Adventures in Doula land - what you never expect

To start, I was at another birth yesterday (that is 5 births in 8 weeks!) and I have to say it is one of the most interesting ones yet... but not in the usual way. Sure some labors are long, some are short; some are loud, some are the picture of peace; some are full of faith, some are lacking confidence from the start. SOME are interesting for the doula for one reason or another - but yesterday it was the first time it was interesting because of some near escapes of bodily harm via the laboring Momma.

In the midst of very serious labor when Moms are feeling like they want to crawl literally out of their skin my job can sometimes be to get inches from their ear and get them to breathe with me, slow things down, relax and generally take it down a notch if possible. I will admit that it doesn't sound like the nicest thing to do (commanding with some strength that Mom breathes with me or what not), but I try to do it with a lot of understanding and sensitivity - sometimes I feel like a jerk doing it so I imagine it sometimes sounds that way to Momma. Sooooo, when I'm telling this Mom at one point to breathe with me (instead of hyperventilating) and to slow it down, she swatted verrrry near my face.

Hmmmmm, I backed away a bit out of reach.

So later when Mom has gone through levitating off the bed (practically) and truly acting like she was possessed, she was getting some medication and had to hold still (it hardly worked - I swear, so far both doula clients that have had medication while I was their doula, it hardly worked - both times not even an hour). So she is holding still with more concentration than I have seen from her thus far and she is squishing my hand (later I checked to see if my wedding ring made me bleed, that's how hard) and she slowly brings my hand (in hers) to her open mouth with bared teeth... and then goes to bite me, and slowly backs my hand away (phew!). Not two minutes later my hand is headed for the same direction and again, she chooses not to bite me.

Hmmmmmm, do doulas taste good? Shall we NOT find out?

Overall, I must say that it was interesting (as so far, every single one is), but next time, I won't have the biting or hitting... even in the heat of labor I need a bit of respect. : )

So how shall I write this birth story then?

The new season starts... now!

I took my last test for my classes today, I am DONE with school! I am done for several years (even if I didn't pass my class), I am not going to be a college student for a while - hallelujah!! I am so relieved to spend time with my family, finish projects, establish the feeling of peace I love, and just play with my boys... what a total joy! I won't feel guilty that I'm not multi-tasking, studying (or procrastinating), and my focus gets to go where it really should be right now. I'm still going to be a doula, but I am overjoyed to simplify - hopefully I can figure out how to relieve some of the pressure from my wonderful husband... he is just up to his neck with work and the stress that goes with it. Poor guy.

So I was a doula after that birth I posted last, and it has also been an extreme learning experience... the birth and labor weren't as much as the following 2 weeks have been (it'll be 2w as of Sunday morning) since this Mom had her baby. She had pretty calm and random labor pains all day Sat. and it wasn't until late Sat. evening (11:00) that her water broke. Her contractions picked up but she was fine still... she said she'd call when she needed more help or had questions. I got a call about 2:30 from her boyfriend asking if water coming out with each contraction was okay (yes) so he said ok... I got a call 15 min. later from the Momma saying she was really in a lot of pain and wanted me to come. I flew out of bed, got ready and was out the door in less than 10 min. I drove a good 40 mph on the roads to get to her house and when I got there and pulled my things out... I could hear Mom pushing from her open window. I hardly remember bolting up their stairs to their apartment and throwing my things on the floor. I walked in to Mom pushing in the tub, "I've already been pushing for 5 min!" she said. I flipped open my phone praying that the midwife was going to fly - but the Dad said they'd called her when Mom started pushing (phew! because while I'd love to catch a baby... maybe with less panic). : ) The midwife showed up maybe 7 min. later and the Mom started calming down. She actually liked pushing and kept asking, "Is that okay?"... I told her to enjoy it! Baby was born into water with one big push all at once, and Mom sat back with relief (with baby still on the tub floor!). The midwife practically jumped INto the pool to get baby, and pulled her up. She was gurgly from mucus in her tummy and nose, but she was breathing pretty well. We'd been there a total of 25 min!

Since that point, baby had refused to nurse for almost 3 days - the key ended up being a suplemental nursing system (SNS) and a fellow Mom nursing her daughter. The new Mom had really flat nipples and the baby just wasn't able to figure it out - after a nursing with a different Momma that didn't have this problem, baby figured it out in less than 12 hours. She was not becoming dehydrated or anything (even though she hadn't nursed) so it was amazingly un-freakish that baby had gone that long.

BUT, the frustration that Mom continues to feel re: feeding her daughter (honestly, I don't think she is cueing into her baby's cues (yet?)) and behavior has been exceedingly time-consuing, energy-consuming for all involved. I don't mind serving this Mom or her family, and I don't mind answering late night calls - but it got to the point where I was answering questions about poop-color at 3:30 am! Since then, it mellowed out a bit, but even then, I'm running to their house on "panic calming" errands - to check out their daughter's umbilical cord, taking her daughter for a walk so that she can rest and shower, eat and listen to silence, getting meals organized for her, having other people go visit, etc. My husband is demanding that next time I get paid. It's hard because I remember exactly, how difficult it was for me to adjust the first time... the feelings of panic, the questions, the frustrations, the anxiety, the post-partum depression... it all takes a toll, but it doesn't need to happen if you have support.

So I'm still learning - learning that becoming a Mom is difficult at SOME point either in the labor, the delivery, the pregancy, getting pg, the parenting, family issues, the issues that baby has - - it seems like there is no such things as an easy pregnancy, labor, delivery, adjustment and parenting. Is that a horrible way to look at it or is it realistic? I think that God uses those difficult situations to make us into parents, to change us into the people we need to be for our kids.

It's funny to see how my impression about labor and delivery and what follows is changing... I can feel my expectations melting away, my first judgement calls lessening... when I get a prospective client, I don't expect anything from them at this point (honestly, I don't even expect them to call me). It's funny, and it's kind of nice, I'm not worrying in the same way, or hoping even... I just feel like I take it one issue/situation at a time.

The story continued...

So this birth that I was at Wed...
When I got there at 7:45 am. Mom was sitting on the birth ball and leaning on the couch, she very much looked as if she was in *early* labor and I wondered about her timing for calling me. She was handling contractions well and not needing anyone's assistance other than heating the heat pad for her back when it got cool. Her husband was filing the birth pool and I was just there for moral support. I was there about an hour and 15 min. when her parents showed up and while contractions had been about 15 min. between them, when her parents showed they jumped to 2 min. apart (still lasting about 1:15 each). Mom asked me about calling their midwife (my friend) so I went ahead and asked about checking her, etc. The midwife said she had day apts. and so either they needed to wait until their apt. at 1:00 or come down now for a check. Mom didn't feel at all like driving (don't blame her) so the midwife came to us.

Midwife arrived maybe 9:15 and checked Mom who was 7-8 cm.! We were both shocked (midwife and I)... still Mom was breezing through labor and got into the birthtub when it was ready (maybe another 3/4 hr) and you could tell by her face that labor was finishing dilation. It was maybe another hour or so and Mom felt like she was getting close to pushing. After another hour or so we had Mom and Dad go into the bathroom so Mom could get a sense of the pressure and sensation of relaxing/pushing/working with her body. After about 1/2 hr. they came back to the pool and Mom was breathing through her contractions.

It was another hour of working with Mom trying a few different things (having her look up with eyes open, leaning on Dad, kneeling, kneeling with one leg up, sitting back) before we realized that maybe Mom wasn't wanting to push. The midwife gave her some homeopathic stuff to help relax Mom and ease the transition into pushing (which can be very scary) - she administered some soothing spray to her bum so that that didn't bother her when she pushed and we tried the Rebozo for Mom to push, standing with Dad swinging her legs out and around in between contractions and then dangling to push when she had a contraction. The midwife could feel the baby actually move upward when Mom had a contraction because she was actually pulling her in rather than pushing her out, she tried pushing down on her bum to show her where to push and lots of encouragement. It was now about 3:00 and had been over 3 hours of pushing contractions - we sent Mom with just Dad and her Mom into the bathroom again... the contractions had spaced out to 1/2 hour between them.

After much talking and brainstorming everyone was sent outside and Mom went into the bedroom with the midwife only. It was another 40 min. before Mom decided to start actually pushing and then it was another 20 min. and baby was born in two pushes. The entire time we could see about 3 inches of her head and her heart tones were fantastic. Mom had pph and needed pitocin and methergine and her bp was super low. She passed out later on in the evening when she went to the restroom with her Mom.

Baby wasn't nursing well and Mom fell asleep almost instantly. 24 hours later things were relatively the same... I am not sure how they are doing today.

My impression was that she was used to being the baby of the family (her Mom actually told us that as well) and that she didn't want to get "down and dirty" with the pain of pushing, she was afraid of having the baby partly because things in her life would dramatically change (baby would be the attention-center, require lots of herself, she was afraid of being a Momma), she wanted to be alone and was too 'nice' to say it. There are a lot of other things too, but this was what I was thinking at the time...

I walked away wondering what in all of creation I had just been a part of. NONE of the suggestions worked - the midwife (her friend as well) finally had to tell her that if she didn't get serious about pushing eventually they would have to talk about transfering and pitocin because she was nearing exhaustion. That was the key believe it or not. It was a whole new experience to be with someone so conciously making a choice to NOT have their baby, it had never been so cut and dry before. It seemed so challenging to present opportunities for Mom and baby to make that final decision together - once you walk through all of them, it just comes down to a choice by Mom.

It was a learning experience for SURE, if presented with that place again I would talk to Mom about making a concious choice (in her ear) to birth her baby. In this situation that's exactly what it came down to.

The world of birth... ever interesting.

A recent, frustrating birth

I have to get my son in a second so I'll be back to post more but...
I went to the most frustrating (as of yet) birth as a doula yesterday... Mom would not push for over 3 hours, it was to the point where we had exhausted all ideas and possibilities (rest, nourishment, encouragement, homeopathy, pushing positions, emotional issues, people and places to push to find the right combination, anything anyone could think of). I walked away feeling so widely frustrated that it took me a few hours to hone in on what was exactly so hard about it all.

I'll have to write more, little one crying, but soon when I have the time I'll be back...