When I first met Kaitlyn, I was struck by her bright blue eyes. They are windows to the soul, so they say, and if that’s the case, then Kaitlyn showed me a heart full of love and excitement for the upcoming birth of their daughter. Bobby struck me as a quieter steadfast counter to Kaitlyn’s effervescent and talkative nature. But his unfailing love for his girls was clear. Kaitlyn admitted reservations with her providers at our initial meeting and left our interview intent on making a switch. And it wasn’t long afterward she had aligned herself with a practice that was more in keeping with her idea of birth. There was a big exhale from all of us when that happened.

The timing couldn’t have been better either since Kaitlyn’s baby had shown some concerns on ultrasound that would almost definitely result in an induction. Kaitlyn and Bobby advocated for as much time to go into spontaneous labor and as little intervention as possible should induction become the plan. And with open communication and good preparation, they were ready for whatever little Malia’s journey earthside would bring. Kaitlyn did not completely escape the induction possibility, however. But she did manage to put off the induction day to a point that felt more comfortable to her. With regular non-stress tests in the last week or two, both parents and providers were reassured.

But at a 40-week NST and ultrasound, there were lower fluid levels detected. All other signs of baby’s well-being were there, but since she had reached the 40-week mark, there was more potential for risks to baby, considering the preexisting conditions discovered at 20-weeks. Kaitlyn was a strong advocate for herself, however, and she declined the induction recommended that day and instead, maintained the original induction plan for the next day. It also ensured the provider who attended her birth was one who would encourage and support her. Kaitlyn wanted to feel strong and independent as she became a mother, and she walked into her induction feeling confident and excited.

Open communication during an induction is key since it can take days for the entire process to unfold. Kaitlyn and Bobby knew the signs to watch for and would keep me posted once the contractions required Kaitlyn’s complete focus and were at the 5-1-1 interval or closer. Kaitlyn was in good spirits, and she gushed over how amazing every single nurse was. I was thrilled for her and had every hope that would such excellent support her induction would unfold beautifully, and she would emerge on the other side as a confident and capable mother.

The induction began with a balloon. Kaitlyn declined the midwife’s recommendation of using Pitocin right away. Her cervix was already 90% effaced (an excellent start!), 1 cm dilated, and her baby was at -2 station. Kaitlyn’s body responded intensely to the balloon. In fact, she was so uncomfortable an hour or so later, that she vomited. They found some medicine to help and the hope

At 1:30 am, the balloon was out, and Kaitlyn was dilated an impressive 4.5 cm. It didn’t hurt that her cervix was already so thin. We were hopeful she would not need too much of a kickstart to get labor going. In fact, her body continued to contract without Pitocin. Her contractions escalated and she was laboring in the shower by 3:30 am to find some relief.

But it was in the shower that Kaitlyn asked for an epidural. Bobby was ready to help her get it because it was a real struggle for him to see the woman he loved in such pain. He asked Kaitlyn if he should get the nurse, and she said, “No, call Amara!” As Kaitlyn explained it later, she knew she truly didn’t want an epidural but trusted I would be able to talk her into better positions to help combat the pain and help her body progress to birth. She just knew it was time to have me there. Kaitlyn’s nurse helped make it happen too, since thankfully, I was just down the hall with another client who had just given birth.

Kaitlyn was dilated 6-7 cm when she got out of the shower and was feeling a lot of pressure and she breathed and vocalized through each surge. Kaitlyn took her doctor up on her offer to break her water to keep the momentum going.

In the midst of her discomfort, she recognized in her heart she still truly desired a medication-free birth. Kaitlyn sat upon the bed and leaned into the squat bar. She did standing lunges with Bobby to help drive her baby’s head upon her dilating cervix. In one particularly sweet moment, Kaitlyn kissed Bobby and whispered, “I love you,” as she recovered between contractions. It almost made me tear up to see this young woman maintain her focus on the reason she was doing the hard work. And Bobby held her in his arms, knowing if he couldn’t save or protect his wife from the pain, he could embrace her through it.

After doing several cycles of standing lunges, Kaitlyn returned to lay on her side in bed for a “break”. The peanut ball was placed between her legs for her comfort. The baby’s heart rate displayed some head compression (aka a heart rate dip through the peaks of contractions), that had us thinking she’d be bearing down soon. In fact, she even did a practice push at 5:30 am, but since her cervix did not slide back, she continued to labor down.

She was pushing headlong within thirty minutes though, and by 6:18 am we could even see her baby’s head. Kaitlyn’s resolve did not waver when she pushed. If anything, it got stronger for she knew it was the final bit of labor before holding her baby. We updated her on what we saw, encouraging her that each push was bringing her baby forth. Bobby continued to offer regular sips of water to keep Kaitlyn hydrated in the mouth. (IV fluids help but the mouth gets dry!)

Timing is everything, and Kaitlyn’s friend, who also happened to be a doula in training, showed up with enough time to attend the birth. And due to lifting of COVID visitor restrictions, Kaitlyn’s mother was also able to be present for the birth. It was a nice bonus to have women who loved and believed in Kaitlyn to be present beside her during her birth into mother.

Kaitlyn pushed with her knees together to open her pelvis, and we continued to offer ideas for different pushing positions to help her baby navigate her way out. Kaitlyn requested a mirror and that gave her a visual on her baby’s head! She pushed with gusto and her midwife got suited up barely 5 minutes after the mirror was in position. And just 3 minutes after that, Kaitlyn pushed her baby girl into the world at 7:32 am on April 8, 2022! She had the cord wrapped around her neck twice, and was in the OP position, a further testament to the moxie Kaitlyn had!

Her nurses remained past shift to see her birth through, and her beloved midwife came on shift just in time to catch. Every single step of this induction was paved in earnest by Kaitlyn and her wishes for her baby. She was open with her providers and expressed her feelings and preferences. And everything came together to make it happen.

“I’m so proud of myself!” she gushed soon after meeting her daughter. And we all echoed that sentiment with a resounding, “You should be!” Then she looked over at Bobby, her rock, her partner, and said, “I couldn’t do it without you.” In his silent way, he returned her love in a look as his eyes rested on both of his girls.

Malia was latched for her first nursing session at 8:20 am and it wasn’t long before Kaitllyn’s loving family came in to meet their newest addition. It was a precious encounter to witness, and included her 12-year-old brother, now uncle, who said, “This is the best start to spring break ever!” I gathered my things and left after that. I knew that even happy go lucky, energetic Kaitlyn would eventually crave the silence that would facilitate a good nap. But I was so proud of her and gave her a hug before I stepped out. She had her baby in her arms, her husband by her side, and the world at her feet. Yes, Kaitlyn emerged from her birth strong, independent, and capable, as she had hoped. She was a mother.

The Birth of Malia Marie 4/8/22