Even MORE chapters from the next book PUSH! The Sequel

It Wasn’t Supposed to Be This Way!

                                                                   Doula

We dance when all the world is asleep

Down long corridors,

Hallways lit by moonlight.

The full moon our only witness

To this soundless dance.

The waves* the metronome we dance to,

Calling him to come

To be with us here.

We love you so

Come dance with us little one.

Come see moon and stars

Waiting, too

Silently waiting

For this Night of nights

This Night chosen from all eternity for your birth.

for Wyatt, November 4, 2012 written the day after his birth. - ss

It started around 6 p.m. on an otherwise quiet Sunday afternoon. I didn’t have anyone due for a whole month, so when my cell phone went off, I didn’t think it had anything to do with any of my clients. It was my supervisor, Mary. A family from North Carolina was up here for a funeral and she had gone into labor, though she wasn’t due for almost four more weeks. It was clear that this baby had other ideas, however, and the mom had gone online to try to find a doula, or a midwife or someone to help her and give her some choices as far as hospitals in the area or birthing centers. I was so excited that Mary had called me. She'd had dozens of others she could have gotten to jump in.

I got the information from Mary and called mom. Between pretty heavy-duty rushes Yvette explained what she had hoped for this birth. She had done her homework: She knew she wanted to have her first baby as naturally as possible and was in great shape to do that. Her father had died unexpectedly, though he was only in his early 50s, so Yvette and Kojo had driven up from North Carolina to support her mom who lived outside of Minneapolis.

I listened and then offered a plan. The closest hospital to them did have a very friendly midwifery group and I had only had good experiences there with their nurses. I told her that I could come to her mom’s house and hang out with them until it was time to go to the hospital. Her rushes were only about every 10 minutes, but enough to take her breath away. I said that she could certainly go to the hospital to be assessed but would most likely be sent home again if she had not begun dilating. I suggested that she at least call the hospital and see if they would let her register over the phone and alert them that she might be coming in tonight. She agreed with this plan and ended our conversation by saying, “It wasn’t supposed to be this way! I am so sorry.” I assured her that she shouldn’t be sorry, that I was honored to be asked to help them, and that we would be seeing her baby very soon. Then she added, “I am just glad this is all working out, finding you and all.” The last thing she needs is to have to get to know someone during the next few hours that she has never met before who will be sharing one of her most intimate experiences with, in a city she doesn’t even know.

During the past year, different hospitals in the Twin Cities have been experimenting with different ways of employing doulas. Some work better than others, but I think we are all trying to be more available to women, no matter what their circumstances. One hospital has a pool of doulas on call, each for a minimum of 12 hours per month. It is a large public hospital with a very diverse client base. They see everything from homeless women with no prior prenatal care, to immigrant women who don’t speak English, to women from the local prison. So, when you sign up for your 12 hours a month or more, you are on-call, and need to respond immediately should they identify a woman in labor who asks for a doula or have offered that to her. You are paid a minimum amount for the hours you are on-call whether you work or not. You are paid more when you do work, though.

Another hospital works with doulas who are introduced to moms during their prenatal clinic visits, so, though you cannot ask for a particular doula, you have at least met most of them by the time you deliver and aren’t completely unfamiliar. Many women hire doulas early in their pregnancy so that they really know each other well by the time they reach 40 weeks. Many doulas work with two or three other doulas in a group so that they can cover and back each other up should one get more calls than expected at any one time. I usually don’t take so many clients per month that I have to call for backup, though I have needed one only once in the past six months. I have committed to each mom that I am with and try to avoid ever having to “dump” someone totally new on them without warning. Early on in our relationship I always make sure to mention the possibility that we support each other and can ask other doulas to jump in for us during particularly busy seasons. If there is any reason to think that I might have two clients who are due close to each other, then I try to introduce them to my backup lady(ies) at least once while she is visiting the clinic. Where I work we ask moms to come for a minimum of four visits before their guess or due dates. That way we can suggest childbirth classes and have plenty of time to get to know them and prepare them for labor and delivery, especially if this is their first baby.

I got to Yvette’s mom’s house about eight o’clock. They had just finished eating so I sat down with them and got to know them over coffee and dessert. They knew they were having a boy and still couldn’t believe that babies could make one’s life so exciting. I simply said, “Well, sweetheart, welcome to parenthood.” Yvette’s mom nodded knowingly.

Yvette was Sonja’s last baby. Yvette’s husband was a merchant marine stationed on the East Coast. When her dad died suddenly of heart failure, the family rallied from all over the U.S. The funeral was over and most of the guests had returned to their homes across the country when Mary called me to have me step in as their doula. Yvette and Kojo decided to spend a few extra days with her mom to support her before leaving her all alone here in Minnesota. Yvette had preregistered at the hospital during the evening and was told to come in if her water broke or the rushes started coming around five minutes apart. I was glad they didn’t insist on her coming in right away because I knew that this was really early labor which, with a first baby, could go on for another day or more. If anything didn’t look right, I knew I could suggest we go into the hospital, but for now it was all good.

Yvette was sure things were progressing, but when the rushes seemed to space out even more I suggested they try to sleep, or just rest. Like most first-timers, they think if they keep walking until they are exhausted, it will somehow “turn it on,” though the opposite can be true. I explained that, like a car, if you run out of fuel—rest and food—your body will send out signals that it is too tired to perform on demand. It is better to rest and keep eating in early labor and then have the energy for when things do really pick up. Real labor will not somehow vanish if the time has come. Nothing can stop it then.

For the next eight hours we tried breathing together, Yvette bounced on a birth ball for a while—always a good way to help baby move down—and I suggested a hot shower. As she was stepping out of the shower we all heard a pop! It was her bag of water. We gave high-fives all around. Now we were in business. The rushes picked up quite a bit then, which they often do. I tried breathing with Yvette and reminding her that she was doing so well, that this is the longest part of labor, becoming fully dilated, and that if she was this relaxed for the rest of her labor she would do just fine.

When we got to the hospital, we realized we were the only people on the maternity floor. It was so quiet, perfect actually. We checked in and were given a beautifully decorated birthing suite. Yvette relaxed at this point. It wasn’t going to be so terrible not being back home to have her baby. We got along just fine, her mother was happy with the arrangements too, and we had the place to ourselves, literally.

So we rested, walked, checked out the birthing tub, and had her bloodwork drawn while Kojo drove around the neighborhood looking for a grocery store to get some snacks. He came back a little while later with bags of organic juices and snacks for all of us. We settled in, turned on a movie and all dozed for the next couple of hours. Toward morning the nurse announced that Yvette was almost nine centimeters! She was really amazing, so relaxed and just going with whatever she had to do. She could tell me what felt ok, what massage did or didn’t help, what she wanted to try next. Though she didn’t have an urge to push when she reached ten centimeters, the midwife suggested a few little nudges. The baby had been quite high up in her pelvis, but the midwife reassured Yvette that he would start moving down. But he didn’t.

She pushed while squatting, while on her hands and knees, while holding her knees, and while standing. After pushing for almost three hours, she asked for an epidural. In the mean time the midwife had consulted with the doctor on call and explained what her own concerns were. Yvette asked me what she could do and I answered that she certainly had tried everything and I wasn’t really sure what was going on. As a doula I can’t do pelvic exams (which as a midwife I had and would have now) which might tell us how the baby’s head was positioned, but I was pretty sure the midwife would have said something if she had a concern.

At this point, Sonja suggest we pray, good Baptist granny that she is. I was fine with this, though I have never suggested this for others. So we prayed for baby to come, that everything would be OK, that the midwife and the doctor would know what is best. After that Yvette sat up and announced that she was done. She said her baby hadn’t move at all, that this wasn’t working and that she was finished trying it this way. The doctor came in and suggested a C-section, which Yvette agree to. But Sonja and Kojo were decidedly not OK with this and began to loudly argue about what they should do. Yvette said she had already decided. They both begged her to try a little while longer and she answered that it simply was not going to work this way. Then Sonja got them to stop arguing and said, “Well, let’s ask Stephanie what we should do.” I was glad she trusted my judgment by then, but I couldn’t agree that I knew what was best for Yvette and I said so.

“Actually, I trust Yvette’s gut feeling on this one. She knows better than any of us what is going on.” I could tell Sonja was hoping I was going to be on her side, but I knew Yvette’s decision was final. I could tell that she meant it. I could not tell what was wrong or what might help, but I had to honor her decision.

While she was prepped for surgery and then taken to the operating room for the epidural, Kojo and I put on our scrubs and got ready to go. We waited and waited and began to wonder what the delay was about. Finally a nurse came down and said that they’d run into some complications with the epidural and that the doctor was using a general anesthesia instead, which I knew would automatically put the kibosh on any of us going into the delivery room.

We changed back into our clothes and waited some more. Then, all of sudden, a nurse came down to our room pushing Baby in his crib. He was fat! We only realized then that he was over nine pounds. And then I noticed a bump on his head. It was bruised and raised, just over his left ear—a classic hematoma; even is his swaddling, I could see his head tilted to the right so that his right ear was almost touching his right shoulder. I wondered to myself how long he had been in that position in utero—could it be days or even weeks? No wonder he wasn’t moving down. The overall circumference of the presenting part of his head was too big to descend, obviously. Maybe if we had known this earlier, he could have been re-adjusted, either with external version methods or with certain positions like lunges during labor, though we had tried that, I now remembered. We'd done lunges, even on the stairs, which should have helped. Too bad we didn’t have time to see the “spinning baby lady” here in Minneapolis before this birth, who has perfected the art. I did give Kojo the name and number of another amazing woman, a pediatric cranial-sacral therapist in Minneapolis who I suggested could work with their baby and help strengthen his neck and any other mal-positioning that might still be going on. Even when we got him to nurse in the recovery room, he preferred Yvette’s left breast and wouldn’t latch well on her right side, further convincing me that he did have something going on on that side.

I went back to visit the next day. Yvette was happy that it was over. She was feeling quite well already and was enjoying getting to know Wyatt, who was named after the grandpa who had so looked forward to meeting him. Wyatt was beautiful. It was important for her to talk about what had happened and why certain interventions were used. It can be difficult to process when a birth appears to have a mind of its own. By going over the chain of events, a new mom can work through her feelings—possibly disappointment or a feeling of failure—though I could assure Yvette she did absolutely everything she could have. We don’t always have the control over our births that we wish we had.

Even though Yvette and Kojo came up to Minnesota for a sad occasion, it turned into an amazing time, complete with a new little life. Sonja could also celebrate her first grandchild. Birth and death seem to be connected somehow; they were this time, at least.

I heard from Yvette every few days after that until they finally flew home to North Carolina. Nursing him was challenging. I was able to put them in touch with the La Leche League in their hometown. I still think of them. Another one of “my” babies.

 

“Fatherhood is the most creative, complicated, fulfilling, frustrating, engrossing, enriching, depleting endeavor of a man’s adult life.” ~ Kyle D. Pruett

Stay tuned for more chapters from the next book!