My first birth as a Doula

September 24, 2010

Holding CY at the postpartum meeting with his mother, MY

As I start slowly on this journey to becoming a DONA certified doula, I will be posting about my experiences here. All names will either be changed or only initals will be used. All blogs are posted with permission from my clients. Thank you for reading about my journey.

Clients: M.Y. and J.Y.

Place of birth: North Austin Medical Center

Date: September 13th

On September 12th, I met with MY and her husband JY for their final pre-natal meeting. I love the 2nd meetings. They are more hands on and we talk about all the different position possibilities during labor. MY was having some issues with swelling and blood pressure, so her doctors conducted blood work on Friday and would let her know on Monday if she needed to come in and welcome her baby boy sooner rather than later.

I get a call not 2 hours after leaving their house on Sunday evening: “We are going into the hospital, they are inducing us tonight!” It turns out MY had a mild case of preeclampsia.

Talk about excitement! And this worked out for my first birth since I could prepare completely. I am sure with my other ones I will be running around, making sure my bag is properly packed, etc…

So, Sunday night, I prepped my bag, making sure I had my paperwork, ID, food, etc…I went to bed at a decent hour, set my alarm at 6am, and unlike my laboring client, I rested fully.

My alarm wasn’t set correctly and I get a text at 615am with the news of MY’s water breaking and that she was at 4cm dilation! Whoo hoo! “On my way!” I texted in reply.

I jumped up, gathered my things, woke up the hubby and baby who drove me to the hospital (we share a car), and, taking a deep breath, entered the Women’s Center of the hospital.

As I make my way down the L&D hallway, the midwife on duty introduces herself to me and says the parents are doing great thus far.

Great! I enter the room with optimism. MY is in bed, turned to her side and JY is comforting her. She is in the middle of a contraction. It seems intense as she grips the bed and struggles to focus. I estimate that her contractions are very intense due to pitocin or she is farther along than an hour and half ago. I immediately jump in, helping the husband out (who looks exhausted) and we get MY to focus and breathe.

When the contraction subsides, we talk. We discuss her visual point she is using, how she is feeling and what she is feeling. Intense is the main theme. Another contraction comes and again, we have to constantly help her to focus. This is at 715. She can’t get out of bed or use any sort of position that uses gravity because of her blood pressure. Laying down only makes her contractions worse and even harder to deal with, however.

We do this for a while. She decides to get Stadol, a narcotic used to help relieve the pain. But it didn’t help. It made her a little sleepy and when a contraction came, unable to stay on top of them. They were very close together and intense.

The midwife comes in and checks her around 830am. She is still 4cm dilated. The optimism in the room deflates. MY is already exhausted. The midwife watches her through a couple of contractions and they begin a real discussion of how MY is going to cope through the rest of dilation.

MY, JY, the midwife and myself all discuss the pros and cons to the epidural and a decision is made to have one. The best part of this process was the staff’s complete understanding that it was totally up to MY. The decision was totally hers. They didn’t  pressure or use scare tactics. They simply gave her facts and allowed her tons of questions in order to make an informed decision. Optimism slowly creeps back into the room as well as a sense of relief.

By 910am, the epi is administered and by 10am, MY is able to rest fully. She can still feel the pressure of the contractions but she doesn’t struggle to get through them. She is relaxing. We work on her visualizing her body working to open up for her baby boy. I work on her lower back and pelvis area, constantly pushing the pelvic bones to simulate walking and thereby, to create more room in her pelvis. MY’s darling baby boy was still pretty high in her uterus at that point (station -1) and we wanted him to boogie on down so more pressure would be applied to her cervix and so she would open faster.

And boy howdy, she did. Within an hour of receiving the epi, she had dilated to 5cm.  With this encouraging news, we went back to work on relaxing, resting, visualizing, and massaging her lower body.

For some reason, I never tired of massaging her. My hands never tired fully and I was content to keep working on her back, legs and feet. I took some breaks, but really I just stayed with MY. Her husband JY was able to get some rest as well, which was necessary as we still had a journey ahead of us.

The midwife didn’t check her again until 220pm, mainly because MY needed rest and to not break any good thoughts about dilation. When she was checked, however, she was at 7cm! We all cheered! They were not stalled and trucking right along!

Around 430pm, things started to get rough. Due to her great reaction to the epi and her progression, MY and JY weren’t as diligent with the bolus delivery of the epi as they were in the beginning. The contractions were gathering in such intensity again, we were afraid of backtracking. A big dose of epi was ordered and soon MY was back in her comfy, relaxing, visualizing state.

By 620, MY was fully dilated with the exception of a rim near the front. But the hospital staff was in no hurry. The baby could move down a little, put more pressure on that cervix rim and open her right up.

We really got to work then. We experimented with the different bed positions, raising it a little to help her baby boy by providing some gravity. I really pushed and kneaded on her pelvic bones  and we even lifted her top leg, knee towards shoulder to give the baby plenty of room to scoot on down. MY was doing a fantastic job, still focusing on opening up and handling the growing pressure.

By 850pm, MY was ready, the baby was ready and we were all ready. MY was on her back for most of her pushing and it was rough. MY was exhausted, nutritionally depleted (not having anything to eat since Sunday night) and the fact that she knew she wasn’t in the right position to be pushing. She kept saying “I want to sit up. I want to squat.” But the midwife was hesitant because of her rising blood pressure. After about an hour of pushing, the baby was a little further down, but not much. Finally, the midwife agreed to let MY sit up. They put the bed up and let her use the squat bar. By that time, we were counting her directed pushing which seemed to help her push for a longer time so her baby could move further down.

As soon as she was upright in a squatting position, the baby’s head could be seen in as little as two pushes. MY was doing great. She was able to push more effectively and for longer in the squatting position. Her temperature had gone up, so we ran for ice and placed them under her armpits to cool her down. The staff didn’t have time to get antibiotics administered so the ice was recommended by the midwife and it worked completely in cooling MY down.

By 1030pm, MY’s & JY’s beautiful baby boy, CY, was born. JY and CY went to the warmer and due to a concern in CY’s breathing, he was taken to the nursery after a brief cuddle session with MY. From there, the third stage of pushing was commenced. The placenta was tiny, just like MY’s baby (5lbs 3oz) and MY, who had let the epidural run out, was now feeling the full effects of afterbirth hormones. She was alert and ready to be with CY. But she would have to wait since her baby was taken to NICU. He was grunting a little with breathing and while it was assured that it was fairly common, MY was concerned and feeling a little lost. Family members tried to reassure her, but a new role was developed for me that I didn’t anticipate: comfort giver after the labor.

I stayed with MY as they administered more pitocin to help her uterus to contract and stop bleeding (it was understandably tired!). I helped gather their things and went with MY to the postpartum room. I went to NICU to talk to the father JY and tell him where MY was and what the plan was (ensure bleeding had stopped, MY to visit baby in NICU and then to pump). My heart went out to MY as she worried over seeing her baby. She was adamant, as she should have been. After she was settled in the postpartum room, MY (always concerned for me throughout her labor) suggested I go home. This time, I agreed. There was nothing left for me to do then as MY’s nurse was taking good care of her and they were prepping her to go see her baby. From there, she would breastfeed him, pump back at the room and finally, rest.

It turns out there was a tiny air bubble outside of CY’s lungs, causing him to not be able to breathe fully. But he responded to oxygen beautifully and over the next couple of days the bubble dissolved on its own.

The rest of the story is now fully theirs as they revel, rejoice and learn everything about their darling son. Congrats to the Y family and thank you for letting me share this experience and for being such a great first birth to attend!