The Birth of Penelope Rose 11/27/22

Katie and Philip met their sweet baby girl, Penelope Rose, on November 27, 2022, after a long labor journey. Katie had a strong preference for the midwifery model of care, and she believed in the process of birth and her body’s ability to do it, so she secured her care with homebirth midwives. Their home was ready, and they even decorated for Christmas early, just in case their baby came later in December. However, we were all pleasantly surprised when Katie felt her first labor contractions on November 26, with an estimated due date of December 5.

Katie’s initial contractions were very regular at 5-7 minutes apart around 4:30 am and by 7:30 had grown longer and stronger and even closer. It was soon clear that her baby had chosen to be born early. Katie alerted her midwives and me a couple of hours later and we all arrived shortly before 10:00 am. Her midwife assessed her and determined she might be dealing with an OP baby, so we went to work having Katie labor on her hands and knees over the CUB chair. A heating pad also eased some of the pain she felt in her back. She was curious about her progress and wondering what sort of labor journey she might expect. So her midwife did an exam the revealed it was still very early labor. Katie was dilated a fingertip and 30-40% effaced, with her baby at -1 station. It was time to rest. Her midwives left at 12:15 and I stepped out an hour later.

Katie rested at home as well as she could, and when things picked back up her midwives and I returned. Katie was struggling with nausea that had her throwing up, and her body was feeling very weary from laboring as long as she had. Her midwives made sure she tried to get some electrolytes down as well as food, but she was having a challenging time. With the strong suspicion that baby’s position was largely to do with her labor journey, her midwives discussed options. After talking through everything, Katie and Philip decided to transfer to the hospital to get some i.v. fluids and see about next steps. Katie’s midwives made the necessary phone calls and had the records all assembled for the transfer, and hugged Katie and Philip as they left. We promised to keep them in the loop along the way since they were emotionally invested as her initial providers.

Katie was patient and brave through three tries at finding a vein, but once the fluid was running, she exhaled a sigh of relief. Her body truly needed hydration and her uterus would likely respond well to it. A cervical exam showed that Katie was dilated 4 cm and 100% effaced at 8:45 pm. She had done good work at home! She was also pleased that there was an amazing midwife on call who received her and would be her provider during her birth.

Katie decided an epidural would be a good tool to help her get much needed rest for (and for Philip!) and perhaps aid in some pelvic relaxation to help baby do some rotation. She got about 7 hours of sleep overnight, with steady progress. We kept her changing positions, and she was dilated 4-5 cm at 11:30 pm, and 6 cm by 3 am. And by 7:50 am her water broke on its own and she was dilated 8 cm!

We used gravity to help by putting the bed in an upright throne position to bring baby down. It helped because by 9:25 Katie was dilated 9.5 cm with a rim on the right side. Baby was also lower at +1 station. We had helped her roll to her left side with the peanut ball between her ankles to open her pelvic outlet. And in 20 minutes she was fully dilated!

Katie began pushing at 9:55 am and she didn’t take long to figure it out. She pushed steady and strong and changed positions regularly, and at 11:44 am we could see her baby’s head and all that hair! And with progress every single push, Katie birthed her sweet girl at 12:03 pm on November 27, nearly 36 hours after her contractions began!

Philip cried at the sight of his daughter and Katie held her close as she let the enormity of what she just did settle on her heart and mind. She was all smiles in those first few minutes, so joyful to have her baby in her arms! The midwife was singing Katie’s praises and pleased to tell her there were no tears. And she even got the opportunity to wait until after the placenta was out before Philip cut the umbilical cord. After their magic hour as a family of three, the nursery nurse returned and did Penelope’s measurements. She was perfect at 7 lb. 10 oz. and 20.25 in. long. The midwife paused at bedside before leaving to congratulate Katie on such a beautiful birth and embracing her as an adopted patient. Her homebirth midwives had also been cheering her on, sending messages of love and congratulations as the updates came. It was a loving village of support for this new family.

Katie’s birth was a beautiful example of how seamlessly a homebirth transfer can work as well as how a doula can be the link to bridge the gap from home to hospital. Making a change in location and providers can be a daunting and scary task, but it wasn’t like that. Katie and Philip were met with respect and kindness and were immediately embraced by the nurses and provider on call. Katie was well cared for and had nothing but wonderful things to say about her experience. Her homebirth providers were pleased with the cooperative relationship between them and the hospital staff, with the transfer of records and information really paving the way for solid continuity of care. It was an amazing example of teamwork making the dream work and Katie and Philip still beam as they talk about their birth. And as their doula, that makes my heart sing!