Maria and Kent welcomed their third baby girl on July 26! I’ll never forget when I first met Maria. She expressed to me that her first two births were less than ideal. She had two beautiful daughters whom she loved, but her birth experiences left her feeling a bit disappointed. She said, “I just want my ideal birth, and this is my last chance.” (No pressure!) We talked about how she wanted to FEEL her birth. She wanted to experience it differently than her others. Maria had a strong desire for natural childbirth and hoped to avoid Pitocin and an epidural. She enrolled in my 2-week refresher class to prepare the best she could, while simultaneously caring for her two young children. And perhaps most importantly, Maria chose providers who believed as she did that her body was strong and capable, and that birth was a natural process that didn’t necessarily need help. She also filled her mind with positivity and the strong belief in her body’s ability.

Maria felt a lot of uterine activity. Her body was gearing up for the big day with bouts of contractions that left Maria tired and wondering. Her cervix was changing week by week. At her 40-week midwife appointment she was dilated 4 cm. She agreed to a membrane sweep, but little came of it. Maria was patient and waited to see what her baby would do. Then a few days later, I got a text at 2:20 am that her water had broken. Since it was late (or early, depending on how you look at it), Maria tried to rest. Her midwife encouraged her to stay home and rest until her contractions picked up.

About 2 ½ hours later, Maria reached out again with frequent contractions that kept her awake. Her midwife felt it a good time to head to the hospital. Within the hour, Maria was settled in her room and dilated 5 cm. She was breathing calmly through contractions but working. Since they detected meconium at the hospital, Maria would be on the monitor for the duration. She focused on her body and not the straps, and stayed positive. Kent went home to help with the bedtime routine but returned a short while later. And there was a FaceTime call or two as well. Maria’s baby was about to be a big sister! The thought can be mind boggling.

At this point it had been about 9 hours since her water broke and her contractions were not very strong yet. Her baby was in the OP position to boot so she might need some help to interface with the cervix. Maria’s midwife respected her desire to avoid Pitocin if at all possible, and instead recommended the regimen of an enema and a breast pump. Maria had some lab work that came back a little concerning so she would be relegated to the bed, in addition to the monitors. But Maria did not let this dissuade her from her goal of movement. Instead, she made good use of the bed, taking advantage of its various shapes and the squat bar to remain upright and mobile.

And the regimen worked! The enema and pump gave Maria’s uterus the little nudge it needed to kick labor into high gear. And things ramped up quickly. Maria labored over the birth ball on her hands and knees, rocking back and forth in the hope her baby might rotate. Then she labored on her side with the peanut ball between her legs. It was just past 2:00 pm and it was evident that her contractions were much stronger. Maria exhaled sighs as her uterus balled up with great intensity.

Twenty minutes later she was dilated 7 cm, 100% effaced, and her baby was at -2 station. There was also a forebag and her midwife broke it with Maria’s consent. The nurse set up the delivery table and Maria’s contractions were consistently 2 ½ to 3 minutes apart. They were in the sweet spot and would be meeting her baby soon.

By 3:12 that afternoon, Maria was doing a lot of bearing down at the peaks of her contractions. She moved to her hands and knees over the peanut ball since she felt like she was clenching on her side. Then at 3:22 she felt lots of pressure to such an extent that she had difficult differentiating between contractions. She was in transition, the place where it feels like there are no breaks! Maria gave herself a pep talk through each contraction, saying, “Ok, ok, ok, I’m ok, I’m ok.” At 3:29 she felt like she had to push, but as it turned out there was still time to labor down.

Maria was upright over the head of the bed and by 3:55 she was sitting up holding the squat bar. Her midwife returned to the room, quietly watching and waiting. An exam at 4:15 confirmed Maria was dilated 9 cm, but she wouldn’t be for long. She reached for Kent’s hand, and continued to breathe through each contraction, allowing the fullness of a low baby to relax and open her even more. And then it happened—Maria was pushing full stop. And she didn’t push long, less than 10 minutes. And as her baby’s head crowned, Maria yelled out in a visceral and powerful way!

Her baby’s head was out, and the midwife moved the nuchal cord aside. But Maria’s baby didn’t slide right out. The shoulders were big and wide and required a lot of effort by Maria and her midwife as her baby made her way out. Maria was so overwhelmed with the sensation of her baby coming out that she screamed out. I looked her in the face and reminded her to push, and Maria returned that focus and pushed with equal measure of strength and yielding. And at 4:36 pm, Maria’s baby was born! With the baby in her hands, the midwife called out, “I need some help here,” as she hoisted Maria’s baby up toward her. Maria grabbed up her daughter with the strength of a warrior, for that indeed is what she was.

Oh the cheeks! And the shoulders! All the rolls! Baby Eleanor needed some breathing support at first as she transitioned to breathing air, but she came around quickly. It turns out she rotated out of OP at the very end and even though she was a chunky girl, because her mom yelled out and paused in her pushing as a result, she did not tear! And this baby girl weighed over two pounds more than her sisters! Eleanor weighed 10 pounds, 6 ounces and she measured 21 ¼ inches long. She had dark hair on her head that came down to her forehead, and she even had dark eyebrows to match. She was beautiful and perfect, and such a triumph in so many ways.

As things settled down and Maria began to process what she had done, she was awash in peace. She looked at me and with certainty told me she got her perfect birth. And how! Maria discovered what she always knew. And she did it in such a big way. (no pun intended) I am extremely proud of this woman! And I’m happy to say she is proud of herself too.

The Birth of Eleanor Kate 7/26/21