The Birth of "Baby J" (part 2)

Preface to Part 2:

Obviously it has been a long time since I have made a blog post...I first want to finish this birth story and describe how this birth has molded and changed my perspective as a student midwife.  The birth of Baby "J" was the first out-of-hospital birth I ever attended and ended up launching me back into the realm of midwifery itself.  I was serving Ginger as her doula.  My inexperience is obvious to me now looking back, but at the time I was so wrapped up in the emotion of caring for Ginger and Scott and their unborn baby...all knowledge of obstetrics was unimportant to me. 

 Prior to attending this birth, I had a very idealistic view of out-of-hospital birth.  I thought that doctors were the enemy and should be avoided and used as a last resort.  Boy, was I wrong!  It is a wise-woman, indeed, who sees a problem coming before it arises and heads it off...not willing to wait until lives are at risk to do something about it. 

Now that I have attended more out-of-hospital births, I understand more clearly that one should not be attached to the birth setting, but instead be attached to a good outcome regardless of where it is.  It is proper that a low-risk birth should proceed at home (or in another out-of-hospital setting) as long as everything remains low-risk and normal.  When something outside of normal limits arises, it then becomes necessary to move into the hospital setting, and thanks be to God that we live in a time when medical doctors and technology allow for the possiblity of a good outcome even in the face of major challenges!  Most of the time a transport to the hospital is done in a non-emergent way, as was the case for Ginger and Scott, but on rare occasions a true emergency arises which necessitates immediate transport. 

 Technology has it's place in the birth world...to save lives when things deviate from normal and become life-threatening.  Midwifes are the guardians of normal.  Obstetritians are the heros of high risk and abnormal.  There is a place for both professions, and when they are able to work together in a proper balance to pursue the best possible outcome for each individual woman with child, women are able to have better birth experiences.

I have been apprenticing as a midwife for almost a year now, so my perspective and knowledge of birth has increased but is, by far, not yet complete.  Each birth teaches me so much!  Each mother and child has their own lessons to offer me...I soak up each experience and allow it to form me as a midwife.   It has been a year since Baby "J" was born, and I have reflected many times on the events of her birth...

 Part 2:

After repeating herself about her concern, the midwife received a positive response from Scott that it was okay for them to transport, so she began to get their charts and things ready to leave.  As I knelt there in front of Ginger, I talked to her, as best I could, telling her how she had done everything right...that this was not any "failure" on her part and that this is what the hospital was there for: to assist when complications arise.  I can't remember exact phrasing, but everything seemed suitable for the time, and I hope that it brought comfort and strength to her and Scott.  After my attempt at encouraging "doula" remarks, I held her knees and cried with them.  This was the first of many tears we would shed together...not all of them out of sadness.  We all had to take time to process this news.  It was a learning curve for me too.  I realized that I had been holding just as high of expectations that everything would go perfectly.

I rode in the car with Ginger as Scott drove, following the midwife to the hospital.  Mostly, my job was to try to keep the atmosphere relaxed and help Ginger through any contractions she had on the way.  Thankfully for her, she only had a couple.

By the time we arrived at the hospital, Ginger's contractions had spaced out a little, which was welcomed by her since they had been so long and intense before we left the birth center.  We took her in by wheel chair so that she wouldn't have to walk and stop with every contraction.  She was very nervous.  She was also very concerned about her birth plan for a cesarean.  I kept reassuring her that transport does not necessarily equal cesarean and that we would cross that bridge if the time came.
Once we were assigned a room and Ginger's I.V. was going, she suddenly perked up.  She was chatting with Scott and even laughing!  They were telling me and the midwife stories, and the mood began to lift.  This was reassuring after what had been going on previously...it was nice to see Ginger get a second wind!  We all thought that this may have been exactly what she needed --a break from a very intense labor.

Eventually, contractions began again and we suggested that she do another "rotation" to see if the baby would turn to a better position.  No change.

The doctor and nurses suggested an epidural and therapeutic sleep.  After much discussion between Ginger and Scott, and some input from myself and the midwife, they accepted this comfort measure and we all took a much needed nap.

We all hoped that she would see some progress in cervical dilation after these hours of rest, but, alas, no change again.

Finally, after about 7 or 8 hours of no progress (or was it 11 hours?) the doctor gave her "the talk".  He let her know that at the moment, baby was fine, but if this pattern of lots of contractions and no progress kept up, eventually the baby would not be able to tolerate it and would begin to get distressed.  He made it clear that she could choose to have a cesarean now while there was time to be relaxed about it, or she could wait until it became an emergency situation.  He gave her a time limit (maybe 30 minutes) and said if there was still no change after that point, he would highly recommend a cesarean.

We all prayed so fervently for that entire time period!  Each contraction Ginger had, we would pray and all say aloud that her cervix was opening, and that, if it were God's will, she would be able to give birth vaginally.

When the news came that her cervix had still not changed she was so deflated.  She and Scott let the staff know that they would consent to a cesarean, so the paperwork began.  While the nurses left the room to get things set up, Ginger asked me, "Does God not hear us?  How can this be happening?"  (or something to that effect).  I responded by giving her the example of Jesus praying in the Garden of Gethsemane.  He asked God to spare him from the torcher he was about to endure...and that if it was at all possible, that he would not have to endure it.  It may have seemed that God was ignoring him, but, in fact, He had bigger plans.  Jesus had to endure that tremendous suffering and death, but God then raised him from the dead!!  The guy stinkin' came back to life into his original body and amazed everyone!  Not to mention that by his suffering and death, Jesus also accomplished the ultimate attonement for the sins of all mankind!

**When someone puts their entire faith and life into the hands of God, it is a very vulnerable state of being.  It is easy to feel let down when things do not turn out the way we want them to.  But sometimes, God's plan is bigger than ours...Ginger has since then begun a fabulous journey in becoming a doula and will be able to comfort and inspire many women during their birth times.  She had a long road of healing but decided to be proactive and follow a calling that, she feels, has been placed on her because of the experience she had birthing Baby "J".**

So, back to the cesarean...I gave Ginger as many positives to think about as I could before they came to take her back to the OR.  At one point, the doctor told a very inappropriate story of how a large (13lb.) baby had died after a cesarean birth recently...at which point I had to do damage control on poor Ginger's psychy. Why would he tell such a story in front of a pregnant mother about to go under the knife?!  I can only assume that he just didn't think before he spoke...he was telling the story to the midwife, so I'm sure he was just caught up in the moment.

They took Ginger back and got Scott all scrubed up.  I was not allowed to go back with her, but I sent my camera with Scott so they could have pictures of their first moments with their baby.  I waited for what felt like eternity for the nurses to tell me that she was okay and the baby had been born healthy.  Scott came out and told us he had a new daughter!!!  I gave him the biggest hug ever and we both were crying, only this time they were tears of joy!

As it turns out, Baby "J" weighed 9lbs. 7oz. and was completely posterior.  Ginger, being the whole 5'1'' tall that she is, says she wonders how Baby "J" fit in her tummy: )  If the baby would have just been large or turned posterior, the outcome may have been different, but the combination of the two made vaginal delivery impossible this time. 

 The doctor reassured her that he did the proper incision and stiching to allow for a VBAC with her next pregnancy as long as the births were 24 months apart.  This was at least a comforting thing to hear...that she wasn't sentenced to a cesarean next time.

I was able to go into the recovery room and visit with Ginger for a little while.  We hugged and I adored Baby "J" for a long time.  I felt so connected to all of them!  It felt as thought they were my family, too.  I wanted to stay a bit longer, but I knew she needed rest and still had a waiting room full of family members eager to meet their newest addition.  **I had been going out to give updates and photos to the family periodically, per Ginger's request.  I was the closest they could get to being with Ginger...the nurses would not take time to relay information back and forth to the family.**  This birth is still, to this day, the most emotional birth I have ever attended.  We will forever have a special relationship that nothing will ever be able to take away.  This family is eternally imprinted on my heart. 


Ginger was very nervous to tell her friends about her birth experience because she was afraid of being viewed as a failure.  More specifically, she was afraid of the naysayers who had been opposed to her out-of-hospital birth greeting her with comments of "I told you so..." and such.  But Ginger did not have an unsuccessful out-of-hospital birth.  On the contrary, she had a very successful one:  she was under supervision of a well trained midwife who was the "guardian of normal" for the birth.  When things got out of the realm of normal limits, the midwife recognized it, made sure there was informed consent and took the appropriate measures to get Ginger and her unborn baby to be able to recieve more advanced observation and assistance to keep mom and baby healthy.  Baby was born healthy, and Ginger remained healthy.  This was a good outcome to an out-of-hospital birth plan.  Unnecessary intervention was successfully avoided, and only necessary interventions were performed under truely informed consent. 

The Birth of "Baby J" (part 1)

After going almost 2 full weeks past their EDD, Scott and Ginger made there way to the birth center.  Scott called me a few hours before they were ready to leave to give me a heads up since I had farther to drive than they did.  I was much appreciative and took the opportunity to get to the birth center a bit early to help make their location change as smooth as possible.  I wasn't sure how far along Ginger would be...she had been having regular contractions all day (with the help of the blue and black cohosh she had started taking every hour, alternately)...so I wanted to be prepared for anything.

Once they arrived and got settled into their room, the midwife checked her and she was dilated to 4cm (this was at about 7pm).  Contractions were moderate but were pretty spaced out, so they decided to take a walk around the neighborhood to try to get things moving and to get some fresh air before it got too dark.  It was the most perfect night for walking!  The temperature was just warm enough to be comfortable without being too cold or hot.  The stars were out and we stopped frequently to admire the constellations.  I just walked around with Scott, Ginger and Ginger's mother, taking pictures periodically and trying not to interrupt their amazing dynamic.  Watching admirably, I couldn't help but think to myself, "This is how it was meant to be."  Scott and Ginger are the kind of couple that would make some people sick to watch (but not me) because they complete each other so perfectly.  They know each other.  They can know what each other is thinking, feeling or desiring just by being near each other.  The aura, if you will, around them was something to bask in.  As Ginger's contractions began to get more frequent and intense, I just stood back in awe and wonder at how much she depended on Scott to hold her through it and how he lovingly cared for her.  Neither of them ever having experienced this before, they both knew exactly what to do and how to make the other feel loved and needed.

As we made our way back to the birth center, things were really starting to pick up.  Ginger's mother and I walked a bit ahead to give them some alone time, but they made their way in as soon as they could between contractions.  Once we were back inside, Ginger's best friend had arrived with some much needed food (and a nice frozen treat for me too:-) so we all sat in the living room together while they ate, as best they could, between contractions, talking, laughter and excitement.

Now would be a good time to mention that about 20 minutes before Scott and Ginger arrived at the birth center, another couple came in who were having things move along a bit more quickly than Ginger.  The other laboring mother was nearing the pushing phase, and it was evident by the low tones we heard through the walls when we were back in Scott and Ginger's room.  I'll come back to this later...it will be important.  And, also, Scott and Ginger had decided that the only people allowed in the birthing room would be me and the midwives.  Scott's mother, Ginger's mother and her best friend waited patiently in the living room Facebooking periodic updates and trying to get their Skype ready for when the baby arrived.  So with that background stated, I shall return to the story.

After dinner, Scott and Ginger went back to their room, and I took a quick break to do that which all nursing mothers must do at some point when baby isn't around...so I sat in the back with one of the midwives discussing birthy things.  When I got back to their room, Ginger was lying on the bed doing a "rotation" (otherwise known as "the rotisserie") which is when she does 2 contractions in each position: lying on back, left side, hands and knees, right side.  This helps to increase the productivity of contractions.  Scott and the midwife's apprentice were right beside her rubbing her arms and legs.  She told us that she really liked when we did that because it helped her to focus on the good sensations instead of the pain that she felt in her back.  With the three of us there to support Ginger, we divided and rotated our support: one of us would apply counter pressure to her back, one would rub her legs and the other would gently stroke her arms.  This was working quite great for a few hours.  The apprentice continued to monitor the fetal heart tones and other necessary things as needed without disturbing Ginger.

 "The lady next door" was nearing completion, but wasn't handling things as gracefully as Ginger was at this point.  We tried to suggest that they put on some music (they had brought their ipod with a "baby" playlist), but Ginger kept saying, "No, not yet.  It's fine."  It was very coincidental that Ginger and "the lady next door"'s contractions occurred at exactly he same time.  It became so predictable that when we heard "the lady next door" start up again, we knew to get in position to help Ginger through her next contraction.  After about 30 minutes of this, Ginger's labor was starting to pick up, and she was also starting to experience fear...no doubt influenced by all the happenings next door.  She said to us once, "How bad is it going to get?"  It was at this point that I pulled the apprentice aside and mentioned that we had to do something about the "torcher chamber" next door.  (The lady was screaming things like "Take me to the hospital!", "I can't do this!", and other negative things.  She really was having a hard time with a few non-emergent complications, but there was not really any good way to explain this to another woman in labor without having her subconsciously accept that as her own "fate".)  So in an effort to reset the atmosphere, we suggested that Ginger try getting into the tub to see if it would help relieve her back labor.  She agreed, so while she and Scott got into the tub, we put on their "baby playlist", with their permission.

A few more walls in between them and some music to assist, Ginger was finally able to relax a bit...but things progressively got more intense.  She said the water helped ease the pain, but her contractions started coming one on top of the other.  Sometimes she would say her pain was continuing for 5 minutes or more at a time.  One of the midwives came in and sat beside the tub with me while the apprentice went to assist with the other birth.  Both of us were encouraging Ginger to let the contractions work for her and reminding her to relax, while Scott sat behind her, massaging and gently stroking her arms and then we would apply counter pressure during contractions, as we could.  She continued to do another "rotation" so I sat back to give them space between contractions, taking pictures and video as I could.

After the "rotation" was complete, we figured she had made some serious progress and was probably nearing the pushing phase, so the midwife asked her if she wanted to be checked again to see what was going on inside.  Ginger was eager to see how much progress she had made.  Her cervix had effaced (thinned out) a bit more, but was barely 5 cm dilated, if stretched.  It was now about midnight.  I don't think the midwife gave her the numbers, but she said something like "you're progressing slowly" or something of that nature, trying to soften the blow of the news.  I could tell Ginger was really discouraged because she was really having to work hard with these contractions and they weren't doing what they were supposed to do.  The midwife suggested she try another herbal treatment to help soften the cervix (belladonna, I believe), and Ginger and Scott agreed.

While Ginger and Scott got out of the tub and dressed, we spraying some lavender essential oil in the room and turned the music down so that maybe they could try to rest between contractions.  Ginger tried laying on the bed on her side for a while, but she could no longer get comfortable anywhere.  It is at this point that things start getting blurred in my memory because everything was happening very fast.  I kept taking breaks, when the apprentice and midwife were with Scott and Ginger, to go out into the living room and give the mothers and friend updates and show them selected recent pictures (with Ginger's permission) so that they would feel as included as possible.  I can only imagine how much anticipation they must have felt watching the clock go by and not having any real-time visualization of what was happening...thus my idea of photo updates.  I'm quite sure I would not do this in every case, but this family just has a dynamic like no other.  They are so close, so in tune with each other, it is truly a breath of fresh air.  I have never seen a family so supportive of what the birthing couple wanted as I saw at this birth.

After giving updates to the family I returned to the birth room with Scott and Ginger.  This is the "blur" I was speaking of earlier.  At some point during this time, "the lady next door" (finally) birthed a baby boy, so we heard the lovely noises of baby cries instead of agonizing screaming, which was a nice change.  This was both encouraging and discouraging to Ginger, but happiness prevailed.  (*Just an aside, Scott and Ginger both remained so positive and gentle the entire time.  As much emotional and physical pain as they endured, they countered it with graciousness.  It was an honor to be in their presence and observe how they treated each other, as well as everyone around them.  Very moving.*)  "The lady next door"'s husband happened to be a chiropractor, so at some point, he came over and adjusted Ginger (with a mutual agreement, of course).  Then once, when Ginger was sitting in the bathroom, the apprentice checked the fetal heart tones while the midwife and I waited in the birth room (we were only separated by a thin door, so we could hear the heartbeat as she was listening with the doptone).  She and I both looked at each other with surprise as we could immediately hear a deviation from what it had been being...it was much faster.  The midwife calmly walked into the bathroom and said she was going to listen also.  She then went to go discuss things with another midwife while we helped Ginger move to back to the bed.

Both the midwives and the apprentice came in and worked together to get a good charting of the fetal heart rate.  Everyone was still very calm and relaxed, but I could sense the concern (subtly) from the midwives.  After this listening session, Ginger wanted to go back and sit on the toilet because that was the only place she seemed to get a break from contractions.  They were fiercely strong and constant whenever she was lying down now.  She would at least get a minute or two in between when sitting on top of the toilet.

It was at this point that the midwife came back in and said, "Ginger, I need to talk to you..."

I somehow knew exactly what that meant, but tried to stay objective and think about how to help Scott and Ginger process the news they were about to hear.

"I'm really concerned about your baby.  The heartbeat is staying very high...," the midwife stated simply and firmly, yet with great gentleness, "I'm going to recommend that we transfer you to the hospital.  I'm really concerned about your baby."

Immediately, Ginger broke down, tears streaming down her face, "No, no, no...", she kept shaking her head.  Scott held her and stroked her hair, his eyes filling up with tears as well.  I knelt in front of her and held her, too, trying to exude calmness and confidence in the midwife's decision (because I too was concerned about the baby) but I knew the pain Ginger was feeling.  I knew what she meant.  She wasn't meaning, "no, no, I won't go to the hospital," she meant, "no, no, this can't be happening.  It's not supposed to be like this.  We're supposed to have this beautiful, natural birth center birth!  This can't be happening now..."

The Birth of Necessary Intervention (an introduction)

I recently attended a birth that was strongly desired to take place at a local birth center.  In an effort to preserve the emotions we encountered, I'm not going to give away the ending (although I'm sure you can gather a bit from the title;-)  I am of the opinion that "if it ain't broke, don't fix it" in regards to fertility and birth.  I firmly believe that when birth takes place at a hospital, the staff is so "on the alert" looking for problems that unnecessary interventions occur far too often resulting in more harm that benefit to both the mother and the baby.  Many movies and books are dedicated to the cause of raising awareness of the way technology has been and is being misused to help inform women and couples of their real options (as they are sometimes lead to believe they have none).  This story is a bit different.  We (who were in attendance at this birth) are very much against unnecessary intervention...that's what drives me to do what I do as a doula and to continue studying to become a midwife.  But sometimes, as you will read, there are situations that need and will benefit greatly from certain interventions.  There is a proper time and place for the use of technology and medical intervention, but a woman or couple who is to going give birth should be well educated in all the options (both natural and medical) in order to make the best choices when faced with the need for intervention.  The couple in this story were exactly that: well educated and well prepared (for a natural birth).  The only sad thing was that their education was lacking in one aspect...they were not emotionally prepared for necessary intervention because of the negative connotation associated with "intervention" itself.  Since it is misused so casually and haphazardly, it is perceived as a "failure" on the part of a dedicated, natural birthing woman when intervention occurs.  Some will say, "oh, I knew you couldn't make it through without pain medication," or, "I told you it wasn't safe to deliver outside of a hospital," etc., etc.  That is a maddening thought when your only desire is to have a natural, vaginal delivery then suddenly and unexpectedly, intervention becomes absolutely necessary.  My hope is that this story will inspire people (both those who have preconceived opinions and those who haven't yet formed an opinion) to see natural birth and out-of-hospital birth in a new light.  The desire and goal of out-of-hospital birth experiences it to avoid unnecessary intervention, and this environment is the safest place to begin that journey (with high hopes that it will end there as well).  Judgment need not be placed on the couple for any interventions that they may need to endure to ensure a healthy birth.  The ultimate goal is "healthy baby, healthy mother", and this story should help you understand that, sometimes, the choices leading up to that end can be difficult and emotional to make.

(The Birth of "Baby J.", part 1 will be posted soon)

From conception forward...

Becoming a mother is an incredible journey!  From conception forward, you are growing as an individual while an individual is growing inside of you...how remarkable!

What an amazing thought as you approach a new life...a new human life, that is.  While the world largely undervalues the role mothers and their unborn babies play in our human existence, it doesn't change the importance of our calling.  In today's culture, I find we must constantly fight for what is natural, whether or not it is popular.  

I am beginning this blog for as a way to outsource all my thoughts on fertility, pregnancy, childbirth, postpartum recovery (i.e.-placenta encapsulation), breastfeeding, attachment parenting...and the like.  Sounds so ordinary.  How many blogs are there out there about such things?  But this one will be different.  I have a passionate heart for these topics.  The talents God has gifted me with have driven me in this direction so that I could find myself and become the unique individual that I am today.  My children have benefited greatly from this journey; therefore, I firmly believe society at large will benefit from my decision to change from being "mainstream normal" to "nowhere near normal".  Hopefully my enthusiasm will be something you share, and if so, I hope you enjoy what my mind has to offer!