Candace and Jacob ushered in their third baby girl, Gabrielle Samantha, on October 23 in a birth that defied their expectations, as third births often do. This was my third time to serve them in birth and I knew that Candace tended to dilate rapidly once her labor got going. But because of this, she was especially worried about timing the drive to the hospital so she A) didn’t give birth at home or on the way, and B) so she would have some time to adjust to the hospital setting and experience her labor there, not to mention make sure her doula got there in time. ;)

Candace made her way to her due date and beyond, and as expected, the induction talk was posed. Trusting her body would go into labor on its own if given enough time, Candace advocated for the latest possible date, 41w6d and hoped she wouldn’t need it. She was also pleased when her midwife said they would not jump right to Pitocin given her history and current cervical dilation. Instead, they would consider alternatives like a membrane sweep, breaking water, and use Pitocin only as a last resort. In the meantime, her cervix began to dilate and ready itself for labor. And while there was no guarantee of when labor would start, but the good news that she had already dilated some of the way.

At 11:50 pm the same day Candace texted the induction date was confirmed, she was having contractions. She was concerned about staying home too long and wasn’t sure whether she would know when to head to the hospital. Thinking to her previous birth in which she hardly made it in time, she wanted to be sure she didn’t do a repeat of that just in the nick of time birth. Candace went into the hospital because she wanted to know what was happening. Her contractions were regular at 3-4 minutes apart and her cervix changed between two checks. She arrived 2 cm dilated and was 4 cm dilated at the next check. Her baby was also moving down slowly between checks. She was debating between options like breast pump and breaking water, as recommended by her midwife.

Around 10:45 am, Candace’s midwife suggested she call for me to head in. I arrived shortly after 11:00 to find Candace sitting comfortably. She was 3-4 cm dilated at that point, after walking some and using the pump. Breaking her water was an option but it had Candace puzzling over whether it was the best decision. She thought back to her previous births to try to predict how this one might go, but her midwife gently reminded her that each birth journey is different. After giving it enough thought, Candance decided to have her water broken. The fluid ran clear, and she dilated from 3-4 to 4-5 cm immediately. The time was 11:27 am. Surely, she would have this baby by dinner, right?

Candace’s body shivered, a sign that labor was taking hold. She positioned herself on her hands and knees but commented to us that her baby was on the lazy river and apparently in no hurry to be born. She also walked the halls for an hour to intensify her contractions, but at 1:40 pm her cervix was still dilated to 5 cm. She tried using the breast pump again, but it was too painful to be worth it. Instead, she moved her labor into the shower. I set the mood with aromatherapy and votives and after an hour Candace was dilated 6 cm, although her cervix was still tilted posterior.

She returned to the shower and positioned herself so the water might provide nipple stimulation and stronger contractions, and alternated so her back would get the relief of the warm water. Next, she swirled her hips on the birth ball, and then did some pelvic tucks with the rebozo. At this point I heard her breath sound more labored and noted that her contractions were steady at 4 minutes apart. After the pelvic tucks, Candace was game to do the flying cowgirl position. We suspected for some reason, her baby was having troubling descending enough to significantly dilate her cervix so we chose positions to open the inlet of her pelvis. The heating pad helped with the back pain she felt.

One last push before baby came!

At 5:30 pm when her midwife returned for an exam, Candace was dilated 6 cm. She had made modest change but was not quite yet in active labor. Her midwife recommended Pitocin or iv fluids at the very least, but Candace preferred some time to wait and see. They decided to powwow again after an hour.

Candace returned to the shower since she found the heat helped. She closed the curtain and closed herself off from everything—the room, the check, the machines, the expectations—everything. She wasn’t in there long, maybe 20 minutes but Candace did her best work in that short time. She cried out in frustration, and as she let those feelings wash over her, labor took hold.

Candace was out of the shower at 6:05 pm and draped herself over the peanut on the bed. She was breathing harder, and her contractions were closer. I pressed on her lower back since she no longer wanted the heating pad. Candace began to vocalize with her contractions, and I just knew her baby would be born soon. I called her nurse who joined us quickly and then summoned the midwife. I called the nurse at 6:18 and the midwife was in the room by 6:27.

Candace was dilated 8 cm at 6:27 but she wouldn’t be for long. She told us she felt like the head was there and she was drawn into a push almost immediately. Her midwife was poised and ready at the bottom end and Candace moved her baby with powerful pushing contractions. And Gabrielle Samantha was born at 6:35 pm on October 23, 2022! The midwife passed her baby through Candace’s legs into her arms, and we helped her lay back upon the bed. She was given the magic hour of skin to skin first, but after that was surprised to learn this was her biggest baby yet weighing 8 lb. 13 oz.

Candace snuggled her baby and let the events of the night and the day settle onto her heart. This was her longest labor and arguably her most challenging one too. She hit a wall and persevered, knowing deep within that she COULD and WOULD see it through. And she did just that. Three baby girls born, all three without epidurals. Candace is amazing.

Ashley and Luke are the proud parents of their first child, Benjamin Phillip, born on October 20, 2022. If pregnancy and birth are training grounds for parenthood, then Ashley and Luke are more than ready for any curve balls life may throw their way. When we first met, Ashley made it clear she had a strong desire for a birth free of interventions. She sought her care from a homebirth midwife because she felt so strongly about the birth she imagined for herself and her son.

Fast forward several months and Ashley was faced with the shocking realization that her little guy had settled into the breech position. She got to work doing all of the things—she and Luke took my Spinning Babies® Parent class and incorporated the daily activities and Three Balances into their regimen at home. But Benjamin was so solidly settled into the breech position he just would not budge. Ashley’s midwife knew what had to be done. Sadly, she made the recommendation that Ashley transfer her prenatal care to an ob-gyn group that could perform a safe delivery of her son. And unfortunately, in Hampton Roads that means a c-section.

Ashley only wanted the safest passage for her baby, but that wouldn’t come without a great cost to her. She mourned the change in the birth she had envisioned and began to pick up the pieces to construct the scheduled c-section birth that was laid out for her. She advocated for providers in the private sector but being that her husband was in the military, she was given only the option of the naval hospital. This only frustrated her further and required even more of the letting go that she had been doing. I was so proud of her for standing up for her beliefs and desires but also for being flexible in the midst of so many changes to her “plan”.

After some back and forth the c-section was scheduled for a day, but no specific time yet, leaving Ashley and Luke to know generally when to expect it. Ashley texted me the vague information around 2:30 pm on Thursday, October 20, knowing nothing but that the c-section would be the following day. So they continued to hold loosely to their expectations.

But two hours later at 4:35 pm their little guy flipped the script again! Ashley texted me to tell me that her water broke! While obviously a bit surprising, they realized right away the gift they had been given. Since her water had broken and her baby was breech, Ashley and Luke made the decision to go to the nearest hospital instead. It was their preferred hospital anyway, and since she was technically an obstetric emergency, it was highly likely they would admit her and take care of her.

They proceeded to the hospital around 5:00 pm, and while they waited in triage for a total of four hours, Ashley was admitted as a patient with the general expectation of a c-section sometime that night. And as if that wasn’t enough, within the hour of their time at the hospital, Ashley began to feel contractions that were uncomfortable. They grew quickly in intensity and had her using her comfort measures from the start. They were painful, making her vomit, and also had her ready to move forward with the c-section as soon as possible. An exam confirmed she was dilated 1.5 cm, so her labor had a lot more time to ramp up. She maintained her sense of humor through it all, realizing how crazy it all unfolded. And some Nubain helped her manage the contractions for a little while as she waited.

Finally, once the OR was ready for them and the surgical team was assembled, Ashley was wheeled back. Luke would join her once the spinal was in place. Once back there, they welcomed their son into the world at long last! Benjamin Phillip was born at 9:35 pm weighing 7 lb. 4.8 oz. and measuring 20.47 in. long. He was perfect, and the sight of him melted away all the potholes and crevices they had navigated on their journey to meet him. Ashley had a bad case of the shakes, so Luke held Benjamin in the OR and kept him close.

Once in their postpartum room, Benjamin had his first chance to latch, and while he tried several times, he preferred to nap on his mom. And could you blame him? He went through an ordeal just as much as his mother did. In the hours following, as Ashley processed the experience, she came to the realization that her son chose his birthday and she got some of the labor experience from her water breaking and some intense contractions to boot. And the icing on the cake was that she chose the hospital in which to give birth. Ashley was treated wonderfully and had an amazing experience. She felt cared for and heard as it should be. And she was less than 10 minutes from her home.

Ashley and Luke learned how to redirect and reevaluate, letting go of some things, and holding tight to others. They are thriving at home now as they continue to navigate parenthood and make choices that are the best for their baby. I am so proud of them. It’s tempting to emphasize the birth of a child when a woman gives birth, but there is also the birth of parents! And these two have hit the ground running in that department.

Melissa and Mike met their sweet baby girl, Aspen Glori, on October 8, in what can best be described an exercise in patience and letting go. Melissa and I hit it off right away and she was forthcoming to me on her strong desire for an unmedicated birth. With her due date a few days away, she hunkered down to wait. There was talk of an induction if she went much past it, but she hoped it wouldn’t come to that. But when she texted with contractions October 6 it seemed perhaps her baby would circumvent any need for induction. They had begun the previous night and never quite went away until the following afternoon around 3:00. Melissa learned the importance of resting and her contractions drifted off as she did.

Four hours later she texted she thought her water might have broken. You’d think it would be obvious like in the movies, but it often isn’t! Melissa waited a few hours and on the recommendation of her provider, she went in to the hospital that night to get checked in labor and delivery to see if her water had broken. It was inconclusive whether her water had broken, but the there was enough of a concern regarding the color of the fluid to warrant induction. Melissa didn’t want to go that route, but she decided to stay at the hospital where they could monitor her baby.  She was dilated just 1 cm so they had plans to eventually ripen her cervix but thought it best to let her rest as well as she could overnight. (So kind of them!)

When they checked her the next morning, October 7, Melissa was still dilated 1 cm, however she had thinned from 40% to 100%. The plan was to start with oral Cytotec. Melissa’s contractions were still sporadic so they would need to get more organized to make cervical change. It didn’t take but two doses of Cytotec for Melissa’s contractions to get consistent and strong. They were 2-4 minutes apart by 2:00 pm and she was wondering if she might need some pain management help.

It felt like the right time to head in so I was there just before 3:00. Melissa was sitting in the rocking chair breathing through contractions. She had significant back pain, so she moved to her hands and knees over the cub birthing chair and Mike began applying counter pressure there. By 4:09 pm Melissa was dilated 2-3 cm. The next move was to labor in the shower, but she wasn’t in there more than 20 minutes before wanting to try something else.

Melissa used the rebozo tied over the door to dangle squat through some contractions in the hope it would bring her baby girl down lower in her pelvis and further dilate her cervix. But the pain was becoming overwhelming and an hour later Melissa decided it was a good time for an epidural. The CRNA had the epidural completed by 6:15 that night. Melissa rested but continued to move into various positions with our support using the peanut ball. She was dilated 4 cm, 100% effaced, and baby was at -2 station by around 7:45 pm.

The consensus was made to begin Pitocin. And after discussing it with her doctor, Melissa was feeling much better about it. It is administered gradually and only to the level her body required for consistent contractions that produced cervical change. Melissa was grateful for the doctors who were on call for the duration of her labor because she felt heard and like she had a say in her care. That is so very important.

We used the peanut and stirrups in various ways and had Melissa in a myriad of positions. But 5hours later she was still 4 cm with some anterior swelling. She also felt some back pain, which was surprising. An IUPC helped measure the strength of the contractions to make sure the appropriate level of Pitocin was used, and by 1:00 am everyone was trying their best to sleep.

Every once in a while, we would change Melissa’s position, including the flying cowgirl which can often be a game changer when baby’s position is less than optimal. And after all this time, it was certainly the case that baby was being creative in her positioning.

Baby had some decels in her heart rate that were concerning around 3:30 am, but a change in position helped that. And by 4:10 the contractions were more regular and as a result, by 4:30 Melissa was dilated to 6 cm! This was exciting news but with her baby still at -2 station her doctor was still concerned. Melissa anointed herself with essential oils to provide emotional support as she navigated the uncertain turn of her labor. It had been a long night and the possibility of a c-section had been mentioned.

After more creative positioning with Melissa (to help her baby’s positioning NOT be so creative!), Melissa was still dilated 6 cm 2 hours later. There was a decision to make and here is where the provider makes all the difference. Melissa knew she loved and trusted the doctor who had overseen her care and knew the incoming doctor might not be on the same page. With signs pointing toward a c-section, she chose not to delay it to the point of the next shift and rather decided to consent to it under the watch of the same doctor. She promised to stay past her shift to see it through, for which Melissa was most grateful.

Melissa mourned the change in plans, and even expressed frustration at the situation. But she was at peace ultimately with how things came together and with the team she had effectively chosen to welcome her baby into the world. Aspen Glori was born without complications by c-section at 10:06 am, surrounded by her mom’s chosen team. However, she was solidly OT and a solid baby weighing 8 lb. 9 oz. It appeared she was born the way she needed to! She was also a lanky 21.25 in long. Where Melissa put that baby in her small frame I’ll never know.

Aspen was skin-to-skin in the OR and had her first latch at barely an hour old. In the hours following, talking through things with Melissa, it was clear she had a mindful birth. She processed her feelings every step of the way, made decisions that she felt were right and that her provider supported and respected. And I can happily say at our postpartum visit she and baby Aspen are absolutely thriving. I am so proud of Melissa owning and embracing her baby’s birth the way she did.

Karynna and Jeremy welcomed their first child, Samuel William, on October 6! This first-time mom was gifted an atypical birth by her son, with a labor that seemed to go full force quickly. She also managed her early labor at home well, timing the drive to the hospital on the later end, which isn’t necessarily bad, but it’s definitely hard!

Out of the blue, I got a text from Karynna around 7:00 am, telling me her water broke around 6:30 am and she was having very light contractions. She had been ignoring them thinking they were Braxton Hicks at first, until her water broke. Soon after that her contractions were strong, long and close. I recommended she give it an hour and see what happens and then update me. Jeremy was at work but knew of Karynna’s plan to lay back down and continue to ignore them.

But by 8:30 they were already as close as 1-2 minutes apart, but lasting 40-50 seconds. She couldn’t walk between them and definitely had to focus through them. She asked Jeremy to come home since she could no longer think straight.

I got a call from Jeremy around 9:00 am that morning telling me the contractions were already long, strong, and close, and only growing more so on all fronts. Apparently, soon after her water broke things went from 0 to 60!

They soon decided it was time to head in to the hospital. Karynna was breathing through strong and close contractions when I joined her. Jeremy went to fetch bags out of the car while I supported Karynna in triage. She was dilated 4 cm when she arrived but had a lot of back pain between her contractions as well. That coupled with the contractions being much stronger than she anticipated, had Karynna wondering how much harder things could get. Karynna wanted to labor without an epidural but she said, “It hurts!”

Once out of triage, we went about offering comfort measures to help her settle into her room. I clipped the fan to the IV pole as Karynna breathed through long contractions. Being a nurse herself, she apologized to her nurse who had been called in. This just shows how sweet natured and empathetic Karynna is, as well as how in control she remained.

When she relaxed her bottom, she had a strong feeling like she had to have a bowel movement. It was 10:50 at this time, less than an hour after she arrived at the hospital. Since Karynna felt so much pressure, her nurse went to fetch delivery meds to have them available just in case she really was close to delivery.

Christian music began to play on the speaker to help keep Karynna focused and grounded. She drew strength from her faith in God, and the music really buoyed her. At 11:04 am she was dilated 8 cm! She dilated from 4 cm to 8 cm in just over an hour’s time! Her baby was moving down most definitely, hovering around 0/+1 station. Karynna’s midwife joined us about 15 minutes later.

Karynna had an interesting focal point to get her through labor—a sandwich from Taste! We continued to bring that up to encourage her through the contractions of transition. A heat pad on her lower back helped to ease the pain she felt there.

Around 11:26 am Karynna sounded a bit pushy. She told me she felt like she was clenching, but I told her it might be the baby’s head that she’s pushing against. She swayed her hips between contractions and did her open glottis breathing through them. Jeremy stayed within arm’s reach and made his presence known with a gentle stroke of the arm and lovingly looking on.

At 11:55 am Karynna did the dangle squat using the rebozo to bring her baby even lower so she might feel a stronger pushing urge. And by 12:00 she went into the shower for some excellent pain relief and continued relaxation as she moved through transition. She got out of the shower 25 minutes later feeling depleted. The heat of the shower can do that, but so can active labor. She lay down upon the bed but was scared to do so knowing it would likely make the contractions hurt more.

Karynna asked if she should push with her contractions. She felt pressure, but her nurse reminded her to wait until she could no longer hold off on the growing urge to bear down. She was dilated 9

We reminded Karynna to trust her body as she lay on her left side with the peanut ball between her legs. Her open breaths turned into gasps as her cervix opened to complete and we heard her begin to push. Her nurse called for the midwife who returned a short time later.

Shivers cascaded all over Karynna’s body as she transitioned from dilation to pushing. She followed the cues of her body and brought her baby down nicely. In fact, we could see her baby’s head by 1:30. A wave of nausea hit her during a push, but her baby was even lower as a result. I could see her baby’s head from the top of the bed at that point! Karynna reached down to feel her baby’s head for herself at 2:15, and the look of awe on her face was priceless.

Karynna continued to follow her body and push as it felt right, and in time she was rewarded with the birth of her Samuel at 3:08 pm! The love and relief washed over Karynna’s face and Jeremy’s eyes filled with tears. We could tell that Samuel was a chunky boy! But when he was eventually weighed and confirmed 9 lb. 8 oz. we were amazed! He flew right out of his mama just fine. He was measured at 20.5 in long. The placenta came a little bit later, and some bleeding was addressed with Pitocin.

The midwife leaned in and congratulated Karynna on such a beautiful job. She listened to her body and didn’t allow her moments of doubt cloud her goal of an unmedicated birth. She was surrounded in people who believed in her and she too, most importantly, believed in herself. It was a great reminder of the power of preparation and positive thinking. And the belief that her body was built by her God for birth didn’t hurt either!

Amy and Eric are three-peat clients of mine! So, they are special to me. Amy’s first labor was long and complicated, resulting in an epidural she had hoped to avoid. Her second labor was more difficult than she expected and had Amy requesting an epidural only to be pushing shortly after. So, this time was it. She was determined and knew in her heart she could give birth to her third baby girl without an epidural. Of course, I believed she could too, as did her steadfast husband, Eric. We were excited to see what her third baby, with the third baby reputation of a wild card, would throw her way.

New van purchase on 8/29 - 3 weeks before the birth

There were some concerns about position in the third trimester, and Amy’s midwife and I advised her to do some posterior pelvic tilts to get her baby more properly positioned to drop into the pelvis. Amy was diligent about the Miles Circuit as well as the posterior pelvic tilts. She had tools and she was going to use them. She was also healthier this pregnancy and gained less weight than her previous two, a difference that certainly can’t hurt. She grew comfortable with contractions, knowing there would be a difference between contractions of labor and contractions for other sorts of things. She was careful not to raise alarms for nonlabor contractions and instead kept herself busy and distracted which was easy with two busy little girls at home.

Belly shot taken 9/6 - about 2 weeks before the birth

Amy’s third baby proved the wild card reputation in many ways. The first being that Amy made it a week beyond her due date! She birthed her first two girls before her due date. There was discussion of an induction on the horizon but surely her baby wouldn’t wait that long! Amy decided to have her membranes swept at her 41w appointment to see if it might jostle up some labor. Nothing but Braxton-hicks contractions resulted from that, unfortunately. Amy had pretty much consigned herself to the fact that her third baby had her own plan. And that she did!

This photo taken the day of the membrane sweep, 9/16

Amy woke with contractions around 2:30 am on Sunday, September 18. She got up and paced around the room to get a feel for whether they were the same old Braxton-hicks contractions, or perhaps she had to go to the bathroom, or maybe, just maybe they were labor. The contractions persisted so she called me an hour later.

Big sisters meeting little sister

That call came to me at 3:33 am. Amy said, “I’m having contractions that seem close, but they are short. I think this is it but I’m not definite yet. I’m wondering if I should go to the hospital or maybe call Eric’s mom to watch the girls.” Then through one of the contractions she confessed to me, “I don’t want to do this anymore.” I reminded her that she DID want to do it, especially this time. I also reminded her to soften her jaw, shoulders, and hands, so as not to clench anywhere. She breathed through a couple of contractions during that short 5-minute phone call, and I reminded her that her midwives had advised her to call if she had three contractions that were strong and required her focus. She was on speaker phone and Eric said, “These are bringing her to her knees,” and that’s all I needed to hear. It was time to call her midwife and head in. Eric called his mom so she could come to the house to watch the girls so they could leave for the hospital. They would call me when they were on the way, and I would leave to meet them since our drives were about 10 minutes different.

At home with baby sister

That second call came from Eric at 4:12 am telling me they were in route to the hospital. I could hear Amy vocalizing LOUDLY through a contraction in the background and thought UH OH! I knew I had to hurry out the door!  That call was just 15 seconds long. I was on my way to the hospital in under 10 minutes.

My eta to the hospital was 4:36 am, this time will be significant later. I was held up by two red lights but still managed to get to the hospital in a speedy 15 minutes. However, when I turned into the parking lot, I saw a car parked in the circular drive outside the main entrance. This almost always means a laboring woman was let out as close to the door as possible and walked in with her partner because the walk from the car to the door was just too much. I knew Amy was laboring HARD.

Security Guard Mike

Then I jogged my way to the front door and paused in the foyer to hit the button to summon security to open the door. As I waited, I looked up through the glass door to see Ericka, Amy’s midwife, jogging down the stairs from the Family Maternity Center. UH OH! I felt panicked and a sense of urgency to GET IN THE DOOR. The security guard, I would later learn it was Security Guard Mike, walked up and let me in saying as he gestured to the car parked out front, “Are you here for them?” I think he knew I was because I was holding an inflatable birthing chair. I said I was, and he remarked very matter-of-factly, “Because I think she just gave birth in the lobby bathroom.”

I ran to the bathroom door, dropped my things on the floor and entered to find Eric sitting on the bathroom floor against the wall breathing hard in a bit of shock, and Amy standing outside the stall with a bright-eyed look of accomplishment on her face, surrounded by about 8 people in scrubs. She saw me and said, “Well, Amara, I did it! I got my natural birth!” I told her, “Yes you did! And you did it with flair!”

I snapped a few pictures and then took a seat beside Eric who seemed to need more attention than Amy in that moment. I praised him for getting Amy to the hospital in time, knowing that drive must have been stressful. Then so they could help Amy go from standing to sitting in the wheelchair to head upstairs, they handed Eric his baby girl. And he looked down at her and wept big daddy tears. It was priceless.

Getting upstairs was an event, from making sure the wheelchair had a pad on it, to walking in a parade formation to the elevator and then onto the unit. Amy was already the talk of labor and delivery, but that talk would continue for weeks following, if not longer. I will never think of that bathroom stall the same, that’s for sure.

Once in her labor and delivery room, Amy’s body started to shake uncontrollably. Her hormones took over, just as they had a short time earlier to birth her baby, and now were working on the placenta. Once it was out, and she was ready, Mary Rose was placed in her arms. She latched easily and Amy started to share the details she remembered. Eric sat upon the couch to continue to decompress and eventually hold Mary Rose again, this time on a proper couch and not on the floor!

Amy told us little bits that she could recall. Amy shared how counted breaths through her contractions, “just five breaths and it will be over,” she told herself. During her phone call with me the reminder to soften from head to toe also helped. In fact, it became her mantra through every subsequent contraction following our phone conversation. “Relax your hands, relax your shoulders,” is what Amy told herself. Soon even Eric was repeating it to her as he drove her to the hospital. And that reminder of “relax your hands, relax your shoulders,” is what Amy credits making the precipitous labor doable.

Once they arrived, Amy had wanted to stop in the bathroom because she wasn’t sure if she had to pee or poo. (Let me note here that had I been with them in that moment I would have discouraged the potty pit stop and insisted on a quick elevator ride upstairs to the unit first!) And when Amy wiped, she saw blood and got concerned, and then reached up to feel her baby’s head! Then there was a bit of back and forth to Eric about him catching the baby, and then Melanie got there. And when she pieced together the details by timestamps of phone calls and pictures, she was only in labor for 2 hours! And Mary Rose was born at 4:36 am, the same time I parked my car. And Amy pushed her baby out in one single push! And for the record, Mary Rose weighed in at 7 lb. 14 oz. and was 21 in. long.

Mary Rose was about as much of a third baby wild card as she could be. These are the many ways she was different: she was born after 40 weeks (8 days after her EDD!), Amy had a membrane sweep, this baby was the only one not OP, labor began in the middle of the night, Amy’s water broke during labor, not before (thank goodness!), she birthed unmedicated, and not in a labor and delivery room! Whew, that’s a lot of firsts!

Some of the first responders from the Family Maternity Center: Martina, RN, Melanie, CNM, and Stacie, RN

Everyone who assembled for the birth, went their separate ways soon after. I went on a mission to find Security Guard Mike and the Family Maternity Center staff who came to the bathroom/delivery room--Melanie, CNM, and the nurses, Stacie, and Martina. Even Ana, Amy’s nurse, made it down there. Plus, there were several extras in the bathroom from the ER too. Ericka, her midwife, did end up in the bathroom too. They all played a part in the crazy birth that unfolded that night and without a picture, Amy might not remember their faces since within minutes of meeting them, they were off.

Mary Rose’s potty

There might have been a bag or two in the car to fetch and the car that still needed to get moved. I imagine Security Guard Mike wouldn’t let their car get towed. It was a crazy sort of birth, for sure. But at the heart of it, was a woman highly motivated to have an unmedicated birth. Amy didn’t need any of us! She did it. Even Melanie didn’t have to do anything but tell Amy to push. It’s quite a story. And one that shows in a dramatic way, that it’s the woman who delivers her baby! I have never, in 20 years and over 900 births ever had a client give birth in the lobby bathroom of a hospital. And that middle stall in the lobby bathroom of Sentara Leigh Hospital will forever be Mary Rose’s potty to me.

Amy and Eric with their three adorable little girls

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.

Amber and Nathan welcomed their second child into the world on September 13, 2022. Amber’s first birth ended in c-section, and she was very motivated to have a VBAC this time. She aligned herself with providers who were supportive and chose a doula this time as well. We had our prenatal visit in which she reiterated with me her strong desire for not only a VBAC, but an unmedicated one. She was determined and motivated and had assembled a team to support her every step of the way.

The first I heard from Amber about labor was a text that came through about 2:40 am on September 13, the day she would welcome her baby. She had timed her contractions for about an hour and had a regular pattern of 5 minutes apart, on average, with the duration of a minute with some shorter and some longer. The app told her it was time to go to the hospital, but she didn’t feel it was time yet. Some were painful but most were still tolerable. They began around midnight. I told her to stop timing and wait until they were consistently longer than a minute and more like 3 to 4 minutes apart before heading in, assuming she was comfortable doing that.

Over two hours later, the text came in that they were heading to the hospital. Contractions were 2-3 minutes apart and longer at 1-1 ½ minutes in duration. Plus, she thought her water started leaking. They were also stronger, so it was a very goo d time to head in! Upon arrival, Amber was dilated 4 cm and 90% effaced—a good place to be. But there was some concern as to whether her sutures were optimal for a safe VBAC, however, Amber held her ground and made it clear to her doctor that her desire was to move forward with a VBAC. They would monitor her and baby throughout and as the nurse said, “watch baby like a hawk” for any signs of a rupture happening. The likelihood was still very slight, but more elevated due to the sutures done at her previous birth out of state.

I arrived within the hour, shortly after Amber was in her rightful room. Her water had broken at the hospital, and she was laboring on her hands and knees over the peanut ball. We placed a heating pad on her lower back where she felt the most pain. The wireless monitor was being charged nearby, with plans to be used later to allow the chance for the shower. And an hour later at 9:00 am she was dilated to 5, 100% effaced, and her baby was at -1 station. Things were moving along nicely, and her baby’s heart rate sounded perfect.

Amber’s contractions were coupling, however, which means they were coming two at a time and then spaced. This was a compelling indication that her baby’s position was not optimal. So, we got to work being strategic! I did some “shake the apple tree” with the rebozo around Amber’s bottom, and then had her do lunges on both sides. And then her contractions adjusted to every 2.5 minutes! She preferred the hands and knees position, so she continued it over the cub chair as she breathed calmly through her growing contractions. “Hand,” she would gasp from time to time, and either Nathan or I would extend our hand out for her to squeeze. Amber had quite the labor grip!

In time, every position hurt, but this was to be expected. Amber felt most of the discomfort in her back, hips, and belly, but they were hurting in unison which was reassuring to us that her baby was moving down, and her cervix was opening. Her contractions intensified and we secured a fan to help cool her as her body worked harder. Amber moved to the bathroom and sat on the toilet to labor for nearly an hour. She felt her contractions get stronger and she said, “ouch” through each one. I encouraged her to change her word to “out” and that became her mantra to her baby through each surge.

By 11:12 am, Amber stood back up and was ready to do some upright positions. She squatted with the rebozo tied overhead, she slow danced with Nathan, and even stood beside the bed and leaned over the peanut ball. At one point her nurse couldn’t get a good read of baby’s heart rate, so Amber lay on her side in the bed. This can be challenging late in labor, but she talked herself through it saying, “I can do this,” and managed quite well. When her midwife returned 1 ½ hours later at 12:50 pm to check on her progress, Amber said, “Good news please.” And her midwife was happy to report with a smile on her face that Amber was fully dilated, and her baby’s head was at +1 station!  “Oh, thank goodness,” or something similar was Amber’s reply.

She began pushing a short time later as her body began bringing the urge to bear down. She started out pushing on her side but didn’t feel that was productive for her. But when Amber sat upright in bed holding the rebozo tied to the squat bar she felt like she was making more progress pushing. She pushed in this position for a while, and then leaned a bit more back to push. Amber reached down to feel her baby’s head and was encouraged to know how close her baby was. She felt it after pushing a bit longer and could really feel how much more head was out! And after just an hour of pushing, Amber welcomed Naomi Blair at 1:45 pm! This beautiful baby girl weighed 8 lb. 3 oz. and was 20.5 in long.

Amber embraced her baby girl, her triumphant VBAC baby, and let all of the oxytocin wash over her. It’s quite an accomplishment to labor without pain medication in the hospital setting, but when pursuing a VBAC, it can be more challenging physically and emotionally. I was so proud of how Amber allowed her labor process to unfold and didn’t allow voiced concerns by her doctor to change her plan. She took their information in and considered her options and weighed the risks and moved forward knowing she and her baby were being closely monitored. Amber’s birth is a reminder that a VBAC is nearly always a better plan than a repeat c-section, especially when the risks can be managed, and safety measures are in place.

Kelly and Dan welcomed their son, Daniel (6th generation!), on September 5, 2022. Birth is always full of surprises and the same was true for these first-time parents. Kelly’s water broke in the beginning, which is the statistically unlikely start. She knew not to get too excited and instead, gave her midwife (and doula) a heads up and spent the day relaxing as well as she could. There were no perceivable contractions, and she felt her baby moving just fine. The plan was to wait 12 hours to see if anything changed or if contractions started, at which point they would go into the hospital and get assessed and determine next steps.

The day was uneventful regarding labor, but it provided a nice chance for Kelly and Dan to spend their last day pre-baby together spending quality time. Kelly did start feeling some mild cramps (contractions?) every 8 minutes around 2:30 that afternoon but were comfortable enough at home to wait until the 5:00 plan. Once at the hospital, Kelly’s midwife confirmed that her water had indeed broken, and she was dilated 2-3 cm. The contractions were coming every 10 minutes, but she wasn’t quite in labor. The suggestion by the midwife was to use the breast pump to bring stronger and closer contractions and if it didn’t work after 4 hours, they would consider using Cytotec.

Well, Kelly’s body responded nicely to the breast pump because by 8:00 that night, Kelly’s contractions had jumped to 4 minutes apart, lasting nearly a minute. She labored in various positions but found hands and knees to be helpful. Over the course of that hour, things took a turn and Kelly threw up a few times and her contractions were consistent at every 3 minutes. The shower was the next plan!

An hour later, at 9:45 pm, Kelly’s cervix was checked, and she was dilated 4.5 cm and 90% effaced. Her body had made some nice changes and seemed to be moving into active labor. I was finishing up at another client’s birth and would be on the road to the hospital within the hour. The drive was 45 minutes, but Dan and Kelly were comfortable waiting rather than calling in a backup doula. After all, first babies take their time, right?

In the meantime, when she emerged from the shower, Kelly wasn’t so sure she wanted to continue laboring without an epidural. It had been her plan to go natural, but active labor was taking over, and her mind was thinking differently. Her nurse and midwife were resolute support for her and encouraged her to continue laboring as she had. I was driving to the hospital with an eta of 11:30 pm. The plan was to continue as she had been, laboring using the comfort measures at her disposal.

I arrived at 11:30 pm to find Kelly laboring on the bed with Dan by her side. She was breathing well through her contractions, but I could hear in her voice that she was working hard. Things had clearly taken off. Kelly felt a lot of pressure sitting upright on the bed so I suggested she move to hands and knees over the cub to see how that might change things. Dan applied counter pressure on her lower back and held a cold cloth up to her forehead. Because she was feeling so much pressure, she got checked at 11:50 pm and to everyone’s surprise Kelly was fully dilated! It was also looking like she may be the first on the unit to have a Labor Day baby and this had extra special significance since the first news story Kelly had done 10 years earlier in New York as a news anchor was about the first Labor Day baby born!

She blew raspberries as the pressure grew at the peaks, and she allowed her body to labor her baby down to the point of really needing to push. Kelly gave her first pushes leaning over the cub, then we set up the squat bar and rebozo. She pushed on her knees with the squat bar. Kelly squatted and kneeled as she pushed her baby lower. She pushed with commitment and strength, and it didn’t take long! Her baby boy was born at 12:35 am after just about 30 minutes of pushing.

Daniel was passed through Kelly’s legs into her waiting arms, and she and Dan looked down at their son in awe. What had just happened? And so fast! We helped Kelly lay back down upon the bed so she could rest with her baby in her arms and wait as the placenta came. Dan had the biggest smile on his face as he looked into his son’s eyes. What an amazing thing to witness!

The placenta came just over 10 minutes later, and it was at that point that Dan cut it. Kelly brought her son all the way up for a kiss and a snuggle as she let the crazy last two hours sink in. Daniel latched well and as his mother looked on. As new as she was at mothering, to look at her you wouldn’t know it. She held her son with confidence, and she was so calm. Her labor had taken off like a shot, but she stood her ground in that storm with Dan by her side. And together they brought him into the world. The rest of us were there to support and guide but they totally rocked it!

Christina and Clint are parents! But their journey to meet their baby could better be described as an odyssey, I think. They were students in my childbirth class so they were very prepared for the many ways birth can unfold. Still, you never know how YOUR birth unfolds until it does.

Christina’s blood pressure began creeping up in the final month of her pregnancy, putting her on modified bedrest and the plan for induction earlier rather than later.  In fact, it was set for 37 weeks. Christina and Clint had a very open approach to the birth and knew the importance of being flexible for the best outcome for their baby, but also for Christine, whose blood pressure continued to trend high.

After a hiccup with no rooms available, she got the call back that there was a room available. So, Christina and Clint made their way to the hospital on Thursday night, September 1. The plan was to ripen her cervix first, since it was not yet effaced or dilated, and baby was high. Cytotec was the mode for ripening the first night. Christina slept and hoped for a change in the morning’s exam. But there wasn’t.

Day two, Friday, they continued the Cytotec through most of the day without much change. Christina rejoiced in the opportunity for breakfast and coffee the morning of the second day and developed a taste for the broth that appeared each meal from the hospital cafeteria staff. And her doctor encouraged her to get some dinner before the Pitocin began that night and Christina was thrilled for that!

They attempted the Cook balloon to ripen the cervix second night. Christina’s uterus was contracting regularly every two minutes, mildly, and low dose Pitocin was the overnight plan for ripening. The bed did her back no favors, so she sat on the kaya birthing stool with her head resting on the bed to attempt sleep.

Christina had the best attitude through the induction. She told me time and time again how she knew her body wasn’t ready for labor so she expected the induction to be a process that could span days. Realistic expectations are important in birth, but especially with an induction. You just never know how it will unfold! Christina was also pleased to know her baby was active, seemingly unphased by the whole ripening process. She could be patient for him. Christina did have some discomfort, but it was more due to the bed than any contractions, unfortunately. She went to bed that second night and hoped for the best.

Saturday morning, day three, the balloon was removed but Christina was only dilated 1-2 cm. This was a difficult moment for her and despite her sunny attitude thus far, she shed some tears and allowed herself to mourn how long and drawn out this birth had become. Her baby was also still very high. Her contractions the previous day were worse than the contractions this day, which allowed her a few hours of rest overnight at least. The Pitocin was high, at 16 mu by 9:30 that morning.

Saturday evening there still wasn’t much happening. Christina was dilated 2-3 cm and was given the gift of a break. She was unhooked from everything and even took a shower! Then she and Clint went for a walk outside in the healing garden and enjoyed dinner of a salad before returning to the room to continue the ripening process. The plan for the third night was to return to the Cytotec and see if Christina’s body responded differently than the first night they tried. Christina hoped to get some rest that night at the very least, and maybe some additional dilation.

The third morning, the verdict was discouraging. Christina’s cervix had not changed. Her doctor laid out two options for next steps: break her water and get an epidural and see if that combination with likely Pitocin might bring on some labor; or proceed with a c-section. Christina didn’t have to think very long about it, for she felt the answer was clear. After three days of ripening a cervix that still wasn’t ripe, she felt most comfortable with the c-section rather than trying another day and running the risk of an emergent c-section later.

This is a brave and courageous woman. This is a patient woman. This is a woman who is not willing to risk potential stress to her baby with another day of ripening and induction. This is a woman who is ready to meet her baby. Christina had a choice, and she made the best one for herself and her baby, with full support from her birth team.

Asher Cole (Hebrew for happy and blessed), was born at 6:45 am on September 4, 2022. He weighed 7 lb. 13 oz. and was 20 in. long. He was a decent size for 37 weeks! And as if the c-section wasn’t already the best decision for Christina, when they got into the OR to get situated, they couldn’t find Asher’s heartbeat. The doctor said, “It’s time. Let’s get him out.” And they did just that.

Asher was latched by 7:55 pm, hardly an hour after he was born, and his mother was beaming with him in her arms, knowing her had come earthside safe and sound. Clint was a faithful and loving partner through it all too. Inductions are grueling for everyone, and the waiting game and living in one room for three days can wear anyone down. His attitude was just as upbeat as Christina’s and that alone was testament to their willingness to do the hard things for their baby. Birth looks so many ways, but at the core it is the same: making the best decisions for mom and baby with love at the center of it all.

Sasa and Tyler welcomed their second son on September 2, 2022, in a beautifully healing birth. Sasa did not emerge from her first birth feeling confident and like she was listened to. She hoped to have more agency and a voice this time, and Tyler and I were intent on helping that happen. We were by her side the first time, so we had an understanding of what that journey entailed.

Sasa’s body had bouts of warm-up contractions for weeks. She was an expert at minimizing and ignoring them, not ever reaching out to me once. In fact, the first heads up I got from Sasa was a quick text on the way to the hospital! It was 8:30 pm on Thursday, September 1, and a phone call right after the text help solidify that these contractions were different, and I should just make my way to the hospital.

Later I would learn that her contractions were different that evening around 5:00 pm, leading her to think it was the real deal. She didn’t want to trouble anyone unnecessarily by raising the alarms too soon or for nonlabor, so she waited. It was a wise decision to leave because Sasa was dilated 7 cm when she got to the hospital. Those second baby labors can really fly!

She breathed through the triage questions and the hep-loc setup which took a bit of doing and maintained her labor groove. Once she was shown to her room the call was soon made to have the tub setup for labor. Sasa felt back pain with her contractions, so I applied counter pressure and a heating pad. Tyler was always right by Sasa, encouraging her and believing in her.

By 10:15 that night the tub was blown up and filled with water, however it was a bit too hot, so some ice was dumped to tweak it to the optimal temperature. THEN Sasa was able to get in. She was feeling tired from her labor, so we gave her some coconut water and added encouragement. Labor always makes women tired but not letting it get in their head is the challenge. Sasa got out of the tub at 11:30 for something different, then labored over a chair through some contractions until she eventually found herself laying on her side in the bed.

Sasa exhaled “ooh” with her contractions as the pressure mounted at the peaks. “I don’t think I can do this,” she confessed at 11:00, but I reminded her that her baby was very close. Her voice continued to climb with the intensity and her growls were stronger. Shortly before midnight, changes in Sasa’s demeanor and voice hinted that she was pushing. Her midwife asked if she felt different, and Sasa confirmed that she was pushing. “Nothing helps anymore,” she said, and then rolled over onto her hands and knees before the next contraction hit.

Sasa’s midwife gave some verbal encouragement about how this birth was different than her first and she was doing amazing. It was important that she had a safe space in which to labor as she wished, and we all understood that. Sasa lay back down on her side and then rolled to the other, and then got up to stand at the foot of the bed. This birth seemed harder to her than her first and it might have been. It also might have been that she was in the hard spot between transition and pushing and many women give pause in that space as they wrap their heads around what is to come.

Sasa moved her hips back and forth and made the sounds she needed to make as she brought her baby down. We placed cold cloths on her neck while continuing to place the warm pack on her back. The midwife pulled the delivery cart near as Sasa pushed unmistakably just before 1:00. The midwife got dressed in the paper clothes and moments later Sasa’s water broke all over the floor. It was 1:19 and her baby was coming!

Nursery was notified as Sasa roared her baby to her perineum. She breathed and paused and was patient at the right time, and then brought her baby’s head out. The shoulders were next, but they took a little effort. But Sasa mustered all her strength and brought her baby out with the next push at 1:37 am!

Baby Lukas was passed through Sasa’s legs into her arms for her to get a look at him and take a moment to realize what she had done. Tyler was just as astounded and overjoyed as Sasa was, taking in everything as Lukas cried out. Once we helped Sasa upon the bed, Tyler cut his baby’s cord. This was not something he did the first time, so it was extra special.

Lukas weighed 8 lb. 8 oz., just 3 oz. shy of his brother’s birth weight. These boys were big for Sasa, but she did it! Lukas latched well and Sasa basked in the oxytocin that follows a particularly amazing birth. She felt different. I could tell she even looked different. Her midwife leaned in before leaving and told her what an amazing job she did. Sasa smiled to hear it and settled into to getting to know her son.

Sasa’s birth was a beautiful example of how every birth is different. Her birth journey was a healing one that allowed her to feel strong and heard, and one in which she had choices and respect, and the freedom to labor as she saw fit. She shined in that environment and under the supportive team that surrounded her that night.