I’m excited to share the details of the recent birth of baby #7, Boe! My husband, Seth, and I have shared 6 natural hospital births together, yet this was our first time truly experiencing a natural birth with doula. For baby #5, we hired a doula exclusively to film and photograph the birth. With baby #6, we again hired the same doula, but didn’t call her until we were on the way to the hospital. We ended up giving birth just 30 minutes later, so unfortunately, she wasn’t an integral part of the labor experience. This time around, we knew we wanted to have the “full” doula experience from start to finish. Read on to learn all about our natural birth with a doula!
Estimated reading time: 23 minutes
Baby’s due date was on a Tuesday. Exactly one week earlier, on a Tuesday night, I woke with contractions that felt both strong and regular. We put Sabrina (our doula) on alert and readied the hospital bags, just in case. I also painted my toe nails because, well, that’s important LOL! I went to bed and then woke up the next morning — the contractions had gone away! On Wednesday night, I again awoke with strong contractions that felt regular. Seth eventually started timing them and found that they were 7 minutes apart for at least an hour. I closed my eyes to get some rest and again, awoke the next morning with no more contractions. Thursday night – no contractions. Friday, Saturday, Sunday – contractions on and off throughout the night. I was pretty worn out from so many nights of poor sleep, but excited for baby to come.
On Monday, the day before the due date, I headed to the OB for an ultrasound and routine visit. There was no availability at my regular office. So, I was scheduled to see a new doctor at a different practice. Given my “advanced maternal age” of 39, this was to be the final in a series of several ultrasounds I’d had with this pregnancy. During the ultrasound, I noticed that tech typed “gestational age of 36 weeks 5 days,” and I asked her about it. She said that baby’s femur and abdominal cavity were measuring smaller than anticipated. And, he was measuring only about 6lbs 15oz.
Afterwards I met with the doctor and she explained that his measurements were consistent with a small baby. While the baby’s organ systems looked great, they didn’t see as many breathing attempts as they wanted in a 20-minute window. And she was concerned that there was a lack of interval growth from my last ultrasound to this one. This means that he hadn’t grown as much as they expected he should in between ultrasound scans.
The doctor concluded that she’d really like me to induce, that day preferably. At the latest, she wanted to see the baby born within 24 to 48 hours. I was very surprised — I wasn’t even kind of expecting this news. Throughout all my visits and ultrasounds, I had only ever been told that the baby looked perfectly healthy. I asked if the inconsistency in the growth could be due to different ultrasound techs. She agreed that it was possible. I tried to gather more information about why she felt an induction was indicated that very day. Was this a potential problem, urgent, or truly emergent?
She asked that I head to the hospital for additional testing, namely a non-stress test, to ensure that the baby was tolerating the pregnancy well. I told her that I would prefer not to induce if at all possible and asked her to check my cervix and sweep my membranes. That’s often helped put me into labor. I was about 3cm dilated, 80% effaced, so she performed the sweep.
I called Seth as soon as I left and explained what was going on. In my heart, I didn’t feel worried or anxious about the baby’s health. So, I was determined not to stress myself out. Instead of rushing right to the hospital by myself, I decided to go home first. Seth and I gathered our bags and some food in case of an induction, and then headed over to the hospital together.
I had a chiropractic appointment previously scheduled for 10am at an office near the hospital. We realized that I’d still be able to make that appointment if we hurried. The chiropractor adjusted my pelvis and then placed some acupuncture needles in the “forbidden places” that can trigger labor, like the area between my thumb and pointer finger, my pinky toes, and my ankles. About 25 minutes later, Seth and I were on our way to the hospital.
We checked in to triage, and the nurse applied the monitors for the non-stress test. Fortunately, baby showed the required number of heart accelerations they were looking for even before she finished entering my information into the computer. This was very reassuring that the baby was likely healthy!
The hospitalist came in to talk with me and offered to strip my membranes again, in the attempt to speed things up and avoid a labor induction. I agreed, and she performed a much more aggressive membrane sweep which seemed to get things moving almost right away. I stayed on the monitor for about another hour. Eventually, we left for home, on the condition that we head in for an induction at 7am if I didn’t go into labor on my own. After using the bathroom, I noticed that the membrane sweep had loosened up the mucus plug and light bleeding came regularly thereafter.
Contractions were mild and irregular throughout the day, but never progressed. In the past, stripping my membranes has put me into active labor within about 6-8 hours. But by around 5pm, it was pretty clear to me that I would not be going into labor that evening. Sabrina (my doula) offered a cotton root bark tincture to intensify the contractions, suggesting that possibly my uterus was tired from the many nights of contracting. As a rule, I’m very hesitant to take any medications or herbal supplements during pregnancy. But after researching the tincture and feeling that it was safe under the circumstances, I agreed to try it. I took 3 droppers full, 1 every 45 minutes. In between, I walked at a fast pace and tried to encourage contractions. Still, not much was happening.
At this point, I reached out to the OB on call to discuss the need for an induction. As she wasn’t the doctor I saw in the morning, she could only suggest that I do what I felt best about. I knew that if 2 membrane sweeps didn’t put me into labor, baby likely wasn’t ready to come. I didn’t want to rush it. Besides, I was exhausted and emotionally worn out with the events of the day. So, I called the hospital at around 10pm and canceled the induction. It just didn’t feel like the right decision. The next morning, Tuesday, I went into the office to discuss the situation with my regular doctor.
The doctor stood by the idea that a labor induction was a good idea, and why not? I’ve had children before, and my cervix is ripe. The induction would very likely go well. But, she affirmed that baby looked healthy on the scans and non-stress test, so there wasn’t an emergency. She assured me that they would support whatever decision I made, while reminding me that baby looks healthy today, but they can’t guarantee that he will tomorrow. In my gut, I still felt best about waiting. We scheduled another non-stress test in the office on Thursday, and I headed home.
My uterus felt super irritable throughout the entire day on Tuesday, and I had been having bloody show since the second membrane strip the day before. Any time I would move quickly, I’d have a sharp contraction. With the pressure of a looming induction now off my back, I set about trying to rest and relax. I focused on hydrating myself well, hoping it would ease some of the irritation I was feeling. I felt peaceful with the decision to wait and let my body go into labor on its own and looked forward to resting up until my next scan on Thursday.
That night, I woke up at around midnight. I was still half awake and half asleep and had been having dreams about having contractions — it was a strange feeling. With time, I became fully awake and aware that the contractions were not just a dream and were coming regularly. I’d had almost a full week of night contractions, so while I wasn’t able to fall back asleep, I rested my body as much as I could. The contractions were strong enough that I was consciously relaxing my muscles and using slow-paced breathing with a focal point. After about an hour, I woke Seth to let him know, and also texted my doula, Sabrina, to give her a just-in-case heads up. At around 3 am, 2 hours later, Seth texted Sabrina again to come on over to the house.
Lying in bed during the contractions was starting to feel stale. So, I positioned myself upright with pillows in a chair in the bedroom and turned on my relaxation scripts. The contractions seemed to come less frequently while I was sitting, but I was focused on deeply relaxing and was less cognizant of them in general. I had determined to try a variety of positions during labor this time around in order to encourage labor progress. So, after listening to about 3 scripts, I moved to a hands-and-knees position, resting on a pile of pillows on the chair with my knees on the carpet. The contractions accelerated. I got up to use the bathroom and the contractions continued to get closer and stronger, both as I stood and as I sat on the toilet. Afterwards, I got back into the hands-and-knees position on the floor, leaning into the chair.
At some point, I became aware that Sabrina was in the room resting on the floor near my chair. She knows that I don’t like being observed during labor — this is one reason that I try not to go to the hospital too early — so she was very quiet and low-key, and I was able to re-enter my relaxation zone. I found out later that she was timing my contractions, using my cleansing breaths as her cue.
Time was a blur at that point, but eventually she suggested that I get back into a sitting position and try to get some rest as I continued to listen to scripts. We both felt that sitting caused my contractions to slow down, likely due to the position of the baby. It was early in the morning, and she knew that both Seth and I had gotten little rest that week. She stayed with me and encouraged Seth to try and get some more sleep. She also brought in some heat packs and placed them on my hip flexors. This felt amazing! She refreshed them every so often. This simple intervention really deepened my ability to fully relax.
Maybe 2 hours later, Sabrina brought in some food for me to eat. We discussed that soon I would get into upright positions to speed up labor, and she wanted me to take in some calories before things picked up in pace. I remember feeling a hungry nausea earlier in the morning, but had eventually forgotten about it as the contractions took more of my attention. She offered me a small variety – a cheese stick, apples, and peanuts. I ate the apples and cheese stick and continued to drink as she offered me my water bottle. Again, this was a simple intervention that was hugely helpful. As soon as I had eaten, I felt the baby moving more, the contractions got stronger, and I felt like I had more energy.
This period of rest combined with food and water was just the combination I needed to move into some upright positions. I moved into the shower and stood through the contractions as the warm water ran over my back and belly. I started using a 3:1 he-breathing pattern as the contractions grew in intensity, and rocked and swayed as I breathed. The contractions were strong and close together as I stood. After several contractions, I started to feel a bit faint standing in the hot water, and Seth helped me out of the shower and back into my clothes.
At this point, Seth and Sabrina asked if I felt like it was time to head over to the hospital. After a few more trips to the bathroom, accompanied by strong contractions and bloody show, I decided that we should leave. Seth brought me back to the bed where I continued to listen to scripts as he packed up the car. The little girls were awake now, so they talked with me as I lay on the bed. Meanwhile, Sabrina came in and applied a TENS unit to my lower back. I’ve never used a TENS unit in labor before, and I found that the gentle electrical stimulus really was a helpful distraction from the sensation of the contraction. (We didn’t turn it off until later in labor when I was pushing.) Eventually, we walked downstairs, said goodbye to the kids amidst strong contractions, and headed out to the car.
The car ride over to the hospital is usually very challenging for me, so we established a game plan in advance. Seth drove, Sabrina rode in the front seat, and I sat in the seat behind her. If I needed help focusing, her plan was to turn around and count down while I breathed. But as we had seen throughout the labor, as I sat upright in the seat, my contractions backed off! In the 20-minute drive, I only had one contraction! It was amazing! I was able to remain calm and relaxed, listening to my guided imagery scripts.
We arrived at the hospital at around 8:30am. Contractions picked back up as I stood to walk into the lobby and up to the labor & delivery unit. This required a lot of pausing, breathing, and swaying. I was brought to triage, where the hospitalist checked my cervix and announced that I was 9 cm dilated. Wooohooo!!! Such great news! They wheeled my bed back to the room where I would give birth and started an IV. My contractions continued to be far apart as I sat on the bed, so I was able to talk like normal and get to know my nurse a bit. This was a very different transition experience than I’d ever had before. This ability to “turn off” contractions by sitting was kind of magical!
Maybe 20 minutes later, Dr. Kuhn entered the room and the nurses prepped for the delivery, moving in the baby warmer and other supplies. I instantly asked her to break my water, and to please stay in the room after she did. I’ve learned from experience that after my water breaks, the birth is imminent, and I was eager to finish labor and meet my baby! She assured me that she would stay with me and proceeded to rupture the amniotic sac. After doing so, she announced that she ruptured the fore-bag and there was likely a hind-bag as well, but the baby’s head was in the way.
From here, I moved into a position to push and deliver the baby. After a mild cystocele with baby #6, I was determined to push as gently as possible and in a position that would put as little strain on my bladder as I could. Sabrina and Dr. Kuhn suggested that I try a half upright/half on my back position — semi-reclined. When the contraction came, Seth and Sabrina would help me hold my legs, and I was to put my chin down to my chest and to push with the urge.
This was a very different position than I was used to! I’d given birth in a hands-and-knees position with my last few babies, and this position, with my feet in stirrups and staring at the doctor as I waited for the contraction to come, felt a bit awkward and “on display.” Still, I was determined to protect my bladder, so I stuck with it!
In our prenatal visit, Sabrina offered to supply arnica oil to help with perineal stretching. I didn’t notice her bring it out, but she must have, because the doctor began applying the oil both internally and externally in preparation for pushing.
The only challenge was that contractions weren’t coming in this semi-sitting position! They only got strong and close when I was NOT sitting. Sabrina suggested that I allow the nurse to start just a “whiff” of Pitocin in my IV to encourage the contractions to start back up. After waiting for a few more minutes, Seth and I agreed. It didn’t take long for the Pitocin to take effect. I pushed through 2 contractions and the baby descended, and on the 3rd contraction, I felt the ring of fire.
Baby’s head was crowning even though the contraction ended, so I just kept pushing to get him out. I didn’t want to wait till the next contraction! His position changed rapidly as I pushed, and he flipped posterior for a moment. I could see the doctor working to adjust to his movements. The stretching sensation was so strong, I called out frantically, “Help me! Help me get him out! Help me!” And then just like that, the rest of the amniotic sac ruptured, his head emerged, then his shoulders, and finally the work of giving birth was done!
They placed the baby on my chest immediately, and I was instantly flooded with relief to be done with labor and excitement to be holding our little boy! Sabrina quickly grabbed the camera and started snapping pictures for us. Baby was 8/10 on the Apgar score, since it took a little while for his color to perk up after birth. After waiting a few minutes for it to finish pulsing, Seth cut the cord. The room was calm and quiet, and baby latched on and began breastfeeding. Eventually the placenta was born, and the IV Pitocin continued flowing for the next few hours. Fortunately, I didn’t have any perineal tears or bleeding to contend with, so the doctors and nurses left the room and Seth and I were able to enjoy some special time together with each other and the baby.
Boe was born at 9:32am just about 1 hour after we arrived at the hospital and 1 day after his due date, weighing 6lbs 12 oz and measuring 20 inches long!
Seth and I both agree that this birth was more calm and relaxed than any other because of the amazing support of our doula, Sabrina. I think it’s fair to say that Seth and I have been around the block a few times when it comes to natural childbirth! Yet it was so helpful to have an extra set of hands to help during labor, an unobtrusive advocate in our corner who knew the hospital nursing staff personally, and a fresh perspective on tips and tricks we could try to promote labor progress and ease labor pain. Here are some specific things our labor doula did that were a huge benefit:
Our doula met with Seth and I a few weeks before the baby’s due date to discuss our birth preferences during a prenatal visit. She helped us create our Birth Preference sheet, and in doing so, it encouraged us to consider ways we could have an even better birth than we’ve had before. For example, I often become a bit unhinged during the car ride to the hospital. Seth’s driving, I’m alone in the back seat trying to cope with contractions often amidst feeling the urge to push….it’s hard work. In this prenatal visit, we were able to establish a clear game-plan of how we’d make the drive as calm as possible. This was super helpful.
Sabrina came to the house while I was in active labor, listening to relaxation scripts. Both Seth and I were both pretty exhausted from a week of interrupted sleep. Knowing that she was in the room with me as I was listening to relaxation scripts enabled Seth to step away for a bit and rest up for the rest of the labor and birth.
In the midst of strong contractions, it’s hard to think clearly. Having a doula was like having a rational brain by our side — one who could suggest tips and interventions to improve my birth experience. She encouraged me to rest (sitting and listening to relaxation scripts) when she could see that I was tired. When she could see that labor was slowing down, she encouraged me to try upright, gravity-promoting positions. In the morning when she knew I would likely be hungry, she gave me food to eat. She brought heat packs, a TENS unit, and touch & massage for my lower back.
Doulas have to walk a fine line in the hospital setting as they help a couple advocate for their birth preferences. Our doula did this masterfully! She was never pushy, bossy, or loud. But when Seth was busy helping me or there were details that we forgot to share, our doula stepped up to the plate. For example, she was the one who told the doctor how important it was to me to push gently and do all I could to reduce strain on my pelvic floor. Working in conjunction with the nurse and doctor, she suggested a pushing position that could help protect my bladder. (I had a mild cystocele with baby #6 and wanted to avoid exacerbating it). And, she suggested a small dose of pitocin while I was pushing, and helped initiate a conversation about it between Seth, the doctor, and I.
As I described throughout the birth story, any time I sat in an upright position, my contractions backed off and grew very far apart. While I’m not 100% sure, this was very likely due to the position of the baby in my pelvis. Before labor began, I could feel that he was side-lying in the womb, facing my left side. This less-than-ideal position is known as Right Occiput Anterior (ROA), and can make it more likely that a baby turns into a posterior position during birth. Baby’s position in the pelvis could also explain why I had that week of contractions throughout the night that sputtered out and never led to true labor.
In childbirth classes, we talk a lot about how to develop a relationship of trust with your provider and how to effectively advocate for your birth preferences. I was reminded about how difficult this can really be when baby’s health is in question. In my case, there were some potential indications from the ultrasound that baby may not be tolerating the end of the pregnancy well. Yet, there were also many reassuring indications that baby was perfectly healthy. They suggested an immediate labor induction.
So, what do you do? Do you always err on the side of caution? Is it selfish or reckless to do otherwise? Of course the answer is no, but advocacy really is hard to put into practice when a baby’s safety is involved.
My personal reasons for wanting to avoid a labor induction were twofold. First, having experienced a labor induction with baby #2, I knew that an induction meant that my entire labor would occur in the hospital. I would be observed, monitored, and limited in when and how I could move. If it has to happen, I would deal with it. But it wasn’t my first choice given my plan for a natural childbirth. Also, I know that labor inductions can pose some risk to the baby. If he was, in fact, healthy but just on the smaller side, I didn’t want to rush his birth.
In canceling the induction, I wrestled with feelings of guilt and some anxiety that maybe I wasn’t making the best choice for the baby. I certainly didn’t want to jeopardize his health and safety. And how could I forgive myself if something happened to him because of my decision? Still, in my “gut” I felt that he was healthy. In the end, I counseled with my doctor and chose to have another non-stress test and delay induction. I feel grateful that I went into labor that night and didn’t have to wrestle with the decision for very long.
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I’m excited to share the details of the recent birth of baby #7, Boe! My husband, Seth, and I have shared 6 natural hospital births together, yet this was our
