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 wan