48 Hours at 42 Weeks
A few months back I answered my phone and on the other end was a bubbly voice telling me about how more and more research has led her to wanting to search for a doula. She told me about how my business name, Mama Warrior Doula, had spoken to her. How the strength in the word warrior, was exactly how she wanted to feel during this process.
At the end of the week, I met with her and her partner Matt. While most partners, have some questions, they defer to the pregnant person when making the choice for a doula. Matt was very involved. He had lots of questions, including ones he had written down. He told me that he wanted for Laura Beth to be respected and safe and as they get deeper into the process the choices and decisions are overwhelming. He wanted to insure that I would be there for them through the entire process.
Every meeting with them, went over the scheduled length, and they kept me laughing the entire time. Laura Beth and Matt, are very special people who have faced a million challenges through out their lives. Their positive attitude, their joy, and their playful relationship was so refreshing.
Laura Beth had a pretty textbook pregnancy. From a physical standpoint it truly couldn’t have been better. However, Laura Beth and her provider often had differences to work out and she was feeling like she wasn’t being heard. After every appointment with her obgyn, Laura Beth would call me feeling negative, feeling like they were against her or dismissing her feelings, and needed for me to get her back to a positive place. I hated that for her, but when I would check in with her later on, she would seem perfectly happy.
At 36 weeks pregnant, Laura Beth called me one afternoon crying. Her provider had crossed a line. Her provider had not only disrespected and offended her, but belittled her in the process. We chatted and disconnected. Later that evening Laura Beth phoned me again to talk about what had happened. At this point, I decided it was time to suggest a provider change. Laura Beth was shocked that this was even an option. I told her that while I couldn’t make any guarantees, I could probably find a provider to take her on regardless of her gestation week.
Laura Beth and Matt, live about 15 minutes east of Middletown, CT. We targeted providers that deliver at Manchester Memorial Hospital first, as this was the closest hospital I thought would respect her wishes. After being turned down, I crossed my fingers and sent a message to one of my absolute favorite CNM’s, Erin Morelli, with the Center for Women’s Health and Midwifery, delivering at Vidone Birth Center, part of Yale’s St. Raphael campus. Laura Beth was 36 weeks and 3 days along at this point. Erin was in the Westport, CT office that week and said that as long as Laura Beth was willing to make the drive to that office for her first initial appointment, they would fit her into the New Haven schedule after that.
Laura Beth and Matt, I think thought I might have been a bit crazy for suggesting that they deliver somewhere that was 50 minutes away. However, I suggested that they take the initial appointment and if it didn’t feel like a good fit, they didn’t have to switch. They had nothing to lose by meeting with Erin.
All day Monday, the day of their appointment, I waited anxiously by the phone for a text or phone call from Laura Beth, but nothing came. Oh no! Had I been wrong? Were they not the patient and midwife soul mates I thought that they would be?!?! I decided to reach out to Laura Beth myself and she apologized for not telling me. She said that she immediately felt comfortable and since I thought the drive wasn’t too far, they were going to switch. YAY! I knew that they would be getting the experience that they had wanted.
Laura Beth’s due date, came an went. Laura Beth would call and text me telling me that everyone was driving her absolutely bonkers asking her why she was still pregnant. Friends and family were insinuating that maybe something was wrong with the baby or pregnancy. I reassured her every time and told her to stop answering their messages.
For anyone reading this, 40 weeks aka “due date”, pretty much means nothing. Most babies come between 37 weeks and 42 weeks gestation. Not all babies, and not all bodies, make babies in the same exact time frame. Stop asking people when the baby is coming!!! No provider would risk anyones health by letting them go farther than they thought was appropriate.
At Laura Beth’s last midwifery appointment, Nancy, another fabulous and loving midwife in the practice, discussed an induction with Laura Beth. They decided on 41 weeks and 5 days and after discussing a few options, they made decisions that everyone was comfortable with, for how to start this process as gently as possible.
On Wednesday, at 41 weeks and 4 days, Matt called me. He wanted some reassurance that every thing was truly ok with Laura Beth and the baby. We chatted for awhile and I decided to go see them that evening. Laura Beth had been having some contractions on and off for the last two days and I was hoping some doula tricks, might help to encourage them along.
At 5:15pm on Wednesday, April 25th,
I arrived at their home and it was obvious, they needed a person. They weren’t falling apart by any means, but the contractions overnight for the last two night and the waiting to meet their baby, was starting to get to them. Matt said, “What can we do? Let’s throw everything at this!” After a bit of discussion they decided to try a castor oil float, clary sage, and some pressure points. I also confirmed (via info from their last ultrasound) that baby was not in the proper position and would do some rebozo work to get baby into a better position. (sometimes an on and off contraction pattern can signify a baby in and OP position)
We started the shakes and decided to play some cards while we waited. We shared stories from our pasts, we came up with additional plans, and we laughed so hard, that someone may have even peed their pants.
At 7:45pm Laura Beth started feeling some contractions. I was making sure to keep her hydrated, and change her positions every 30 minutes or so. It was a cold and rainy night, and while Laura Beth was sitting on a birth ball, she said, “Oh my gosh! Is that thunder?” Matt and I both started dying laughing. Laura Beth had rolled the ball under the coffee table and when it pulled back, it made a small noise. He said, “No, it’s you!”.
We had a late dinner and 4 hours after the first shake, Laura Beth had another. Matt reminded me about the clary sage oil, and we placed some pads on her chest. At 11pm, her contractions started to slip into a pattern. I did some more pressure point work and within the hour, she was having contractions about 4 minutes apart. Matt was sitting next to her, encouraging her through every contraction with tears in his eyes. I asked if he was ok and he said, "When is an appropriate time to cry? Now? Ok good". My heart melted. He’s truly an exceptional partner and father.
I encouraged them to try to rest. Laura Beth and Matt climbed into bed and she fell asleep for the small intervals in between the contractions. At 4am after 3 hours of contractions of 3-4 minutes apart, Laura Beth was really uncomfortable. We decided to call Vidone and tell them we were going to head their way. On the drive down, Laura Beth’s contractions began to pitter out. I actually contemplated turning around, however, her induction was scheduled for this day anyways. She was now 3 nights in of contractions, and was 41 weeks and 5 days. We all agreed it was time.
It was now Thursday, April 26th at 5:40am. Upon arrival they checked Laura Beth and while she wasn’t very dilated she had made huge changes in effacement. It was decided at that point to start the induction with the way they had planned in the office earlier in the week. They decided to use a cook catheter. This is a small tube that’s placed inside of the cervix with a balloon that gets filled up with saline solution on each side of the cervix, applying pressure and assisting the cervix in dilation. This is called “mechanical dilation”.
The shift change for both nurses and midwives was at 7am. Laura Beth was happy to see midwife Sarah come on. We had done a very good job of being peaceful and jovial in this scenario, but then there was a bit of a change in energy. A nurse came on shift and her and Laura Beth clashed right away. Matt then also began to become very protective of Laura Beth. The nurse did not handle this interaction very well. They could never manage to gel, even with both of them trying, and every single time the nurse entered the room, Laura Beth’s contractions would slow or even stop during her presence. I say it all of the time, but we are animals, and if we don’t feel safe in our birthing environment, our bodies will fend off labor.
The nurse took longer breaks from us and Laura Beth began to cruise into a contraction pattern again.
The nurse came in for a vitals check at 11:50am and during that time Laura Beth pulled Matt towards her and said, “Your energy helps me to relax. It’s calming and makes me feel secure.” I watched the nurse roll her eyes. It was the first time, I had a true negative feeling about the nurse. Why would that cause anyone to eye roll? There was something else going on here.
At 1:21pm through a shut bathroom door, Laura Beth yelled, “Melissa! Balloon!”. I buzzed for the nurse and told her that Laura Beth had thought the catheter had shifted. This would signal dilation of the cervix to about 4 or 5 centimeters. The nurse came in and asked if it fell out. I told her no, but that Laura Beth had felt it shift into her vagina. She said something that made me feel as though she didn’t believe Laura Beth, but that she would grab a midwife to “just check it out”. Laura Beth was right. The catheter had done it’s job and she was dilated to 4 centimeters.
Toward the end of the nurses shift, it continued to get more and more uncomfortable. Laura Beth had asked her multiple times to relay information through myself or Matt and asked her not to touch or guide her through labor. I think it’s important to say, that Laura Beth at this stage didn’t want any of us to touch her, but the nurse struggled to maintain boundaries and not follow Laura Beth’s instructions.
I suggested that Laura Beth get in the tub to help her relax and cope with contractions. After she was comfortable, I ran out for dinner. When I came back, I was informed that there had been another intense verbal moment between the nurse and Laura Beth. Matt asked her to