Baby Willow's birth story from our doula

This is the birth story written by the student doula we had at Willow’s birth. My own story is coming soon.

Baby Willow’s Birth

I arrived at the hospital at 6:15 and Wm was getting her epidural. As she settled in, I was able to enter and see how she was feeling. Wm was mentally starting to calm down. Pam was her nurse and said she was contracting regularly at about every 2 minutes. Mark and Wm told me it had been a bit difficult getting to the point of getting the epidural. At the time I arrived, Wm was 3 cm at the last time they had checked her, 90% effaced and a -2 station.

At 7 p.m., Dr. G came in the room and checked Wm, she was dilated at 5 cm, 100% effaced and still at a -2 station. He said she was progressing very nicely and Pam said she would have a baby born before her shift was over. Wm was then able to have some juice and broth and Pam left a bag for Wm just in case she got nauseous. Wm read some from a magazine and relaxed a bit.

At 7:52 – Wm was 7.5-8 cm, 100% effaced, and -1 station and Dr. G entered and said that there was some concern for the baby – that the baby was showing some distress after every contraction and he wanted to perform a scalp stim test on the baby to make sure the baby was ok. In order to perform the test, Dr. G was going to have to break the water.

Dr. G broke the water and performed the test on the baby’s scalp and the test was positive – meaning the baby was ok. At that time, the amniotic fluid shot out and soaked Dr. G’s pants, leaving Wm sitting in a pool of amniotic fluid.

When Dr. G returned at 8:04 after changing his clothes, Wm was dilated to 8.5 cm, 100% effaced and -1 station. He informed Wm that since there was so much amniotic fluid he was able to tell that the fluid was clear that there was no concern of meconium. Wm told Dr. G that she was in a lot of pain. So he checked her again at 8:31 and she was 10 cm, 100% effaced and -1 station. He told her not to be concerned it was just pressure because the baby was dropping.

Dr. G told Wm he could give her a pudendal block to help take the edge off. Head nurse Carrie stepped in to help. Wm was in tremendous pain and Dr. G said probably the best thing to do was to start pushing. He said that he didn’t want her to push unless she either went to the restroom or had a catheter inserted. Wm said she felt she needed to go, so she asked Mark and I to leave while she got a bed pan to attempt to “go” on her own.

At 8:40 the pudendal block and catheter were inserted. Mark and I were able to enter the room again and the dropped the bed and got ready for Wm to start pushing. Wm asked for the straddle bar. Carrie went to search for it but was unable to get it as another patient was using it (we were told there were 3 women including Wm in labor at the same time).

I attempted to use the scarf to start a tug of war to simulate the straddle bar, but just as we got started, Carrie entered with the bar and you could see the relief spread all over Wm’s body. At 8:45, Wm started to push. Mark was up over Wm’s right shoulder and I was at Wm’s left side. After about 3 pushes, Pam removed the straddle bar and told Wm she had gone as far with the straddle bar as she could. They readjusted Wm.

As she was pushing, Wm was yelling at Pam to stop putting the monitor on her belly. Pam would tell her that she had to check the baby’s heartbeat and she needed it there to make sure everything was okay. The next contraction Wm yelled at her again to take the monitor away.

I rubbed Wm’s forehead with a wet washcloth and Mark supported her on her right shoulder. She pushed and at 9:08 the baby’s head was out and the shoulder and body followed immediately. A beautiful baby girl. Her 1 minute apgars were an 8/9 according to Carrie. She told me there was a bit of fluid in the lungs as the delivery was very fast.

Carrie had to leave and Lisa came in and worked with Willow and her lungs to suction and rub her to get the fluid out though her breathing was very good and in normal limits. Once her breathing cleared, Lisa weighed the baby and measured her. Baby Willow was 7 pounds 15 ounces and 20 1/4” long.

At 9:15 the placenta was delivered and Dr. G was doing repair work on Wm who had 2nd degree tears. He told her that she did not have one big tear of a series of small tears.

While the repair work was being done, Mark handed me a camera and asked me to take lots of pictures while he took video. I was able to watch the nurse work on the baby and see Wm watch them from her bed. I felt very honored to be able to witness the love that was present in the room from the nurses working on the baby, the doctor working on his patient, the once again father with admiration of his wife and love for his new daughter, and the once again mother and her love as she viewed her newborn. I snapped as many pictures as I could.

At around 10 pm, Wm’s repair was complete and she and Mark were handed their beautiful baby girl. Everyone took a few minutes looking at this most amazing new person to enter the room, and she was able to latch and nurse from her mommy as soon as she could.

At around 10:45, Mark, Wm, and Willow seemed to be settling in with each other very nicely and I was no longer needed.

Wm and Mark are such an amazing couple. Wm was so strong and her courage was so empowering to witness as she faced her fear of pain and birth a beautiful baby girl with Mark by her side always – a strong support with devotion to her and her comfort, a constant source of humor and strength in both his actions and his words.

The loving support between the two of you will enable you to be caring and compassionate parents to your expanding family. I am honored to have been at your birth. Thank you for allowing me to be there.

Your doula

A student doula?

Over the weekend we met with a student doula, a woman who has gone through the training, but has not attended any births, besides those of her own children. She has given birth to two children, which I think is even more important than attending the births of others. But still, it’s a big experience gap compared to our last doula, who had three children of her own and had attended over 100 births.

Our holiday-season due-date doesn’t work for our prior doula, and we are hesitant to spend $800 when we have a little experience under our belts and I plan to accept pain relief on the earlier side. Nevertheless, we started to worry about the quality and quantity of staffing available over the holidays, what we’d do if we got the one doctor in the practice I’m not comfortable with, and/or a nurse that wasn’t helpful. Perhaps it would be helpful to have someone in the room we knew ahead of time and could count on, even if she wasn’t highly experienced. Perhaps we could find a mutually beneficial arrangement in which we help her meet her qualification requirements and she helps us with support at a minimal cost. So our former doula put us in touch with her student.

She seems like a nice person, someone I’d be happy to share a cup of tea with, someone I could handle being naked in front of when circumstances call for it. She only charges $100, so I thought she was fine for the price.

But in the car ride home, Mark brought up concerns about her chatty nature. During the meeting, I was fine with it, because she came across as friendly. But he made me think, do we really want a chatty person during labor, especially someone who admitted that she may get nervous, although she swears she’s confident and capable of doing the
job? When we looked for a doula the last time, the ones I liked best were the doulas with a yoga or massage background, the ones who exuded a sense of calm and zen-like peace. Perhaps because that’s not my personality and I found that tranquility a good counterforce to my more goal-oriented focus of let’s get this thing out.

Mark seemed to indicate that he wouldn’t be comfortable under the guidance of a chatty person. I told him that if he wasn’t comfortable, then we should skip it. Because one of the main functions that we want a doula for is to be able to guide Mark. If he’s not comfortable with her, then I won’t be comfortable, and it’s not worth it.

I agreed that a more zen-like person would be a better match. However, the likelihood of finding a perfect zen-like student, who is fully available over Christmas and New Year’s, is very remote. We have no other candidates to consider. We had met another doula once who really rubbed both of us the wrong way, and that wasn’t the case with this one. I actually liked this woman - she just might not be the perfect person to guide us through labor. However, I think we are looking at either her or nothing.

As her first potential clients, I imagine she’d be devoted to the job and would try her best. She’d be willing to take pictures and/or write a birth story and I am always appreciative of good record-keeping. She could be a potential source of advice. If she doesn’t know something herself, I think she’d make use of her teachers and student network to find things out. Unless there was a major snowstorm (which is a risk) or she is sick, she would be a familiar face that we could count on seeing. So I don’t see that there is much
to lose in trying her out for $100.

If we hire her, she’ll come to our house for a longer meeting and hopefully Mark could make clear to her what he needs to be comfortable. We have two weeks to think it over, but I think we are learning towards becoming the first practice clients for a doula-in-training.

If you’ve used a student doula, how was your experience?

To get a doula or not the second time around?

Having continuous support during labor makes the process go faster. I’ve been wavering on whether or not to invest in a doula for the second time around. Though I admit that having someone there I know is on my side is a huge benefit, even if I have a better idea of what to expect compared to the first time.

A friend of mine says that at her hospital (in North Carolina) they have volunteer doulas available on-call at the hospital, available to everyone. My concern would be not getting to know the doula ahead of time, making it a matter of chance just like a nurse or a doctor. But at least it’s an interested and hopefully caring party available to all, willing to be at the mother’s side for as long as she needs. I do think that should be available to all.

Any thoughts – is a doula worth the investment the second time around, especially if I plan to go for pain relief (epidural) on the early side?

The story of River's birth

I should have posted this on River’s birthday. But I’d actually forgotten that our doula put together this birth story. Since I just ran across it, I’ll post it on his 13 month birthday instead.

Here is the story of River’s birth according to our wonderful doula:


Wm’s Birth Story
December 8–9, 2007

Wm had been noticing some encouraging signs that her baby was on the way for several days, and at 2.20 pm on December 8, just a few hours after her pre-natal yoga class, she experienced some contractions. No slow to start labor for Wm: her contractions immediately started at 3 to 5 minutes apart right from the get go. I suggested she tried to take a nap given that no sleep would be forthcoming that night, but it’s pretty hard to actually sleep when you are in early labor with your first baby! She tried to rest as best she could, but when contractions are so close together, it doesn’t give much time to focus on relaxation.

I arrived at 6 pm and could see that Wm was already very uncomfortable during the contractions. She needed to stand to remain comfortable and so we got into a rhythm where she would sit on the sofa with the hot pack underneath her when resting, and then stand every time a contraction came and put her arms round Mark and bury her head in his chest. They stayed like this for an hour, working hard, and I could see how strong Wm was. The tears and laughter perhaps made Wm feel she wasn’t coping well - but showing those emotions in early labor is a sign of great strength and self-awareness, portraying an innate knowledge of the enormous task that lies ahead. They don’t call it labor for nothing!

Shortly after 7 pm, as the contractions became more intense, Wm and Mark decided that it was time to go to the hospital. She knew that she wanted an epidural and so it was not a priority to stay at home for as long as possible. In addition, she was already having enough trouble that the five minute journey to the hospital was very difficult for her. We entered the hospital through the Emergency Entrance which is never a pleasant experience. Nurses kept trying to offer Wm a wheelchair and it was gratifying to see her refuse. First, upright was more comfortable for her, and secondly, a woman in labor is not sick! An aide came down to take us up to Labor and Delivery on the 4th Floor and we settled in to Room 441 with Kathy as our nurse. Wm politely answered all of Kathy’s questions despite being in active labor.

Unfortunately, hospital protocol made it necessary for her to be monitored for 20 minutes, which meant lying on the bed – the most uncomfortable position imaginable for a laboring woman.

At 8 pm Dr H arrived, a young petite woman, gentle and unassuming and with a quiet confidence. She checked Wm and announced that she was 2–3 cm dilated, 90% effaced, and the baby’s head was at -3 station. (To allow passage of the baby, the cervix has to efface from 0 to 100%, dilate from 0 to 10 cm, and the baby has to move down from -4 to +4 station.) This was good steady progress although I suspect Wm had hoped she might be further on after 6 hours of pretty intense labor.

The anesthesiologist was called and we continued working with the relentless contractions, which were not giving Wm any break at all. A nurse came in to insert the IV, which was necessary because of a positive Strep B test, as well as for the epidural, and a bolus of fluid was administered in order to prevent her blood pressure from dropping with the epidural, which is a common side effect of this procedure. Wm, who abhors IV’s because of difficulties in finding a vein, was very stalwart during this procedure and barely flinched as the needle was inserted.

Finally at 9 pm, a somewhat brusque mannered young doctor walked in and announced that she was the anesthesiologist. I don’t think she even told us her name, but proceeded to lecture Wm on the importance of keeping absolutely still during the procedure – not an easy feat when you’re having strong contractions. In no uncertain terms, she told Mark and I to leave and “go get a cup of coffee for 20 minutes”.

So we waited right outside the door, straining to listen to Wm’s reactions. To our dismay, we could hear that she had to go through a couple of very difficult contractions as the needle was being positioned in her back and she was obliged to remain totally immobile. It must have been so difficult for Mark to hear her and not be able to comfort her as he had been doing so beautifully all day. However, 20 minutes later, we were ushered back into the room and found Wm grinning from ear to ear as the epidural worked its magic.

Dr H returned to explain that, contrary to Dr C’s promises, the ubiquitous hospital protocol insisted on continuous fetal monitoring once an epidural had been administered. However, she assured Wm that her interpretation of the monitor was very conservative and she was not about to react immediately to a change in the baby’s heartbeat. Wm had been concerned about continuous monitoring because it encourages too many false positive reactions in the doctors and greatly increases the risk of unnecessary interventions. Dr. H said she would return at 10 pm to check Wm’s progress. So we settled down to a pleasant half hour of chatting and resting as the contractions were now a blip on the monitor screen and no longer an overwhelming sensation for Wm.

At 10 pm Dr H returned and checked Wm to find that she was at 5 cm dilation and the baby had moved down a little to -2 station. This was great progress for only 2 hours of labor. No wonder poor Wm had been having such an intense experience – her labor was moving along very fast. Mark and I, baffled by the pull-out bed, called for Kathy’s help and she showed us how to work the various bits and pieces.

By 10.15 pm, Mark was settled on his pull out bed and I was comfortably installed on the egg crate foam mattress that Mark had ordered on arrival. We switched off the lights and attempted to sleep. Thirty minutes later, three nurses came running into the room, all lights were on and an oxygen mask was swiftly placed over Wm’s face. The nurses had noticed the baby’s heart rate dipping down with each contraction and needed to move Wm onto her other side. We discovered later that the little guy had the cord wrapped round his body and it was getting compressed by the contracting uterus when Wm was in certain positions. Right side lying seemed to work best for the baby.

Kathy examined Wm and announced that she was now 5–6 cm and the baby was even lower. We resumed our dozing until 1.30 am when Kathy returned yet again to examine Wm. Excitedly, she said she thought she was now 10 cm and might be ready to push. This was incredible – to move from 6 to 10 cm in just 2½ hours – I could hardly believe it! Kathy returned with Dr H who also examined Wm and said she was 8 cm, 100% effaced, with the baby at -2 station. Apparently, Kathy’s miscalculation had been due to the bag of waters bulging out into the cervix, which made it difficult to assess dilation. Dr H suggested breaking the waters to “speed things up” but Wm did not want any unnecessary interventions and so they agreed to wait another hour before doing anything. It must have been disappointing to find out you were not as far along as you had thought, but neither Wm nor Mark allowed this news to discourage them.

At 2.45 am Dr H returned and explained that there had been no change. She highly recommended breaking the waters in order to allow the baby to come down further and put more pressure on the cervix. After some discussion, Wm agreed to this procedure and sure enough, as the bag of waters was pierced, the baby’s head immediately moved from 2 to 1 station and rotated into a more favorable position. There was light meconium in the water, which meant that the baby was perhaps a little stressed.
We resumed our napping although Wm was beginning to feel a little discomfort as the baby moved down the birth canal. For some women, the epidural does not numb the lower pelvic region as well as it does the abdominal area, and this unfortunately seemed to be the case for Wm.

At 4.30 am, the doctor returned to check Wm once more and explained that she was almost fully dilated but there was a lip of the cervix still on the posterior edge. This was unusual as most women have an anterior lip to the cervix. Thirty minutes later, the same procedure proved that there was still a lip in the way and Wm was becoming more uncomfortable by the minute. In response to her unease, Mark got off his pull-out bed and came to sit by Wm, holding her hand tightly during each contraction and giving her loving words of encouragement.

At 6.15 am the doctor announced, after the check, that the baby had moved down to 0 station, which explained Wm’s growing discomfort. She said there was still a little bit of posterior cervix left but she suggested that Wm start to push anyway. The pressure of pushing often moves the cervix out of the way. Sure enough, after the first pushing contraction, the cervix disappeared and Wm was set to birth her baby.

Initially, Wm felt discouraged at her pushing efforts. She was exhausted and in pain and convinced herself that she was not doing a good job. This was far from the truth: after the first few learning contractions, she really got into her groove and moved her baby down incredibly fast for a first time Mom. It took her 100 minutes to push her baby out – that’s on the fast side of average for a first baby. This is when I saw Wm’s true colors: pushing was excruciatingly painful for her and yet she mustered up enormous courage and strength to successfully “push through the pain”.

Our lovely nurse Kathy was replaced by Natalie at 7.15 am, who thought that yelling at Wm would be an effective way of getting her to push. This tactic did not work: Wm was doing very well on her own with Mark and I gently encouraging her and she didn’t need a staff sergeant. Now we could see the top of the baby’s head with each contraction and excitement was growing in the room. Dr H, however, was tied up in the ER and Kathy returned to be with us despite no longer being on duty. The baby’s head was crowning, and still no doctor, and I was glad we had two nurses!

Finally, Dr H appeared and she quickly donned her gown and got into position to catch the baby. This was surely the most challenging time of labor for Wm, who urgently wanted to push her baby out, and at the same time was in a lot of pain. With much encouragement from an excited Mark, she gathered up the final ounce of strength and out popped the baby’s head. Dr H had been obliged to cut a small episiotomy to allow for passage of the baby’s head, as the heartbeat was dipping a little and the baby needed to breathe air. It was at this point that we saw the cord wrapped around his body, which Dr H expertly unwrapped and proceeded to cut. With Mark’s tears of joy streaming down his face, and Wm unable to believe what she had accomplished, their beautiful baby boy slipped out into the world. He weighed 8 lbs 10 oz and was 21½ inches long.

While Wm patiently underwent extensive repair of the perineum (that took over two hours), I watched Mark fall hopelessly in love with his son as he cradled him in his arms in the rocking chair. Finally, Wm was able to welcome him into her loving, mothering arms and he nursed lustily for 45 minutes. Thank you so much for allowing me to be a part of this incredible journey into parenthood. Your strength, patience and good sense were inspiring!

Your Doula,
Mrs. wonderful December 12, 2007



Our doula was able to capture the events and details that we were in no position to do. However, she couldn’t capture the emotions that accompanied the events for me.

These were:
-Shortly after labor began – tears.

-By the time I called the doctor and by the time the doula arrived – full crying

-By the time we arrived at the hospital – bawling. I’ll never forget the look the kind security guard gave me, which seemed to be one of great concern and pity.

-After the epidural – end to pain. I was a little nervous but excited and amazed that the baby would soon be there. I knew it would be my last evening as a non-parent. Mark and our doula were able to sleep. I lay there with a head full of excited thoughts, pressing the increase medicine button more frequently as the hours went by.

-When the pain began again – some surprise. I had thought the worst was over. But the doctor said she could give me some topical if it got bad, which reassured me.

-I was very happy with the nurse who was with me for most of the time. When the bitchy nurse joined in during the pushing, I was highly annoyed and pissed. I asked her to please be quiet. Mark concurred. “Really,” he said. “Stop it.” She did.

-When I began to push – bloodbath and pain beyond description. This was especially demoralizing since I’d thought the pain was over. I was also upset that the doctor was not there to give me the promised topical relief. Someone else had a life threatening emergency that night (I think an ectopic pregnancy) so the doctor was with her until River’s head had already emerged.

-When the baby came out – freaked out. It felt like a huge mass of weirdness. No instant love here.

-As I was getting sewed up for two hours – more pain, though not as bad as the labor itself. Hurt and exhaustion. I really didn’t mind that River spent his first two hours with Mark.

-First day or two – Continued pain. Another bloodbath (the toilet filled with blood the first time I tried to go to the bathroom and I had to get patched up again – very scary). Some confusion, wonder, amazement. Sometimes I thought he was very cute, other times he looked pretty ugly to me.

-With time, adjustment and love. I came to love him more quickly and more intensely than I expected to.

Have you posted a birth story? Please share the link.

If I Had to Do it Over Again

If I had it to do over again

If I had the opportunity to go through pregnancy and first childbirth again, knowing what I know now, these are the things I would do differently, and the things I would do the same.

Things I would do over:

• I would restrain my intake of sweets and other junk food during the third trimester and after the birth. Then again, maybe that indulgence was what got me through the experience emotionally. However, it also left me with some extra fat cells that are feeling at home in my body.
• Start pumping earlier – I didn’t start until six or seven weeks, when my supply was probably already established at just the level River needed. As a result, I never had excess and I didn’t get much pumping. I imagine it would have been hard to return to work and continue breastfeeding at 12 weeks. But I did enjoy the one-on-one time with baby, without having a machine attached to me as well. Maybe I’d start a bit earlier if I had it to again, but not a lot.
• Get a hospital grade pump right away – I didn’t research pumps and didn’t even realize there is a difference between hospital grades and those you can purchase in stores. I’d buy one used on ebay (as I ended up doing when River was 8 months old). Lactina Selects are now running about $350 used and seem to maintain their value pretty well.

Things I would definitely do again:

• Hire a Doula
• Have a good swing available from day 1
• Arrange for household help for the first two months – especially, someone to pass the baby off to in the mornings after sleepless nights
• Use cloth diapers
• Do prenatal yoga
• Treat myself to prenatal massages
• Get out of the house and continue on with life, taking baby along for the ride
• Have at least five months maternity leave
• Involve my husband in as many aspects of the experience as possible.

Searching for Quality Maternal Care

My husband and I had another pre-natal doctor’s appointment today and again, the quality of the visit was disappointing compared to Bolivia. At my last appointment in Bolivia I received quite a bit of information. In addition to 3-D pictures, the doctor spent a good 45 minutes examining the fetus, he provided detailed and helpful responses to my questions and I learned a lot. I was told the fetus was almost one kilo, and was in the top 3% for height-weight at its point in development. He showed me a chart indicated that if that rate of growth continues, I could expect the baby to be between 3.5 and 4 kilos at birth (postnote: he was correct, the baby was born at just under 4 kilos).

The American doctor listened to the heartbeat and measured my abdomen, saying “OK.” That was it. The answers to our questions were extremely terse and I had the feeling we were taking his valuable time. We asked if there were any doulas he’d recommend. He gave us a single first name.

“Any ideas on how we could locate Gloria?” Mark asked.

I asked why he recommended this particular person. “Because she knows my name,” he said. “The other don’t.”

Is that really a reason why we’d hire someone? Because she knows the doctor’s name?

Mark’s impression is that the doctor is flakey and he isn’t impressed with the knowledge levels displayed by the staff we’ve had contact with. Now, when we still don’t have full confidence in our primary doctor, we have to begin to rotate through the other four doctors in the practice, so that we’ll have had at least five minutes of contact with the random person who will deliver our child.

It’s understandable, with such a low level of personalization, with no single individual really paying attention to the needs of the couple throughout the pregnancy process, that demand is growing for non-medical staff like doulas. I almost look back nostalgically to the local country doctor – the person who knew his client well, who was available to come in the middle of the night if necessary. Since doctors have moved so far from this model, people have to look elsewhere to find a person who will listen, provide personalized advice and promise to be available over a period of several months.