Oh how plans can change
Joy and Chris DeClerk’s Birth of Fisher Griffin 2/11/08
Joy and Chris, firm in their commitment to each other and resolved to start a family together, gathered their resources and chose to aim for an unmedicated delivery of their first child. Chris’ family had a long tradition of C-section deliveries, and Joy’s heritage delivered babies speedily and often in the home. As they prepared and visualized their experience they focused on the positive and swift experiences of Joy’s kin, they educated themselves in childbirth classes and hired Holly, a doula and former college classmate of Joy’s to aid them in their journey. This is the story of Fisher Griffin DeClerk’s birthday.
Joy had a delightfully uneventful pregnancy. She fueled her body with what it needed and gave it the attention it deserved. Other than the expected aches and pains she had a not-so-short bout with a stomach virus that had her cautiously staying close to home. As her belly grew so did their anticipation and excitement about how their birth would unfold. In late January, an ultrasound revealed that Fisher had moved into a breech position. Frustrated with the ‘turn’ of events, Joy and Chris incorporated swimming and frequent pelvic tilts into their days to encourage their son to move around. Addressing the possibility that he might not, but refusing to dwell on the issue and wallow in the stress of what that would mean, they did what they do best; they remained calm, focused, and relaxed.
On February 10th, checking in with their doula, Holly, Joy reported some contractions the day before, that she thought Fisher had moved to head down and that she may have lost her mucous plug- all quite encouraging signs. Reminding Joy to call her when anything was different, even if it was 3 in the morning; their doula encouraged her to continue resting and conserving her energy- labor was probably not too far in her future even though the doctor estimated her to be only at 36 weeks. The power of suggestion proved to be strong; Joy called Holly at 3:08 that next morning thinking that her water had broken while up for a bathroom break. The doula suggested that Joy try to continue to rest as she was not having any contractions yet and to call her back if she felt any more fluid and Holly would come to check things out.
A short 45 minutes later, Joy had had 7 contractions in that time and the fluid continued to drain, Holly was on her way and arrived at 4:10 to assess things. Joy had just had a shower and was trying to eat a few grapes for energy, but her contractions had increased greatly in frequency and intensity. Joy was handling the surges with expert calm and focus as she leaned over the kitchen’s island and rested her arms on the back of the couch. Eager to assess things and suspecting that they were moving as fast as the laboring women in Joy’s history, Holly ushered Joy to the couch. From feeling on her belly, it seemed that Fisher was still head up. Joy’s 6 cm cervix would have been a great sign, but in the opening there were two butt cheeks, not a hard low head.
Understandably disappointed and trying to allow for the time needed to absorb the implications of these events, Joy and Chris quickly packed their bag and printed their birth plan as Holly tried to prepare them for the large transition ahead. She walked them through what would happen once they got to the hospital, how it would be a great deal different than what they had been visualizing, and how things would be moving very fast. Characteristically calm, but clearly comprehending the intensity of the situation, Joy and Chris followed Holly to Baptist Hospital a short ride away. Joy processed what was happening well as she calmly walked through the sky-bridge into Labor and Delivery. The team was ushered into the C-Section suite and the predicted whirl-wind of activity commenced. As nurses questioned, consented, started and IV, drew blood and outlined the plan, Joy continued to contract even more strongly. Her body had not changed its plan and was prepared to deliver its hatchling in the usual way. Joy in the midst of it all was trying hard to focus and remain peaceful, but despite all her focused efforts allowed herself a much needed moment of grief at the loss of the birth scene she had envisioned. Healthy and normal, she engaged in this disappointment and moved to a place of somewhat anxious resolve- she recentered herself in the reality of her situation and moved on.
Joy was feeling increasing pressure, and Holly suggested that someone check her cervix- at 5:10 she had made it to 9.5 cm and Fisher was very low. Nikki the nurse confirmed that he was indeed a boy, she could feel his outdoor plumbing quite well. Feeling the urgency of the situation and hoping that Joy would not have to be put to sleep for her delivery, Holly asked Mike the nurse anesthetist if he would try to place an epidural as Joy lay down, to help decrease the intensity of her sensations, he said he would try. Just then Dr. Singleton appeared- he was on call for Dr. Garner and after a quick and sincere ‘I Love You’ from Chris, the nurses whisked Joy to the nearby OR.
The commotion had ended, there was an unusual silence, Chris was without his wife. It was strange, it was abrupt, it was unsettling. In these moments of dis-ease Chris did his mourning. He was concerned, scared, unsure, shocked. Holly tried to give him the peace he needed and the reassurance he wanted, letting him nervously pace the hall and alternately going over what was happening on the other side of the doors where his wife seemed so far away.
It felt like an eternity, but it was only 10 minutes when the doors opened and Jo the nurse escorted Chris and Holly to Joy’s side. She lay on the table, draped in blue as Chris sat beside her, relieved to once again lay eyes on her. Dr Singleton began the surgery, Joy’s epidural working perfectly she waited patiently, holding her husband’s eager hand as they waited to hear the voice of their son. Out he came- cheeks first, head to follow a short time later. Fisher Griffin arrived at 5:33 the beautiful cold morning of February 11th, 2008. He hollered out to announce his presence with vigor, Joy and Chris cried- the brief roller coaster ride had come to its end and their reward was brought from across the room in Daddy’s arms. The new parents gazed with adoration into the face of their perfect little man.
Joy and Chris, bonded so tightly in spirit, respect, and commitment created a child of their love. They planned and educated themselves in preparation for a calm and safe arrival of their son. They focused only on those things over which they had control and turned the rest over to the cosmos. The peace that they embody served them well through their rapidly moving and unexpected delivery. They continue to this day in the spirit of this well educated tranquility in their lives as parents.
I am honored to have been invited to share in the birth of precious little Fisher. – Holly Best Parker
QUICK DASH TO THE FINISH – VBAC
Written By: Doula Student Brittany Umholtz
After 42 weeks and 1 day, Tara was finally in labor. She had planned a VBAC after her first birth started with an induction at 42 weeks and ended with a c-section. Now, with this pregnancy every non-stress test had perfect results. So she felt good about putting off an induction on Monday. But, by Wednesday, labor had yet to kick in, despite various self-induction methods. So after putting it off for days, she finally went to the hospital for an induction that she had wanted to avoid. This was a little before 6:00 pm. Due to a heavy client load at the hospital, her doctor wasn’t able to place the catheter immediately that would help dilate her cervix. And I was just waiting for a call from Amy (Tara’s certified doula) to call with an update. But we knew she was have some mild contractions even before she went to the hospital.
A little before 8:00 pm. I called Amy and she said to call back a little later because she had not talked to Tara yet. But about 45 minutes later she called back and said that Tara’s water just broke on its own and everything looked great but we still didn’t know about her dilation. Amy hopped in her car and quickly got to the hospital just after 9:00 pm. She called and said I should come too, and I was ready and quickly raced to the hospital.
I walked rather quickly from the parking deck to the elevators, then tried to calm my energy, mentally focusing on the calming mood Cora showed me how to ease into at the last birth I got invited to. By the time I picked up the phone to the nurses’ station, I felt very centered and mellow. I tapped on the door to Tara’s room and slipped into the quiet room. It was 10:08 pm.
Tara was pushing on her hands and knees, but she soon got on her left side. Toby quickly showed me what to do with the camera. Holly was our nurse, so it was great having a friendly face on the medical team. I had never met their doctor before, but he was there and very quiet and respectful. Pushing was very effective for her in this side-lying position, but baby Violet’s heart rate was staying in the 80’s and 90’s so the doctor said the baby needed to be out in the next push or he needed to do an episiotomy. He did make a little clip (which became a 2nd degree tear).
I have never seen a baby born so fast! In literally a blink of an eye the birth went from crowing to entire baby in the doctor’s hands. Violet’s cord was wrapped around her left shoulder, which was easily slipped off as she was handed to Tara. Violet was absolutely perfect. Her Apgar scores were 9 and 10. In all the excitement over not only a fast birth, but also the success of a VBAC, I forgot to check the clock. But the nurse got it. After 42 weeks and 1 day, Violet had arrived at 10:19 pm. Her total labor was only about 5 hours long. She was also a perfectly sized baby at 8 pounds, 3 oz, and 20 inches long.
I snapped as many pictures as possible of everything I could, including Violet with her first foot prints. My favorite pictures though, are the ones of Tara right after she had Violet; that tearfully joyous look all women have. That look and sense of accomplishment have become my favorite part of birth. It’s as if, for one small moment in each mother’s life, God sends all the joy and love He has to that mother’s heart and her tears and smiles are the only way to show it to the world.
After such a long pregnancy, Tara made a quick dash to the finish. Actually, after doing about 90 mph to get there in time, it seems I did too!
FOLEY INDUCTION THAT WORKED LIKE A CHARM
By Holly Best Parker, RN, Certified Doula
Melani had great support from her husband; she had a great pregnancy and had encouraged her doctor to allow her to go past 41 weeks gestation. After beautiful reactive NST’s (non-stress tests), she went to labor and delivery the night of March 28th at 41 weeks and 4 days of pregnancy for induction via placement of a Foley catheter for cervical ripening. She was given a sleeping pill to take at home and allowed to leave. We all arrived at 7:00 a.m. the next morning for a day (hopefully) of walking and pumping before we tried any pitocin. Melani did not want pitocin if possible to avoid it. Amber, her nurse, got her settled in the room and then the doctor came in to check her cervix at 8:40 a.m. We were amazed, she was already 5 cm dilated and 100% effaced. But the head was still very high, and no contractions that she was aware of. It was hard to believe. For the next 3 hours we left the hospital and went shopping and walking, then squatting and lunges in the back hall of the hospital. And then pumping and more walking. At 11:40 a.m. Amber checked Melani again and she was 6 cm (and baby still high). After this check, Matt went to eat and Melani laid down for a nap and to listen to her guided visualization CD – very relaxing. By 1:30 p.m. we were up walking and pumping again, contractions stronger, but not yet in full swing. By 3:20 she still had not changed her cervix but she got a renewed focus on speaking to her body.
At 5:45p.m. her doctor came in to check again. He wanted to break the bag of waters so that she might progress faster and might not have to get pitocin, but baby was still very high up and he thought he might have felt a cord in front of the head, so he wisely decided against breaking the bag of water at this time. Melani had dreaded the thought of pitocin, but the time had come – she had walked and pumped for 9 hours, this was a good time for the intervention. She laid on her right side because I thought the baby was posterior and this might be the reason for the lack of dilation. By 6:15 p.m. the next nurse, Courtney, took over for Amber and Melani began to breathe heavily and become more vocal. She asked her mother and mother-in-law to go back to the waiting room so she could find her groove. By 8 p.m. she was up on to the birthing ball to try to find another position. Courtney checked her and found that the baby had moved down some. Cervix was the same (6 cm). I encouraged Melani that this was actually a big change and that the pitocin was doing its job. Just after being checked Melani complained of pain in her butt – wonderful!!!! She was feeling the strength of the pitocin and was complaining that she needed to be off the pitocin, it was too strong, she was ready to throw in the towel and get an epidural. I reminded her that Courtney could check her again and if she had changed, we could stop the pitocin and she could then get into the tub.
A mere one hour after her last check, the cervix changed to 9 cm!! We were able to get off the pitocin and into the warm tub. She made it clear that she would not be re-emerging from the tub until after she had given birth; this was the place to be!! Her mom came back in to help fan with washcloths and offer juice and ice. After an hour in the tub the doctor was back to check for himself. I encouraged Melani to think about whether or not she wanted him to break her water now as he would likely leave it up to her wishes. She moved back to the bed, slowly and gingerly, and the doctor discovered that the baby was still lower in the pelvis. So Melani gave the decision to the doctor about whether or not to break the bag of waters, and he did – clear fluid. She moved back to the tub, though she thought she would be unable to do so – she was in the zone – glazed and in transition fully. The waters again calmed her, but she was squirmier this time. I encouraged her to move to her hands and knees as I could still tell the baby needed to move more to the front. Melani floated easily to this position and Matt was again able to press on her hips and sacrum. After several contractions in this pose, I was thinking of another way we could encourage the baby to align better in the pelvis. I suggested that Melani put her right foot on the ground and keep her left knee in its current hands-and-knees position. She was unable to get her foot in place and settled with her bottom on her heels and her head resting on Matt’s knee. At 11:10 p.m. she had a grunty contraction that I was thrilled to hear; just after the next surge, she declared that “He’s stuck!!” “No he’s not.” I tried to encourage her. We helped move Melani to the toilet for a couple more pushy contractions.
By 11:20 p.m. she had made it to the birthing stool and was pushing very well. I held compresses to her bottom and she requested Matt’s mom back in for the delivery as she pushed strongly. The doctor could not believe she had progressed so quickly and was belated in his arrival to the room, but he made it. At 11:53 p.m. baby Chess came into the world. As he emerged, Melani proclaimed in an invigorated and thrilled tone – “That just came out of me!!!!” We were all very pleased.
Contrary to the ultra-sound at 41 weeks, baby Chess did not weigh over 8 pounds, 13 oz after all . He was a perfect 6 pounds, 10 oz.!!