Welcome to the world, Cohen Reed, born to his adoring parents, Cierra and Tyler from my virtual summer BirthWorks 8-week series. Cohen was born on July 21, 5 days past his guess date, and after a very long labor. Cierra was an incredible rock star through it all, and Tyler was her unfailing support. Cierra’s cervix was making some headway (no pun intended) prenatally. She was dilated 2-3 cm at her 40-week appointment. She had nonstress tests and even an induction scheduled, although she hoped not to need it. A text just before 1:00 am on July 20 confirmed that Cierra wouldn’t make her induction date. And that was just fine with her! She felt contractions that intensified through the night, moving closer over the hours. As luck would have it, she had a prenatal appointment scheduled for that morning and after speaking with her midwife decided to move forward with that and do a nonstress test while they were at it. For good measure, Cierra did the Miles Circuit at home before proceeding to the hospital in the hopes to encourage her baby to get his position sorted out.

Cierra moved to 6 cm in an hour and then did another round of the Miles Circuit since her baby’s position was almost certainly causing some delay in her progress. Remember, this all began at 1:00 am so she was already at the 15-hour mark and just starting active labor. Her contractions were picking up so she gave the shower a try. Cierra emerged shortly after and tried a myriad of positions to encourage her baby’s descent. She sat upright, she lunged, she swayed, she stayed so very active. But three hours later she had moved just ½ a centimeter. She returned to the shower and remained in there for nearly an hour, but after laboring on the birth ball for an additional 45 minutes she was 7 cm. And she was exhausted. After conferring with her midwife the decision was made to break her water. It was 9:15 pm. She labored in a variety of positions and then moved her labor back to the shower an hour later. By 11:30 that night she was dilated 8-9 cm, making her way, slowly but surely. Cierra tried the peanut ball and exhibited the signs of transition. She began instinctively pushing but after an hour her cervix was still not gone completely. Cierra weighed her options and to preserve her energy and a bit of her sanity, she opted for an epidural. She found relief and some rest, and we continued to rotate her fully from one side to the other, incorporating the peanut ball to keep her pelvis open. Cierra resumed pushing at 4:35 am. And just like with her first stage, she pushed in all sorts of positions. The rebozo tug of war became her most effective method, bringing her baby’s head into view. 

Cohen was born at 7:46 am after over three hours of pushing! His cord was around his neck and over his shoulder, and caused him a bit more of an adjustment period. But he improved quickly with an apgar of 9 and was received gratefully by his mother. As hard as she worked to bring her son into the world, all was forgotten in that meeting. Cohen weighed 8 lb. 1 oz. and nestled in nicely with his parents. Cierra and Tyler were a united pair and did not let the uncertainties of COVID-19 and a protracted labor dim their spirits. Every single step of the way they weighed their options and followed their hearts. I admire them so much for it and will forever be grateful they chose to include me on such a momentous experience for their family.

Cohen today

In an effort to facilitate contacting hospital administrators to return doulas to the birth space, I have written a blanket letter for the intention of distributing as you see fit. Please copy and paste it and mail or email to those in leadership at the facility in which you have chosen to give birth. Feel free to make any changes you see fit. DONA International has also drafted a letter than can be forwarded on concurrently or separately. Whether you use my letter, DONA’s, or your own doesn’t matter. The more letters the better! Just reach out.  If you are looking for more evidence, visit my previous blog post for links.

To Whom it May Concern:

First and foremost, I want to express my appreciation for your diligence in keeping your staff and patients safe during the COVID-19 pandemic. It is no small task, and as with any unprecedented outbreak, evidence and information is constantly being weighed to assess potential risks to your staff and patient population. However, my request to you addresses the safety of your patients and has evidence to back up the benefits to their experience in your facility. I am writing this letter to ask you to please reintegrate doulas into the birth space by acknowledging them as a member of the labor and birth team, not as a visitor subject to the hospital restrictions. At the time of this writing, several Hampton Roads hospitals permit doulas to be physically present in the labor and delivery room. Sentara Leigh and Riverside Regional have opened back up to doulas and Sentara Williamsburg never restricted them. Please consider following their lead to insure your patients receive the support they expect.

The Centers for Disease Control and Prevention’s guidelines on caring for a mother with COVID-19 recommend healthcare facilities follow, “infection control guidance on managing visitor access, including essential support persons for women in labor” (Interim Considerations for Infection Prevention and Control of Coronavirus Disease 2019 (COVID-19) in Inpatient Obstetric Healthcare Settings, February 2020). They go on to state, “If restriction of all visitors is implemented, facilities can consider exceptions based on end-of- life situations or when a visitor is essential for the patient’s emotional well-being and care.” Surely, labor and birth should be considered an experience in which a doula’s presence is essential for the patient’s emotional well-being.

The evidence is overwhelmingly in favor of the presence of a doula during birth, showing a significant improvement in birth outcomes for both mom and baby. A 2017 Cochrane review of 26 trials of continuous labor support and doula care involving over 15,000 women in 17 different countries in high and middle-income settings found many improved incomes for women and infants including: “increased spontaneous vaginal birth, shorter duration of labor, and decreased cesarean birth and instrumental vaginal birth, as well as a lower incidence of the use of any analgesia or regional analgesia, less likelihood of a low five-minute Apgar score and fewer negative feelings about childbirth experiences. We found no evidence of harms of continuous labour support.”(Continuous Support for Women in Childbirth, Cochrane Database Syst. Rev, July 6, 2020).

 In an effort to improve outcomes and lower the rate of the primary cesarean, both ACOG and SMFM came together with a list of guidelines to that end. Using the evidence collected by the Cochrane review quoted above, they encourage the continuous presence of support personnel, such as a doula, due to evidence showing improved outcomes, including a lower rate for cesarean delivery. (Safe Prevention of the Primary Cesarean Delivery, American Journey of Obstetrics and Gynecology, March 2014).

And in a timely response to the Coronavirus, both DONA International and AWHONN made public statements in March 2020 about the vital role of the doula and how the doula should not be a visitor relegated to hospital restrictions, but rather considered an essential member of the birth team. (AWHONN Position Statement: Continuous Labor Support for Every Woman, Journal of Obstetric Gynecological and Neonatal Nursing, 47, 73-74; 2018). Nurses are not able to spend as much time with their patients as the doula can. And it is specifically that constant one-on-one presence that provides the benefits demonstrated by the numerous studies. In fact, with heightened vigilance and increased task load in response to COVID-19, nurses are busier than ever. Laboring women are also dealing with heightened fears and concerns giving birth in the pandemic. Their need for emotional support and attention is greater than average. Clearly the doula is more beneficial than ever, and more essential for every member of the birth team. The evidence in favor of a doula’s presence cannot be ignored. 

It also bears mentioning that I have hired my doula to be present with me during my birth. She is contractually secured as part of my birth team. She is certified and has a skill set that she brings to the birth space, skills different and separate from those of the nurse, and skills that cannot be expressed the same virtually. The benefits conveyed by her steady one-on-one presence may be compromised in the virtual setting. 

For all of these reasons, I respectfully urge you to reconsider integrating doulas into the birth space. With the benefits clearly stated in evidence and the strong desire by your patients for doula support, with adherence to personal responsibility and safety through PPE, frequent and thorough hand washing and sanitizing, I am confident you can see to it that doulas return to the labor and delivery room. 

Thank you for your time and attention to this matter,

(Your name)

Our community was thrown off kilter mid-March with the official arrival and acknowledgement of COVID-19 as a global threat in the United States. It was upon us and as with any stressful event, many birthworkers, myself included, walked through the stages of grief in regards to the pandemic. First there was denial. Surely this wasn’t really a thing, was it? Then anger. I felt this acutely as a doula. The restrictions on birth support hit me in the gut and I’m not ashamed to admit that initially I took it as a personal attack on doulas. Of course, I have since come to my senses and understand that at the heart of the decision by hospital administration was to keep everyone safe, including doulas, which brings me to the third stage, bargaining. Birthworkers explored how to continue to offer birth support, even if virtual, and they pivoted to accommodate the needs of their clients through FaceTime, Zoom, text, and phone. Depression, stage four, was in there too, and lingers today for many of us. As doulas, we yearn to be with our clients, sharing their birth space and offering physical support in their presence. It pains many of us when we are separated from our clients during birth. It’s truly a struggle that hits a doula right in the heart. And finally, we encountered acceptance. COVID-19 would remain in our midst for awhile and would have far-reaching implications on how births would look for the foreseeable future. It was our new, indefinite normal, restrictions, masks, hand sanitizer, and all.

Now it’s time to act. We’ve had our six months of processing, doulas and birthing families alike. But the last stage of acceptance is unacceptable, especially when it comes to restricting doulas from physically attending births in the hospital setting. It’s time to push more aggressively to reintegrate doulas in-person at birth. If you are a birthing parent, I implore you to advocate for your doula, and for all doulas, to return to the hospital. Doulas should be permitted to attend in person because it is the right of every laboring woman to have support, but also because the research is extensive proving that the continuous labor support doulas provide improves birth outcomes. Doulas help everyone, including the staff and care providers! In fact, reputable birthing organizations made statements early on defending doulas as essential members of the birth team, and encouraging them to be permitted to continue to serve in person DURING the pandemic. On March 12, 2020, DONA’s statement for including doulas as an essential member of the support team was compelling, as was AWHONN’s pro-doula statement from March 11, 2020.

So what are we to do to affect change in hospital policies? There needs to be a push from the patients to hospital leadership. Contact the manager of the labor and delivery unit, and the administrator of the hospital. Make a phone call. It’s harder to ignore a voice on the line. Follow up your phone call with an email and a letter. Paper trails are also hard to dismiss. DONA has made this easier by drafting a letter to hospital administrators. They have already done the work for you. You can find that letter here. Simply print it and send it along. Furthermore, if there are other hospitals who have allowed doulas to return, be sure to mention them as well. In Hampton Roads at the time of this writing the only hospitals permitting doulas to attend births alongside the primary birth partner are: Sentara Leigh, Sentara Obici, and Sentara Williamsburg. And don’t forget to express your wishes with your provider. Not just one, but to each doctor and/or midwife at every single appointment. 

This push needs to come from the birthing families, not the doulas. The amount of research in favor of the presence of a doula is dizzying. And the number of statements by various obstetric, nursing, and birth organizations is compelling. The evidence is there and the need for one-on-one labor support is higher than ever. What’s lacking is the advocacy for the presence of doulas during the pandemic. I have compiled some links in an effort to cut down on your need to research data. You will find them at the end of this post. Feel free to use any or all that you see fit. And write those letters, send those emails, and make those phone calls. The change must begin with the birthing women. Not the doulas. We believe in you and we support you. You can do this! (Sound familiar?) Thank you so much for trusting us to serve you and for fighting for that right…for all of us.

Below are some links to incorporate into your letters/emails/calls campaigning for the reintegration of doulas to attend births in-person. Please don’t forget the links embedded a couple of paragraphs above to statements by both DONA International and AWHONN for having doulas attend births in-person DURING the pandemic. They are particularly timely and relevant since the statements were made in March 2020, right as the pandemic was taking hold in the US.

Cochrane Database Evidence that continuous labor support may improve outcomes for mom and baby

 AWHONN Position Statement for Continuous Labor Support for Every Woman

 ACOG (American College of Obstetricians and Gynecologists and the Society for Maternal-Fetal Medicine’s joint document on the Safe Prevention of the Primary Cesarean Delivery

 ACOG Approaches to Limit Intervention During Labor and Birth

 March of Dimes Position Statement on Doulas and Birth Outcomes, January 30, 2019

 Evidence Based Birth: The Evidence on Doulas, Updated May 4, 2019

Congratulations to Ashley and Chris on the arrival of their third son, Bennett Alastor, born July 6. This couple were repeat clients of mine and reached out early. They also decided to welcome this baby at home in light of the advent of COVID-19 and the subsequent restrictions imposed by hospitals on birth support. Ashley had always been surrounded by family and this birth would be no different. So she decided to welcome her baby at home. Ashley did not reach out to me very often, that tends to be her way. Even when she waited beyond her due date. For that, much to her frustration, also tends to be her way. But when the text came through at 7:00 that Sunday evening, I knew it was labor. She had already done “all of the things” (hydrating well and getting in the shower, and even the Miles Circuit) and still her contractions persisted. Updates would come as needed, which again, was Ashley’s way. 

 The next text was from Chris and came at 10:44 pm. The fact that he sent it and not Ashley was a strong indication that she was a bit too engrossed in her contractions to be troubled to type a text. And sure enough, Ashley’s contractions were steady at every 3 minutes and lasting a minute each. It was time and I was on their front doorstep within the hour. Ashley’s mother opened the door for me holding the family pooch. She was waiting by the door for me as I approached. It was a precious moment for me, and one that is only possible with a homebirth. 

The room in which Ashley lay was decorated with a lovely string of lights and she had her mom and sister, and husband, of course, all right there. Things were escalating for sure, and she paid less attention to the Harry Potter movie on the television. (Yes, they named their son after a Harry Potter character. They are big fans!) Family chatted excitedly about the coming baby, but also were available to check on big brothers who were sleeping right next door. Chris applied counter pressure and Ashley’s midwife and assistant attended to her medical needs, allowing space and time for contractions to come and go as they worked.

Chris’ hands flew up in victory as he exclaimed, “You did it!”

Ashley’s breathing grew short at the peaks of her contractions and her back gave her great pain. The warm rice sock and counter pressure helped, but she found herself doubting whether she was progressing. Of course, the very doubt was a sign to the rest of us that she was progressing quite well. But she requested an exam just to be sure. Her midwife assured her it wasn’t necessary for they were checking with their eyes as long as everything was going well, and it appeared to be. Plus we also added that numbers lie and the centimeters of one contraction had no bearing on the next or on how much time remained before her baby was in her arms. Ashley’s breathing changed and sounded more like she was transitioning into second stage. She entered the tub right then—it was 12:30 am—but she was unsettled about the urge to push and how she would know it was time if she didn’t feel it. (She hadn’t felt a strong urge in her previous two births, or at least was pushing before the sensation to bear down was overwhelming.) This was different. There was no reason to do anything different unless Ashley was ready. But Ashley really wanted to know her dilation so her midwife obliged and confirmed she was most definitely close at 8-9 cm. It was 12:35 am. “But that’s the worst part,” exclaimed Ashley. To which I responded, “Yes, but it is also the shortest part.” Two more contractions and her water broke, and we could see Bennett. Ashley pushed through her discomfort and when her baby’s head was out she reached down to feel. And then with the next pushing contraction she birthed her son into her own hands. Bennett Alastor was born at 12:43 am, to tears and celebration in his parents’ bedroom. And all while his big brothers slept on the other side of the wall. 

He was snuggled in his mother’s arms a long while with Dad cutting the cord and even his first assessments done in that time. Bennett weighed 6 lb. 11.8 oz. and measured 19 in. long, the same weight and length of his own mother, as noted by the woman who birthed her. And that was just the icing on the cake really. The simplicity and comfort of a homebirth is something special and Ashley and Chris settled into their own bed as the rest of us gathered our things and left them to rest. I appreciated being reminded that birth works and doesn’t usually need anything more than the woman birthing. Especially considering the state of the world currently, with fear and confusion about the pandemic at every turn. Welcome to the world, Bennett Alastor. In your sweet home you were sheltered from so much, and we were all put in touch with what normal birth looks like, from behind masks, of course. 

Bennett Alastor now

Ada Roan changed her parents’ world forever when she arrived on July 1. You see, they didn’t know whether she was a girl or a boy, so when she came barreling into the world, promoting her brother to BIG brother, her parents were thrilled. But let’s backtrack a bit to the beginning. Elisa and Trae were repeat clients of mine so they reached out very early in the pregnancy. They also secured a place in my refresher class to brush up on labor and birth and to dedicate some special time in preparation for this little one. There was a long drive this time, just like the first time, but Elisa was comfortable with laboring at home until she was certain things had kicked it up a notch. She sent me a text around 8:00 am on June 30 to tell me she thought something was happening. It was early, if it was even labor, and she was trying to rest. She continued to have contractions through most of the day without progression, and finally managed to take a nap and wake to virtually no contractions. But that evening they had returned, although still mild. I counseled her to minimize and not update unless she had to stop what she was doing to cope and so Elisa tried that. 

 Then at 1:33 am, Elisa reached out to tell me although she had some outliers, her contractions had become quite strong and she was calling her midwives. They were still just 5-10 minutes apart, so not terribly close. However, with an hour’s drive ahead of them, a call to them midwife confirmed it was go time. And over the course of that drive the contractions intensified to 3 minutes apart and very strong. Trae had called in a favor to the bridge tunnel and had an escort insure their safe and very swift passage. It was a record-breaking trip across the tunnel for Trae, that’s for sure. Elisa was greeted by her midwife and confirmed 7 cm dilated soon after setting foot in her room. She was admitted, baby was monitored, and she labored on through the required initial 20-30 minutes.

But a funny thing happened as Elisa labored on her side. Holding Trae’s hand and breathing through very strong contractions, she began to involuntarily push! Trae recognized the sounds and knew what was coming. Later the midwife would commend him on his keen ear for labor. Elisa’s water broke with a splash 10 minutes later at 3:48, and she was pushing unrestrained with the next contraction. Elisa rode the powerful waves of her contractions in that bed with such strength and control. She didn’t push long, and in her endearingly comical way, she managed to shriek, “Holy ring of fire,” right as her baby was coming out. At 4:03 am her sweet baby was born and Trae announced, “It’s a girl!” And their sweet Ada was born in the OP position, looking right up at the ceiling, which in hindsight explained a lot about the on and off contractions. But it was also an unintended protection against giving birth at home or on the way! Elisa snuggled her sweet girl and had her latched easily and recounted the crazy ride of her birth (and the crazy ride to her birth!). Ada weighed 7 lb. 4 oz. and measured 20 in. long, weighing over a pound less than her big brother. Elisa was grateful for that small mercy. And I, for one, am grateful to have been there to serve you and to witness your strength once again as you crossed the threshold to motherhood after a very surprising (one again) labor. And I am once again grateful to the providers and staff of Sentara Leigh Hospital for recognizing doulas as an essential part of the birth team and no longer restricting their access to in person birth attendance.

Ada today

Jacqueline and Tony welcomed their third child, Cooper Jay, on June 12. After giving it some thought, and listening to what her heart had been saying for many years, Jacqueline decided to welcome Cooper at home. After all, she herself had been born at home and she had always felt drawn to it. This was also my third time to serve as their doula so we rejoiced together with the previous births and looked forward to welcoming Cooper with just as much love. Jaqueline was in her first trimester during a time of much upeaval. The Midwifery Center at DePaul had just closed its doors, and her beloved midwives who had cared so well for her twice before, would be attending births at a different facility that did not have the same amenities, aka a birth tub. Then the world was overtaken by the COVID-19 pandemic, further affecting her birth options, most namely, that she could have her doula and children present. Finally, she had good reasons to just listen to the desires of her heart without reservation. She did her research and found her midwife. 

Towards the end of her pregnancy, Jacqueline lost sleep over bouts of contractions that left her confused and frustrated, and very exhausted. After one particularly tough night, she reached out to me. And as it turned out, those contractions would never relent and I was at her house shortly after lunch. Jacqueline was lovingly doted on by her daughter who was a veritable doula in training! Tony drifted in and out to take care of the children’s needs as well as giving Jacqueline the in person emotional support she needed. Things were slow to intensify, but several hours later, once her midwifes had arrived, Jacqueline drifted into more active labor. Her contractions were strong and she felt pressure like she might need to push but she could sense that her baby wasn’t descending. Her midwife did an exam and confirmed that Jacqueline was dilated 7 cm and 90% effaced. Her baby was likely malpositioned so the recommendation was to do some stair walking. Jacqueline had already been laboring in a variety of positions but her baby needed a bit more. So she walked up and down the stairs, legs spread as far as she could manage, all while having contractions, for about 45 minutes. The stairs flipped a switch and Jacqueline was working. I recommended the shower and she returned to where she had already felt such comfort hours before. Jacqueline felt such pressure from her contractions that she knew her baby would be born shortly. Then we heard a loud splash (over the sound of the shower!) as her water broke. And with a growl her baby was quickly on the verge of birth. Jacqueline only pushed a couple of times before her son entered the world at 9:41 pm! She grabbed him to her chest and took in all of the emotions. 

Jacqueline was surrounded by her husband and children, feeling all of the love…and admiration, as we heard, “I didn’t know my mom had superpowers!” She settled into her own bed in her own room as she completed delivery of the placenta and began her recovery. Her children peeked in on their baby brother and welcomed him with snuggles and sweet words. Tony and Jacqueline exchanged a kiss and after admiring Cooper, Tony went downstairs to prepare a snack plate for Jacqueline and the kids. After some extended skin to skin time and nursing, Cooper was weighed and measured. His numbers came to 7 lb. 7 oz. and 20 in. long. He had a head full of brown hair which prompted Jacqueline to share with us that she had dreamed years ago she would welcome a brown-haired son. Clearly his time had come. I love that Jacqueline listened to her heart instead of her head so much. She is a thinker. She followed her desire to welcome her baby at home, and she even followed her yearning for a third child, who turned out to be the one she had been dreaming of all this time. Congratulations again to this family who is so dear to me. I appreciate you and am grateful to have journeyed in birth with you three times.

Cooper now at 3 months old

Keely and David became parents on May 11, right in the midst of the COVID pandemic. They were students in my 8-week BirthWorks class, which finished up right as the world was thrown into a tailspin. Hospitals restricted support persons to one, and there were masks and social distancing all over the place. Keely and David rolled with it, and kept a positive outlook knowing that a new baby would give a wonderful perspective and bright light to focus on in the midst of such uncertainty and worry. Keely managed to see her due date come and go and waited over a week beyond before her labor began. With an induction scheduled for less than a week away, the clock was ticking.  Keely felt bouts of contractions the night leading up to the induction, but she managed to stay pregnant. She and David reported to the hospital and powwowed with the midwife to put together a game plan. Keely was 2-3 cm dilated at the start so the plan was to use a balloon with low dose Pitocin overnight. However, soon after the balloon was in place, contractions picked up. There would be no need for Pitocin after all.

Keely got some medication to aid in relaxation and sleep and they allowed for some sleep off and on for an hour. Then her water broke! Within an hour of her water breaking, she was dilated 6-7 cm. It was just 12:47 am! Keely was hoping to get some more sleep but her baby had other plans. (Don’t they always?) She labored on her hands and knees quite a lot for it seemed to make her contractions the most tolerable. But it was likely also the reason her labor sped along so quickly! There was talk of laboring in the shower, and she even had the wireless monitor ready to go, but things moved too quickly for that. Keely remained in that position on the bed and focused on breathing deeply in her nose and out her mouth, with David beside her every step of the way. 

Baby’s heart rate dipped, most likely due to the rapid progress of her labor, but Keely continued to breathe with her contractions until her body was led to push. And she pushed well! Connected by Facetime, Keely’s birth team, doula included, encouraged her and cheered her on. Keely was dilated 9 cm by 3:51 am and was pushing full force shortly after that. A forebag was broken by the midwife and in Keely’s words, “then Clara flew out!” Keely welcomed her daughter, Clara Brown, into the world at 4:16 am. “We’re tough! We did it! We can watch the sunrise together.” Such sweet words spoken to this baby girl in her first moments. Clara’s birth was a beautiful reminder of the power of a woman, the love of a mother, and that even in the midst of a pandemic, life goes on. Babies are born. And thank goodness for that. Clara was welcomed with such love and her parents exhaled their relief and expressed their thankfulness at the tremendous gift of her birth. I loved getting to know this couple as we journeyed together, and even though hospital restrictions left us connected virtually at the time of the birth, my heart was with them as sure as if I had been in that same room. Congratulations on the arrival of your precious gift, a profound reminder that the world will go on.

Christina and Sam welcomed their son, Sean Elliot, on April 19! They were students in my 8-week BirthWorks class as well. Christina’s labor was a lesson in the unpredictable nature of birth. It was confusing from start to finish. I got a text from Christina around 6:20 pm on April 18 telling me there was a good chance her water broke. With leaking here and there, after many hours had passed, she went in to the hospital as advised by her midwife, just to confirm that her water had indeed broken. And yes, it had, although she was not yet having contractions. Her cervix was 3 cm dilated, 75% effaced and her baby was at -2 station. She returned home to try and rest with the plan to call at 6:30 am with an update.

At 4:45 am, they had an update. Christina was contracting and they seemed closer than 5 minutes when Sam tried to time them. She had labored in the shower for an hour and was feeling significant back pain with contractions. Sam did counter pressure and encouraged Christina to labor in forward leaning positions. Her labor was intensifying and Sam recognized the change in Christina’s demeanor as her labor required more of her focus. She returned to the shower to labor and when she emerged it was time for me to come. 

When I joined Christina she appeared to be laboring very actively. She was feeling discomfort in one hip, which had me wonder if her baby was still a bit malpositioned. Christina labored on her hands and knees over a pile of pillows, side-lying, standing by the bed, all as her contractions grew stronger and stronger. She cried out at the peaks which had us suspecting it was nearing time to head back to the hospital. One more trip to the shower to labor, and then it was time to make the trek. 

When Christina arrived at the hospital around 8:00 that morning and was triaged, she was dilated a surprising 3 cm. She had not opened significantly from her previous check nearly 10 hours earlier. She was effaced to 90% though and her baby had moved down to -1 or 0 station. The unremarkable change in dilation was a shock to all of us. However, a tidbit was confirmed with the exam that shed some light on her lack of progress: her baby was in the OP position. There was still some work to be done. But Christina had been up most of the night with contractions that were closer than 5 minutes apart for much of that and she was tired. She opted for some iv pain medication in the hopes it would help her to relax and maybe get some rest. 

Things changed incredibly quickly after that because by 11:15 am Christina was dilated 9 cm! (Remember, she was only 3 cm dilated 3 hours earlier!) Things progressed so quickly once she relaxed! And when she rolled over to her hands and knees, her baby made his final rotation and was born OA! And you know when he was born?? Sean came barreling into the world at 11:34 am after hardly any pushing! He weighed 7 lb. 4 oz. and measured 20 in. long. He changed his parents’ lives in that moment, and proved that every bit of it was worth it. Christina was a warrior through an especially unpredictable labor. She followed the cues of her body and trusted that her decisions were always the best ones. You truly rolled with it and you did so during a pandemic. Congratulations to you both! You should be so proud.

Sean Elliot today!

Mallory and Dustin welcomed their second baby, a sister for Ryleigh on April 17. That sweet baby is Elouise Joy and no doubt brings lots of joy to her parents and big sister. I was blessed to have accompanied Mallory and Dustin for their first birth so it was an honor to be invited back again. They also attended my 2-week refresher class specifically for veteran parents, so they could brush up on the finer points of labor and go over the differences they might expect for a second labor. Mallory rounded out her third trimester in the midst of the COVID-19 pandemic so plans changed and things became very different. My support would be virtual. But at the core, what was true was the same—that Mallory would welcome her baby surrounded in loving support with providers she trusted. For they were the same providers who took care of her in her first pregnancy. Mallory’s due date came and went, and just over a week later she was scheduled for an induction. 

Mallory and Dustin arrived at a very early hour and as inductions often go, it was slow. And on top of that their baby was suspected to be OP, which would bring its own potential challenges and delays. Mallory moved through the Miles Circuit to try to encourage her baby to rotate, all while the Pitocin crept up incrementally. That evening just before 6:00 pm things were looking more like labor. Mallory was dilated 4 cm a short while before and her midwife broke her water. Praise and worship music played as she breathed and focused through each contraction. The next stop was the shower where Mallory labored in lunges. The pressure grew within her pelvis so much so that it made her throw up. Even so, after leaving the shower, her midwife checked and while the baby was lower, Mallory’s cervix was still dilated 4 cm. But Mallory did not let this discourage her. I reminded her that the number did not matter and was no indication of how much longer labor would last. We dimmed the lights and she returned to the shower and just 30 minutes later she felt so much pressure that her midwife did another exam revealing she was dilated 7 cm! Mallory rolled over to her hands and knees and labored since it felt best for her. And just 15 minutes later we heard the unmistakable sound of pushing! Mallory was fully dilated at 8:23 pm and her midwife dressed in the paper suit (and mask, of course), and pulled up the delivery cart bedside. Mallory followed the cues of her body and in maybe two contractions she pushed her baby right on out! Elouise was born at 8:28 pm!

Mallory lay down upon the bed and held her baby close. She had done it! In the midst of a pandemic with an OP baby and a virtual doula, she had done it. Dustin called home right away so grandma and big sister could get the happy news before bedtime. We heard Ryleigh’s happy squeals at the official promotion to big sister and it made us all smile. In the end, Elouise was born in the OA position, rotated right at the end, probably because her mom was so active in labor. She was also born without her hands by her face, another unfortunate positional challenge that was rectified. Even more amazing is the fact that Elouise weighed 9 lb. 2 oz., was 21 oz. long, and Mallory did not tear. And she was latched to her mom’s breast by 8:42 pm. Mallory flew from 4 cm to birth in just ONE HOUR! Indeed, every birth is different. And we can often count of second babies coming quickly once they are ready. Thank you for allowing me to serve your family again. You were amazing and remained positive and saw your birth through in spite of the many challenges you faced. Way to go!! 

Erin and David welcomed their second child, a son this time, on April 5! Erin like many of my clients, has the distinction of giving birth during the Pandemic, with hospital restrictions that relegated my support to virtual. Funny thing, I was her in-person doula with the birth of her first, so we were curious how this virtual-doula thing would pan out. We had our prenatal visit and remained in steady communication prior to labor. Erin’s body made gradual changes that had her midwives telling her weekly, “Today could be the day.” But still, she had bouts of contractions that had her thinking it might be labor, only to fizzle out with a bath. They had a rather hefty commute to contend with in addition to securing care for their toddler, so the logistics of when to leave were complicated.

Then late on Sunday, April 5, I got a text from Erin that was different. It was nearly 10:00 pm (that was different!), and she was really having to breathe through her contractions that were felt down low. They were far apart at 10 minutes, but they had Erin stopping in her tracks and that was something. Well, just 30 minutes later, Erin’s contractions had moved to 5 minutes and then closer, and much stronger and longer. David was talking Erin through each one, reminding her to drop her shoulders and take deep breaths. I could hear him on the other end of the phone. Needless to say, they were packing up and heading out. They arrived at the room at 11:00 that night, and began the admissions process. The midwife came in to assess a short time later and determined that Erin was dilated 6-7 cm with a bulging bag. She felt so much pressure, almost like she was pushing. I reminded her that the bulging bag would make her feel that way and to blow through it as her body finished dilation. A cold cloth on her neck offered a little bit of relief, but her labor was racing on full speed. Erin’s water broke at 11:32 pm and she was fully dilated that instant. Her contractions immediately moved to pushing contractions as she roared her baby to crowning in moments. David was such wonderful support to Erin, looking into her face and supporting her neck through the past part of the birth. When labor moves that rapidly it can be difficult to get a handle on it, but David was definitely Erin’s touchstone. Their baby’s head was crowning by 11:40 and at 11:46 pm Scott Bearach was born!

“Sweet boy,” said Erin, as Scott struggled to open his eyes for the first time in a bright room. His cry was strong and we could tell he was on the chunky side. Erin did an incredible job in the midst of a tornadic labor! She was in active labor less than 2 hours! After things settled down and they had their magic hour with their son, the moment of truth came to learn exactly how big Scott was. He weighed in at 8 lb. 12.8 oz. and measured 20.5 in. long. He was definitely a sturdy baby! Congratulations again, on giving birth with such courage and strength during such an uncertain and crazy time. It was an honor to be present, and to have David be such an excellent hands-on partner. You both rocked it and I am so proud of you!