Stephanie - The Grand Finale
Note: All professional photographs provided by Shea Wordell of Sterling Photography
I'll never forget the first time that I met Stephanie. I was standing outside of a local restaurant with my husband waiting for our table to be called. She walked out with a very very pregnant belly and holding the hand of the sweetest little boy. It was quickly apparent to me that they had known each other for years. He introduced me to Stephanie as his high school friend. As we spoke I quickly realized that Stephanie was not carrying her own biological children but was carrying twins as a surrogate. I was not a birth worker yet at the time and hadn't had any children of my own, so my knowledge of surrogates was very limited. I was fascinated by her as if she was some kind of circus sideshow and I remember looking up more info on surrogates, what that meant, how it legally worked, and looking up (stalking) Stephanie's Facebook profile. Over the years Stephanie has provided me with many opportunities in my Doula career. The first induction that I attended as a doula was with Stephanie, the first time I saw an epidural cause an emergency was with Stephanie, the first time I ever saw a set of twins come earth side was also with Stephanie. I had thought that our journey together as birthing person and doula was over, as Stephanie had begun to start her education to become a midwife this past year. It would be to my surprise 10 months ago when she reached out and told me to save her a spot because she was going to do an embryo transfer. She told me the story of a man that no one else would carry a baby for, due to his age and how sweet and lovely and wonderful he was and how she couldn't imagine this man without his own child. During her pregnancy I would go to Stephanie's house for prenatals but they were mostly just us talking back-and-forth about life, about the things that were going on in her household and in mine and then maybe a smidge about pregnancy and discussions of other birth-y type things. I had assumed that Stephanie's birth would be just like the others that I had attended with her. Quick, to the point, strong, powerful, unmedicated and this funny transition period of hers that is like something you would see in a movie, that doesn’t usually happen in real life. This pregnancy was different than Stephanie's others. She was having more contractions on and off and she definitely thought that she would be having this baby earlier than planned. That would be difficult as the family that she was carrying this baby for was located in Italy and had a set time that they were arriving in Connecticut. She was doing everything she could to keep this baby safe. She would stop her work, she would take periods of rest, and hoped that this family would get to see their little boy be born.
It seemed absolutely appropriate to me, that on the morning following their arrival to the United States that Stephanie would text me at 3:14am to tell me her water had broken. She wasn't experiencing and contractions yet, so we both decided to head back to bed.
At around 5am she texted me again that she had woken up to a contraction and that she had soaked through her clothes. I decided to take a shower and head over to her.
Upon my arrival she was contracting every 3-4 minutes. Her previous labors had all been short in comparison to what is standard for birth. So, when I arrived to her home, we decided she would eat some breakfast and then we would head to the hospital, so that she had some time to settle in and prevent having a baby in the car.
We arrived to the hospital at 7:25am. A midwife, Aron, checked Steph's cervix and she was 3cm dilated. We were all a little bit shocked. Based on the way she was feeling, I think we all assumed that she would be farther along than that.
She then called her best friend Carla and told her to come to the hospital as well. Carla is also a surrogate and has attended all of the births that I have been present for with Steph too. Steph had invited her cousin Jessica to come to the birth as well. Jessica had never seen a birth before and she was so excited for the day.
It was obvious pretty early on, that Steph's baby was OP. OP stands for occiput posterior and is a label for the babies position inside of the pelvis.
While a baby being OP is a normal position for baby, as a doula, I often see this one cause the most chaos for labor and birth. It can sometimes include lots of back pain for the birthing person, longer labors, longer pushing phase, and sometimes whacky heart tones too. While I teach my clients spinning babies techniques and exercises, which usually helps to get babies in the best positions, Steph is a single mom, without someone to help do them each day. Steph had also been seeing a chiropractor, but was fearful of doing anything to encourage baby coming prior to the parents arrival, so had been conservative during adjustments.
The first sign, was her water breaking prior to having contractions. This is often a sign of a misaligned baby. The next, was her need for lots of counter pressure on her sacrum to help cope with the back pain. Her contractions had also spaced apart at differing points and we had to use a breast pump to bring them back.
As we walked the hallway, trying to keep the contractions consistent, she would motion for help each time at her back. Steph was super pleasant though and friendly. Stopping to talk to some student nurses who were all standing in the hall. She invited them all to attend the labor and birth of this baby.
We were also starting to stress a little bit. Stephanie had called and texted the intended parents multiple times, with no response. We were hoping they wouldn't miss it!
What we didn't know, is that we were in for a very long road ahead.
We immediately started to try to get baby to turn, get baby to apply pressure to the cervix, and try all of the tricks I had up my sleeve.
Eventually, Elio and his partner would arrive, dressed in his best to meet his very first baby.
While Stephanie and Elio had talked regularly and had many face time calls, this would be the first time they would all be meeting in person.
Carla and I would continue to support Stephanie, me trying to get the baby to make a turn and Carla providing comfort, as Elio anxiously buzzed around the space.
(Um I feel terribly bad that I was smiling in this picture, while she is obviously in quite a bit of pain, from a position that helps baby get into the inlet, of the pelvis.)
Stephanie was more uncomfortable than I can remember previously seeing her during labors, but she was still light hearted and humorous.
At this point every one was starting to make predictions for the time of birth. Guesses were ranging from 1pm to 4pm, which would still make this one of Steph's longest labors.
Elio and his partner were waiting patiently. They were making phone calls to family to provide updates, running in and out for coffee and snacks, pacing the hallways, making concerned faces when Steph would make audible noises to help cope and most of all you could tell they were anxious for baby's arrival.
Stephanie was starting to ask for more and more help. I suggested trying the tub. Steph had never used the tub before and she was excited to give it a shot. This also allowed for us to try some other positions to get baby to move while she was more comfortable in the water.
Sometimes when in pain, laboring people will struggle to not keep all of their muscles tight. I had seen many instances, where they were capable of letting go a bit more once buoyant.
While in the tub, Steph started to feel things becoming more intense. At one point, she also sounded like she was starting to push.
Then she said, "If I'm going to have this baby in the room, I need to get out of this tub!"
We headed back to the room and the nurse went to grab the midwife. The news was quite discouraging and I could see a bit of defeat come across her face. She was 4cm dilated and 60% at 11am. She had been doing lots of work the last four hours with very little change.
I suggested that Steph try nitrous, to see if it would let her lay down and close her eyes for a bit. It wouldn't give her tons of relief, and she still needed counter pressure with every contraction, but it was allowing for her to feel a break in contractions that were now steady at every 3 minutes apart.
Steph was struggling and I could feel how stressed it was making Elio. At one point, I heard him mention that he felt guilty for putting her through so much, just for him.
I once again started putting Steph through a series of things I was hoping would move the baby into a less painful position for her. She was game to try anything that might bring her some relief.
Four hours later, after another cervical check from Aron, we had found out that Steph had moved only one more centimeter in dilation. Aron decided to try sterile water injections. While I had seen this technique work many times before, it hadn't changed anything for Stephanie.
I was starting to become worried for my friend. I wasn't sure what I had left to offer up to help. I had reached out to my doula sisters and ran through the lists of everything I could try, and it appeared that I was out of techniques.
There was one more thing that we could do, which was an epidural and rest. However, the last time Stephanie had an epidural it caused the need for emergency response for her and the baby. While everyone turned out fine, I knew Steph was afraid to try that again.
However, there is a time and place for epidurals, even when you don't want one, and that's when you're suffering. Steph was suffering.
You could feel the others in the room agonizing over the torture that Steph was enduring. Stephanie and I spoke quietly about the epidural and she wanted me to go talk to the doctors to see what they thought.
When I walked to the desk, four members of her practice/covering practice, were sitting there discussing patients in lieu of shift change. I spoke with Dr. Arky, someone who knew Steph and someone whom I deeply trust, and he assured me that we could prep ahead of time in case of an emergency, so that the others in the room wouldn't be in a state of panic, in case something bad did occur.
Just a few minutes after the epidural placement at 5:40pm, Stephanie was feeling significantly better. The midwife had performed a cervical check right before it and told us she was 6cm dilated. The epidural had taken away her pain, but Steph still had great movement and control of her legs. Exactly what we could have hoped for.
At 8pm, the new midwife on call, Devon would come in to do a cervical check. I could tell by the look on her face what was going on. She didn't want to say it, because cervical checks are subjective, but she thought Steph was only 5cm dilated. I watched Jess's face give a full 'WTF?!'. I explained that her cervix didn't go backwards but that different fingers feel different things. What it did mean though, was that in the 12 hours since we arrived to the hospital and all of the work we did, had only resulted in a change of 2cm's.
While Steph was now comfortable, she was still awake and not resting. I was sure that her mind was in the way. I begged her to sleep in hopes that the rest would allow for her cervix to dilate. I knew that she was thinking about how she had birthed 7 babies vaginally and that the eight and final might end in an unplanned cesarean. How could she not. I needed for that mental block to get out of the way.
Steph drifted in and out of sleep and said she felt some pressure at 9:30pm. Thank goodness!!! We had finally had some real change. Steph was now 8cm dilated and 100% effaced. Her body and this baby were finally making moves.
At 10:50pm Steph said that she had an urge to push and her body was shaking as well. The room filled with folks as she had reached fully dilated. It had taken all day, but Steph was ready to push.
At 11:06pm the head emerged and I felt Devon get a little tense. I watched her close her eyes for a brief second and take a cleansing breath. The nurse asked, "is there cord?". Devon calmly replied no and the nurse and I pushed Steph's legs back as far as we could. The baby was stuck just a little bit at the shoulders. Steph was asked to give a great big push and there he was; Francesco cried for the very first time at 11:07pm.
His family, especially his Papa was thrilled for his safe arrival.
Stephanie looked at me and mouthed thank you, and closed her eyes. The look of relief washed over her.
There was no hesitation from Elio when the nurse suggested that he get skin to skin with his new son. He peeled off his suit which he had worn all day in anticipation. Tears streamed down his face. He was a father.
Carla before leaving insisted on some baby snuggles prior to heading out, in return for her helping to support Steph all day and his Papa was happy to oblige.
Elio and his family wanted to call everyone and inform them of the news. He asked to Steph to hold Francesco. She thanked us all for our support through out the day, as she had him in her arms, but she had no idea how thankful I was for the honor of being her doula for all of these years.
You see not only has Stephanie given me many opportunities as a doula, and many families the opportunity to have their own children, but she's also provided me with an understanding of what true selflessness can actually look like.
When people hear of her role as a surrogate, many of them say, "I could never give up a baby that I carried for all that time." Stephanie always quickly replies with, "They trusted me to grow and care for their baby for the last 40 weeks. I'm simply giving them their baby back."
She is an absolute magical bonus that came along with the marriage to my husband and has become my dear friend.
I would do it for her all over again, but I believe this birth solidified this as our birthing person and doula GRAND FINALE.
Thank you Steph. Love you to pieces.