Earlier in the day Lisa, my doula partner, had messaged me that she had a client that seemed to be in early labor. Lisa had thrown her back out and could barely move. She would need for me to go in her place, if this was it.
I messaged Lisa's clients, Erica and Ryan, who I had met previously. Erica kept me in the loop through out the day, which included her contractions starting and stopping.
Around 7:30pm on August 5th, we decided that I would head to their home and see if I could help get things moving. Erica was scheduled for an induction later on in the week.
I arrived to their home about a hour later and I watched Erica, in the same way I watch every laboring person, when I arrive to them. It took me about 15 minutes to realize that she was actually having surges. I wasn't sure how strong they were, but they were coming every 5 minutes or so.
Erica moved around the house, switching positions, and eventually getting in the tub. She was very uncomfortable, but handling the surges very well.
They eventually were coming every 3-5 minutes and we decided to take the 45 minute drive to the hospital birth center where they had chosen to have their baby.
About 5 minutes into the ride Erica calls me and says, "Ryan's check engine light is on and something else is flashing. Of course this would be happening right now. We are just going to keep on driving though." I made sure to follow them the whole way in my car, just in case.
We arrived to birth center at 12:14am and were greeted by the most lovely midwives I had met and not someone who is normally on staff. Her name was Oni, and she brought with her an overwhelming feeling of peace. They placed Erica on the monitors and we heard her little one having hiccups.
At 1:03am they removed her from the monitors and checked her cervix. Erica was 5cm dilated and was happy to hear that she could stay.
At 3am Erica decided to get into the tub. I joke that it's more like a pool, due to it's massive size. It's similar to an 8 person hot tub for reference. Erica felt some relief from the water.
She was handling her surges very well from the outside. I was surprised at 4:15am when she said, "talk to me about the pros and cons of an epidural". I went through the both sides and she replied, "I'm not ready for that yet."
I told her that I thought her labor was moving along quite nicely, but she was doubting herself a little bit. She was nervous that the pain would only intensify and that maybe she hadn't made any change.
When I tell you that Erica is the most peaceful and in control person I have ever seen during labor, I am not lying. I have had many clients take hypnobirthing classes, and had a bit of a negative feelings about them myself. Often times mothers aren't able to stay in that state, and they become very disappointed with themselves, when they aren't able to labor in that manner. Erica was very easy going about it. She had planned to stay in that state until she couldn't anymore. I think that was part of why it was possible. She wasn't putting any pressure on herself.
I helped to keep her cool, by using ice dunked cloths, a small fan and kept her hydrated. At 6am Erica was tired and decided to get out of the tub to see if she could maybe rest.
A nurse said to me, "she seems maybe a little too comfortable, right?" Labor and delivery is the only place in the hospital where pain and blood are good signs of things to come. I told her that I thought Erica was close to transition, and she replied, "Oh yeah?". She thought I was crazy, but I had been watching Erica intently for 10 hours now. There had been a shift.
At 6:14am they checked her and she was 8cm dilated. That number gave Erica life. I looked over at Ryan and he was giddy with excitement and beaming with pride. The midwife and nurse after nurse, were commenting on her control. I was so impressed, I could barely stop myself from saying so repeatedly.
Just before 8am, Erica looked me intensly in the eyes and said, "I feel like her head is descending lower into my pelvis." She leaned back once again began her breathing. I was so in awe, I actually sent a video of her laboring to by doula crew. Everyone, was commenting on how lovely and amazing she looked while in this intense part of labor.
Erica mentioned that she had some discomfort on just one side, so Ryan and I took turns helping to relax her belly with rebozo techniques in hopes that the baby, might settle in to a more comfortable position.
At 8:45am Erica's noises changed and became more of a shushing noise than a deep yoga style breath she had been doing all night. I watched her belly as it began to not only tighten but just bare down in the slightest way during the surges.
At 9am Erica is 9 and 3/4 cm dilated. She opted to have her water broken by the midwife. As the waters poured out, the midwife tells her their is meconium in the water.
This was the first and only time I watched Erica start to panic. That information threw her for a loop. She was now worried for her baby and couldn't get back to her place of peace. She began telling Ryan and I that she couldn't do it anymore. That she had no more energy left. That she wasn't ready.
The midwife started giving her pushing instructions at 9:45am, to help give Erica some focus, but she couldn't get back to that place.
I switched places with Ryan and positioned myself next to Erica's head. I reminded her of her strength and capabilities. I reminded her of everything she had just done for the last 12 hours and how much easier this could be if she could get back to that place of peace. With each surge I began breathing next to her, the way that she had been previously breathing and it clicked. In between each push, Erica once again laid her head back and went to her own place.
She had taken back her labor.
Erica began to make lots of progress with each surge and we began to see small portions of the babies head. Ryan was elated and anxious.
At 11:15am I watched a large head emerge from Erica’s pelvis and within seconds knew exactly what would come next.
The room went into slow motion and I looked into Erica’s eyes and began telling her she had to push as hard as she could. The midwife began demanding directions and asking for multiple tools and the nurse was in a full blown panic unable to understand what the midwife needed. There was also a new nurse to the birth center, training to come onto the team, who had previously worked at another location, and while she knew what the midwife wanted she was struggling to locate the items.
A team of nurses rushed in as alarms blared and began slamming themselves on Erica’s belly. Her glasses were fogged up and sitting over her eyebrows. As they tugged the baby they were moving Erica down the bed. She was halfway down the bed and all of the sheets had been removed as they pulled her even more.
She asked me what was happening and I replied, "your baby is stuck. It's called a shoulder dystocia". I grabbed her face and told her to focus on their words. She began listening and pushing as hard as she could. I grabbed her left ankle and brought her knee to her ear.
I heard Ryan say “oh god! What is happening?!” and put my hand on a nurse that had entered the space that I knew well, who was standing on the chair above me pushing on Erica’s belly and she knew what I needed. With no words exchanged, she leaned down into Erica’s face and took over.
I followed Ryan as he went into the bathroom and I grabbed his face, with his ears pinned in between my fingers “Is my baby going to die? What’s going on? Are they going to die?”
I didn’t have the answers I just kept telling him to slow down and breathe. He slowed down and stopped screaming and began to take slower breaths and then just weeped asking me the same questions over and over again, but more calmly. I felt like his knees were buckling and I was holding his entire body up by his head. We stood in the bathroom doorway directly across from the end of the bed. I had Ryan faced towards me as I watched the mass panic over his shoulder.
There were 13 people in the space now and an obgyn was standing in the center of the room yelling at people to get her a covering gown. It was like the rest of the room paused and all we could see was a woman demanding to be shielded from blood from nurses who had more important jobs than gown finding. And Ryan said, “who cares! Help them!”
I watched the midwife spinning the baby's head and the obgyn eventually stepped in to then be pushed aside by another obgyn, who then took charge and began assigning tasks. It was like he had a string tied to each person in the space and was moving them like marionettes.
He shoved the other obgyn's hand into Erica and past babies neck and she released her arm while this doctor spun the baby around and then cut a very tight cord around the neck and shoulder as soon as it could be seen.
In the next push Erica delivered her baby. “11:20 Baby!” 4.5 minutes from head to body. Normal 2 step delivery is completed in 60 seconds or less. It felt like a hour.
4 nurses went to work and the baby wasn’t responding.
I could see her right arm in between two nurses and it was ashy in color. I had my head at this point pressed into Erica’s as she began asking me if her baby was going to die. I talked her through what they were doing, never answering the question. I didn’t know. No one knew. The whole place was still loud with voices and someone dropped an instrument tray making a loud crash.
They intubated baby and began looking for heart tones. 11 minutes went by before anyone said anything positive, “I hear heart tones.” At 14 minutes “She’s trying to cry", I heard a nurse yell. Erica was on and off sobbing and watching someone breathe for her baby.
A team from the larger hospital this birth center is associated with, entered the room and began to take over. Ryan went over to the warmer to see his baby. They were telling him that the baby was breathing and to watch her chest but I knew baby was bagged and someone was breathing for her.
He came back and stood next to me. Erica was in between sobs and questions and kept connecting with my eyes in such pain and panic. I hated I had no way to answer her questions.
25 minutes later teams of people walked out with the baby to take her to the NICU.
After 30 minutes the placenta was still inside and the obgyn was trying to do what he could to encourage it. At the one hour mark, no update on baby, the obgyn asked Erica if he could give her a narcotic.
I explained to Erica that he needed to manually remove placenta and asked for them to bring her nitrous too. The obgyn mouthed "thank you" to me and grabbed my arm. All of this was hard for him too. I not only didn’t want her to feel it, but I wanted to give her some place to focus, moving the nitrous mask on and off her face would add a possible distraction, and to be honest make her feel relaxed through getting her high to stop the anxiety.
It took 124 minutes from Baby to completed repair of her tears.
The obgyn explained he would have to do a rectal exam and Erica said, “might as well” and then she asked if he wanted another go round after.
Her peaceful and respectful labor turned into a dark and traumatic experience. Finally doctors were coming in and out and giving us updates on their baby and eventually offered Ryan the chance to go to the NICU. The baby would be transfered to the York St campus of Yale, where they could better serve what she needed, with a bigger staff. Ryan would be going with her.
The room settled and it was just Erica and I. We cried for a bit and then I helped her clean up a little. I had been sent a picture from a doctor in the NICU. I asked Erica if she wanted to see her baby, and she closed her eyes, "No. I don't want to see her in a picture for the first time. I want to touch her when I see her." It broke my heart and again tears began to flow.
There was a knock at the door, and too our surprise, they had brought Erica her baby to see before they transferred her. Erica reached her hand inside of a small hole and she touched her baby. She talked about her face and who her features reminded her of. She was so thankful for that opportunity.
A doctor explained that while the baby was still intubated, the tube was attached to nothing, and their little girl was breathing all on her own. She was a fighter, just like her mama. She was trying to pull the tube out herself. They said things looked really great and that the oxygen levels from her cord blood at birth were in normal range, which meant that she had enough oxygen to support her still, even during the time of the shoulder dystocia.
They would be transfering Erica over to the other campus as well to be with her baby in just a few short hours.
I helped to pack up Erica and Ryan's things, change her clothes, and we chatted a little bit about the birth. She then decided to rest and take some space for herself.
We kept in contact daily. I couldn't stop thinking about them and all that they had gone through in the first few hours of their baby being earth side.
On Thursday at 6:22pm, the best thing possible came through my text messages. It was a picture of little Miss Edith in a carseat, heading home with Erica and Ryan. I got immediate goose bumps as I saw that chubby little face and was so very relieved for them.
This story could have ended very differently. If Erica hadn't been in such good control, resting and breathing through each contraction, or if she had decided on an epidural, she may not have been able to move her baby out with such powerful force. I believe, that the ability to save and store her energy, saved the life of her baby.
The connection that is established between a baby and it's mother is something that none of us will ever fully understand. These moments though, make me feel a little bit more connected to this entire process and has made me a believer in the universe always being at play.
Erica, Ryan, and Edith it was a tremendous day, the day I watched you three become a family. I can't wait to watch you continue to grow together.