Alex and Josh’s first journey to parenthood ended in preterm loss that was difficult, but also only intensified their desire for a child. Her second pregnancy progressed well, but in consideration of her previous loss, if she didn’t go into labor on her own at a certain point, her providers felt it best to induce labor and keep a close eye on the baby. Alex advocated to move the induction a week later and her providers obliged. Her hope was that labor would happen on its own. And that’s what happened!

On August 18, Alex noticed her body gearing up with contractions. They came and went for a couple of days until the middle of the night on Sunday, August 21. They were every 4-5 minutes and lasting a minute, some coming closer than that. Alex and Josh remained at home laboring another six hours before heading to the hospital. Their timing was so wise because once they arrived, Alex was dilated 4-5 cm, 80% effaced, and her baby was nice and low at 0 station.

When I entered the room, Alex was still smiling and had the NOVII monitor on her belly. It glowed kind of like ET, except blue. It was the tool that allowed for freedom of movement and hydrotherapy even though her baby was monitored for the duration. Alex breathed calmly through her contractions that had quickly moved to 2-3 minutes apart, some drifted to 5 minutes. “Ooooh,” she exhaled confidently with each surge.

Alex moved through many positions. She labored on hands and knees, then sat upright on the bed like a throne, using gravity to her advantage. She stood beside the bed and leaned forward as relaxing and inspiring music played in the background. Her contractions spaced apart during this time, which had us wondering if there might be a positional issue with baby. Just before 2:00 pm her doctor did an exam and confirmed she was dilated to 6 cm, however baby felt higher. Alex was not discouraged and continued her active laboring.

She stepped it up and did lunges and dangled with the rebozo, squatting back onto Josh, her loving and steadfast partner through it all. She did hip swirls on the birth ball and posterior pelvic tilts. She labored on her hands and knees over the CUB again, this time incorporating lunges. The nurses changed shifts into the evening and a popsicle was a gift from Heaven for Alex at just the right time. She indulged in a second one.

Alex continued her labor cycle with hands and knees on the bed and even labored laying on her side for some rest. She stood and swayed beside the bed and just past 8:00 pm had another exam and agreed to have her water broken. Alex was dilated 8 cm (at 8pm!), but baby still felt high at -3 station. There was also light meconium. Alex returned to the rebozo tied over the door and dangled through contractions to encourage her baby to move deeper into her pelvis. We also did a side-lying release to see if that might create more space.

Next Alex labored in the shower and stood strategically to allow the water to bring on stronger contractions via nipple stimulation. I placed votives in the shower and some essential oil on a washcloth to create a calming environment where she could really tune into her body and tune out everything else. The baby had a dip in heart rate during the shower and since they had trouble getting a steady connection with the fetal heart rate, Alex exited the shower and labored on land.

At 10:00 that night she was dilated 8 cm, or perhaps only 6-7 cm. Baby was a little lower at -1 station. We shook the apple tree with the rebozo (to loosen and relax her pelvis and perineum), and she returned to lunges. After the rebozo work, Alex’s contractions were closer again. But she was getting tired, so she lay back down on the bed with the peanut ball between her legs for some rest. It wasn’t easy but it did allow for some “rest.” The contractions spaced again but felt stronger. So just before midnight since her cervix was the same and the contractions had drifted apart to 9 minutes, Alex agreed to some Pitocin. They began at the lowest dose. Alex labored in the flying cowgirl position, and then felt some new pain in her right hip. We wondered if her baby might be trying to figure himself out in there. A heating pad helped relieve the pain in her right hip.

It didn’t take long for the contractions to jump back to the 3 – 3 ½ minutes range and some even closer. So, Alex got back up and did some lunges and then walked her hip out. We then used the bed to mimic a throne so Alex could use gravity again and she felt a difference in the pain—it was more in the front and back rather than on her right side. This was encouraging. The Pitocin was increased again, and we dabbed Alex’s face and neck with a cold cloth.

Then she had the feeling like she had to poop, which told us perhaps things had changed! It was just before 3:00 am and it prompted an exam. And Alex was 8-9 cm and her baby had moved down to -1/0 station. She continued to breathe calmly through each contraction and resumed her circuit of movement. Josh was an emotional and spiritual support to Alex, telling her to “breathe in Jesus and breathe out Josiah.” He also prayed over her. I found Josh on more than one occasion reading Scripture or praying throughout labor.

An ultrasound was used to try to figure out baby’s position since labor had been so gradual, and he was looking somewhat transverse to Alex’s right. So we did some belly sifting. The baby’s heart rate started to show some dips that were concerning so the Pitocin was also turned down by half. Since labor had been so gradual and Alex was getting very tired, she took the recommendation to get an epidural. The hope was that she would get solid sleep and perhaps something would relax in her pelvis and allow her baby to make the adjustments needed.

There was a delay in getting the epidural since the anesthesiologist was in the OR for a c-section. But eventually, after 2 hours and 2 different people trying, Alex got the epidural and hoped for some relief next. But that isn’t exactly what happened. Not too long after, her baby’s heart rate dipped. They shifted her position to improve his heart rate and it helped, but it dipped again. A constellation of concerns all came together that brought the medical team in to speak with Alex and Josh about next steps. She had been dilated 8 cm for close to 10 hours without progression, and her baby’s heart rate was displaying some signs that perhaps he didn’t have the stamina to withstand labor much longer. The recommendation was made for Alex to have a c-section.

This is never an easy decision. Alex asked the questions and sorted through the answers. There was no doubt she worked with her body and did all the things to coax her baby out. The flow of staff constantly complimented her on her control and how calm she was through her entire labor, but for some reason her baby wasn’t descending. Alex decided to move forward with the c-section with Josh’s full support. She cried, not tears of disappointment, but grateful tears knowing she had assembled a team that did everything to help her baby to be born vaginally. It didn’t take long before she and Josh were in the OR meeting their baby.

Josiah was born August 22, 2022 (8/22/22!) at 9:45 am, weighing 6 lb. 11 oz. and measuring 20 ¼ in. long. He was perfect and worth every bit of the journey. He is a gift from God, their sweet rainbow baby. Alex’s postpartum wasn’t without its complications, but at the time of our postpartum visit she was doing well and sorting through the early newborn issues of reflux and colic with Josh. Once again, they have assembled themselves a team of support to find the answers they need. It takes a village, that’s for sure.

The Birth of Josiah Emerson 8/22/22