labor

Birth Story: Louise Wynne Kelley - Right on Time

*All photos by Meredith Westin Photography

August 2017 5 weeks pregnant

Early in our pregnancy my husband and I traveled to Colorado and climbed to the top of Aspen Mountain. The concierge at our hotel said it was 2-3 hours long. I was confident I could do it and that it wouldn't be "that hard".  After an hour and a half we reached a beautiful scenic overlook, took in the view, and started out on what we thought must be the final summit of our climb.  Quickly I realized we still had a LOT to climb; more than half; and each part steeper than the previous. I told myself one breath at a time. One step at a time. You got this. You are doing this. These are all things I've learned help mamas in their journey from my career as a doula.  As my mindset wavered and doubt crept in, my cheerful husband was 3 steps ahead of me telling me how great I was doing. Even though I wanted to roll my eyes (ok I did roll my eyes a couple times) and negative thoughts filled my head (like: what were you thinking, you are so out of shape) I leaned into his cheerful positive attitude, took a deep breath, and willed myself to know I could reach the summit.  The view from the top was more beautiful than I could have imagined.  I couldn’t have been more happy to have accomplished the trek.

40 weeks

I actually wanted to be “overdue”.  Who says that?  I do. I guess I was just savoring my pregnancy and trying to get all the things done.  I tend to be a procrastinate, so I am glad my baby got the drift that she shouldn’t be too prompt with her entrance.  As a childbirth educator I knew my body was right in line with the statistics.  Studies show that on average, first time mothers deliver 3-5 days past their guess date.

I remember receiving a text from a mama friend on my due date saying, “Is today your guess date?  Thinking of you, mama.  Way to grow that baby well. Xoxo”  I had never thought of it that way before.  How thoughtful.  Yes, my body was freaking amazing for carrying another human being inside for that long!   I was able to finish my Spinning Babies Educator Training amidst the worst snowstorm in April history on my “guess date” weekend.  Gail Tully and her team along with Phyllis Klaus touched my belly and gave me all the good birth juju I could ever desire.

40 weeks 5+ days

After making an admittedly poor choice to drive 30 minutes to sell old workout clothes to make some extra cash, I swore off ever driving more than 2 minutes for the rest of my pregnancy.   My baby was squished so high inside and when I was driving, it felt as though her knees were in my throat.  Either that or the onset of early labor was causing nausea.  I had finally decided I was ready for this baby to come. That night in the bathtub I told my baby it was ok if she came now.  I was ready for her.

Later that night,around 11 PM, I started having mild cramping. I was up intermittently throughout the night, but was still able to sleep. In the morning I told my husband to go to work and I would let him know if anything changed.

40 weeks 6 days

With fervor and mild urgency I dusted, vacuumed, did the dishes, and set up my birth altar. Nesting is REAL, people.  The dustmites had no chance of surviving.  I had intentions to meet a friend for coffee but I canceled.  In my work as a doula I always suggest to my clients and students to “carry on” with their regular daily life in early labor, but I absolutely could not imagine being in a coffee shop with these cramps.  Around 9 AM I texted my Doula to let her know something might be happening.  She called me right away to let me know she was headed to another birth. I wasn’t worried.  Nothing major was happening.  After speaking with me for several minutes she sensed I may be further along than I thought.  She got extra bonus points for calling my husband herself and telling him to come home from work. Shortly after he arrived home with several bags of groceries in a super excited mood -  Because, “Hey! he was going to have a baby soon!” - I resorted to the bathtub. 

I texted my sister. She has four kids, but if the stars miraculously aligned, we were hoping she could be there for the birth.

I was in denial that labor was starting and before I knew it there was no room to “think”.  As the contraction waves became regular and strong I was soon in labor land. 

My Doula arrived fresh off another birth.  At this point every contraction required my full attention and was matched with a calm and steady, low, deep moan. Hands and knees became my savior.  I was climbing the mountain.   I called Kate, my midwife to let her know things had started and she asked me to start timing contractions. They were coming about every five minutes.  She said she would finish up what she was doing and head over.  She arrived just before 4 PM and sneakily checked baby’s heart rate and my vitals during and after contractions.  Side Note - We hired Kate without even interviewing other homebirth midwives.  She was confident, caring, gentle, smart, and intuitive.  She made our decision to have a homebirth feel easy and safe.

All of a sudden I felt a big bulge in my underwear. My water had broken. Viola!  The magic compression of those strong contractions was moving baby down and out. There was a little bit of meconium in the water so my midwife kept a close eye on our vitals.

Kate asked if I would like to be checked cervically. I was open to the check, but didn’t want to know the number. Thank goodness I asked not to know.  Later, I would find out I was only two centimeters. I think I would’ve lost it after having had these hard contractions for nearly 5 hours.

Around this time my sister arrived and brought her goddess mama energy with her.  She called in the troops to help watch her children and made it happen to be present for me.  She has a calm presence and I was so glad she was there (she’s the one holding me up in the pushing pictures).

The next several hours were kind of a blur. All I remember is breathing, having my support team right next to me, and thinking "holy crap I never thought it would feel like this". I told myself, one contraction wave at a time. There were thoughts of doubt in my mind but I reminded myself I can do it - I can climb this mountain. And sometimes I even repeated that out loud. “I can do it.  I can do it.  I can climb this mountain”.  We all giggled at the fact that I naturally started rehearsing the word “ouchie” during contractions.  It was my ritual and it seemed to help.  I stared at my affirmation cards hanging on the wall and stared at spots on the floor just to focus my attention.  I labored in the shower, on the floor, in the bed, and eventually my midwife said it was OK for me to labor in the birth tub (Sometimes women relax when they get into the birth tub so they don’t want you to get in there too soon in case it slows labor).

Holy Jesus that tub felt amazing. I remember saying how good it felt, and in my head  I thought “I’m never getting out of here”.

Around 8PM my midwife checked my cervix for the second time, and I wanted to know my dilation. I don’t remember exactly but I think I was a six-ish on one side and then eight-ish on the other. She thought my baby’s head was coming down at a little bit of an angle creating the uneven dilation on each side.   

Kate suggested a seemingly horrific series of different movements to help baby’s head realign. I rolled my eyes at this suggestion. In her sweet voice I remember her saying, “I know you are in labor. Sweet Amy would never have rolled her eyes at me otherwise.”  As a Doula I know certain positions make the contractions more intense, but in the long run it’s worth it as it makes labor shorter.  I would do anything to make this shorter so I obliged.  I had to do each movement for three contractions.  Three contractions on my back in the water.  Three contractions leaning on the left side.  Three contractions leaning on the right side.  And three contractions on my hands and knees.  Eye roll ensued.  I felt so proud when I had actually finished what they suggested. 

Meanwhile, I caught glimpses of my support team sneaking sleep; making smoothies, and seamlessly moving in support of my baby’s arrival.  I was comforted to know they were taking care of themselves. 

The pain in my hips was intense.  The hip squeeze did me no good, but I did find a little reprieve as my doula Alicia shook the hell out of my poor hips with the rebozo.  I thought my hips were going to split apart at one point.  But alas, I am here to tell my story.  My hips did not split apart.  My pelvis is intact.  It boggled my mind to think my sister went through this 4 times and even birthed one baby that was over 10 lbs!  Thinking of that helped me stay present.  I can do this.  I got this.  I am going to make it to the top of the mountain.  I thought of all my strong clients who pushed their babies out.  I thought of all my amazing friends who surrounded me at my blessingway with their words of wisdom.  I started to trust myself.  My body started to open.  Around 11pm I unintentionally and unavoidably started to grunt at the end of every contraction.  I knew this was a great sign-  my body was starting to push! 

I knew pushing could take hours so I tried to not look at the clock and not think about time.  I gave every contraction my full attention.  I grunted and when it felt there was room for more, I started pushing.  The pushing lasted for a little less than 2 hours.  I remember asking my birth team, “Can you just pull her out?”,  clearly, I had to finish the task.  We tried several positions.  Ultimately, my doula grabbed her rebozo and used it as a support/pushing tool.   That seemed to do the trick.  More and more of my sweet baby's head became visible with each push, and soon enough her whole head was out.  For an entire minute her head was out.  Then one final push.  My husband caught her body and handed her right to me.  She was plump, with a head full of hair, long fingernails, tons of vernix, and the sweetest most alert eyes.  She came out making eye contact with all of us around her.  Her (dog) sister, Harriet, peeped her head up onto the birth tub just as Louise was born.  I truly can’t imagine birthing anywhere else or with anyone else. 

If I could choose three words to describe my birth it would be empowering, supported, and intense!  Labor and birth is surely physical and extremely mental - Kind of like climbing a mountain.   If you can let go of the doubts, breathe into your strength, and acknowledge your progress one contraction at a time, the whole timeline of everything might not seem so daunting. Having a hardcore team of cheerleaders alongside you makes all the difference.  I could not have done it without my husband, our midwife, birth assistant, photographer, doula, sister, and my doggie doula.  I am forever grateful.

Written by Amy Kelley, Doula, Blooma Childbirth Educator, Prenatal Yoga & Kids Yoga Instructor.  You can find me on Instagram as @amykelleydoula

 

Blooma and HeathEast Early Labor Lounge – NOW OPEN!

Delaying admission to Labor and Delivery until a woman is in active labor can be challenging for families. Many women arrive for evaluation before they are in active labor.

Early labor management is a critical time to reduce the cesarean birth rate. When women are admitted to the hospital in early labor they are at increased risk for receiving interventions and having a cesarean section (Rahnama, et al, 2006). With the exceedingly high rate of cesarean sections in the United States (32% from 2013 census data), prevention of the first cesarean birth is important in reducing the overall cesarean rate (current rate of vaginal births after cesarean section – VBAC - is approximately 10%). When women present in early labor at a HealthEast hospital, we often recommend that they go home to labor in the comfort of their own environment. Some women are uneasy with this, feeling nervous to labor at home or are concerned they may birth at home or while in transit. At Woodwinds Health Campus, we want to provide our clients with a comfortable alternative to going home. An Early Labor Lounge has been shown to improve client satisfaction and decrease early admission, thereby lowering the rate of medical interventions and cesarean sections (Rahnama, et al, 2006).

The Blooma and HealthEast Early Labor Lounge offers a space for women and their support team to use until the onset of active labor. The Early Labor Lounge is a beautiful and relaxing space, with floor to ceiling windows looking out over the natural woodlands surrounding Woodwinds. It has supplies needed for the laboring team, such as birth balls, yoga mats, rocking chairs, snacks, hydration, relaxing lighting as well as inspirational messages of encouragement and empowerment to help women as they work through their labor.

Maternal anxiety and fear can lead to medical interventions and less optimal birth outcomes (Hodnett, 2008); promoting comfort and empowerment of the laboring woman can help her cope with the challenges of labor. It addition to staying relaxed and comfortable in early labor, some comfort measures can help a woman progress through labor. Some strategies and techniques include intimate support from a partner and/or doula, ambulation, position changes, utilizing a birth ball, rebozo use, therapeutic shower or bath, acupressure, massage, and nutritional support (Paul, 2017). Some of these supportive therapies are offered in the Blooma and HealthEast Early Labor Lounge.

By providing this space, Woodwinds families will have a comfortable alternative to going home if they arrive in early labor. We hope this will improve our patients’ happiness with their birth experience and improve outcomes. We hope the Blooma and HealthEast Early Labor Lounge makes a positive impact on the clients we serve and finds a permanent home at Woodwinds and other locations.

Written by Natalie Jacobson-Dunlop, MS, CNM, APRN, HealthEast Certified Nurse-Midwife

 

 

 

 

 

Hodnett, E. D., Stremler, R., Eston, J. A., et al. (2008). Effect on birth outcomes of a formalised approach to care in hospital labour assessment units: international, randomised controlled trial. BMJ, vol. 337, (Aug 28 1) 2008.

Paul, J. A., Yount, S. M, Blankstein Breman, R., et al (2017). Use of an early Labor Lounge to promote admission in active labor. Journal of Midwifery and Women’s Health 62 (2), 204-209.

Rahnama, P., Ziaei, S., Faghihzadeh, S. (2006). Impact of early admission in labor on method of delivery. International Journal of Gynecology and Obstetrics, 92 (3): 217-220.

Ask the Educators: What If I Poop During Birth?

Childbirth education at Blooma serves families no matter what type of birth they are planning. All classes present evidence-based information for normal and safe birth, influenced by the Lamaze 6 Healthy Birth Practices. Classes provide information to expectant families to reduce their fear or anxiety while building confidence and preparing them for birth.

We love hearing your questions, and helping you make informed decisions for your birth. Many mamas and partners want to know, What if I poop during birth?

Educator Sarah Auna answers the question many are nervous to ask....

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Birth is not proper :: it’s primal

Birth is not lady-like :: it’s boss-like  

Birth is not pleasant :: it’s powerful

Birth means not holding things back :: ANYTHING!

 

Including your poop. Let the poop go. From a birth worker’s perspective poop = progress.

Pooping during labor means a birther’s body is releasing, letting go, and opening up. It means the baby is moving itself into a position low enough to stimulate the colon, meaning progress is being made!

Now you have to be a real birth-nerd (like we are here at Blooma) to come to a place of “celebration!”  when it comes to pooping in front of your birth team. So here is some info you may need before you can really let it all go in birth…

 

Will I poop during my birth?

The plain answer is simply, yes. Most likely. But, not in the way that you think.

The human body “cleanses” itself a few days, or sometimes hours, before active labor starts. This allows your body to focus on the work of labor.

You’ll likely have most of your bowel movements in private during early and active labor. This is one of the reasons why it’s so smart to labor at home as long as possible. It allows you to eat the calorically-dense, highly-hydrating, nutritious foods that feel good in your body --- and then use the privacy of your own bathroom to let them go.

If you need to “go” at your place of birth - you can ALWAYS ask for privacy. Many birthers love to use the toilet to support themselves in birth. It’s cool, private, quiet, and a familiar place of “letting go”. Just keep in mind -- if the sensation of needing “to go number-two” is combined with an uncontrollable urge to bear down… then you’ll likely have an audience in the bathroom -  because it’s not time to poop - it’s time to push a baby out!!

This “uncontrollable urge to push” is known as the Fetal Ejection Reflex and it’s often all mixed up with that “I have to poop” feeling.

Here are some common phrases birth workers hear when this Fetal Ejection Reflex is present:

“I feel like the baby is coming out of my butt”

“I can’t, not push!”

“I’m puuuuuuuuushing!”

“It feels like there is a bowling ball in my butt!”

“I have to poop so bad!”

“I sound like my toddler when they poop!”

 *GRUNTING* ... just primal grunting.

 

What if I poop my hospital bed?

If you’re choosing to birth on a bed (with or without an epidural) and you poop during your pushing phase -  then your midwife or nurse will be at the ready to clean it up quickly (often without your knowing) and your doula will be there “fluffing the air” with some quick peppermint or citrus oil, while she thinks: “Hooray! Great work! Great progress! We’re almost there!”

 

What if I’m having a water birth and I poop in the birth tub?

Many women find that having the “shroud” of the water in birth really helps to the facilitate that “no f***s given” vibe that’s needed to tap into their primal- birthing self.

More importantly, if/when you poop in your birth tub -  it’s not a “CODE BROWN! EVERYONE OUT OF THE POOL!” scenario. Rather, the midwife or nurse, whose job it is to be at the watch, will use a little fish-tank net to swoop up the floater before you (or anyone else) even know it’s there.

 

Remember, poop = progress!  Get real with yourself, your partner, and your pride and if you’re struggling to find peace with this aspect of birth…. just recall midwife Ina May Gaskin’s birth declaration: “LET YOUR MONKEY DO IT!” and you’ll tap into that primal, powerful birther who is ready to bring forth life, no matter how messy it gets.

 

Sarah Auna is a birth doula, childbirth educator, and yoga teacher at Blooma. She specializes in adding humor and real-talk to birth and motherhood and she’s here to help you through all of this! Find her classes HERE.