A Birth Story: Adler Josue

Tiffanie was my long-distance doula of sorts four years ago during my pregnancy with my son Eli. When I had concerns, I called her. She always had suggestions about what could help. As his due date came closer, she would call just to check in. I was so physically ready for him to come, and she listened and understood. When labor finally started, she sent one text message: “You can so do this”. Somehow those simple words of encouragement were just what I needed, a reminder of my body's strength and capability to give birth.

My husband Franklin and I were thrilled to find out we were pregnant again. There was no question in my mind that I wanted Tiffanie there for this birth as our doula, now that we lived closer. I'm so glad I had her for this pregnancy and birth in particular, because it was so completely different than my others. In the first trimester I had a really rough time with morning sickness. It left me not functioning most days, with nothing in my stomach and unable to think past the nausea. Tiffanie was there, checking in on me, again suggesting things I could do to help. After the nausea, I had heavy late first trimester bleeding. I thought I was loosing the baby. Franklin was so concerned and didn't know what to do for me, and Tiffanie talked to him on the phone and offered him some suggestions and reassurance. The bleed was diagnosed as a subchoronic hemorrhage- very common, and not necessarily a problem, although it did increase my risk for miscarriage and later placenta problems. Tiffanie right away researched supplements I could take for placental health, and so I took her advice and started them the same day. Eventually the bleeding stopped and the hemorrhage healed.

At 33 weeks, I started getting really concerned. I was feeling pre-labor symptoms, very similar to how I felt the week before Eli was born. Tiffanie was away on family vacation in the mountains, and I didn't want to bother her. Finally I just sent a quick message to her, asking her thoughts on my symptoms. Were they normal? Or should I be concerned, since I was only 33 weeks? Even though she was on vacation, she called me right away. She listened, let me vent out my concerns and feelings about the symptoms, and told me she thought I should call the midwife's office. I was seen at 33 and again at 34 weeks for pre-labor symptoms, and told to take it easy. Tiffanie was checking in on me frequently those few weeks, and suggested magnesium baths and talking to my baby.

She met with Franklin and I so we could talk about our birth plan together, and what we each wanted for the labor and delivery.

I was 35 weeks and 6 days, when I woke up feeling “off”. I told Franklin I felt stuck, heavy, full of pressure, or something, like I needed to get some air. We had our hospital tour that morning. I was pleased with how accommodating the hospital was with my birth plan, which included me being very active during labor, free of monitoring and I.V.s, wearing my own clothes, laboring in the tub, and Franklin having skin to skin with the baby before any weight or other checks. I thought I would be set! Little did I know, that I’d actually be back just a few hours later, and the labor would be very different than I imagined.

I was at home, and very luckily Franklin and my mom were both at the house as well, when I felt a pop and a gush. I thought my water had broken, and was surprised- I’d never had my water break before. But then I looked down and saw that it wasn't water still gushing down my legs, but blood. I can't even remember the minutes that followed clearly, even though they are sharp with fear in my mind. I yelled for Franklin. He came, I started crying. We grabbed towels and left the house, I didn't even say goodbye to the kids or my mom. We arrived to the hospital. I just wanted to know if they could find my baby's heartbeat. I signed a consent for a c-section. There was a blur of papers and nurses and doctors in the room. I was in the hospital bed with two IV lines in each arm, unable to move or even shift my legs because of the bleeding. I was still hemorrhaging, and they were saying “placental abruption”, which I already knew from that first moment at home. A placental abruption is where the placenta separates from the wall of the uterus, either fully or partially, and can be fatal for both mom and baby (luckily, my abruption was only partial). 

Franklin and I were both overwhelmed with fear and shock, this was so different from what we had “planned” or imagined. In came Tiffanie.  Her calm, focused, familiar and loving presence was just what I needed. She helped Franklin and I sort through the information and options being thrown at us. When baby and I were both stable, she told me I could ask them for a minute alone to process, since she could tell I was totally overwhelmed by the number of people in the room. She asked me, “What do you want to do?” and helped me see the pros and cons of each decision we could make at that point. The baby needed to be born quickly, but I wasn't having contractions. I looked to the midwife, and she said that I was beyond the normal natural delivery I wanted, and outside of midwifery's care. The doctors were pushing for c-section, but they did offer induction as a second option, although they seemed to think it would likely end in c-section anyways. We decided to try a quick-as-possible induction. I also had an epidural catheter placed without any medication in it, just so I wouldn't have to be put under general anesthesia if an emergency c-section was needed at any time.  We started pitocin right away. Then, it was a waiting game. The baby had to come, before I lost much more blood or he showed signs of distress, or I would be having an emergency c-section. At one point the baby's heart rate dropped during contractions, and even before the nurse came running in Tiffanie was suggesting changing my position to help the baby. Once I began to feel contractions, I felt them burning in my lower back. I asked Franklin to hold a cold cloth against it, and Tiffanie ran back and forth refreshing the cloth with cold water for him, so he never had to leave. The room faded away around me as I focused on the contractions getting stronger. Franklin never left my side, he massaged my head and shoulders, and held that cold cloth against my lower back. 

Suddenly, I felt something different. I think I remember half-apologetically warning Tiffanie that I might need to start screaming through contractions. She said that was good, just to make sure I wasn't tightening while screaming but using my voice to open my body. Within just a few more contractions I said I need to be checked, NOW. I am so, so grateful Tiffanie was there, because while she ran to get somebody, Franklin was able to stay with me, and during that next contraction I felt the baby coming. They were telling me not to push since they weren't ready, but it wasn't me pushing, it was the baby finding his way out with each contraction. Finally, they were telling me I could push, and with a huge yell I let him go. My Adler Josue was born, crying, pink, healthy, and BIG- 6lbs 12 oz. He was placed on me, and I just couldn't believe he was there so quickly. The delivery ended with a lot of bleeding on my part, and was a rough recovery. However, I was just so relieved to have our healthy boy in our arms. I was so amazed that I had been able to avoid a c-section despite the circumstances.

My labor and delivery with Adler was very, very far from what I had planned. But when I think about it, despite the fear, and the shock of it all happening so quickly, and with so many unplanned, but necessary, interventions- it was such a good birth. It could have easily ended so differently. But, Tiffanie was there, making sure the labor and delivery could still be as much as possible what we wanted, and I have no doubt it made the difference between a c-section and me birthing my baby with that big, powerful yell.

My labor and delivery with Adler was very, very far from what I had planned. But when I think about it, despite the fear, and the shock of it all happening so quickly, and with so many unplanned, but necessary, interventions- it was such a good birth. It could have easily ended so differently. But, Tiffanie was there, making sure the labor and delivery could still be as much as possible what we wanted, and I have no doubt it made the difference between a c-section and me birthing my baby with that big, powerful yell.

I am so grateful for Tiffanie. Her sincerity, her passion for birth, and her broad scope of knowledge, understanding, and experience, were all invaluable to me during my pregnancy and labor. Just having her presence and heart-felt support was like she was still saying, (and I think this is what she will always say to any laboring woman), “You can so do this”.

The Value of Prenatal Visits

The Value of Prenatal Visits

One of the most valuable things I learned during my doula training is the importance of the prenatal visits.  I schedule at least two, two-hour prenatal visits with my doula clients.  During those visits we discuss the family’s birth vision and plan.  We do art.  We talk about fears and misconceptions.  We discuss past experiences and how they can affect this birth experience.  We discuss tension, relaxation techniques and then we put some relaxation techniques into practice with contraction simulation.  I spend time showing partners how they can support mamas, through touch and movement.  And we even discuss what happens when things don’t go as planned.  

Most importantly, in those four hours spent together before the birth I get to know the family and how I can best support them in their labor and birth experience.  I can start to read a mama’s face and pick up on her body language.  I can understand her likes and dislikes.  I build a relationship with both parents.  I become familiar with their mannerisms and body language.

As a doula, it is important to know what the mama needs and to be able to see when she needs more than we discussed in our prenatal visits, but is equally important to see when she doesn’t need more and when it is time to fade.  Each labor and delivery is incredibly unique.  

Some labors are marathons, requiring every skill I have ever learned as a doula.  I need to do the double hip squeeze and massage and cheer and coach alongside the partner.  I need to be the sounding board for parents when things aren’t going the way they had hoped and they have to make decisions.  I feel the disappointment and hurt for them as they agree to interventions they had not intended.  I am exhausted with mama as she labors into her twenty-fifth hour.  I suggest changes in position when baby’s heart rate dips or mama is experiencing intense back labor.  Because of those four hours we have spent during prenatal visits, there is a familiarity and built trust.  Those intimate moments during decision making and laboring and unknown and emotion and exhaustion are shared, not just with the family, but with me, as their doula.

Some labors require me to sit back and let a mama do the work her body has been preparing for.  It is in those births that I am so grateful for those four hours spent in prenatal visits because I know.  I know this mama and what she wants and needs.  I know this partner and the strength and support he can offer.  I know the groundwork that has been laid and the strength and capabilities of this family.  I know I can step in and when I should step in and do more, but the rewards of those four hours spent with a family are so great when I get to watch them do their thing while I take some pictures and fetch cool washcloths.

You see, for me, those four hours is where the real work is done.  We discuss, we prepare, we build relationship, we become a team.  Then, at the birth, I fade.  I fetch cool cloths, and water, and ice, I hold hair back while mama vomits, I remind the partner of a few things he can do to comfort mama, but I fade.  It’s not about me.  It’s about this family.