A Vacation Birthday - July 6, 2010                                                                            I have been eagerly anticipating the arrival of my last baby in June (turned into July). When we first met, mom was convinced she would be having this baby in June and I happily reset her due date for early July - boy am I happy we did that. After many false labors, we turned the corner in July to find baby still not wanting to join us in our extrauterine world. On July 3rd Mom and Dad had gone shopping and Mom reports losing the last of her mucous plug. She arrives, in the afternoon, for a relaxing massage with an amazing friend of mine. About an hour after the massage is schedule to begin I recieved a text from said awesome friend - SROM - for those of you not 'in the know' - Spontaneous Rupture Of Membranes - in other words, her water broke on the massage table. Mom and Dad call me on their way home and are having contractions as they drive home - water is definitely broken. Surges are strong and close together, mom is handling them well. I gather all my things together - kiss the kids, kiss my husband and call my mom to arrange some alternate plans for my relatives who were all supposed to be converging on my house later that evening. Dad calls and asks me to please meet them at home as soon as possible. When I arrive mom is working in the bathroom - the surges are coming close together and while not impossible - they are definitely stopping her in her tracks, "women really do this?!?!?!?", she asks. I reassure her that not only do women do this, but there are women all over the world doing it right now with her. She is glowing and beautiful. At this point, we talk about options. She is birthing in hospital, with midwives. She is GBS+ so antibiotics are recommended and there is definitely meconium (early baby poop) in her fluid. They decide - with the contractions so close together, her bag broken, the meconium and the GBS+ - to go to the hospital. We fly down Houston freeways to the hospital. We arrive and are brought into a L&D room. The first nurse insists she lay in the bed with the monitors - we talk about options and I offer to hold the monitor on to get good readings, but mom relents and gets into bed for her strip (reading baby hearttones). The surges are much more difficult this way, but mom powers through with Dad providing counter pressure on her back and some light aromatherapy, we talk her through them. "you are so strong", says dad. They are in love when they look at each other and he is all supportive tension, never leaving her side, always watching her face - waiting for a small signal from her to change, to do something....different. He is the ideal picture of concious concern and love. The midwife arrives, no pressure to examine. Baby is Beautiful - Labor is Lovely! We move to the birth ball for a while, me sitting behind offering counterpressure, effleurage and gentle words, Dad in front being her rock, her stability - his eyes never leave her. After a while the pain is difficult and she wants to move to the shower, we take turns holding the shower spray against her back and talking with her, trying to keep her warm and distracted. Eventually, Dad changes into swim shorts and just hops in there with mom to better help her. We stay like this for a long time - Mom, Dad, the Midwife and Me - in the bathroom, listening to baby on the doppler every once in a while, talking and just laboring. After a bit mom is tired of the shower and is complaining of back pain. We move to the bed where the midwife (finally - I am not complaining) encourages a vaginal exam. She does the lovliest thing - she doesn't tell anyone how dilated Mom is, babys station, effacement....it is not relevant to the task at hand. She does however find a pocket of water that is keeping the babys head off the cervix and offers to break it, with no pressure. We all talk for a couple of minutes about the pros and cons of doing this. Mom and Dad decide that since the bag is already ruptured there is no harm in opening this pocket and letting the fluid out. Immediately after Mom goes to hands and Knees and labors well. With the midwife there, I step away for a moment to call my kids. When I return she is still on hands and knees - but grunty. So fast, I think. We move to the toilet and stay there for a good long while. Mom is feeling more and more pressure building into her bottom and we encourage her to grunt with it and push a little. Mom Ikeeps checking to make sure there is no baby coming out and the midwife is checking heart tones every once in a while. An hour or more goes by and the midwife asks for another check and suggests active pushing. We go to the the bed and mom is ready - everything seems to be right for baby to arrive, but something is holding her up...... We all want to meet her so bad. The midwife is patient, but firm - instructing mom how to push - squatting, hands and knees, side-lying and supine. We try everything, but with every two steps forward we take one and a half steps back. It seems she will not descend and her recovery is taking longer and longer after each contraction. I go to get more water for mom and the midwife meets me in the hall. "We have to work harder" she says. We go back in and I tell mom, "It is time....to push, harder, longer, stronger, past the point of pressure and burning. You have to push past all of that and bring her to you." Mom is ready and this time when she pushes we see her stay...more head, further down, closer and closer now with each push....she is amazing. Dad cannot speak, tears fall from his eyes and he is in awe of his wife, "I didn't think I could do this. Look at you do this....this is amazing". Crowning is amazing, the baby resting there, stretching, pushing, mom working to hold her there, letting her body stretch, the midwife, guiding her with her hands and words. Again, I am thunderstruck by the gravity, the awesomeness and the power of this. She arrives, bursting from her mother - but, there is no cry. The nurses rush in and I tell dad, "follow your baby". They take her from her mother to the warmer and dad follows - they work. Everything is suspended - an ant trapped in a water bubble...no time exists, there is nothing, me holding mom, Dad trying to see what is going on - from elation to the worried father. The flurry of nurses, hands, masks, gloves. "I can see her," I tell mom, "She looks pink"...... then it happens, the most beautiful sound...not a cry, but a squeak. A small sound that fills the room, everyone breathes as this sweet baby girl is rushed out of the room and far away from mom to recieve additional help, with Daddy in her wake - tied to her, never leaving her - ever again. It was the meconium - it seemed like there was more than I had ever seen. She had aspirated the meconium and her lungs couldn't work right with all that sticky stuff in there. Mom and I wait, reassuring each other, "She is fighter," mom says. "she is tough," I say, "like her mom - a warrior". We wait and talk and repair and clean and wait. Sweet baby girl had a nuchal ARM - the whole thing up around her neck - keeping her from coming down. It gave mom a pretty good tear and that gives us something to focus on while we wait. The reapir hurts, but soon it is over and we are waiting again. Dad comes back with baby....for just a moment. She is intubated and incubated. She will be going to the NICU - we don't know how long. But, she is beautiful, a miracle, a gift. Daddy follows in her wake - a dark shining hero, full of joy and misery, hope and despair.

I am happy to report this beautiful baby girl is stable and doing great. Mom and Dad hope to have her home very soon. They are working hard to stay positive, as baby seems to make improvements every day. It was an amazing birth, with an amazing result: a strong family

Positive Hospital Birth - June 26, 2010                                       Mama had been calling me for two days. She is in prodormol labor. Things are moving slowly and she is getting tired. I encourage her to eat well and rest - early in the morning on the 24th. Around 3:00pm labor gets more difficult. I gather all my doula things, kiss the kids goodbye and head out for a long night. When I arrive mom is in good active labor in the bathtub. The contractions are all in her back and we think the baby might be sunnyside up. I have to say....this mom is strong - she is handling everything well in the tub, moaning low on hands and kness with the contractions - but, she has had major back problems in the past and my normal comfort measures for back labor are not only ineffective, but actually seem to make things worse. We are lucky, daddy knows her well and understands her body. He works hard to help her and I watch, learning from him and helping with soothing and encouraging words. He says I am a miracle - that my presence seems to make her better, but I know it is really that she has not found her comfort with me and is not ready to be vulnerable and instructive while I am there - as we work, her barriers crumble and we begin to see hard labor. They decide to stay home for a while, hoping to arrive at the hospital before transition, but late in active labor (also, to avoid Houston's atrocious traffic). We leave for the hospital around 7:30 or 8:00pm and arrive about 30 minutes later. We meet our lovely nurse and are whisked straight to a labor room (no triage). Mom is put on the monitors, while I negotiate intermittent with the staff and talk about delaying blood draw until we get setteled in and mom is not so nervous. Baby looks great and mom is a champ. We get off the monitors and she is offered a check, she consents....4-5, nice and stretchy, -1, 80% - cannot tell babys position, but we all still suspect baby is posterior - as moms back labor seems to be getting worse. our nurse is amazing - we love her. She is so kind, helpful and encouraging. Mom is up, on the toilet, walking the room, riding the birth ball and showing signs of transition (shaking, vomiting, etc...). 2 Hours later she is moving along, but really starting to show signs of exhaustion. The nurse has gotten approval for intermittent monitoring, but they will not allow her water (she has no IV)....Dad comes unglued! After a heated discussion, dad calms down and they (mom and dad) decide that she will continue to have fluids by mouth - no doctor consult, just their decision. It is 10:30 - her water breaks and she asks for an exam - she is 6cm, 100% and 0 station. She is disheartened as her body was telling her she had made more progress, but I remind her and dad that she has made tremendous progress - 1 whole station, 1 whole cm and effaced the rest of the way in 2 hours....that is amazing for a first time mom with a op baby. Renewed and refocused - we soldier on. for the first time, mom questions her resolve - 'I can't do this'. Dad is right there, reminding her why she is choosing this. An hour goes by working hard and hoping. most of the contraction has moved to the front, but she is still battling alot of back pain. By this time, we have found lots of comfort measures that work, despite our inability to use counter pressure, pelvic presses, etc... She loves the smell of lavendar, she is soothed by gentle effleurage during contractions with viscous labor ease oil, she needs to close her eyes to focus during contractions, but look at dad in between. She is a warrior, a champion, a patron saint of women who endure - in this moment - she is my hero! she moves to the toilet to try and empty her bladder and feels the urge to push - an exam reveals 8cm, 0-+1, 100%. She is renewed and ready to continue, despite the intense pressure on her tailbone and our inability to find a comfort measure to counteract it. it is midnight. The day is gone and exhaustion is setting in...the urge to push is strong...9cm, +1. The Doc arrives for the first time......this is difficult. She is doing great, she has just been told she is 9cm...she has been laboring off monitors for a while. Doc wants her back on and she agrees - his exam reveals...7-8cm, 0 station. He reports baby is OP - states that she has a long road ahead of her and leaves. the nurse and I reassure her that everyone examines differently. Our nurse feels strongly that she is at least and 8 with a stretch to 9. We refocus and start to work again. Hands and knees alot, mom is tired. For the first time she says, "I can't do this - I need something - I want a break - maybe I need an epidural". We talk and I remind her how far she has come - Dad is soothing her with kisses and kind words - we remind her this is the end of the marathon - how much work she has done already - her body has proven that is can do this... now she just has to rest and let her baby do everything. 'Down baby, down', she says, 'open, open, open.' And we wait, one contraction at a time, one moment at a time, one sip of water, one kiss, making it through every moment and never looking to the next. It is 2am and a firm cervical lip is left. So little work to be done, but there is so much time stretching out before her.....an endless vista of contractions - she cannot see the end. Her husband leads her through visuals of her cervix opening, her baby crowning, holding him, kissing him, taking him home. He is amazing - truly, not a coach, but her hero - who will guide her and help her to safe passage. It is awesome to behold and suddenly I remember how lucky I am to be here, witnessing and helping as best I am able. Mom no longer has the urge to push - she is calm - her back labor seems to be less and with her contractions I see her body arc and her jaw clench. I encourage her to grunt with the contractions, but her exhaustion is overtaking her. I actually encourage a vaginal exam - I really believe she is 10cm and hearing this news may make her want to push.... our lovely nurse who has been bedside for almost the whole labor - informs mom that she is 10cm, +2 or +3. Mom pushes gently and we can see babys head/ As baby is crowning, doc enters. She is pushing in traditional hospital style, but she is echausted and cannot imagine pushing any other way... she says her legs won't hold her anymore and she is okay to push this way. We help her pull back on her legs and we bring the bed up to almost sitting - Dad holds a warm compress to her bottom as the baby begins to emerge - he is brave - mom is strong and powerful - her pushing is gentle and firm, baby is well and responsive - he is born - they are amazing!!! I am in awe, as I step away and pick up the camera to capture these first moments of a new family together!!! I am overwhelmed as I watch Mom and Dad marvel over their little man. Later, it is 5:30am and my head lays on the bed next to Mom, watching her new man try to nurse. Exhaustion and delight are comingled. It is time to go home, kiss my kids, kiss my amazing husband (without whom I would not be a doula), drink a big glass of water and sleep the sleep of the exhausted. I am tumbled in dreams of babies and daddies and mommies. The faces of all the women I have ever watched in labor all together - a universal mother, delivering me into my purpose.

Two Births in less than 24 hours!!! - June 22, 2010

So, I have been working as a doula for awhile now and I have always been very lucky. I try to take on about 3 births a month, but sometimes I have a hard time saying no. This month I ended up taking on 5 births and had a feeling I was overdoing it, but things have a way of working themselves out. On June 9 I attended a beautiful short labor starting at home and laboring there most of the day, we went to the hospital early to avoid traffic and were a little surprised to find she was already 4 cm. She labored well, with amazing support from her husband (another doula and me). Never a doubt entered her mind. Within 3 hours of being at the hospital we could see a little of baby's head and we knew we would be meeting him soon. Momma pushed hard and quick. She was amazing and beautiful. a lovely natural vaginal delivery in a beautiful and supportive enviornment. It started my month out great. I was waiting for my next mom to go. I expected to hear from my mom due on June 8th very soon and my mom due on the 15th was showing early labor signs. On the 13th I headed out to do some appointments, still waiting on both moms and I was planning on spending some time with my mom who was post dates, as she was beginning to get a little peeved. I visited her last that day and found that she was, in fact, growing restless. The baby was low and her belly was pendulous. We decided a fun activity to get her mind and body moving would be a belly cast. We had such a hilarious and wonderful time casting her belly and by the time we had a big beautiful cast made she seemed more settled and content. My client due the 15th called on Monday to tell me she was 5cm dilated, but still no action (this was her first baby!!!). On the 16th my postdates mom called around 5 or 6 to let me know she was feeling crampy and she thought this was going to be it. I arrived at her house late in the evening to find her relaxed and fresh from a shower. Her contractions were doing what they needed to, but it still looked early. The midwife arrived right after I did and checked mom, she was at 4cm with her bag intact. Mom and Dad decided to head out into the humid Houston night to have a little walk and get dad some much needed caffiene. They returned a little while later and we all sat in the living room talking and working. Around midnight it seemed like things were slowing down and the midwife suggested some rest might be in order. Dad was hungry, so the birth photographer and I decided to go get some food while they rested. We took our time, hoping everyone would get some rest before the long night, we thought lay ahead. Our timing couldn't have been better....when we walked in the door the midwife said her bag just broke! She had made it to the bathroom and was obviously in transition. We moved into a warm tub and and while the work was hard, she seemed to relax in the warm water, changing positions to help this beautiful baby come down. After an astonishing twenty minutes she was getting pushy and said she really wanted to go to the potty. Once there, it became clear very quickly that she would stay there. With Daddy lovingly holding her, the midwife kneeling in front of her giving her the words she needed to hear - powerful, strong, slow, down, amazing, beautiful and me squatting beside her - she birthed, it seemed without trying. Letting her sweet baby girl fall into the midwifes hands and straight up to the family waiting to meet her. Can you say amazing? It was miraculous. A birth to inspire and witness, to support and guide, but never to interfere. After that things became a blur of cleaning and comforting, admiration and celebration. I headed home around 4:30 or 5:00am....it didn't really seem to matter in the moment, I could have stayed there forever - but I knew I had to leave and let mom and dad revel in their daughters and their families new beginning. So to home I went and crawled into bed at 5:30 in the morning, utterly exhausted. Hoping my husband would stay home so I could sleep a little later.  Cut to 6:15am - my phone rings. It is my mama who is due on the 15th. Right on time. (well one day late - who counts one day late?) She too complains that she is crampy and this seems like it might be the day. No, she doesn't need me yet, but she will soon. I got myself together and actually went back to sleep for another hour. She calls again - it seems fairly intense, she says. She is thinking about going to the hospital (she is already dilated to 5 before this started), will I meet her there? Of course, I am on my way. I walk into the hospital moments behind them and meet them in triage - yes, she is in labor, yes the contractions are strong, yes she is dilated to 5.5, yes her bag is intact, yes - we may go for a walk. We got all our stuff together and move to her room, then we walk - up and down the hallways - mom is a champ, a warrior - she is beautiful and clever and funny. We walk until she is tired and we have to listen to baby's heartrate. Baby is good, we sit on the birth ball, do backwork, aromatherapy, breathing exercises and guided relaxation. Dad tells jokes - he's pretty funny and keeping mom lighthearted. She goes to the bathroom and thinks maybe her water has broken, but is unsure. Moments later, around noon she gives her first sign of transition - looking at me and saying, 'I don't think I can do this, Kathleen'. I reassure her that she can, that she is, that she will. Dad is there, encouraging her.... She decides to ask for a vaginal exam to give her some idea of the progress she has made in this short time - All that is left is a cervical lip, a tiny thing....mom is renewed and determined to get this out of the way...she wants to push - squatting with the next few contractions, the lip disappears and she is grunting the baby down....pushing gently with each contraction....talking her baby down. Doc arrives on the scene, in street clothes, throws on a pair of gloves and starts massaging to help stretch the muscles and prevent tearing - she is very focused on helping mom have this baby with no intervention - her green glass necklace brushing moms leg as she leans down to get a better angle. It was beautiful and wondrous and lovely and supportive....did I mention miraculous????? This beautiful baby girl was brought right up to mom's skin where daddy and mommy could love and admire her. I was in awe.                                                        TWO AMAZING BIRTHS IN LESS THAN 24 HOURS!!!!!                                                                            I have never had two of my clients deliver so close together...nor have i ever had two clients have such drastically different and yet eerily similar birth experiences. Both were well dilated before labor, both labored about seven hours, both had amazing support from their families and care providers and yet - one was a third birth after primary c-section, one was a first birth, one was hospital, one was home, one was midwife, one was obstetrician. I was in a constant state of awe all that night and day. Blessed to witness the power of women, the power of birth, the power of CHOICE!