Thursday, March 11, 2010

The Birth Story of Sarah Rose

As told by my dear friend and doula, Amara Minnis

I knew your mom before she was pregnant with you because we attended the same MOPS group and we had babies born about six weeks apart the previous year. So several months later, when I learned she was pregnant again I could hardly believe it. We talked off and on as her pregnancy progressed. And she expressed her desire for a natural birth this time around and her interest in having a doula to support her. After talking about her options and her hopes for your birth, we agreed that I would be her doula. In the meantime I gave her some DVDs to watch and a birth ball to borrow to help her prepare for your arrival and get you in the optimal position for birth.
As your due date drew closer, your mom had weekly appointments with her ob-gyn. Her cervix was making small changes in preparation for your birth, thinning out and opening gradually. I saw her on Wednesday, January 27 at our MOPS meeting. It also happened to be your big brother, David's, first birthday. She had a doctor's appointment the previous day and had her membranes stripped in the hopes that labor would begin within 24 hours. Your mom was optimistic since having her membranes stripped had been successful in bringing on labor in the past. She had some cramping and contractions but unfortunately she woke up still pregnant. So it was off to the MOPS meeting that next morning. I think it was ultimately a good thing though because your mom was able to come all by herself without a single child, which was very rare. So it was a truly restful and relaxed time with adults, a sort of last hurrah before becoming a mommy of three.
Your mom had another appointment with her doctor on Friday and had her membranes stripped again. She also scheduled to have labor induced the next Monday, February 1, if you didn't come before then. But she was hoping to avoid an induction so she was determined to get labor going on her own with natural methods beforehand. Luckily, within a short time your mom was feeling contractions. She called around 12:30 to let me know just in case the contractions developed into real labor. They were about 6 minutes apart and moved to 5 minutes, lasting about 40 seconds. An hour later she called again to tell me her contractions were 5 minutes apart and lasting a minute. I was encouraged for her and hoped she was in real labor.
She went to her in-laws house to spend the afternoon and later confessed to me that her contractions spaced apart with all of the people "watching her pot." I had commented to her that sometimes a watched uterus doesn't labor so well and gets performance anxiety. And that seems to have been true for your mom in this case.
After your parents returned home the contractions were 6-7 minutes apart. But thankfully, after your mom got settled, her labor picked up again and the contractions moved back to 5 minutes apart. I called your mom around 4:30 to check on her and things were going well and getting stronger but she didn't think I needed to come yet. I suggested she sit on the birth ball but she said it needed air and they did not have a pump. I had already packed the car in anticipation of joining your mom in labor so I told her I could bring the birth ball that I had in the back of my car. I was just up the road so it wouldn't be any trouble. Your mom liked that idea and so I was there in about 10 minutes with the ball. I greeted your parents, gave your mom some suggestions and hugged her and told her I was there when she needed me.
Well, my phone rang just over an hour later and it was your mom. She told me I could come any time as her contractions were definitely getting stronger. I had just gone to the grocery store but assured her I would be over once I unloaded the groceries.
I called on my way around 6:30 and was there a few minutes later. Your mom was sitting on the birth ball right in front of the television, watching Wretched TV with Todd Friel. It was a show your dad liked to watch and not one your mom preferred so it was particularly funny that your mom was so insistent on watching it. Your parents had just called the Group for Women, which is the ob-gyn practice where your mom's doctor, Dr. Noffsinger practiced, to tell them labor had begun.

Your mom was doing a wonderful job with her contractions. As one would come, she took deep breaths and closed her eyes. She tried to stay as relaxed as possible, leaving her body loose all the way down to her fingers. She took sips of water to keep herself hydrated and took trips to the bathroom to help make room for you to move down. We talked a bit at first, which I think spread her contractions apart. But by 8:55 that night they were closer again, less than 5 minutes apart and lasting more than a minute.
Your mom's mom called to see how things were going. She was concerned about your mom remaining at home as she labored for fear she would not be able to get the pain medication when or if she wanted it. But it was your mom's hope to labor and birth you without any pain medications so her plan of staying home longer was a very good one. She knew she had to trust her instincts about when to leave for the hospital and she felt that her contractions were still very manageable at home.

Your mom didn't talk long since her labor pains were increasing in intensity and she really needed to focus to get through them as relaxed as possible. I suggested she change position in an effort to bring her contractions even closer together. So she stood up and tried to labor leaning over the TV tray. I watched her as she had a contraction and she stood up on her tiptoes as the contraction came to a peak. I realized that by watching her feet I could see what her uterus was doing. She labored standing up for a few minutes but told me she really preferred the feeling of sitting on the birth ball. So she returned to it.
She had eaten a bit to keep her energy up: some yogurt and a chocolate chip cookie. Your dad made some peanut butter sandwiches to bring to the hospital in case he got hungry or your mom needed something to eat after your birth and the cafeteria wasn't open. From the way labor was going it appeared you would definitely be born sometime before the sun came up.
Your mom told me she was concerned about the snowstorm that was predicted for overnight. She wanted to be sure she left for the hospital before the snow began to fall. We checked the weather to be sure but there was no snow expected until about 4:00 or so in the morning. Nonetheless, your mom was thinking she'd like to leave for the hospital by 10:00pm. So by 9:50 we were out the door.
I followed your parents to the hospital and rejoined your mom as she was walking to the emergency room entrance of the hospital. Shortly after we entered the ER your dad caught up with us, carrying so much stuff he looked like a pack mule. I took the birth ball out of his hand so he would look a little less laden with stuff. But he was obviously happy to help your mom in any way he could.
Your mom was admitted and brought to her room, #4. She would labor, deliver, recover and spend some postpartum time in that same room. So your parents made themselves comfortable since they would remain in that room until discharge. Your mom's nurse, Melissa, hooked her up to the electronic fetal monitor as well as a contraction monitor. It was standard hospital protocol to assess your mom upon admission but it wasn’t pleasant. The belts weren't very comfortable and neither was lying in the bed through contractions. But your mom did a wonderful job of breathing deeply through her contractions and patiently answered the questions that were being asked of her about her health history.
Unfortunately, it also happened to be shift change. So your mom was stuck on the monitor a bit longer than she liked while the nurses were giving report. Finally her new nurse, Tina arrived around 11:15 to introduce herself. She explained to your mom that she needed to stay on the monitor for awhile so they could check your heart rate for a significant amount of time, just to be sure you were still safe and happy on the inside. When Tina asked your mom if there was anything she could do, your mom asked her if she could take away the pain. With hardly a pause, Tina told your mom that she didn't want to take away from her birth experience. I was happy to hear her say that although she was kind of giving your mom a hard time.
At 11:36 your mom's cervix was checked and it was dilated 6-7 centimeters. Your mom was pleasantly surprised. The nurse still had to put in a heploc for your mom since she preferred not to be hooked up to the IV pole to get fluids. She had been drinking water and would continue to eat ice chips to remain hydrated so as to avoid the IV. It was also your mom's plan to stay as mobile as possible and pulling an IV pole behind her wouldn't be in line with her plan.
Shortly after that, your mom's nurse came into her room to put a "fall risk" bracelet on her wrist. Since your mom had taken a spill on the stairs earlier in her pregnancy, they had to put a note in her record and give her a bright pink bracelet to wear as well as post a sign on her door. Your mom has a great sense of humor and without skipping a beat said, "Aren't all pregnant women fall risks?" And no one could argue with her.

It was exciting to know that your mom's labor was progressing and she wanted to update friends and family through Facebook. Unfortunately, the hospital had put a block on that site so everyone was left hanging on her last update, "To the hospital!!!!" I promised your mom when all was said and done that I would give the details of your birth as soon as I got home. A nurse came in just after midnight to draw some of your mom's blood and shortly afterward, Dr. Harris-Proctor came in to greet your mom. She was staying overnight in the hospital, probably because she expected your mom to give birth overnight but also because the weather forecast was for a record snowfall of 6-12". There were several nurses spending the night just to be safe. They were concerned about making the drive home in the weather. But there was no snow falling yet so the big storm was yet to be seen. I was a bit skeptical and would believe the snow when I saw it.
Your grandparents called to say that David wasn't sleeping well so they were thinking about brining him and Eve back to their own house to sleep in their own beds. That way they would hopefully rest easier. Luckily, David was able to fall asleep peacefully. But your mom was having her own trouble resting. She had been laboring for many hours and it was getting very late. So wanted to lay down in bed and I encouraged her to do so if she could get some rest in between contractions. In time, her contractions spread apart but that was okay as long as it was temporary. It was also about time for your mom to be monitored for 20 minutes (that was required at every hour) so the timing was convenient for staying in bed. She lay on her side and I suggested she put a pillow between her knees. She seemed to like that.
Dr. Harris-Proctor came in to check your mom's cervix again around 12:20, almost an hour after the previous exam. She was still 6-7 cm, which was the same as before. I reassured your mom that it wasn't necessarily a problem. It could just mean that her body was in between and may dilate significantly in the next contraction or two. There is no exact timeline for labor and a lot of progress can be made in a very short amount of time. I encouraged your mom to get out of bed to see if things might pick back up again. So she sat on the ball beside the bed and leaned over, resting her head on a pillow on the rolling table. I rubbed her back some to help her relax in between the contractions. She did that for awhile and then moved back to the bed, with trips to the bathroom here and there.
Your dad and I were sitting beside the bed, supporting your mom and she worked through her contractions, trying hard to stay as relaxed as possible through them. I reminded her to relax her jaw and her hands as the contraction peaked and to blow them away with deep breaths. It helped your mom to think of the contraction getting through the peak, instead of the whole contraction. Once the contraction got to its most painful part it gradually sloped back down until it went away completely. Your mom's contractions would take a long time to trail off but at least the discomfort was lessened for her and she was able to relax enough to allow them to pass. They would also come in pairs at times, with a longer contraction followed by a shorter one.
Your mom told us she was feeling a lot of pressure in her rectum so we told Tina. At 3:20, Dr. Harris Proctor came in to check your mom's cervix and found her to be dilated 7cm, as before. She did mention that there was some fluid as well as a bulging bag through your mom's cervix. That means the amniotic sac had created a bag in front of your head, preventing your head from applying pressure directly to her cervix. This can make labor take longer since the head is not making direct contact with the cervix. The doctor suggested that your mom have her water broken. She wasn't sure about this so she thought about if for awhile. The doctor left the room and was available if your mom decided she'd like to have her membranes ruptured.
Your mom talked with me about it and we discussed the benefits and the risks and how it might impact her labor. The main result would be that her labor would be shortened but would also be more intense. Your mom was getting tired but she really wanted to meet you. I told her the pain of the contractions was the worst at 7cm but after breaking her waters it might intensify some due to the added pressure from your head on her cervix. She was already experiencing a good deal of discomfort with her contractions and told me she got the epidural when she was dilated 7cm in labor with your brother, David. She said she remembered why she got the epidural because she was experiencing the pain all over again this time around at 7cm. I told her she could do it and was so close to being done. She ultimately decided to have her water broken so Tina let Dr. Harris-Proctor know.
The doctor returned minutes later and your mom's water was broken around 3:35 in the morning. She also did a cervical exam and told your mom that she had dilated to 9cm. Sometimes, just by breaking the bag of waters, the baby's head moving down onto the cervix can dilate it immediately. Your mom's cervix was probably sitting soft and stretchy and ready to dilate but only needed a little more pressure from your head. It's wonderful how you and your mom worked together for you to be born and that's just one example of that.
Your mom's contractions really picked up after that. They sensations were very intense for your mom and she was required to concentrate much harder than before. They took her by surprise and she was beginning to doubt herself. She told me she didn't think she could do it but I assured her she could. She was feeling a lot of pressure and I told her you were getting into position and things were probably moving quickly. It felt like no time at all had passed and your mom said she felt a lot of pressure like the baby was coming. She was lying in the bed and rolled over to her side, gripping the side of the bed. Then when her contraction began to build I heard her make a grunting sound as if she was bearing down. It was startling and meant she was probably fully dilated. I cautioned her not to push until we could be sure it was time. Instead I told her to blow with the pushing sensation so the contraction could pass.
We called Tina to let her know your mom was feeling like pushing and she came in quickly and checked your mom's cervix and discovered she was fully dilated. It was 3:50, just 15 minutes after your mom's water had been broken! It also meant your mom could push you out but the doctor wasn't yet in the room and they had to get the bed broken down. Thank goodness, Dr. Harris-Proctor came in right away and they got busy getting the bed ready for delivery. I stayed close to your mom's face, encouraging her to blow with the urge to bear down and to grunt just a little if it would take the edge off. Your dad looked down and saw that your mom's perineum was bulging with your head trying to push it's way out. His eyes got big and he smiled and said he thought you were coming.
Then your mom had another contraction and she said that you were coming. She could feel you moving and the intense pressure that comes before crowning. She gave out a mighty sound that let us know it was definitely time to push. Thankfully, that's about when your mom's feet were situated and we had someone on either side of her to help support her legs as she pushed. She took a deep breath and held it and pushed, and your head was already starting to crown. As she took another breath your head came right out and the doctor tried to remind your mom to push slowly but it all happened just too quickly. Your head was out and your mom pushed again and your hand came out and then the rest of your body.

You were born at 3:52 am in one contraction.
You were placed immediately on your mommy's tummy and she wrapped her arms around you and held you close. Your dad came right to your mom's side and was grinning from ear to ear. He was obviously so proud! They brought you over to the warmer to get checked over. You were doing well and your dad was right by your side taking pictures and offering his finger for you to hold. He noticed you had a skin tag on your chest just like your big brother, David. And you had a little bit of strawberry blond hair. Your Apgar Scores were 9 and 9 and you got pink very quickly.
Your mom had her eyes on you and was so happy to have you out. The doctor predicted you would be born on a wave of amniotic fluid and that's pretty much what happened. Your mom admitted that it was more painful than she thought it would be but I was so proud of her. And I think your dad was too. Even her doctor was impressed. Your mom had such a wonderful sense of calm during your birth, and showed great trust in her body.
You weighed 7 lbs. 3 oz. and were 20 1/2 inches long. You coughed up some fluid as the nurse checked you out. She sat you up and patted your back to help you clear the fluid but it was to be expected considering how quickly you had been born. It can be hard to clear out all of the fluid through the birth canal if you don't spend much time there getting squeezed. The baby nurse explained to your mom that your respirations were a bit high so she suggested you be put skin to skin with your mom inside her hospital gown for kangaroo care. You liked being close to your mommy because you didn't fuss one bit. It was 4:25 when you were snuggled with your mom like this.
You were sucking a lot and while your mom held you she gave you her finger and then a pacifier to help.

She used a pacifier clip that her friend, Sarah, had made for you. It was so pretty it looked like jewelry. The nurse told your mom to wait until your respirations slowed down before she breastfed you. We could tell that your breathing was slowing down just by watching and listening so we were optimistic it wouldn't be very long.
Your dad said a blessing over you before it was time to feed again. It was such a sweet prayer and I was so pleased to see your parents taking a moment to thank God for the precious gift they have in you. Shortly after that your mom put you to her left breast and you latched on almost immediately. You were hungry!
I wanted to give your parents time to get to know you so I packed my things and headed home. The drive home was so beautiful. The snowstorm that had been predicted has begun. It probably began very close to when you were born. The streets were covered with a blanket of several inches of snow and there were very few cars on the road. It was so quiet and peaceful and offered a lovely time to reflect over the miracle of your birth and the strength and love your mom had shown through it all. Your mom, being such a nurturing woman, wanted me to send a text to her phone when I arrived home safely because we had seen the snow had begun to fall shortly after your birth and she was concerned about me. I thought that was so sweet of her and such a motherly thing to do. But I'm embarrassed to admit that I forgot to send that text and she later told me she was worried about me. I just fell into bed when I got home and completely forgot. But needless to say, it was such a privilege for me to attend your birth. Your mom is a very strong and determined woman and your dad is a very faithful and kind man. You are a very lucky girl with two parents and a sister and a brother who love you so much! I wish God's blessings to you in your life, Sarah Rose!

Love from your Doula,

Amara Minnis, CD(DONA), PCD(DONA)

Sarah Rose is now almost 6 weeks old and is doing great. She is precious and such a good little baby. She has already slept over 8 hour stretches at night for mommy and daddy! We are so blessed!

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