An Induction Success!

**names and pictures used with permission**

Having been on call for the full "two weeks before and up to two weeks after," I was surprised that Chloe hadn't gone into labor yet.  A first time mom, she was very excited about her pregnancy, and did everything she could to make it the best it could be!  She was seeing a chiropractor, drinking red raspberry leaf tea, and eating dates daily

She was having minor cramping and Braxton Hicks-ish contractions on and off, but nothing serious.  At one appointment right around 40 weeks, she was 4cm dilated, 80% effaced, and the baby was at "zero staion" (code for reeeally low in her pelvis).  Still, no labor!

Her doctors were very relaxed with her, and gave her a full two weeks past her due date before wanting to induce her, and it was very low pressure.  She agreed to the induction, and as we were having a phone conversation about what to expect, I remembered the "stats" from her last appointment, and suggested seeing if her doctor would break her water before trying pitocin.  Typically breaking the water before labor begins is a bad idea for a variety of reasons, but since Chloe's body was SOOOO ready for labor (for my first-time clients, I am typically with them in hard, active labor for half a day before they are at 4cm!), and from my experience with how quickly labor progresses after the water is broken when baby is so low and well-positioned, I thought it might be a welcome alternative to starting labor with drugs.

They got to the hospital at 6am on Tuesday, February 3rd, and by the time they were all settled into their room it was close to 8 o'clock.  She was 5cm dilated and 90% effaced, and baby was even lower. The doctor came in to speak with them (Chloe had previously requested that they break her water in lieu of starting pitocin) and seemed hesitant to break her water, wanting to start with pitocin instead.  Chloe was strong and advocated for herself and what she knew she wanted, and her doctor consented to breaking her water, which he did at around 8am.  He told her he would see if she had any contractions in the next four hours, and then would come start the pitocin drip.

Well, she did have some contractions.  Many good, strong contractions.  I arrived shortly after 8 and she was already feeling them pretty well, although she was very relaxed and chatting through them.  Her husband, Matt, was rubbing her feet and making her feel as comfortable as possible.

Contractions quickly picked up in speed and intensity, and Chloe was handling them beautifully.  The most comfortable position for her was sitting upright or reclining in the bed.  I think because things were happening so quickly this was the easiest position for her to stay relaxed.  They were actually coming so quickly that the doctor called the nurse to see if she would consent to taking some IV fluid to slow them down.  She declined, as she was feeling well and staying extremely hydrated by drinking water and juice.  

As things were picking up, she said, in kind of a puzzled and surprised voice, "It's not pain, it doesn't hurt.  It's just very intense!"  Later, she said "I can understand why people would want an epirudal!"

At one point, toward the end, she vocalized, "It's so much, it's just so much!"  It was at this point that I knew she needed something new or different to help her cope with the intensity of her labor.  We had tried many positions, going to the bathroom, and vocalizing.  I remembered the previous offer of IV fluids and asked if she wanted to try that now.  She said that sounded like a good idea, and it really did help.  It gave her a fresh burst of energy and slowed her contractions down enough to where she was getting a slightly longer break in-between.

She became extremely inward, vocalizing and doing her best to relax through her contractions.  At one point, while in the bathroom, she suddenly got the urge to push, and I called the nurse.  Everyone came in, bustling about to get the room ready for a baby, while Chloe continued to do her thing.  The doctor arrived, and she began pushing in earnest at 2pm.  He was extremely impressed with her ability to move her baby down, and she was loving this new stage of labor!  She said it felt so much better to push!

Finally, at 2:41, Adara Rose made her entrance into the world after a 100%, drug-free labor.  Chloe and Matt made an awesome team, and it was a huge privilege to help them bring their daughter into the world!

A Birth Story

Madeleine’s Birth, written by Kim
28 June 2010


I got a call at around 5:45 on the morning of June 27th, saying that you had been having some consistent, albeit not too painful contractions since 2:30! You and Rob were both taken off guard because you were expecting the contractions to be coming more like 20 to 30 minutes apart, as opposed to the 5-6 minutes apart that you were experiencing. Since it was obviously early labor (and would be for a long time!), you labored at home with Rob all day.

I got another call that evening a little after 5. You said the contractions were becoming more uncomfortable, and we decided that I should come to your house in a half-hour or so. Christina (the doula-in-training) and I arrived there at around 5:45, and your contractions became more spaced out—up to nine minutes apart! We had a hunch that the new people in the room caused your body to slow down a bit, so you and Rob went for a walk at around 6:30 to try and get things moving again. It seemed to work, because when you got back at around 7:30 you were saying that your contractions were “not fun.” You were coping very well, though, standing up and pacing through each one, sometimes leaning on Rob or against a wall. You also started experiencing nausea around this time. Rob offered to get a saucepan in case you had to throw up. :)

At around 9:00 the contractions were getting more painful and closer together, so we decided to head to the hospital. We walked into the emergency room entrance, and the guy at the front desk tried to make you sit down in a wheelchair to go up to the maternity ward, but your contractions were much more painful when you were sitting, so you fought it. He eventually gave in and let you walk. When we got upstairs, they checked you in to triage, and our nurse, Gina, checked your cervix. Unfortunately and surprisingly you were only 1 to 2 centimeters dilated. This was super discouraging news, but you took it really well. After talking it over with Rob, you decided that you wanted to go back home to continue laboring there.

Shortly after we returned home, your body decided it was time to get down to business. Your contractions almost immediately picked up in both intensity and frequency (though they were never a consistent amount of minutes apart). At around 11 pm you noticed some bleeding when you went to the bathroom. Rob called Dr. Kruskol, who reassured you that it was most likely from the vaginal check at the hospital. You continued laboring upstairs with a fan blowing on you, while munching on frozen blackberries—it was HOT! We placed the exercise ball, which Rob had thankfully blown up earlier in the day, on the end of the futon. You got into a rhythm of lying down on the futon between contractions, and standing up and leaning over the ball during them. You and Rob were both so very tired, since you had been awake and in labor for almost 24 hours. You wanted so badly to be able to lie down during the contractions, but the pain was just too much! You had to stand up in spite of your exhaustion. You were also struggling with nausea, but were never able to throw up and relieve the sickness you were feeling. This was definitely active labor, and you were handling it so well in spite of the heat, your tiredness, feeling sick, and the intense pain.

At around 1 am, I suggested a shower to try and help with the pain, and you reluctantly agreed, but because of the heat it wasn’t much of a help. You and Rob got out after a short 10 minutes or so, and your contractions were becoming closer together, averaging at 4 to 6 minutes apart. We headed back upstairs, but after a several minutes of very frequent and intense contractions, we decided it was time to head back to the hospital.

We entered the emergency room entrance for a second time, and this time you could not talk them out of making you use a wheelchair. So you sat down, but every time a contraction hit, you made the guy pushing you stop the chair so you could stand up and lean on one of us for support. At around 2am, we arrived in triage and Gina checked you again—you had progressed to 7 to 8 centimeters dilated!!! There was a lot of blood, and your very intense contractions were right on top of each other. Your body was quickly approaching full dilation!

We were sent to room 2606, and you were hooked up to a fetal heart rate monitor and a capped IV was put in your arm. You were feeling a lot of pressure and shortly thereafter you began to feel an urge to push. Gina checked you and you were at 9cm. She told you not to push, but you couldn’t help it! I helped coach you through those contractions with light breaths, and finally, at around 3am, you were given the go-ahead to start pushing! That strong urge to push had gone away, though, and you were unsure about how to do it. But after a few good tries you were really making progress. Gina was checking you during one of those initial pushes, and she said she felt the baby’s head move down over an inch! Despite your tiredness and the extreme pain, you had so much power and strength!! The pain of pushing actually seemed to frighten you, but the nurse and I assured you that it was normal, and you buckled down to get your baby out.

At 3:12am Dr. Kruskol checked you and confirmed that you were fully dilated, and the baby’s head was moving down through your pubic bone. We could see her hair and her wrinkly little scalp! You were so focused and determined. Finally, at 3:36am Madeleine was born into the world, and was placed on your chest right away. All the pain and pressure of labor was immediately gone, and you were completely enraptured in your new little one. “Oh my god, she’s so little!” were your first words after seeing her. Rob cut her cord, and you and Madeleine were both anxious to breastfeed as the doctor was stitching you up. When he was finally through, you and Madeleine settled in for a nice, long nursing session. She latched on immediately and nursed contentedly for at least an hour—the first hour of your family’s new life together.

You Can Do It.

Let's face it: birth is scary. It's unknown. If you've never given birth before, and you live in America, you will, without a doubt, have apprehensions about your ability to birth your baby. I did, for sure. And I don't know any other mom who didn't question herself as she approached her due date.

Why is this? Why do we question our bodies' abilities to give birth, when millions of other women have gone before us and have done just fine?

There are lots of reasons, I think. There are the notorious and unhelpful horror stories told to us as pregnant women, about how unbearably painful labor is. There is the media. The countless pictures of "perfect" bodies we encounter every day certainly do not serve to help our self-images or to boost our confidence in our bodies. There are our doctors, who treat us as if we were a problem to be managed medically, and not as the powerful and truly capable women we are. And the list goes on...

But here's the good news--what no one tells you and what they don't want you to know:

YOU CAN TOTALLY DO IT!!!

If you're educated about the process, well prepared, and have a good support system (doula!), it's not nearly as scary as they say it is. Labor is totally manageable.

I was talking to our local Bradley Method instructor, Susan Booker, about it after observing one of her classes. During the class, she walked us through an average labor--how long your contractions are compared to the amount of resting in-between. I learned that in the typical labor, your uterus is contracting only 11% of the time. ELEVEN PERCENT! So when you hear one of those horror stories about the 20-hour-long labor, she was actually only having contractions for a little over two hours. The early ones don't even hurt! And by the time your labor is really getting going, you have hopefully gotten yourself into a good rhythm and wonderful endorphins are pumping through your veins. You've had a chance in early labor to experiment with what feels good and what makes it worse. And your loving and supportive partners are surrounding you, helping you get through every second.

And contractions aren't normal pain. As many natural childbirth advocates say--it's "pain with a purpose." Labor pain is not sudden or severe, like getting your hand smashed with a hammer or stubbing your toe. It is intense, and in the heat of labor it's honestly quite crazy. But your contractions ebb and flow like a wave. They start soft, build up and then peak, and once you've made it over the top, you sort of float back down to several more minutes of rest and relaxation as you prepare for the next one. As your labor progesses, the contractions get "longer, stronger, and closer together" (as my childbirth ed teacher, Beth, always said), and you get less time to rest. It gets so, sooo hard. But that means it's almost over :) As soon as a laboring mom feels like she doesn't know how much longer she can go on, she's usually minutes away from pushing her baby into the world.

I remember when I was pregnant, worrying about whether or not I would be able to give birth without an epidural or other interventions, talking with my good friend, Lauren (seasoned momma of 4). I told her that Greg and I were going through the Bradley book together, and had been practicing relaxation every night before bed. She said casually, "Oh, you're gonna be fine." I was so surprised at her surety! Her almost nonchalant confidence completely went against all the doubt that had been instilled in me, and gave me that much more belief in my body's truly awesome design.

And I did it. I totally did it! And it was AMAZING!! I have never experienced a higher high than what I felt after going through labor and giving birth to our beautiful daughter.

So don't listen to the doubters and the nay-sayers. Our bodies are powerful and beautiful and totally capable.

You can do it!