Leila and Keithen welcomed their first child together, a son, on September 19, 2021! Leila had a strong desire to feel empowered, heard, and supported in her birth, like she was an active participant in the process. She had a loving partner in Keithen who wouldn’t leave her side, but she knew the benefits of a doula were backed by evidence and so they incorporated me, as well as chose an OB practice with a low c-section rate in the hopes of making the likelihood of a surgical birth slim to none. They also enrolled in my childbirth class to be as prepared as possible for a birth they couldn’t predict.

Leila’s contractions began midday on September 18. She was ignoring and trying to rest, but the contractions persisted. She also felt a lot of pressure in her bottom which was alarming and seemed to point to the real deal. The contractions escalated in intensity and moved to 3 minutes apart, so a call to the midwife confirmed it was a good time to head to the hospital.

When I met up with Leila and Keithen in triage, Leila was breathing deeply through each contraction, laying in the bed consciously softening the parts of her body she could so as to get through the required 20-minutes on the monitor. The midwife checked Leila and she was 2 cm, a number much lower than she envisioned based on the strength of her contractions. But her contractions were close and strong so we hoped her body would catch up to that once she was settled in her rightful room and completed the admissions process.

Leila labored hard for another hour, using the birth ball and moving into various positions. Surely things were changed after all she had felt, but her cervix remained 2 cm. Leila decided an epidural was the next step. For whatever reason, her labor was taking it’s time and she already felt depleted after contracting much of the day. Th baby’s heart rate dipped post-epidural, which tends to happen. Then Keithen leaned in and spoke to his son in utero and the heart rate returned to normal! Leila’s blood pressure remained low so we gave her some juice and oxygen in the hopes it would improve.

A couple of hours later, Leila was dilated to 3 cm, a modest change, but thank goodness it was a change. She struggled to quiet her mind and about an hour later was able to sleep. Leila struggled to rest through the night. The new day brought a new midwife who established that Leila had dilated to 5 cm. Pitocin was used to bring on stronger and closer contractions, and several hours later around lunchtime she had opened to 6 cm. She was also 100% effaced with her baby at 0 station.

The epidural was less than perfect, requiring Leila push the PCA button and ultimately a bolus added to the line. We helped her rotate from side to side, strongly suspecting her baby’s position was somehow off. It just HAD to be. We did a side-lying release and got creative with the peanut ball to open her mid-pelvis. 

Two hours later, Leila remained 6 cm dilated. So we tried putting her bed in trandelenvurg along with some increased Pitocin and continued position changes. By the afternoon, her baby’s heart rate was showing dips that could be a sign of rapid progress or a sign that baby was getting tired. And a cervical exam revealed Leila was dilated 8 cm! This was very encouraging so as Leila’s contractons became more painful, we were hopeful it just meant it was almost time to push. Two hours later she was 9 cm and her baby was at +1 station, so she was moving in the right direction, albeit surprisingly slowly. With a lip of cervix on the anterior side, we made sure Leila was positioned in such a way as to encourage baby’s head to melt the cervix away. 

Her baby’s heart rate tumbled again, bringing in some extra people and some new strategies. The midwife tried having Leila push as she pushed the lip aside but it wouldn’t budge. They lowered the Pitocin to give baby a breather and allow the heart rate to stabilize. And about 45 minutes later, Leila was fully dilated! It was time to push! Leila was ready and she gave a strong push with the next contraction. But her baby’s heart rate dipped very low. She breathed deeply to allow for some recovery, and then she pushed with the next contraction. But the same thing happened—her baby’s heart rate fell very low. Every push had the same effect, and her baby was not recovering quickly between the dips. 

The doctor and midwife had an honest conversation with Leila, and it was clear what was the safest route for her baby. It wouldn’t be easier. It would be harder. Leila would welcome this baby in a c-section birth. She cried over the change but she also knew in her heart it was the best decision for her baby. The Pitocin was turned off, and soon each member of the birth team paraded in to introduce themselves and make sure Leila and Keithen had all of their questions answered. 

They didn’t wait long before going to the OR. And sweet baby Jude was born at 7:14 pm! The mystery of Leila’s labor was solved when the OB confirmed Jude was in the OP position AND had the umbilical cord around his neck. It made it more challenging for him to make the necessary rotation at the end, that’s for sure.

When Leila, Keithen and Jude were together in their postpartum room, they got to know each other as Jude latched for the first time. He was a peanut weighing 6 lb. 11 oz. and measured just over 19 in. long. Next to petite Leila, he didn’t look very small though.

Leila and Keithen journeyed to meet Jude with love and discernment. I thoroughly enjoyed how loving they were, and noted so many ways Keithen cared for Leila in her labor. I had no doubt she would be in excellent hands as she recovered and healed at home. Leila exemplified to me the true spirit of letting go in labor, loosening hold of the birth she envisioned almost from the very beginning. But she was always, every step of the way, informed, included, and supported. She had a voice and she had choices. And that made all the difference.