Before working as a doula in Bakersfield, Visalia, Hanford, and the lower Central Valley, I was in Chico, CA -- up north. This mother was a client of mine, and here she is shown having her second baby at home, after a very medicalized first birth due to her baby's health issues. This time around she labored all night, with erratic but strong contractions. When she finally realized they needed the midwife, it was just in the nick of time! The joy and ecstasy she experienced by this fast, healing birth shows in her body language, and of course her face! For this woman, being left undisturbed to labor was a huge part in the emotions and feelings that helped her have an ecstatic experience. It is a day she will always remember and have pride in -- and no matter how a woman's birth experience goes, with support from her team and knowledge of her choices, she can also be left with these good feelings. 

Jill and Carol are positive that if I hadn't had Marsha and Becky encouraging me to change positions and move around, or if I had been unwilling or unable to do so, I would have needed a cesarean because of Baby K's position. He just wouldn't have descended at all. I also think that my pelvis was able to shift and move to get him out partly because I was seeing a chiropractor throughout my pregnancy and my joints were nice and loose. I'm also lucky that I had a midwife who let me push for so long. I'm really lucky that Baby K and I both physically handled labor well and I was able to have a med-free birth like I hoped for. I also couldn't have done it without Justin. He was with me through every single contraction, and he helped me focus my energy while pushing. I am a lucky, lucky, lucky woman. 

Sariah knocked on my door at 12:10 am and said “It’s baby time!!” Her face was so hyped up. I was immediately thankful that I was feeling better. “Ok,” I said, “I’ll be right up.”

I went into the bathroom and got my ziplock bag of a mini-version of my doula kit. I had good feelings all along that it was going to be a fast birth so I didn’t feel like I had to bring very much. I went upstairs to their apartment. Charlotte greeted me with a big grin. She said “I’m having lots of contractions and I can’t talk through them.” We were all excited.

She phoned the doctor, as she was standing on the second step. She began having a contraction so she handed the phone to me. I heard a beep and I wasn’t sure if it was an answering machine so I just started talking.

“Hi, this is Amanda, Charlotte's doula. Charlotte is in labour and we are going to head to the hospital.” Then I heard a very groggy voice say “Ok, Charlotte…. right…. ok how long until you are at the hospital?” 
“45 minutes,” I said.
“Ok, I’ll meet you there.”

We phoned Oscar, our taxi driver who was going to be on call for her birth. Charlotte had a few more contractions and then Oscar knocked on the door. Eric grabbed the bags and we were headed upstairs.

As we were gathering our stuff, Cora woke up. She hadn’t woken up in the night for over a year, Eric told me later. She woke up, sat up in bed and said “Baby sister is moving.” Charlotte went over to her and said “Yes, baby sister is coming.” Cora said, “Um, yes. I’d like some milk.” Sariah and Charlotte laughed. “Yes, Cora. You can have some milk.”

We went upstairs and got in the cab. Charlotte was on her hands and knees in the back seat of this huge van that Oscar brought. We all got in and Oscar tried his first attempt at the very steep driveway. The tires squealed in protest. He reversed and tried again.

Oscar’s friend who was with him hopped out. Then Eric got out too and they were trying to figure out how to get the van out of the steep driveway. Charlotte was getting anxious as she didn’t want the van to roll back and squish Eric. She was yelling at him a bit from inside the van. Then they reversed and tried going up the other side of the driveway. (The driveway was a circle.) No luck on the other side either and then Charlotte said, “Oh, my water just broke!”

I yelled at Eric that Charlotte’s water broke. It was clear the van was not getting out and the bumping and jostling was really hard on Charlotte as she barely had any time between contractions.

Finally she turned and yelled at Eric out the window, “We need to get out of here!” He said “Ok babes, I got this! I will get us out of here!”

By this time the taxi drivers were talking to this other woman at the top of the driveway. Eric walked up to her and asked “Can we get a ride to Puerto Vallarta please! My wife is in labour and her water just broke.”

The lady said “Of course. Jump in!”

The lady, who introduced herself as Georgina, and her English husband Danny owned the smallest car in existence. And in the backseat was a carseat. Georgina wedged herself into the carseat. Charlotte was in the front seat on hands and knees. I was in the middle, leaning forward, rubbing Charlotte’s shoulders and whispering encouragement into her ear. Eric was beside me in the backseat.

Danny was an excellent driver. Between he and Georgina, they knew every bump and pothole along the way. He was careful and he was very fast. Charlotte worked on keeping her moaning low pitched to allow her cervix to Open Open Open. I would count on her ear when the contractions came, to give her something to focus on. We would come up to a red light and Georgina would look and say “Ok, Danny. Just skip in. We have to keep moving!”

Outside of Bucerius, there was a police car going the same direction as us, we pulled up beside it and Georgina, sitting in the child’s car seat, yelled out the window to them, asking for a police escort.

They pulled ahead of us, lights and sirens going, and we went very very fast behind the cruiser. He pulled off as we got to Nuevo Vallarta, and waved us onward. Charlotte was doing so well through all this stress. The contractions were strong and very frequent. She concentrated on her noises and said “Open open open.” Her ability to remain as calm as she did through all this uncertainty and near-disaster impressed me to no end.

The epidural was in place and Dra Laura said “I have to move the baby’s head just slightly. I am going to stick my hand up and when I tell you to, I want you to push just a little and I can tip the baby’s head.”

Dra Laura did just that and Charlotte looked at me with wide eyes and said “I can feel the baby coming down the birth canal.”

They decided it was time to move Charlotte to the delivery room. They told Eric and I to go put our stuff in her postpartum room and then come down and get in our scrubs. He and I got into the elevator with all our stuff and were just told a room number. The doors shut as we saw Charlotte wheeled down the hall and Eric looks at me and says “And this is when we steal your baby!” And I laughed. But we both felt a bit uneasy.

We dumped the bags and headed back down. The hospital was entirely empty so we weren’t sure where to go. We saw someone and asked. They gave us scrubs and we were changing and trying to figure out a one-size-fits-a-mammoth scrubs. Eric’s head bandana looked like a nun’s hat until he tied it. Then he tilted it to the side, real gangsta’ style.

We got in the delivery room, as Charlotte’s baby was starting to crown. She said “The baby will be here any minute!”

Within 10 minutes, the baby’s head was clearly going to come out. In between contractions, Eric started telling me a pirate joke, which I honestly can’t remember a word of. Then suddenly, out came the baby! They cut Lyra’s umbilical cord and lay her on Charlotte’s belly. Charlotte cried and said “Hello, welcome baby!” Eric too was making joyful exclamations of being a dad again. 

They took Lyra to the warmer, and checked her out. The pediatrician suctioned out her nose and she put her hands up to fight him. She was immediately alert and looking around. Charlotte quickly delivered the placenta so that no one but the doctor even noticed.

The staff put Lyra in an incubator and took her to the nursery with Eric following closely behind. He was clear and confident in his role of dad. I mean, he’s done this all before!

Charlotte and I stayed in a corner of a hall for more than an hour while we waited for the effects of the epidural to wear off a little. Then after a few times asking the nurse, they moved her upstairs to her room. Soon they gave her baby Lyra and Lyra latched on immediately.

Mom and baby safe and happy. After such an adventurous and fast labour, they were home from hospital that very afternoon.

It was such a privilege to be a part of a whirlwind Mexican birth experience. Charlotte, I am extremely proud of you at what you accomplished. Eric, you were a fantastic and assertive father in exactly the role you needed to play. You together make a great team and I am nothing but grateful to be included in such a momentous day.

It’s Sunday afternoon and I am just enjoying a lazy day, knowing that any day it will change very quickly with a phone call.  My daughter is 39 weeks pregnant with her first baby.  After many years of wanting a baby more than anything, she is finally going to be a mother at the age of 38!  She had really wanted a home birth (all those stories of me birthing her at home had really soaked into her psyche), but she finally came to terms that, due to her financial situation, she would be birthing in a hospital.  She did a lot of research, spoke to some midwives, and had found an OB who would support her dream of having an intervention-free, natural birth.   The phone rang and I could immediately hear a bit of concern in her voice.  “Mom, how do I know if my water broke?”  She had stood up and felt warm fluid trickling down her leg.  After our conversation she was convinced it was not urine, but the leaking seemed to have stopped.  I suspected that she may have had a small leak of fluid from the space between the amnion and chorion.  She was not experiencing any further leaking or contractions so she decided to just ignore the occurrence.  I, on the other hand, saw this as a sign that things may be happening and asked her if it was OK for me to go ahead and make the 2 hour drive to her home on Monday to accompany her to her doctor’s appointment on Tuesday.  She was very pleased at the idea and told me to just pack to stay until after little Reyelle came earthside. 

I arrived at her house and got settled in (as much as you can settle in when you are sleeping on the sofa!).  On Monday we just hung around the house and tried to organize all the cute baby stuff.  Well, maybe we played with all those cute little cloth diapers a bit too much!  But it was a fun day just talking and dreaming about her future.  It was a very special time of mother/daughter bonding.  Tuesday came around and it was time for her appointment.  She decided to tell the doctor about her “leaking” on Sunday.  Needless to say he was not happy that she had not called him when this happened.  And, yes, even her absolutely fabulous, natural-friendly doctor, pulled the “dead baby” card (which, of course, left her in tears).  He did check for the presence of amniotic fluid in the vaginal canal and did an ultrasound to check fluids and did finally say that all was fine.  He did not see any signs that it was amniotic fluid (although I still suspected it may have been a small leak). 

On Wednesday she and I decided to do some shopping.  She was 39 weeks 5 days at this point. She had a few last minute items she needed to purchase and/or exchange and I knew that walking would do nothing but positive things for her.  At 5:15 PM we were at home and relaxing after our long day of shopping.  Jessica went into the restroom and suddenly hollered out “MOM!  Oh my goodness, my water just broke for sure!”  I went into the bathroom and found her standing next to the toilet, straddling a large and growing puddle of clear fluid on the floor.  I grabbed a feminine pad and a towel and got her into the living room.  I had a pack of PH test strips ready for just such an occurrence (yes, I know it is “out of scope” for a doula, but this was my daughter and I thought I could take some liberties!) and went back into the bathroom to clean up and test the fluid.  It was clearly 7.5 to 8.0 on the ph scale so I knew that it was definitely her amniotic fluid this time.  I reminded her that her doctor had told her to call him or go into the hospital if her water broke.  He had also told her that, absent a rupture, he was fine with her laboring at home as long as she wanted, even waiting till she felt the urge to push to make the 5 minute drive the hospital.  She decided that since she was not contracting at all, she was just not comfortable with moving to the hospital at this point.  My advice to her was that, if SHE did not want to go in yet, then the best thing she could do was for her and her husband to try to get some rest until things picked up.  She decided that that was what she wanted to do and got her hypnobirthing audio going on her phone and went to bed to rest.  She said that around 6:00 PM she began to experience very mild contractions but she could completely relax and even sleep through them.  I periodically went in to check on her but she seemed to be resting quite comfortable and did not want to disturb her peaceful state. 

A little after 9:00 PM she called me into her room and told me that she felt it was time to go to the hospital.  She had decided that she did not want the drama of waiting too long before arriving at the hospital and would rather go now and get settled before things really picked up.  She got dressed and just kind of casually got her stuff ready and packed in the car.  At times I was unaware that she was even having contractions, although she did sometimes have to stop walking and talking to focus on her script and relaxation.  Parking and getting into the hospital proved to be an adventure.  We had to enter through the ER and check in with a security guard.  He offered to get her a wheel chair but she declined.  I am sure he must have been wishing she would have taken him up on his offer when twice, on the way to L&D, she had to get down on all fours on the floor of the corridor during a contraction! 

We arrived in L&D at 10:00 PM and were admitted to triage.  Of course she got the scolding again from them about the fact that she had been leaking fluid for almost 5 hours now and was just now arriving to the hospital.  They examined her and found her to be dilated to 6 cm.  But now, my baby who had been handling her contractions so incredibly well, was forced to lie on the gurney in triage, on her back while they hooked her up to the monitors.  She now was having a hard time coping with her contractions.

The orders from her OB were for her to have intermittent monitoring (15 minutes out of each hour), a hep lock instead of IV, minimal cervical exams, no offers of analgesia, for her to be allowed mobility to labor in any position she desired when she was not on the monitor and, lastly, for her to allowed to push and deliver in whatever position she found the most comfortable and effective (unless, of course, there was an emergency situation that negated it).  The nurse in triage was an absolute angel.  Even though she had to make Jessica uncomfortable with the contractions during the exam and monitoring, she spoke nothing but positivity to her about her ability to birth her baby naturally if that is what she wanted.  However, the nurse actually assigned to her once she was moved to a labor room was a different story (I will refer to her as “Nurse Sour Puss”!).  We had to keep reminding her of the orders.  The lovely nurse from triage even came in and backed us up!  They were having a difficult time keeping the monitor on the baby and kept insisting that Jessica stay in positions that were very uncomfortable for her.  She managed to do as they asked and, finally, at 11:00 PM, they were able to get the monitors off.  

After that, I immediately suggested Jessica get into the shower.  You could tell that Nurse Sour Puss was not happy with her patient being out of bed with ruptured membranes, but I just reminded her of the doctor’s orders, and Jessica told her that she was doing it anyway.  Jessica spent the next 45 minutes in the shower and was doing very well.  You could tell when she was having a contraction, but she coped quite well with them.  At various times she would have me running the stream of water over her belly and at other times she wanted it on her lower back.  She was making very little noise, just a low moan during the contractions.  I noticed a couple of times that Nurse Sour Puss would be standing at the bathroom door just observing.  I got the impression that this was the first time she had had a mother use the shower as a pain management tool and actually found it fascinating (hopefully she learned something!).  

At 11:45 PM she insisted that Jessica get back into the bed for more monitoring.  Again, my daughter (who had been managing her contractions quite well) started struggling with control.  About 11:55 she was kind of thrashing in the bed and I thought that perhaps she was wanting to try another position.  I asked her, “Honey, what are you trying to do?  Do you want me to help you into another position?”  She kind of whimpered and said, “I don’t know what I want!  I am just trying to get away from it!”  I leaned down and whispered to her that it certainly sounded like transition and that those feelings were just proof that she was making good progress and would be holding little Reyelle soon!  The nurse kind of looked at me as if to say “How can you possibly know that without a cervical exam?!”  She did not believe that this first time mom, who had just been 6 cm less than 2 hours ago, could be close to the pushing phase.  

With the very next contraction Jessica began making some grunting sounds at the peak of the contraction.  I asked her “Are you pushing?”  She said that she wasn’t sure.  But with the very next contraction (it was now midnight) she looked at me and said “Oh yeah, I need to push!”  The nurse, still being the naysayer, told her to not push, wait for a few contractions to pass, and IF she still felt like she wanted to push then she would check her for dilation.  Around 12:15 AM she did a cervical exam (only her 2nd exam since arriving at the hospital at 10:00 PM) and seemed quite surprised to announce that Jessica was complete and could push.  Jessica was just experimenting with a couple of positions in the bed for pushing .  At 12:30 the nurse just abruptly said, “Ummm, I will be gone a few minutes, stop pushing till I get back!” and abruptly left the room.  Jessica was really struggling with the whole “don’t push” thing, so I gently reminded her that this was her baby, her body, her delivery and for her to do what she felt comfortable with.  When, after several contractions, the nurse had not returned, I pushed the call button and asked when her nurse would be returning.  The charge nurse came in and told us that Nurse Sour Puss had gone to lunch and that she would be helping us.  While I was appalled that the first nurse decided to take off for lunch without so much as informing us what she was doing, it actually turned into quite a blessing that the charge nurse took over.  This woman was convinced that Jessica (who had been struggling with moving the baby down at all) could and would push this baby out. She made some suggestions on positions/techniques and finally Jessica appeared to be making progress.  

I remember pushing for almost 2 hours with my own first baby, and, as a doula, had seen many mothers push for long periods so I was not really surprised when things did not progress quickly.  The new nurse was very encouraging though.  She cheered for the tiniest bit of progress!  What none of us realized was that the slow progress was due to an asynclitic baby!  Mommy ended up pushing for over 3.5 hours.  During that time there were numerous times when they had trouble keeping the baby on the monitor.  While this nurse was obviously concerned with monitoring the fetal heart tones, she also was equally concerned with keeping mommy as comfortable as possible.  Several times Jessica would say something like, “I don’t think I can push her out!” but the nurse was always encouraging to her. This phase was where I was so happy to have my doula training and experience to rely on.  It was really hard to see my daughter trying so strenuously to bring her baby down and getting so discouraged!

Finally, after over 3 hours the baby was crowning.  Because of the long pushing phase and the difficulty in keeping the fetal heart tones monitored, they called in the pediatric team in case there was a problem with the baby.  The room was full of various personnel who were all in their little corners, chatting casually with one another, and just waiting for the baby to arrive so they could do their job.  In the midst of this the doctor arrived and observed the atmosphere (discussions were going on about what they had for dinner, where they went that past weekend…).  He announced to the crowd “I want the lights dimmed and everyone to be quiet and respectful!  This mom wants a natural, peaceful delivery of her daughter and we are going to give her what she wants!”  You could have heard a pin drop in the room!  The lights were dimmed, the doctor asked for some warm oil and he started massaging the perineum.  With the very next push Jessica made tremendous progress and within 3 pushes the baby’s head was out.  It was at that point, upon seeing her lopsided cone head,  that it became clear that her asynclitic presentation was probably the cause of her slow descent.  With the next contraction the doctor instructed mom to reach down and grab her baby.  Jessica was literally shaking with exhaustion and said “I can’t, I am afraid I will drop her!”  The doctor assured her that he would NOT let that happen and to just grab her baby. 

There could never be enough words to express the swelling in my heart when I watched my exhausted daughter reach down and pull her daughter out of her body and up to her chest!  I had a new level of respect for my daughter!  The pediatric team was quickly dispatched out of the room as it was immediately obvious that the baby was doing great.  All she needed was a little skin to skin time with mom.  Thankfully, this was at a hospital that has already obtained the “Baby Friendly” certification so they were not trying to hasten the separation of mommy and baby. 

At this point I was able to kind of take a back seat and just observe the new mommy and daddy reveling in their new roles.  Baby stayed on mommy’s chest while the doctor waited patiently for the cord to stop pulsing.  It was quite something to observe.  This long awaited baby was here and being loved on by her new parents.  I could not help but think back to the births of my own children 40, 38 and 33 years ago.  So much has changed since then, but so much is still the same.  My daughter had managed to achieve a hospital birth that was very close to the home birth that I had experienced at her own birth 38 years prior.  In my job as a doula, I know that the birth of the baby usually signals the beginning of the end of my relationship with this new family.  This was so different.  I knew that this was just the beginning of a lifetime of love that I would be able to shower on this baby and her parents!

PS:  Some of you may question the fact that I do not mention dad much during the labor and delivery.  Let me assure you that dad was very much there and involved in the process.  This family has a unique circumstance where daddy has some severe disabilities in his legs due to burns he suffered many years ago.  He is very limited on the amount of standing he is able to do.  So, while dad was there and contributed very much to the emotional support of his wife, I was the one who provided most of the physical support to my daughter during her labor and the birth of her baby.  

Karen is a mother, grandmother, and doula. She had a home birth in 1975 with a chiropractor attending. Karen is a Christian who doesn't think God made any mistakes with the way He designed women's bodies. Ever the caretaker, she has an adult, adopted developmentally-disabled brother who she helps care for. Karen loves to sew and cook, but she hates to clean up after both!  Reyelle is her 5th grandchild. Find her on Facebook to learn more about her doula services.  

I have been a couple of days ahead of these 31 days' posts. Yesterday, on day 8, I was ready through Tuesday, including a special Mother's Day post for day 10. All I needed to do upon waking up today was hit "publish" for day 9's post. 

I was called to a laboring mom in Tulare at 2 am, yet I knew I could use my website's mobile app to publish from the hospital -- but not so, I kept getting an error message (while mom was being triaged in a Visalia hospital and I was in the waiting room). I finally gave up and focused on this birth, knowing I could figure it out later.

This birth! This birth was amazing. My friend and fellow doula, Denise, asked me to support her during her surrogacy birth. Her husband, Chris, was a huge helper -- after all, he has supported her through her natural births before. That left me wondering, what would my place be when the partner is already doing great? I did doula the dog while we labored at their house; poor Buddy had been hiding under the bed until I arrived. I walked in to lay my hands on Denise's back to let her know I was there, and from under the bed, something began licking my feet. Buddy!

What we couldn't predict was, once we got to the hospital, Chris started feeling very sick to his stomach. He needed to go to the car and rest for a while, and he was kind of in and out of the scene. When he was present, he was very present, offering everything he could to support Denise (and the way they worked together was inspiring). And when he needed to step out, he knew things would be okay. 

Denise had an amazing midwife, Rita. Rita is a powerhouse. She had five children of her own, and when she enrolled in a midwifery program Stanford offered for three years back in the 80s, she was pregnant with her 4th baby. Many doubted she would finish, but Rita is nothing if not relentless! And this shows when it comes to supporting her patients. Not only did she go to bat for Denise's comfort and preferences, she also knew how to talk to Denise to keep her courage up and help her move forward when she hit emotional and physical walls. 

The intended mother was at the birth, and she quietly witnessed the whole thing, very concerned for Denise's safety and comfort. When this little baby girl was finally born, she was laid on Denise's chest, with her mom right there, awestruck and deeply moved. I don't think any one of us in the room had dry eyes. Soon the mother sat down in a rocking chair and baby was placed skin-to-skin with her. We all watched this new mother interact with her baby -- the sweet words, the lilting voice, the facial expressions and the snuggling; it was an amazing peek into the private world of a mom and her infant. Soon the new dad joined mom and baby, and again, the tender voices and touches were sweet affirmations to those present that this new gift was one worked hard for, one cherished. 

I didn't intend for this to be anything more than a short Day 9 post to stay on track, but it is hard to withhold the beauty of birth -- every birth. I am amazed at Denise's strength and her generosity. She truly went through one of the hardest physical and emotional experiences in her life to grow and birth a baby for a family who did not have this ability. Four hours or so after the baby's birth I finally left, but one of Denise's last comments to me was this: "I am so grateful I could do this for them."

And I am amazed. 

My brother and his wife were expecting their second daughter any day and I desperately wanted to be there for her arrival.  Now, it should be known that we are a family of “moderate hippies." Grow-ing up in the Pacific Northwest, you are subject to crunchy granola-ism by proxy.  Like it or not, you will be more “green” than people from, say, Detroit, just by default. So I was confused, but not surprised when my sister-in-law announced that she would be using a doula for her second child’s delivery.  “A what?” I asked…”a doula.” was the reply. “What is that?  Is that like a midwife?”  “No, it’s like a birthing coach or a mother’s helper.” “Huh.”  I was picturing a stern matronly woman that smelled of patchouli and wore Birkenstocks.  Someone that espoused the virtues of going drug-free while standing on your head and breathing like an Iditarod racer through contractions…no thank you.  With three children to my credit, I have always been happily pro-drug, pro-hospital, pro-doctor.

Despite the fact that I have given birth more than once, I still became quite excitable as we timed the contractions.  My sister-in-law braved the pains from the comfort of her upstairs bedroom as we waited for her doula to arrive at the house.  I was timing them at three minutes apart and was wondering why we weren’t just meeting this delivery person at the hospital.  I harbored secret fears that my niece would be accidentally born at home and I don’t know if I could’ve kept from passing out if she had tried that business…

It was also interesting to watch her “work the crowd."  You could tell she had assessed the situation (slightly hysterical grandmother, worried sister-in-law, sick husband – did I mention at that very moment, my brother, the father-to-be, had been struck by a gastrointestinal bug?) Ashley diffused all that was ramping up.  Focusing on mom, but speaking to all present, she assured everyone that the baby would not be there in the next hour and that we would calmly work our way to the hospital.  I’m certain that my sigh of relief was audible when she made it clear that this baby would not be born in the upstairs bedroom of their family home.  

I stopped perspiring when it became more-and-more clear that this gal knew what she was talking about.  So far the baby had not fallen out en route, despite my misgivings about contractions that were three minutes apart and our not being hauled by screaming ambulance to the emergency department. Remain calm faithful reader.

Our doula (yes, at this point she has become “our doula”) was as steadfast in her calm and patient demeanor as I was borderline hysterical. I watched this magical gift of a woman do her thing. Yes, at the risk of sounding like a crazy, hippie-dippy, magical loving, fruit loop of a nut job, I will put it out there. I will say it: This magical gift of a woman, this doula, was wonderful.

In what was, for me, the comfort zone of beeping machines, copious hand sanitizer and droves of personnel equipped with advanced degrees and special badges, I watched the most basic of all things natural unfold: A woman, comforted, coached and calmed a laboring mother while the laboring mother brought her baby into the world.  It was a revelation for this mother, how a delivery could go so smoothly…

Because we are led to believe that laboring women need monitoring, constant checking, IV’s, medications, interventions and whole carts of instruments to bring a human being into the world.  When maybe the most effective, and dare I say, most important vehicle to assist in delivery is a calm companion -- someone who knows, with unshakable conviction that women were designed to have babies.  That birth is not an instantaneous process.  A person comfortable with the fact that labor and delivery take as long as they take, a person adept at soothing a laboring mother through the pain and anxiety of childbirth.

Having seen it for myself, watching a team work with a laboring mother in that hospital room, it dawned on me what a genius arrangement this was.  Dad was watching the progress, eagerly engaged, free to ask questions and procure ice chips while mom was fully tended by a constant, unwavering support person.

During my own delivery, six years ago, the assigned labor nurse whom I had grown to love, had her shift end smack dab in the middle of my laboring!  And she left!  She went home because her work day was done.  The second shift came on as I was transitioning into hard labor and I hated that second delivery nurse.  She was loud and obnoxious, interjecting her belligerent opinions with every breath.  And I was too wrapped up in birthing a baby to tell her where I really wished she’d go.  What a different experience that could’ve been.  If I’d had a doula, as a personal support person at my side, “Nurse Ratchet”, as she’s become infamously known in my birthing story, could have gone away.  Or at least shut up.  But I had not known there was this option.  I only knew what the hospital staff told me…

And let me tell you another story where a doula could have quite possibly changed the course of history.  A couple of years back, I was invited to photograph at a delivery.  Not a National Geographic-type assignment, but a tasteful, photo-journalistic capture of the first moments of life. Mother laboring, father cord cutting, baby weighing in, all of those moments.  At three centimeters, this laboring mom was beside herself with pain and she became petrified at the prospect of having to birth a baby.  She screamed frantically until an anesthesiologist came in and gave her an epidural. She was dilated to four centimeters.  As her contractions continued, the epidural was not enough and she became terrified. Her mother could not talk her down, the daddy had to leave the room – everyone was asked to leave the room.  The epidural was turned up and medication was administered intravenously.  The shrieking subsided as we all waited in the hall.  She was dilated to seven centimeters.  Her labor progressed.  Before she was ready, she was at ten centimeters and there was no more medication to be given.  This birthing woman screamed and cried and swore and shrieked and there was nothing more to be done (pharmaceutically) as she endured that transition into second stage.  

The doctor arrived amidst chaos and hysteria while a crowd stood, wide-eyed, in the hallway. Suddenly and abruptly, all of the ruckus stopped.  Dead silence.  Minutes later, a nurse emerged with a silent, swaddled infant.  I will never know what actually happened in that delivery room in the wee, wee hours of the morning, but I do know there was no audible first squeal from that baby, there was no “war cry” as that laboring mom delivered her infant with her own body.  I can speculate that when her practitioner walked in, he evaluated the hysterical situation and whacked that mom up with something akin to the old twilight sedation that women in the 1950’s delivered with, and he pulled that baby out before things got any crazier.  That is what I honestly believe happened, but I will never really know for sure. What if she had a doula?

This is long!  Be warned!

I think when a person in is a position to serve a woman while she is in labor, that person should have required training every few years, like a recertification, on what it feels like to have a baby.  I am not certain how this certification could be obtained, virtual reality plus some sort of pregnancy suit? Actually having a baby? I haven’t figured out the logistics, but I have recently had a recertification of my own, and that is called, my fourth child.

This fourth pregnancy was a surprise.  Technically, I got pregnant at a time when no one would be able to get pregnant – only I guess more like I got pregnant at a time I felt I was highly, highly unlikely to get pregnant.  My last menstrual period was June 10th.  I did not get pregnant until July 13th at the earliest (a time when I was waiting for my period to start), to July 20-ish at the latest; looking at the date he was born now (April 6th), July 13th seems closer to the target date…we were on vacation.

I had lots of irritable contractions combined with irritable baby movements (probably more of the latter versus the former) that would happen around 10 pm to 1 am.  The week before labor began I pretty much experienced these every night and I hated them.  During these times, I would have waves of panic and anxiety about the reality of actually having to go through the birth process again, and I was always grateful when they were over and I could finally climb into bed.

Friday the 5th of April was pretty normal except I had two very serious bouts of grumpiness that made me feel deeply in touch with someone who was (hopefully!) going to start labor soon -- it was like total,
irrational, not-triggered-by-much anger that switched on so fast, I knew it was something else with some other root than just me being moody. 

We had pizza for dinner, and like I had for the last week, I restrained myself from eating too much (“If labor starts tonight I don’t want to be too full,” was my rationale).  I had two pieces and then cut myself
off. I took a little nap in bed, which I hoped would actually be “going to bed,” but I woke up at about midnight when I couldn’t ignore the antics of Wild Baby any longer.  I watched TV a little and sat on the ball to try and bounce my guy into a calmer state.  At 1 am I decided to watch the last episode of Mad Men on Netflix so I would be ready for the new season, with the intention of going to bed after that.

At 2 am, just when I was settling into sleep, I realized I was contracting, and these contractions felt different.  They came 5-6 minutes apart, were totally manageable, and lasted about 40 seconds. I tried to sleep, but I was also mindful of needing to recognize true labor so I could get my sister and my mom on the road from two and a half hours away if this really were it.  

Everyone was asleep, and as long as I was okay, I felt no need to wake them.  I was feeling hungry, so I ate half a lemon Chobani (again, not wanting to eat a lot) in the morning quiet. I did call my sister at 3 am to let her know it was go-time.  I labored longer, in the quiet of my living room, tending to small errands and tasks between contractions.  At 4 am I woke Brad up to tell him I was in labor.  He came out to the living room and asked, “What can I do?” and I immediately answered, “Take the recycling out, it’s driving me crazy and I have contemplated doing it myself for the last 2 hours.”  I was hoping he would just lie back down on the couch and snooze a little, but he was up and ready to go.

I thought I would wait to call my midwife until 5 am, but at 4:30 my contractions began to get stronger and longer and closer together, just as they should, and I finally had some show. I phoned Linda to let her know I was in labor.  She asked me a few questions, and then said she would be over soon.  She lives about 40 minutes from us. 

At 6 am, Linda arrived, and things were beginning to feel real.  We had our tub set up in the dining room and I was feeling a pull to climb in, but I didn’t want to stall labor if I wasn’t that far along.  I asked Linda to check me and she said I was 3 centimeters (“Not quite active labor!” I thought with a little disappointment), about 90% effaced, baby maybe at -2 station?  I can’t remember that part.  I mentioned I wanted to get in the tub, but I should probably try the shower instead (so gravity could keep helping my labor), and Linda agreed. 

I got in the shower, and I really don’t know how long I was in there.  The water felt great on my belly and during contractions I would swing from side to side so the water could fan over me.  In between contractions I alternated putting my foot up on the side of the shower to lunge, in case my baby was posterior like his two brothers before him.  Soon I found I had to vocalize during the contractions.  I was in the bathroom alone and I had a lot of time to think. The thought that kept coming back to me was, “All is as it should be,” which was part of a prayer Brad had said earlier in the week when I was feeling really overcome with fear.  I rubbed my belly and talked to the baby and told him to hurry, it all felt like it was happening in slow motion.

When I got out of the shower it was about 7 am and Linda checked me again.  I was 5 centimeters.  I went straight for the tub at that point, dropped my towel, and climbed in.

Jacob and Jonas were awake and had been for a while.  Soon Isaac woke up and came straggling out of his bedroom in his standard sleeping attire – undies and a t-shirt.  Brad told him we had company and he might want to put clothes on.  Before Isaac woke up I remember Brad asking Jonas if he knew why Linda was at our house so early?  Jonas admitted he didn’t, and we made a joke about Linda just coming for an early-morning visit.  Brad then said, “Your mom is going to have the baby today.”

I looked to the tub for the relief it had brought in the past; with both Isaac and Jonas I got into the Jacuzzi tub at 5ish centimeters and after an hour was at 9ish centimeters, and I was hoping for the same, with the addition of having the baby in the water. After 30 or 40 minutes it seemed the tub wasn’t going to work as I had planned.  I had intense pain in my lower abdomen to the point of not being able to sit in a relaxing position, so the whole time I was in the water I had to be on my hands and knees, and I didn’t want to stay that way much longer.  Also, Brad started making pancakes in the kitchen.

At about 7:45 my mom, sister Shiela, and her two boys arrived.  I headed to my bedroom, finished with the tub.  Linda had set things up around the pool in preparation of a water birth, so some rearranging was in order, moving things to my room, getting equipment ready if needed.  Once in my room it was just Linda, my mom, Shiela, and I.  Brad had the boys going with pancakes and if they were making any noise, I sure didn’t hear it.

I asked someone to bring the piano bench into my room as I was laboring standing up, and I wanted to continue to lunge in case I had a malpositioned baby (which I don’t think he was, but I was a little gun
shy).

I think I had Linda check me again, and I think I was 7 centimeters?  I am not really clear on this part.  I wasn’t ready to sit down, so I continued to labor standing up. Shiela was a super doula – she would squeeze my hips during my contractions, and it brought so much relief!  One thing I know about that double-hip squeeze is, it is hard to do when you have to press your arms together at the height of a woman’s hips – you get tired fast, and the laboring woman usually doesn’t want you to stop.  If the
mom can get on her hands and knees on the floor, you can squeeze her hips with your own inner knees by straddling over her back, but I didn’t even want to try or offer that as I didn’t feel good in that position. 
Over and over, a contraction would come, and I would tell Shiela, “Hips, hips, hips,” and she would start
squeezing.

In reality I have no idea what kind of time span this all happened in, I say over and over, but maybe it was only about 5 contractions?  Or maybe it was 10?  

I did finally sit on the bed for a bit. I remember taking my watch off and handing it to Shiela with the feeling that this was taking too long. I know for a fact I wasn’t looking at my watch or paying attention to how long it was taking in a linear fashion, but it was more some sort of symbolic resignation that I
would try to just flow with the timetable my body and baby presented even though I am as impatient as they come; in the last picture of me with my watch on, I see the time is 8:55 am.

I decided to visit the toilet.  I spent a couple of contractions there, and Shiela was with me. She said my noises changed and she knew I was getting closer.  As I sat laboring on the toilet, I opened the shower door next to me and contemplated getting back in -- I was looking for anything to comfort me at this point.  Then I decided to see if I could feel anything inside of me, so with one finger about one knuckle in I was shocked to find something!  “Is that a head?” I asked.  But then I realized it was a bulging bag of water, with a head behind it.  After all the years of hearing practitioners say, “I feel a bulging bag of water” (which I did remember Linda saying when she checked me last), I finally knew what that felt like and what it meant.  I think I almost gingerly hopped off the toilet at that point, feeling remotivated.

I had one contraction standing up, with Shiela at my hips.  Then I had another, and my water exploded all over the floor.  There was a little meconium but Linda said it looked old and there was no reason for concern.  I finally climbed into bed.

At this point I knew it would soon be time to push.  I suddenly had the need for Brad to come and be with me, so I called to him and patted the side of the bed next to me, I just wanted him to sit with me and be near. Shiela was on the other side of me, and Linda was at the foot of the bed.  My mom was by the door, ready with the camera, and the boys were in the living room playing Legos (again, I never heard anything from the boys, and there were 5 of them.  Actually, I think after they ate pancakes they walked to the park with the dog to play for a bit. But I do know when the baby was born, they were playing Legos in the living room).

I did begin pushing at some point, and Linda said I still had a rim of cervix and she was going to try and move it, and I was totally fine with that because if anything was holding this baby up, I wanted it gone.  So for a couple of contractions she worked on that and I guess it went away.  I was pushing with such intensity but it felt fruitless.  I truly felt nothing moving or changing and I imagined pushing forever
and not making any progress.  It was at this point that I remember thinking, “I should have gone to the hospital so I could have the drugs!”  (Interestingly enough, when I had my babies in the hospital, I never thought to ask for drugs, because I know if I had had the thought, I would have asked; maybe at home when it is not an option, my brain safely went there, just as a way to cope and vent.)  Brad and Shiela were helping me pull my legs back during the pushing.  Instead of rolling my chin to my chest, which I have helped women remember who-knows-how-many-times, I arched my head back against my pillows.  I also had my body twisted in some way, crooked a little. Linda gently reminded me to get better aligned (with words and heart I could understand at that point), while giving me positive encouragement for this task I had to undertake.  

Linda!  What else could you want from a midwife?  Really, not one thing.  As a doula, I get really uncomfortable when people say, “Stacie, I couldn’t have done it without you.”  Because, come on, you could have, and you would have.  I don’t want anyone’s birth experience to have me entangled as an
essential ingredient; it should be all about the mom and her family, not me.  But I have to concede that
when the right person is helping you with the right words and attitude and presence and spirit, it helps make the experience even more amazing, if that is possible.  When you have the right midwife, the feeling is similar to being in your own home – the comforts of being in your own bed, using your own bathroom, lunging on your own piano bench – Linda was a natural extension of that.  It felt right that she be here, in our home, unobtrusively watching over the birth of our baby.

The support Shiela gave me was also invaluable.  Family members don’t always make the best doulas. 
Shiela actually has taken a DONA-doula training, and that coupled with what she knows about me (just about everything), made her perfect for the job. She stayed by my side, she gave me verbal encouragement, she wished she could help me more.  The truth of the matter is, only the mother can have the baby, but she doesn’t have to be alone while she is having her baby.  I will forever treasure that my sister was there to support me during one of the most intense experiences of my life.

Pushing was hard, it was really hard – it seemed harder than it ever had been.  I know I was lost in my head, and in there, the storm was raging. Every push came with screams, I hate to say it.  I have never screamed with any of my other babies.  And also, I cried, which was something new for me.  In hindsight I probably could have pushed more effectively keeping those screams to myself, but they just came out.  I know the boys didn’t appreciate the noise (although they all later admitted they weren’t scared), I am thankful my neighbors didn’t call the police, and the screaming is not my favorite thing about the birth video – oh well!

After so much pushing (again my sense of time is really off here), finally his head emerged.  I felt his head with my hand, but it really didn’t mean anything to me, I just wanted the rest of him out!  I pushed for one or two more contractions, maybe three, and then his shoulders popped and he tumbled out on a
wave of fluid and tons of baby poop.  Linda helped bring him to my chest, all the while rubbing him and talking to him and watching him carefully.  I was so relieved and instantly went from that person experiencing the very hard work of pushing toward a goal, to that mother experiencing her baby
for the first time.  I was rubbing him and toweling him off and just taking him in, my body relieved of the burden with the prize in my arms.  He was born at 9:42 am.

We all watched as he turned from purple-y to pink.  His apgars were 8 and 9.  Very soon after birth he wanted to nurse and he seemed to know just what he was doing. The boys peeked in one by one, only appearing mildy interested (we had two 13 year olds, two 11 year olds, and one 7 year old), and then backing out of the room again.

There were lots of things in the birth kit we didn’t use.  My perineum didn’t need massaging, which Linda was prepared to do.  We didn’t need the bulb syringe to suction the baby’s airways. There are lots of Chux pads that didn’t get used.  Everything just happened easily and well, as it so often can when left to its own devices. I am sure the level of comfort and security factored into that for me as well.  I am still struck by how ordinary things were and how extraordinary they were. Within a couple hours I was back in my shower.  A little while later I threw a load of laundry in.  My mom bought donuts and I happily ate three.  Our new (nameless) baby was being admired and touched and held by his cousins and brothers and dad and aunt and grandma, while also nursing and visually taking in all he could.  In many ways it was like a normal Saturday morning at home, but then, it was also like some rare, high holy day, calm with introspection, peace and joy.

Ezra Christian was 8 pounds, 1 ounce.  There was much debate about his name – the other choices were Benjamin, Ruben, and Abraham. He was born on what we in the LDS religion believe to be Christ’s birthday, and also the day the LDS religion was restored; Christian is my brother’s middle name, and we
felt it appropriate for Ezra as well.

Moving through that birth, I didn’t feel alone.  I remembered so many births and situations and strong mamas moving gracefully through this work.  I could name each and every one that came to mind, but hey, this one’s my story.  Just know if I have been with you for the birth of your baby, you were with me during mine in spirit and endurance and admiration.  This has brought me so much more appreciation and compassion for birth and women while experiencing it – that’s why I feel there should be something birth workers can do every few years to get back in touch with what it can really be like to physically grow and have a baby.  It changes you, and sometimes we forget that.