldn’t come soon enough. I have seen women do hard things over the years but this past year has brought an entirely new level of challenge. And I hoped Jaclyn might be the last client to wear a mask through her labor. Jaclyn did it though, and will always have the distinction of giving birth during a pandemic. Let’s hope there won’t be too many more of those as the weather warms and the rules dissipate. Welcome to the world, Madison Rose! You are very much loved!