Ezra Mendel entered the world on April 4, 2021, perfectly timed on the last day of Passoover, promoting Jessica and Marc to parents! Marc sent me a text one minute before midnight of Jessica’s due date, to say that contractions had been coming for 40 minutes of varying intensities. It was just a heads up sort of text as they were still trying to sort out whether it was labor. After I reminded them to hydrate, get in a warm bath, rest and not to pay too close attention, we waited to see what the night would hold. Just two hours later, the contractions were stronger and closer and Jessica was feeling nauseous. This seemed to be labor! Her contractions were closer than 5 minutes apart and escalated quickly in a short time. 

When Jessica threw up, we thought a call to the midwife was in order. And with the blessing to head in, they were out the door. Just before 4:30 am, Jessica was confirmed 2 cm dilated and her baby’s head was at -1 station. Her blood pressure was high so there were tests to run, but Jessica continued to move along in her labor. Just 90 minutes later she was dilated 3-4 cm and definitely being admitted to have a baby. Some iv medication aided relaxation as Jessica waited for a room. It was a busy birth-day!

Shortly before 7:00 am, right during shift change, Jessica’s medication was wearing off and her contractions were growing in intensity. Her baby was in the OP position and the pain in her back was intense. An epidural was the plan since it would help with the pain and also lower Jessica’s blood pressure. She was brave as she sat through the procedure, and it was quick and effective. An hour later she was dilated 5 cm. 

The midwives changed shift as the nurses did, bringing someone new. And it happened to be Jessica’s favorite midwife of the group! Ezra’s heart rate dipped a bit lower than normal ranges, so some oxygen and position changes helped in the interim. Jessica moved side to side, but since she had pretty good leg control, we had her labor on her hands and knees for a period of time. And just two minutes later her water broke with a splash! There was some meconium, which would bring a few extra people to the birth. And it might be sooner than later since Jessica was dilated 7-8 cm! Since her baby looked good on the monitor, the midwife assured Jessica and Marc that they were comfortable with everything and had no plans to change “the plan”. 

Continued position changes using the stirrups for a time and then the peanut ball, laying down and sitting up, really helped to complete Jessica’s dilation. And just before 5:00, feeling lots of pressure, Jessica began to push. Her baby’s heart rate was reacting to the intensity of labor as well, so pushing was a good idea for him too. Jessica was an excellent pusher and her baby’s heart rate rebounded between contractions like a champ. Jessica smiled as she pushed from behind the oxygen mask, overcome with the joy and excitement of meeting her son in a few short minutes.

At 5:12, she reached down and felt her baby’s head with her own hand. She had moved her baby down so quickly, from 0 station to +3 station in just two pushes! Jessica stayed the course and the nursery staff was called in shortly. And just 3 minutes later, Jessica and Marc welcomed their son, Ezra Mendel at 5:25 pm! When Ezra came out, a fountain of fluid followed him, spraying out in a dramatic way that left its mark on the floor and the midwife’s scrubs. He was pink from head to toe (literally) and rest against his mom’s chest before taking a quick trip at the warmer. He was returned to his mother’s arms soon after and Jessica didn’t let him go for over an hour. And for the record, he did manage to rotate into the OA position for birth, thanks to his mother maintaining her mobility even with an epidural. 

Ezra weighed 8 lb. 7 oz. and was so completely loved. Jessica and Marc noticed hairy shoulders, long fingernails, and even a dimple. He stuck his tongue out like a lizard and his parents were completely taken by him. When he was ready he latched and had his first feed as his mother looked adoringly on. This couple were beautiful partners and I am so proud of how they navigated the strong, choppy waves of labor. Welcome to the world, Ezra!

Rachel and Bruce became parents on March 9, 2021 as they welcomed their daughter, Eliza Mae, in a most surprising and keep-you-on-your-toes-guessing-all-the-while sort of birth. They were educated and ready, having attended my in-depth childbirth classes. And Rachel was the oldest of 8 children so she had some insight into becoming a mother. But this would be her first go. And if we know anything about birth it is that we cannot ever know for sure how it will unfold.

Rachel’s guess date of March 1 came and went and she tried to remain calm and patient. I didn’t hear from her really until she was 41 weeks and looking at an induction in a few days if labor did not happen first. She wanted any tips for starting things up and I reminded her that nothing would do it if her body wasn’t ready, and encouraged the relaxation benefit of massage and discouraged the pressure of the massage starting labor. Exercises to optimize her baby’s position were wise as was going for walks and spending time with Bruce in the final days. Labor would start if it was time and it wouldn’t if it wasn’t. And all of the trying to get it to start wouldn’t help and would actually possibly delay labor even further from all of the stress. Rachel took the advice with plans to wait.

But less than 24 hours later the text came to my phone. It was 6:55 am on March 9 and Rachel had been feeling contractions for 3-4 hours that were finally regular, just not consistent. They were mostly not too strong so I encouraged her to rest as long as possible and only do the minimum to get through them until her body required more. She had an appointment at 2:30 for an NST and ultrasound and wondered whether she should go in. Meanwhile, the plan was to do the Miles Circuit to help baby settle into position, and use comfort measures as needed. Several more hours of inconsistent and not too strong contractions, and a call to her midwife confirmed she was to report to her appointment. Turns out she was dilated 4 cm, 80-90% effaced, and her baby was in the OP position. The ob also swept her membranes in the hopes it would get her labor into a more productive pattern. Rachel returned home and her contractions quickly escalated.

Even with steady and strong contractions, Rachel attempted another round of the Miles Circuit in the hopes her baby would move from OP to OA. She had been contracting all day and was ready to meet her baby. But with contractions only 2 ½ minutes apart, lasting a minute, there was not a lot of rest time between and Rachel still wasn’t sure. I recommended she call the midwife again and possibly head back to the hospital. After an hour of contractions at that interval, they spoke with the midwife who said to head back in.

The car ride was awful, but it always is awful in labor. And since Rachel had been laboring so intently over the phone, her midwife arranged for them to go straight to a room bypassing triage. Rachel was seen to her room and climbed upon the bed for an exam. Her midwife did the exam and said, “Well you’ll be glad to know you are fully dilated.” Talk about a shock! It was about 7:15 pm and Rachel had been there a few hours earlier dilated just 4 cm! 

Her nurse worked on admitting her into the system and preparing the delivery cart and everything else that needs to happen beforehand, while Rachel worked through very intense contractions all while laying for the requisite initial monitoring. Her water broke 10 minutes later at 7:27 pm and she was pushing a few minutes after that. A few minutes later Bruce texted me back to confirm I should come to the hospital. I left quickly and was there in 10 minutes but it would prove to be just a smidge too late…

Rachel was a great pusher and moved her baby quickly down to birth. The heart rate dipped too low for comfort and there was talk of maybe having to take measures to encourage a more rapid birth. Rachel wanted none of that and so instead she pushed like never before and her baby was crowning in no time. She pushed with such strength and brought her daughter into the world at 8:10 pm! She was born strong and vigorous after that initial cry, and I walked in the room one minute later to find Rachel clutching her newborn baby girl and trying to catch her breath. She was happy and relieved, I could tell that even from behind her mask. (Yes, she wore her mask while pushing. Amazing.) Eliza weighed 7 lb. 15 oz. and measured a lanky 22.5 in. long.

It was remarkable how much her labor changed in so short a time, bringing Rachel from 4 cm to birthed in just under 3 hours. But make no mistake, shorter is not easier. Not in childbirth. Rachel was a champion at stepping up to the task as her contractions ratcheted higher. And we’ll never know how Eliza managed to rotate in the end after being persistently OP, (Rachel’s erratic and slow to progress labor had OP written all over them), but we suspect Rachel’s diligence with the Miles Circuit had something to do with it. Or maybe it was the membrane sweep that intensified the contractions right when Rachel (and Eliza) needed it most. Perhaps it was the feeling and listening to her body that helped Rachel welcome Eliza far more than the knowing and doing that had led her up to that point. All of the red raspberry tea, pineapple, eggplant, spicy food, dates, etc in the world won’t coax out a baby who simply isn’t ready. It was patience and diligence that made all the difference. Congratulations on the surprising and wonderful birth of Eliza Mae! You rode the waves of your labor like a pro.

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!

Gabriela and Michael welcomed their daughter Aurelia Autumn on September 17. Gabriela had a medical reason for induction which had her at the hospital at 39 weeks. But she was open-minded and trusted her providers and she trusted her body. It would know what to do. After all, her body had been making some progress behind the scenes. It was dilated 3 cm at the start of the induction process. After talking through options with her midwife, the decision was made to begin with Pitocin and go from there. It was a gradual start with the dose slowly increasing until labor took hold. And several hours later, even though Gabriela was shaky and queasy, her cervix remained 3 cm dilated. She was 80% effaced though and we were hopeful things would kick into gear soon. 

About 90 minutes later, at 2:30 pm, Gabriela was contracting every 2 – 2 ½ minutes and having to breathe and focus. Her midwife stopped in to do an exam and confirmed that Gabriela was dilated 4-5 cm. They decided to break her water to keep the momentum moving forward and that is what really pushed her over the threshold into truly active labor. We first heard some sighs as Gabriela exhaled and she grew less patient with things. “I’m over these,” might have been uttered from her mouth between contractions. Things appeared to be moving quickly and Gabriela surely felt that way. But at 6:10 that evening she was dilated 5-6 cm and 90% effaced. She moved to her hands and knees to labor with more painful contractions, but it was a challenge to keep her baby monitored. So Gabriela turned over and reclined in the bed. She continued to exhale her sighs and dig deep as her contractions mounted higher. “I need something,” she told us. And then on the heels of that she growled, “This baby’s coming!” A quick check confirmed she was dilated 8 cm and her baby was at 0 station. It wouldn’t be long now! Gabriela grew nauseous and threw up as the midwife opened up the delivery table. And five minutes later she was fully dilated with her baby at +1 station.

Gabriela pushed in a variety of positions and even incorporated the rebozo. Clearly, her baby’s position was less than optimal, making her work much harder in second stage than expected. It would explain how incrementally she had dilated as well. After pushing nearly an hour and a half, the OB came in to evaluate and explore options. Mention was made of a possible vacuum assisted delivery, but just the mention of it seemed to be all Gabriela needed to actually NOT need it. The doctor’s face brightened as Gabriela pushed her baby into view with impressive commitment and vigor. And she brought her baby into the world a few contractions later at 9:31 pm. Aurelia was born with a head full of black hair and had rotated into the OA position. She was perfect, and she weighed in at 7 lb. 11 oz. and measured 20.5 in. long. 

Gabriela saw her natural birth through. And Even though she had to be induced. Even though she endured Pitocin. Even though her baby was a bit off kilter inside. Even though there was talk of a possible vacuum (and even a c-section)!  Even though she was surrounded in masked faces while a pandemic raged around the world. Even in spite of all of those things. Gabriela did it! And Michael stood strong by her side every breathe, every contraction, every stage. What a great team!

Aurelia Autumn now