Julie & Seth
Around 7am on Saturday morning, my phone dinged, and then rang just a few minutes later. It was Lisa Falkner, of Compass Birth Doula and LMT, who also happens to be my business partner. “Well, Julie’s in labor...”
I figured I might get a call like this at some point over the weekend. Lisa’s oldest daughter, had been dealing with suspected flu systems, and rather than put anyone at risk, I would be supporting her client today. While Lisa and I have been each other’s backups for awhile now, this is the first time we have actually ever had to use the other.
Lisa and I host quarterly meetings in which our clients get to meet the other one of us and have a quick chat. This is so that if for some reason one of us does have to go in the others place, the first time we meet, isn’t during a birthing persons, most vulnerable moment. I had just recently just met Julie and her husband Seth, at one of these events.
I showered, grabbed some coffee, and let Seth know I was on my way.
When I arrived at their home, I could hear Julie from the door way. She was making an audible noise, and Seth led me to her. She sat down on the couch and we chatted a bit about what was going on. Julie was in great spirits. She was past her due date, and had some accupuncture the day before. She was ready to meet her baby girl.
Seth was diligently timing Julie's contractions, and making sure to remind her to drink often. Her contractions were coming about 6 minutes apart and lasting for 30-40 seconds. She was managing them at this point on her own, tilting back and moaning through them. I suggested that she have some breakfast. Seth prepared her some eggs and an english muffin. While I'd like to say that this kitty was being protective of his mama while she labored, I think he was actually just waiting for a nibble from her plate.
After an hour of observing Julie, I suggested she move around a bit, use the restroom, and have a change of scenery. We relocated into their living room. After a bit more time, Julie's contractions got closer together, and were coming about every 4.5 minutes. They also were increasing in intensity.
I began to do some rebozo work, to help change the position of the baby a bit. She was having a low stabbing, zing, and sometimes that can mean that baby may not be in an ideal position, or that perhaps there's a hand on babies forhead for instance. Now, all of this is just a guess, but either way it did seem to help Julie at this point in her labor.
Julie was doing very well. She was taking every contraction as it came with strength, but a bit of panic started to set in. I began to talk Julie through every contraction. Now, while many people may prefer silence during contractions, a lot of people often find comfort in knowing where they are in a contraction.
As the time grew closer for each contraction to start, I reminded Julie to take a big, deep cleansing breath. Each time I did that, she also instinctively found her focal point. I whispered to her that the contraction was climbing, reminded her how short each peek of contraction would be, counted the peek down, and then let her know that her uterus was beginning to soften, and to take a deep cleansing breath to end the contraction. In between each contraction I rubbed Julie's back and made sure her energy was heading towards the right places.
Seth and I took turns helping Julie to feel comfortable in between each contraction. He put on meditation music, which seemed to help ground Julie. At this point, she wasn't comfortable in any other position, but variations of hands and knees.
Around 11am, Julie decided it was time to give her OB's office a heads up. The doctor on call said she wanted Julie to come in right away, and would send her home, if she wasn't in active labor. Julie was in active labor at this point, there was no doubt in my mind, but I encouraged Julie to stay home a bit longer.
There were a few reasons for this. I knew that we weren't at a point where baby was coming. We hadn't hit the transition phase yet. Often times, if you aren't over the midway hump, things can slow down in the hospital environment. Studies have proven that women dilate faster and have shorter labors, in their own home. The other reason, is if you aren't at the point where they want to keep you, being sent home, destroys the psyche.
Over the next hour contractions had gotten closer together and were coming every 3.5 minutes or so. Julie now thought this was probably a good time to head to the hospital. She was having a lot of pressure in her bottom. Her desire to only crawl at this point, was a good enough sign for me too.
At the hospital where Julie had chosen to deliver, they only let one person in the triage space upon arrival, with the laboring person. There have been times at this hospital, where they have left doulas sitting for hours, away from their clients. As we were leaving the house, Julie voiced concern about being seperated for the car ride, and then again in triage. She was telling Seth to memorize the way that I was talking her through contractions. I could feel her anxiety rising.
We got in our cars, and I followed them to the hospital. Julie did not want to have to walk through the entire hospital having contractions, and so she was walking the fastest and longest strides possible.
When we walked into L&D, Julie didn't give them a chance to send her to triage and me away. It's in my top moments where a mama was NOT having it. "I feel pressure and I want a room now. I'm not waiting. I'm not going to triage. A room now." And then she proceeded to basically search for a room. It was AMAZING! They put her right in a room, obviously.
I believe that a lot of Julie's ability to stay focused on what she wanted from her birth, came from the 8 week Bradley Birth Class that her and Seth took. It helped to prepare them both physically, mentally, and emotionally during their pregnancy, allowing for them to avoid having medical interventions, and feeling confident in their decision making.
When they checked her, we found out that all of the pressure was from the bag of water. It had slipped through the cervix and was what they refer to as a "bulging bag". This adds a lot of pressure to the cervix, and explains why being at a 90 degree angle was most comfortable for Julie.
They checked her in and they left us alone. Julie was able to labor comfortably, and how she wanted. She had a fantastic nurse, and we were excited to learn she was 6cm dilated at 12:45pm.
Julie did great at keeping herself hydrated, having a popsicle here and there and staying focused on the labor. I continued to talk her through every contraction. At 3:00pm Julie was struggling with the pressure. We discussed having her checked again, and maybe allowing them to break her water for a bit of relief. We didn't talk about this with a nurse or a doctor, but in a place, where she knew her options, and their risks. Julie decided to get checked and decide from there.
The resident came in and checked Julie at 3:15. She was 9cm dilated and her water was still intact. Julie appeared a bit shocked by the news of how fast things were moving, and when the doctor mentioned to me breaking her water, I asked for her to just give us a moment. Julie wanted up and out of the bed and was back bent over within a minute. It was Julie, Seth and I in the space, and Julie yelled, "there's something coming out!"
I went around to peek at Julie's bottom and discovered that her bag of water was making it's exit and ballooning out. I checked to make sure there wasn't a face in there (using my eyes only), and then grabbed a towel, for what I knew would be a natural membrane break, and grabbed the nurse. I was happy that she wouldn't need to make the decision and that everything was going according to her birth plan, with no interventions. The doctor and resident came back into the space, while the nurse and I cleaned up. Julie asked the doctor, to please allow for her to birth on all fours. She had spoken about this topic with her OB at the office, prior to ever being in labor. She reminded them, that he had agreed to allow for her to be in whatever position she was comfortable in during this stage of labor. They were a bit hesitant, but the resident convinced the OB from Julie's practice, to let her try.
That may seem silly to some people reading this, however, many hospitals in our area, still prefer for women to be on their backs. I was really impressed, with the care she was receiving there. They were very hands off, never mentioned medication to her, never pushed her to do anything she didn't want to do, and tried to keep the space calm, and in Julie's control. They did this by communicating everything to her, through me and Seth. At 3:30pm she climbed into the bed and hung her body over the top half, using the power outlet as a focal point.
Everyone allowed for her to guide herself and only offered help when she asked. Most