The Birth of Aspen Glori 10/8/22

Melissa and Mike met their sweet baby girl, Aspen Glori, on October 8, in what can best be described an exercise in patience and letting go. Melissa and I hit it off right away and she was forthcoming to me on her strong desire for an unmedicated birth. With her due date a few days away, she hunkered down to wait. There was talk of an induction if she went much past it, but she hoped it wouldn’t come to that. But when she texted with contractions October 6 it seemed perhaps her baby would circumvent any need for induction. They had begun the previous night and never quite went away until the following afternoon around 3:00. Melissa learned the importance of resting and her contractions drifted off as she did.

Four hours later she texted she thought her water might have broken. You’d think it would be obvious like in the movies, but it often isn’t! Melissa waited a few hours and on the recommendation of her provider, she went in to the hospital that night to get checked in labor and delivery to see if her water had broken. It was inconclusive whether her water had broken, but the there was enough of a concern regarding the color of the fluid to warrant induction. Melissa didn’t want to go that route, but she decided to stay at the hospital where they could monitor her baby.  She was dilated just 1 cm so they had plans to eventually ripen her cervix but thought it best to let her rest as well as she could overnight. (So kind of them!)

When they checked her the next morning, October 7, Melissa was still dilated 1 cm, however she had thinned from 40% to 100%. The plan was to start with oral Cytotec. Melissa’s contractions were still sporadic so they would need to get more organized to make cervical change. It didn’t take but two doses of Cytotec for Melissa’s contractions to get consistent and strong. They were 2-4 minutes apart by 2:00 pm and she was wondering if she might need some pain management help.

It felt like the right time to head in so I was there just before 3:00. Melissa was sitting in the rocking chair breathing through contractions. She had significant back pain, so she moved to her hands and knees over the cub birthing chair and Mike began applying counter pressure there. By 4:09 pm Melissa was dilated 2-3 cm. The next move was to labor in the shower, but she wasn’t in there more than 20 minutes before wanting to try something else.

Melissa used the rebozo tied over the door to dangle squat through some contractions in the hope it would bring her baby girl down lower in her pelvis and further dilate her cervix. But the pain was becoming overwhelming and an hour later Melissa decided it was a good time for an epidural. The CRNA had the epidural completed by 6:15 that night. Melissa rested but continued to move into various positions with our support using the peanut ball. She was dilated 4 cm, 100% effaced, and baby was at -2 station by around 7:45 pm.

The consensus was made to begin Pitocin. And after discussing it with her doctor, Melissa was feeling much better about it. It is administered gradually and only to the level her body required for consistent contractions that produced cervical change. Melissa was grateful for the doctors who were on call for the duration of her labor because she felt heard and like she had a say in her care. That is so very important.

We used the peanut and stirrups in various ways and had Melissa in a myriad of positions. But 5hours later she was still 4 cm with some anterior swelling. She also felt some back pain, which was surprising. An IUPC helped measure the strength of the contractions to make sure the appropriate level of Pitocin was used, and by 1:00 am everyone was trying their best to sleep.

Every once in a while, we would change Melissa’s position, including the flying cowgirl which can often be a game changer when baby’s position is less than optimal. And after all this time, it was certainly the case that baby was being creative in her positioning.

Baby had some decels in her heart rate that were concerning around 3:30 am, but a change in position helped that. And by 4:10 the contractions were more regular and as a result, by 4:30 Melissa was dilated to 6 cm! This was exciting news but with her baby still at -2 station her doctor was still concerned. Melissa anointed herself with essential oils to provide emotional support as she navigated the uncertain turn of her labor. It had been a long night and the possibility of a c-section had been mentioned.

After more creative positioning with Melissa (to help her baby’s positioning NOT be so creative!), Melissa was still dilated 6 cm 2 hours later. There was a decision to make and here is where the provider makes all the difference. Melissa knew she loved and trusted the doctor who had overseen her care and knew the incoming doctor might not be on the same page. With signs pointing toward a c-section, she chose not to delay it to the point of the next shift and rather decided to consent to it under the watch of the same doctor. She promised to stay past her shift to see it through, for which Melissa was most grateful.

Melissa mourned the change in plans, and even expressed frustration at the situation. But she was at peace ultimately with how things came together and with the team she had effectively chosen to welcome her baby into the world. Aspen Glori was born without complications by c-section at 10:06 am, surrounded by her mom’s chosen team. However, she was solidly OT and a solid baby weighing 8 lb. 9 oz. It appeared she was born the way she needed to! She was also a lanky 21.25 in long. Where Melissa put that baby in her small frame I’ll never know.

Aspen was skin-to-skin in the OR and had her first latch at barely an hour old. In the hours following, talking through things with Melissa, it was clear she had a mindful birth. She processed her feelings every step of the way, made decisions that she felt were right and that her provider supported and respected. And I can happily say at our postpartum visit she and baby Aspen are absolutely thriving. I am so proud of Melissa owning and embracing her baby’s birth the way she did.