The Birth of Melody Belle 9/15/22

Katie and Will were recent clients of mine when they reached out about baby #2! Their children would be just 14 months apart, the perfect spacing for siblings as best friends and also an easy labor! Katie’s first birth had more interventions that she had wanted so she decided early on to welcome her second baby in a homebirth. However, it was discovered that her baby had an atrial defect in the heart that would require a higher level of care. Katie’s dream of a homebirth quickly shifted to a plan for an induction of labor in the busiest hospital in Hampton Roads. This was not what Katie had anticipated, but she had time to get used to the changes well before labor day.

Katie had a preterm labor scare that brought her to the hospital to get checked. Thankfully, she wasn’t in labor, however her cervix was dilated to 2 cm. so she was put on high alert. A couple of weeks later, she reached out because she suspected she might not make it through the weekend. At least she was full term at 37 weeks. She woke with horrible back pain and felt tightening and burning in her stomach along with nausea. Turns out she went to the hospital overnight fearing she might stay home too long and give birth in the tunnel. She was dilated 4 cm, however, her contractions were not changing her cervix beyond that. Katie was so ready to be done. And on top of that she felt like she wasn’t being heard. Requests for a birth ball went unanswered until she was out of triage and in a labor and delivery room, and she felt like she and her husband had been abandoned to wait and see. She was trying to figure out ways to insist on staying to be induced, but after several hours of no cervical change, and adhering to best practices, her providers told her she would have to go home and wait for active labor. And if she didn’t go into labor before, they would be in touch to schedule an induction in her 39th week. Katie was discouraged but she went home.

Surprisingly, Katie’s body held on until the induction. The date and time remained a mystery up until the last minute as she waited for a bed to open up. Finally, the call was made, and Katie and Will were on their way to the hospital for a 2:00 am induction. I got the alert text around 1:15 a on September 15 telling me so. This was a surprise, but a labor text would have been the same. So I waited for updates of regular contractions to signal it was time.

Pitocin began at 4:15 am, and with another wiggly baby, Katie’s sleep was interrupted by regular adjustments to the monitor and the belly bands. She was 4 cm on arrival, but the doctors were optimistic that they could break her water later that morning with a favorable result of labor. Katie waited through mild contractions she could hardly feel as the Pitocin was raised incrementally to 16 mu. After waiting for Will to go home and feed dogs, and get back, Katie’s water was broken just before noon. It flowed clear and her cervix opened from 4 to 5 cm immediately. I was in the car and by her side about 30 minutes later.

Katie had a large group of family present in support. Her husband, Will, was there of course, plus his mom and dad, Katie’s sister, and their firstborn daughter, just 14 months herself. I wondered if the people were distracting her from moving into labor and told her if she needed some privacy, she could have it. Katie nodded, but I think she knew she needed every person she had invited into her birth space.

The doctors returned to insert an FSE (fetal scalp electrode) because they were still having a difficult time keeping her baby’s heart rate on the monitor. Katie was open to anything that kept her baby safe and considered the loss of a belly band a bonus. Then, I recommended she get out of bed and swirl her hips on the birth ball to bring her baby’s head down upon her cervix. Next, she labored in the flying cowgirl position with the peanut to keep her baby moving down. She got up to make a bathroom trip after that and remained in there for a good while with her feet propped upon the foot stool.

Katie and Will returned to the bed, stopping through a contraction or two along the way, and then Katie returned to lean over the cub birth chair and lunge on each side. This was when I noticed her demeanor change. She felt nauseous and her breaths moved into moans. An exam confirmed she was dilated 8 cm already and it had only been an hour or so.

Katie continued to burp loud and long, and she finally vomited, which only brought her baby down further. We shifted the bed into the throne position so she could make use of gravity to dilate her cervix to complete. The rebozo tied to the squat bar provided a way for her to ground herself as she breathed through very strong contractions. The pressure in her pelvis grew until we saw and heard that she was starting to push.

I asked Katie where she wanted to push her baby and she expressed her desire to push on hands and knees. We returned the cub to the bed and she rolled over and grabbed it. Will stood at the head of the bed and that was where Katie gave her first strong pushes. The room quickly filled with hospital staff (17 to be exact!) and she focused on Will’s face and my words as she pushed. The doctor met her where she was, with no cervix check required. He simply affirmed her efforts and told her she was amazing.

Katie pushed through maybe 2 or 3 contractions before welcoming her second baby girl, Melody Belle, at 3:20 pm! Katie reached down between her legs for her baby and looked into her husband’s eyes with such joy, it was beautiful to witness! Her MIL and sister were overcome by the miracle of birth, crying as they watched, and a few minutes later, Katie’s young daughter returned in her grandpa’s arms to see that her baby sister had arrived. The room was abuzz with activity, but Katie was in her own world with her husband and newborn baby girl.

Melody went to the warmer for some minor assistance clearing fluids, and arrangements were made with the cardiac team for an echo to be done soon. Katie had a minor repair but had her baby in her arms for much of it. And once she was done, her firstborn daughter came in for a snuggle right in the hospital bed. Katie and Will welcomed their second baby in a family-centered unmedicated induction in the hospital. And while her room was filled with people, many of them medical students, I know they learned some important lessons that day. We all did. Lessons about autonomy in birth, trusting the birthing woman to know what’s best, welcoming family if it brings peace and comfort, and not disturbing the natural process when it works best. I realize Katie’s labor was induced, but once she was laboring, she was left to labor with little interference beyond the monitors. She was given space and time and wasn’t touched. She birthed her baby with nothing needed of any of us. And we were all honored to be there to see her do it.