Welcoming Finley!

Welcoming Finley! Born May 5^th, 2013

         Erika and Luke first met me early in their third trimester and we spent quite a while chatting and getting to know one another. I felt a fairly instant connection with them and was thrilled when they made the decision to have me as their doula for the birth of their son. After a previous miscarriage, it had taken them a while to accept that this pregnancy would indeed result in a take-home baby. They had waited until she was more than halfway through this pregnancy to let their families know and being aware of just how private they were made it that much more special to be a part of their journey.

        We spent our prenatals discussing which aspects of their birth were the most important to them, her health history, as well as the flexibility of birth and the importance of not having rigid expectations. Erika's mother had a traumatic experience during the birth of her youngest child where she damaged her back and was stuck in a wheelchair for a few months postpartum. Erika had experience with throwing her back out in the past which had made it temporarily impossible to get around. We knew that the fear of this happening again, or having an experience similar to her mother's was going to be a very real concern for her during labor. We spent more time than usual discussing the type of back pain that can accompany labor and the possibility that this could be a normal part of her labor, all the while knowing that if and when this happened, large amounts of anxiety would accompany it.

        Erika still wanted to labor at home as long as possible, though since they lived about 45 minutes from the hospital, they knew they would have to time their trip really well. They lived a few miles off a main road and we all joked at their home visit that they may be some of the only folks who had to pack a chainsaw as part of their hospital bag in case any downed trees attempted to delay them. Their last prenatal appointment was Wednesday, May 1^st and the doctor confirmed that very little cervical change had been made. Thankfully, no one seemed to be in any hurry to rush things along and we all knew that Fin would make his appearance when he was ready, though we didn't anticipate that it would be so soon after.

        Erika sent me a text message around 6:30am on Saturday, May 4^th to let me know she was pretty sure her water had broken earlier that morning around 2am and that she had been having sporadic contractions since then, around every 15-20 minutes but she still managed to get some sleep that night. I was finishing up at another birth when I got her message so I knew I was in for another long day. She made herself a plan to stay home until things intensified, to stay super hydrated, and to go for a walk if contractions started to taper off. Shortly after we exchanged messages, she started getting some bloody show and I assured her that would likely increase as the day went on.
        As Erika labored throughout the day, they found ways to keep themselves busy, though I think Luke did most the nesting for both of them. He kept himself occupied by vacuuming, cleaning the toilets in the house, ironing all of his work shirts, and even baking a sweet potato pie! Erika was thankful he had found such a productive outlet for his excitement and anxious energy.

        I was incredibly thankful to get to sleep for about 6 hours before checking in with them again. It was now almost 6pm and her contractions had started to become more painful, though they were still 6-10 minutes apart. She was still feeling pretty good and getting some rest in between the contractions. They decided to go ahead and make some dinner and if contractions continued to get closer together, they would start to plan their trip into town. By 7:30pm, her contractions were getting more and more painful, requiring some focus to get through them, but still about 5-10 minutes apart so they decided to go ahead and get ready to come to the hospital.

       They called me at 8:30pm to let me know they'd made it into town and were walking around the hospital grounds trying to decide what they're next move was going to be. There was talk about walking around the mall, even potentially getting a hotel room, though by 8:45, the decision was made to go ahead and check in. We made sure that everyone was on the same page about when we would say that her water had broken so that she could avoid the unnecessary interventions that would have been implemented if they'd know how long it had actually been.

        Erika and Luke arrived in the labor and delivery triage around 9pm. She changed into a gown and her first cervical check revealed that she was between 1-2cm dilated, the baby was really low at -1 station, and she was about 60% effaced. She really felt like this was where she'd be when she arrived so she wasn't too surprised. I arrived about half an hour later and her contractions were becoming consistently 5 minutes apart and quickly increasing in intensity and frequency. While in the little triage room, she started having to stand and sway during the contractions, sometimes crouching on her hands and knees until it was over.

        Luke was incredibly attentive, staying very close, ready to help her with the next contraction. We finally got moved into room 1310 where we sat for over half an hour before anyone came in to check on us. They got her saline lock IV put in and gave her a quick run down of their monitoring protocols before we were alone in the room again. We started trying to make things a little cozy and get Erika as comfortable as possible but it was getting increasingly more difficult to relax and focus her way through each contraction. It was easy to tell from an observer standpoint that she was making quick progress and that where all this extra intensity was coming into play.

        Around midnight, it was just getting to be too much and no amount of position changes, heat, or massage seemed to be making a difference. Erika had been feeling nauseated since arriving at the hospital and had been throwing up quite a bit in the hour and a half we'd been in the room. Luke and I struggled to find a way to help Erika not feel so tense and every contraction brought more and more concern about the pain she was starting to feel in her lower back. The nurse came in to check her and she was between 3-4cm dilated already, completely effaced, and little Fin had made his way down even farther! We discussed pain medication options at this point and she decided to try some IV Stadol and Phenergen to take the edge off and to help with the nausea. This allowed her to relax, especially in between contractions and make a concerted effort to build up for strength for what was to come. Not long after receiving the IV meds, her contractions were about 2-3 minutes apart and head compression started to be evident on the monitoring strip, meaning that Finn was really starting to move down into her pelvis even more. The medication only last about an hour and had almost entirely worn off when the nurse came in to let Erika know that their anesthesiologist was about to head home for the day, meaning that if she was going to want an epidural at any point, she had to make that decision now.

           The intensity of the contractions and the fear that her back was going to be damaged was overwhelming at this point, really causing a lot of extra tension and pain so she made the decision to go ahead and get the epidural so that she could get some more long term relief. I left the room around 1:45am for them to prepare her for the epidural and while I was gone, she had another cervical exam. She had already made it to 7cm and it looked like the epidural wasn't going to slow any of that progress down. I arrived back in the room at 2:40am and Erika was laying on her side to help Finn's heart rate stay stable. She was in much better spirits and feeling good about the decision she had made. We discussed the fluidity of labor and birth and the fact that plans frequently change. We all felt that she had made exactly the right decision for their situation and started to bring the focus back in on how quickly we'd be meeting this sweet baby.

             Only twenty minutes after I got back in there, she was checked again and was between 9-10cm dilated, with just a little bit of cervix remaining before she could start pushing. By 3:30am, she was starting to feel her contractions enough to know when she was wanting to push and within 15 minutes, she was really starting to give pushing all she had. Finn was incredibly active during her entire pushing phase, which is fairly unusual. It was so crazy to see Erika's belly move in between the contractions with such big movements even while she was pushing. We could see about a half dollar size part of Finn's little head which was also wiggling around a ton! The nurse joked that he was going to be the first baby to be diagnosed with ADHD in the womb. We maintained a lighthearted casual conversation throughout all her pushing phase, dreaming of the little boy that Finn will one day be, running naked through their land chasing wild animals and all the joy he was going to bring to their lives.

               With each push, Erika would make a little progress but then Finn would just sink right back in. After 2 hours of pushing, Finn still couldn't make it under her pubic bone so the nurse went ahead and called in Dr. Merkell. The doctor suggested that they try a vacuum to help pull him under the pubic bone and went over the potential risks. I was super thankful that she went over the procedure in detail, reassuring everyone that the vacuum was meant to pop off when it hit a certain level of pressure and that this was entirely normal. The first time the vacuum popped off, I could tell that the sound was pretty alarming for Luke and Erika, and honestly, I felt the same way. The second time that it popped off, we were all a little less worried, though knowing that there was a 3 pop-off limit, we knew this next push was going to be the game changer. Erika pushed with absolutely every bit of strength and power she had within her and at 5:47am, their son was finally born!
              All the anticipation that filled the room was quickly replaced with an overwhelming amount of joy and love felt by everyone involved. Finn looked great and was instantly showing signs that he was ready to try nursing, licking his little lips and looking around. Erika had a small 2^nd degree tear that the doctor quickly repaired and while the nurse got her all cleaned up, they weighed Finn and found that he was 6 pounds and 6 ounces. We got Erika more comfortable in the bed and finally got Finn to latch for the first time around 6:15am. He would latch for a few minutes and then pop himself off as they both got the hang of this new relationship. Once they were all comfortable and preparing to call their families around 7:30am, I headed home, checking in via text message later that day.

           They stayed in the hospital for two nights, getting lots of assistance from the lactation consultants to help them get the hang of breastfeeding and after some initial soreness and a little bleeding, nursing started getting easier and easier, especially once Finn got the latch down and they were settled in at home. Erika's strength through the insane intensity of going from 1cm to complete in that short amount of time was incredibly humbling and Luke's consistent love and support was a joy and privilege to witness. No matter how many births I attend, every single one of them leaves me so absolutely impressed with these fabulous mamas and their partners, and I know that the amazing partnership that they built upon throughout labor will continue to flourish and grow as they continue in their parenting journey. 

Welcoming Judson!

Welcoming Judson to the world!
Born on December 28th, 2012 at 11:47am

  I first met Matt and Ashley at a local Meet the Doulas event about half-way through her pregnancy. We quickly hit it off and established a relaxed, comfortable relationship with one another. Our prenatal visits frequently lasted longer than we'd anticipated and were never complete without us all exchanging warm hugs. Ashley was fairly convinced that her body would take its sweet time going into labor and that she would end up going past her due date, so we didn't really expect Judson to make his arrival in 2012 at all.
They decided to eat some Indian food for dinner on Thursday the 27th, which seemed to be what got things started. Ashley started having some stomach pain, accompanied by frequent trips to the bathroom, which she just attributed to her dinner choice. In hindsight, all of this was clearly early labor. Ashley had a small burst of water around 9:30pm that was likely when her water broke. Even after that happened, she still wasn't convinced she was in labor. She stayed mostly in bed until around 4am when Matt got up with her. They labored together throughout the house and gave me a call around 6am. We spoke about a half an hour later and I gathered up my things and headed out the door.
I arrived shortly before 8am and stood at their front door long enough to listen to Ashley working through a contraction before going inside. She was in the living room on her hands and knees, supported by pillows, with Matt sitting in front of her. Going only off of her intense focus and the moans that were getting her through each contraction, I knew we should start thinking about heading toward the hospital sooner rather than later. I heated up a rice pack that I'd brought and applied to to her lower back as she continued laboring in the living room. I recommended that she get up and go use the bathroom, noticing that she had a couple contractions on the way there. She walked around the kitchen a bit, leaning over whatever was closest when a contraction started coming on.  She made her way over to the couch, which happened to be covered in clean clothes, propping up pillows to try and get comfortable. We moved the birth ball up onto the couch for her to lean over and she rearranged herself after each contraction. We used a flat sheet to try a bit of rebozo-like shifting but it wasn't helpful at combating the back pain so we just kept using the rice sock. She called her sister to let her know what was going on and it was during this call that I realized her contractions were only about 3 minutes apart. Shortly after getting off the phone, Ashley also started to feel nauseous, once again making me think she was much farther into labor than I had previously thought.
I started mentioning that we should probably think about heading to the hospital soon, having Matt show me what needed to be loaded into their car. Once everything was packed, it took us about 10 minutes to get Ashley to the car and another 5 to get her inside. We headed toward the hospital at 9:25, driving well over the speed limit the entire time. We arrived at the hospital at 9:45 and Ashley was wheeled into a triage bed. I went in with her while Matt parked the car. At this stage it was taking a lot of moaning to get through each contraction. When Matt came in, I confidently handed her over to him as I went to go wait in the hallway - and later a waiting room, since they had a one person per patient rule. At one point, I sneaked back in to get my birth ball & peek in on them and Ashley was entirely in her own world, not wanting anyone to touch her. When the nurse came in, Matt immediately went to their birth plan, making sure the nurse knew that they didn't want to use Pitocin and that Ashley was ready for the epidural. At this point, none of us knew just how far along she was and that we didn't have time for either of those things.
I was pacing out in the waiting room when, all at once, nurses began loudly telling people to move out of the way. Ashley was being pushed down the hallway on a bed, practically at a run, with Matt in tow. I quickly learned that she was already 9cm dilated and feeling like she wanted to push. They wouldn't let me in until they had her all set up on the bed and the longer it took, the shorter my fingernails got. I was so happy when I got inside, quickly going to Ashley and telling her what an amazing job she was doing. She started pushing at 10:20am, barely half an hour after we arrived!
The baby hadn't made his way under her pelvic bone just yet so we knew there was the possibility of a long pushing phase. Ashley started to push with each contraction, learning to push through the pain. Before long, she had a really amazing feel for each contraction as it started to build, waiting until it was at its most powerful to really start to push. As we started to see more and more of the baby's head, we encouraged Ashley to reach down and touch his head. Matt and I continued to cheer her on, totally amazed at her composure and strength. After almost an hour an a half of pushing, Judson was losing patience and his heart rate started to show some signs of distress, decreasing and increasing a little more than normal so the doctor decided to cut a small episiotomy. With the next push, Judson made his way into this world at 11:47am, quickly letting us know that he wasn't thrilled with the change in environment.
After the long wait, he was finally here, weighing 7 pounds, 5 ounces with dark hair and eyebrows. Matt and Ashley were in love with every little thing about him, completely overwhelmed that he was actually here. Judson got to enjoy some skin to skin with Ashley before we attempted breastfeeding for the first time. It didn't take much effort at all to get him to latch on and he was an instant pro. Those first few hours always seem so surreal for new parents, like they expect that, at any moment, they'll wake up from this incredible dream. I love getting to be a part of it. The pure love on their faces as they stared down at their son brought tears to my eyes and was a beautiful reminder of what an amazing privilege I'm given.

Just a little giveaway!

To celebrate crossing 200 likes on the Simply Supportive Doula Services facebook page, I've decided to give away a few things to one lucky fan. 

To enter you must like my facebook page

Then you must comment on the giveaway post with one of the things you like to see your favorite birthy pages post on their pages.  If someone in particular sent you my way, let me know and I'll give them an extra entry. You can also get an extra entry by following this blog and leaving a comment here to let me know you did (or already do.)

Easy peasy! And in return, you get a chance to win a fun (and super random) little package! 

1. An adorable little penguin postcard from my favorite artist (Kurt Halsey Fredrickson)

2. A Mayan Worry person, especially made for telling your health worries to. You just tell this little lady your worries, put her under your pillow at night, and by morning, the worry people have taken your worries away!

3. Your choice of a red, blue, or green breastfeeding symbol ornament (handpainted by me)

4. Your choice of one of the hand knit hats pictured (if you win, I'll send you a better picture to choose from)

5. 10 No Show Premium Ameda disposable breast pads

6. 5 packets of Belli vitamin E, lavender oil, & gotu kola stretchmark protection elasticity belly oil 

7. A tin of Comfrey Working Hands Balm by Redbud Garden (in Huntsville, AR)

And probably some sort of chocolate (so that I have a really good excuse to buy chocolate!)

You have until this Saturday, December 15th at midnight central time to enter!

And you should also go check out my newest birth story from my last amazing clients!

Welcoming Crosby!

          I met Hannah and Casey a little later in her pregnancy than most of my clients which meant that we saw a lot of each other in the weeks before Crosby's birth to make up for lost time. Her daughter's birth had been an induction and Hannah was set on doing everything in her power to make this an entirely different experience.  After a pretty uneventful pregnancy, Hannah's doctor started noticing that she was measuring a few weeks smaller than expected and suggested that she have an additional ultrasound to check on the baby and make sure all his measurements were on target. At this ultrasound, they diagnosed Hannah with oligohydramnios, meaning that the amniotic fluid level was lower than they liked to see it. Her doctor suggested that she go be admitted to the hospital overnight for IV fluids but also made it sound like if the fluid levels hadn't improved the following day that they would push for an induction. Hannah and Casey discussed their options and stayed for a non-stress test which showed a spectacular looking baby so they chose to go home for the evening and attempt to hydrate on their own before returning the following day for another ultrasound. They did a lot of their own research on low fluid levels to prepare themselves for future doctor's visits. I accompanied Hannah to her follow-up ultrasound appointment which showed even lower fluid levels and her doctor started pulling out lots of scare tactics. It was the first time I'd ever actually heard a doctor pull the “dead baby card” with my own ears and I was so impressed with the way Hannah handled herself throughout the entire ordeal. Despite only being 36 weeks along, her doctor even said he would induce her if she'd entertain the idea (which she would not!) She agreed to stay overnight for IV hydration and thankfully, the ultrasound the following day showed increased fluid levels, though the baby had flipped and was now breech, so while one worry was taken away, another one was added.
Hannah started doing everything she could to get him to flip back around, including some chiropractic work and thankfully, he cooperated quite nicely. Once he was back head down, the focus started to be back on the birth and avoiding an induction. It was difficult to shift back out of scarey medical mode after how much her doctor and the entire experience with the low fluid levels had really undercut her confidence.
  She was worried about going past her due date and having to fight an induction so she was taken by surprise when her water broke around 2pm, Saturday, the 24th, a few days after she hit 39 weeks. She and Casey had already had a big date night planned so they just kept their plans, enjoying what they thought would be their last night before meeting their son. She went to bed expecting to be woken up by labor by morning but Crosby had other plans. They continued to stay home, hoping that labor would start on it's own, and while Hannah was having some contractions, they were very irregular and never fell into a pattern.
She made an appointment with her doctor's office for Monday at 2pm with a plan to tell them that her water had broken that morning. They confirmed her water had indeed broken and found that she was 2cm dilated and 80% effaced. The doctor gave them some grief about not coming into the hospital right away and wheeled her over to be admitted at the hospital. I arrived around 3:45pm, just as she was getting settled into her room. They got her hooked up to the monitors and confirmed that she was indeed having contractions, even if she wasn't really feeling them very much. She was fearful of the Pitocin since it was used during her first labor and there hadn't been any build up, only what she remembered to be excruciating pain right from the start, so she made sure she got them to agree to start low and raise it as slowly as possible. Around 5pm they got the Pitocin going through her IV, starting at the lowest possible dose of 2 units/minute and slowly moving up to 6 over the next 2 hours. Hannah was checked again at 7:10pm and was still 2cm dilated, though she was now 90% effaced. The baby was still really high in her pelvis so we started working on positions to try and get him to move down. We made sure she was going to the bathroom about once an hour and during one of the bathroom trips, she noted that she felt like something had “popped” while she was in there, which I suggested was likely the baby moving down into a better position. The Pitocin was slowly increased to 12 units for two hours and at 9pm, Hannah had progressed to 2.5cm dilated, 90% effaced, and the baby had moved down quite a bit. The nurse came in and checked her 45 minutes later and nothing had changed so Dr. Pappas relayed that he wanted to up the Pitocin again to 20 units/min but Hannah declined and asked that it be pushed back an hour. Around this time, Casey left for a bit to pick up some caffeine for he & I since we figured it was going to be a long night. Dr. Pappas came in at 11:15pm to check her again and Hannah was still 2.5cm dilated. The Pitocin was then upped to 20 where it would remain “until sunrise” with an understood deal that if she made progress by then, the doctor would consider lowering it back down.
The contractions slowly started picking up in intensity and frequency after midnight. We spent much of the night chatting about our lives, remembering to go to the bathroom, making guesses about when Crosby would arrive, and laughing about how the room (& the blood pressure cuff) seemed to be jinxed, with everything needing to be held just right. I french braided her hair and we fit in a couple episodes of The Office before Hannah's contractions started requiring a little more focus. The heating pad seemed to be helpful when she was sitting in bed and we learned that it didn't matter how many time Casey or I suggested it, she had no interest in doing any sort of leaning. She managed to get a little rest in between contractions and Casey tried to do the same.
The doctor came back in at 5am and Hannah was completely effaced, 5cm dilated, and the baby had moved down a lot more! He was so happy with this progress that he agreed to start lowering the Pitocin back down. He told her that she held up her end of the deal, so now it was time for him to hold up his. I was incredibly impressed! The baby was at +2 when he checked her, and since +3 is crowning, I knew that if she wasn't already feeling a lot of extra pressure, she was about to. Almost as soon as the doctor left the room, labor really kicked into high gear. Because of all the pressure that she was feeling, she didn't really have much interest in getting up and out of bed but she gave it a shot for a  few minutes. I tried to prepare her as best as I could that she was going to have to fight the urge to push. I told her that was her going to be her new mission for the next few hours. This meant developing new ways to get through each contraction as she cycled through different breathing, noises, and moans as her will was tested. Casey and I held her hands through each contraction as she buried her face in this soft little pillow or in Casey's shoulder. During the more intense contractions, she would cry out a bit before they would start to subside and she could regain some sense of composure. It was beautiful to watch the way Casey held her and marveled at her strength through these increasingly tough contractions. Throughout this time, the Pitocin kept being lowered every half hour and sometimes sooner.
The nurse came in at 6am to check her again and in just under an hour she had progressed to 8cm. Every contraction remained just as intense as the one before but with more and more of an urge to push during the next hour. Shortly before 7am, her body took over and started pushing on it's own. She still wasn't completely dilated, lacking only about half a centimeter which meant almost another full hour of having to fight against her body. At this point there wasn't really much of a break between contractions because she was feeling so much constant pressure. There were a few times when a contraction would really get to her but Casey would tell her she only had a couple more to fight through, brush some hair out of her face, and she would go barreling into another one.
At 7:30, the doctor came in and checked her, noting that she really only had one little lip of the cervix remaining. During her next contraction, he told her to give in and push just a little bit so that he could push that lip out of the way. At this point, he left to go try to get some paperwork done and Hannah got to start pushing with the nurse. She pushed on her back for a little while but the baby wasn't making his way down very well so the nurse suggested some hands & knees pushing to help him descend. After pushing on her hands and knees for about half an hour, they got her to flip back over and start pushing while pulling her legs back. Once she got in this position, the baby started making his way down very quickly! The doctor was called, as well as a back up nurse just in case the doctor didn't make it, and Hannah continued to push, despite them urging her not to. The nurses shoved Hannah's legs back at this point, I assume mostly because that's what they're used to, which she later said was incredibly painful.
Dr. Pappas barely had time to get his gloves on as Crosby sat right on her perineum, waiting for one last push to bring him earthside. Crosby made his way into our world at 8:12am, a little over 66 hours after Hannah's water broke. Dr. Pappas was very respectful of their wishes for delayed cord clamping and held Crosby level with the placenta for 60 seconds before handing Casey scissors to cut the cord. Crosby was then brought up to Hannah's chest where he let us all know he was less than thrilled with the change in environment. After a few minutes on her chest, staring at him in amazement, Casey accompanied the baby over to the warmer to be dried off and weighed while Hannah had a small tear repaired. He had beautiful blonde hair like Hannah and though it looked curly in all his newborn cheesiness, after his bath it was obvious it was straight. Hannah had him attempting to breastfeed by 9am and though he latched on and off a couple times, he was still mostly uninterested. Since they believed it had been almost 24 hours since her water broke, they kept them an extra night in the hospital (but oh, if they only knew!)
The confidence she had in her body that enabled her to stay home as long as she did, the strength it took to endure 15+ hours on Pitocin without so much as a tylenol, having the opportunity to push in a position other than on her back (in a hospital!!!), and last but definitely not least, talking them into turning the Pitocin almost completely off, are all thing that you don't get to witness every day. There were so many amazing aspects of Crosby's birth that I had never had the privilege to see before, making it an even more unique experience than I'm used to.

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(I'm one birth story behind since I forgot to bring my release form to the postpartum visit but I'm putting it in the mail Monday so hopefully my October birth will be up here soon!)

A reminder

Our big Meet the Doulas event is this coming Saturday and I'm super excited about it! We have tons of swag for our goodie bags, awesome door prizes,  and lot of smart ladies to answer all your doula-y questions! Please join us at Terra Tots at 2pm for all the fun!

While you're at it, go check out our new growing doula group in the Northwest Arkansas area! Our website is HERE and our facebook group is HERE.

Welcoming Eva Francis!

Born September 1st, 2012
       Sam and I first met when she was about 20 weeks pregnant and we clicked almost instantly. The next time that we got together, I got to meet Kelly, who later that same day would become her husband. I've never had the chance to see someone both on the day they got married and the day they welcomed a baby into the world, so I felt quite honored. We met quite a few times over the following weeks, getting to know each other and making plans for Eva's birth. During our first meeting, Sam told me that although she was due at the end of August, she was sure she was having a September baby - so no one was all that surprised when her due date came and went without any sign of a baby.
Sam called me around 3:30pm on Friday, August 31st to let me know she thought her water had broken about 25 minutes earlier. She said it was clear and that she was leaking a bit with each little contraction. At a prenatal appointment earlier in the day, she was already 2-3cm dilated and 50% effaced. She sounded reasonably calm, though every word buzzed with excitement and anticipation. She promised to keep in touch and I began to gather my things, drinking most of a pot of coffee and waiting by the phone. She called back a little after 6:15pm to let me know that they were heading to the hospital and asked me to meet them there.
I arrived at triage shortly after they did at around 7:00pm. She was already having contractions every 4 minutes, during which she would close her eyes and roll her ankles and toes around. The nurse in triage was pretty terrible. She was already talking about Pitocin and IVs, not having mobility, and just being incredibly negative and pushy. This nurse checked her at 7:15pm and she was between 4-5cm dilated and 90% effaced. Sam's contractions were starting to take a little more focus and she would rhythmically rub my hands, commenting on their unusual softness, making us both smile. The nurse wanted her to be wheeled over to L&D but Sam insisted on walking, making it into a room at 8:30pm. This is when we met the amazing nurse that would care for her until after Eva's birth and Sam commented that she was glad she had the “biatch from triage” because it made her even more grateful for Amy, her new nurse. Amy got her on the monitors and put in a saline-lock in place of an IV.
She checked Sam at 8:55 and found her at a good 5cm dilated, completely effaced,with the baby at -2 station, still fairly high in Sam's pelvis. Dr. Merkell was the doctor who would attend the delivery, and although Sam had never met her we were optimistic that she'd agree to follow Sam's birth preferences. Amy got the doctor to agree to intermittent fetal monitoring which meant that Sam would spent about 30 minutes on the monitor and 30 minutes off. During her time on the monitor, she had to lay in the bed which really restricted her movement but we made sure she didn't go through a single contraction without hands on her. This is when everyone started learning what was going to be helpful throughout Sam's labor. She wanted Kel to rub her hands or her feet during contractions and when her hands weren't occupied, she wanted to be rubbing something, frequently my belly, arm, or hand. When she was free from the monitors, she walked back and forth across the room, coming back to the bed to lean over the ball during contractions. She would use this time off the monitor to use the bathroom as well, although being on the toilet made her contractions more intense. While she was leaning over the ball, either Kelly or I would press firmly on her back or hips until the contraction let up. She was getting really good at sensing them coming on, finding a rhythm with her body as each contraction built, peaked, and let down. She managed to eat a few cherry popsicles, which according to her had a lot of depth to their taste and might have been the best she'd ever eaten. Her family visited frequently during this time and her mom took video of her both in between and during contractions to show off her strength to family members waiting in the lobby. It was also around this time, during one of her breaks from the monitor that I french-braided her hair in an attempt to keep it out of her face during the hard work to come.
Sam was checked again at 11:05pm and we were told she was 6½cm dilated and the baby had moved down quite a bit with her head well applied to Sam's cervix. The fetal monitor was starting to show the expected signs of head compression as the baby continued pressing down on her journey out. While Sam was on the monitor and stuck in the bed, her contractions would slow down, giving her about 5-6 minutes in between to rest and regain her strength. Once she got back up, her contractions would pick back up and she would fall back into her ritual of pacing across the room and then leaning over the ball on the bed during contractions. While she was leaning over the ball, we would push the heating pad into the small of her back, apply counter-pressure, and massage away on her upper and lower back. From a light touch up and down her arm to massaging her feet, I tried to continually be touching her, even between contractions. When she was checked at 1:15am she was 7cm dilated and her contractions were really starting to pick up in intensity. They were still about 3 minutes apart when she was in the bed on the monitor and about 2 minutes apart when she was up and swaying through the pain.
Around 2:30am, the baby's heart rate was falling a little at the end of each contraction and although it quickly returned to normal, this meant that Sam would need to be on the monitor constantly from here on out. We spoke with the nurse and she agreed that it would be okay for Sam to get out of bed as long as we could keep the baby on the monitor. Sam stood beside the bed, swaying and moving her hips around in between contractions and assuming her favorite position of leaning over the ball during contractions. She was starting to need to make some low moaning noises around this time and moved back to the bed at 4:15am for just long enough to get checked. She was starting to feel a lot more pressure and was really glad to hear that she was about 8-9cm dilated, with it being a little bit thicker at the top. She was incredibly thankful to get up after this check and fell right back into her routine. At 4:30am, Sam started really needing to moan during her contractions. Since this was the first time Amy had heard her from the nurses station, she came in pretty quickly and recommended getting back into the bed for another check.
At 4:35am, the nurse checked Sam and found that she was completely dilated. During Sam's next contraction, the nurse told Sam to try and push and while she did, she pushed the small remaining lip of Sam's cervix over Eva's little head. Sam pushed two more times before Amy said she needed to go get the doctor. Dr. Merkell came in and instructed Sam to push while she set up everything she needed. Sam's mom and I switched places at one point so that she could help encourage Sam from the head of the bed while I waited for Eva's arrival with a camera in hand. Sam was making great progress and was just as awesome pushing as she'd been throughout the entire labor. By 4:50am, we could all tell that Eva had a little bit of dark hair and at 4:55am, Eva Francis was finally earth-side.
She was immediately placed on Sam's chest as she was cleaned up. They managed to get a few extra minutes still connected and then Kelly was instructed to cut the cord. Eva didn't quite pink up as quickly as they would have liked so she went over to the warmer to get dried off and stimulated a little more. Kel went over with the baby while I stayed with Sam at the bed. She had a small 1st degree tear that needed to be repaired and she even developed a little mantra to make it through this part of the delivery as well. While the doctor attempted to numb things up as much as possible, Sam just repeated rhythmically, “a stick and a burn” over and over. There were lots of facial grimacing and attempts to distract her but it was over pretty quickly.
The nurse weighed Eva and she was 7lb 9.6oz and was 20.3 inches long. She was returned to Sam's chest and we quickly started trying to get her latched on. Eva still sounded really gurgly and after she spit up a bunch of amniotic fluid during the initial breastfeeding attempt, the nursery nurse suggested that she be suctioned a little to get any remaining fluid out of her lungs. After she was suctioned, she was much more interested in breastfeeding and first latched on at 5:40am. She had a great latch and took to breastfeeding like a pro. I left the hospital around 5:30am to come home and get some rest, returning later that afternoon to check in on the new family. Sam did such an amazing job during her entire labor that it was no surprise to me that she took to motherhood just as well. We had a great little moment during our afternoon visit where we both expressed how well we felt we got along and we made the mutual decision that we just had to be friends from here on out. It's pretty rare that I feel such a great connection with a client of mine and I look forward to seeing our relationship grow and change!

**Posted with permission**

Big things are happening in NWA!

Between the Improving Birth National Rally for Change on September 3rd and the super awesome Meet the Doulas of NWA event on September 22nd, my time is fully of planning right now. I'm learning to navigate media/press releases and researching the beginning steps for a non-profit. It's been pretty incredible to watch what was once just a little idea begin to grow into a community event that people are getting excited about. Once I can manage to get a non-profit doula group in this area, I can make a foray into grant applications in the hope of finding a way for every woman to have access to a doula, regardless of their income.

I've now been to 15 births and can say I've had a birth at every local hospital. I'm also gearing up to take my NCLEX (and add R.N behind my name) in just a few weeks. It looks like I will be trying to secure a local nursing job, at least part time, so tomorrow I will be meeting with two fellow doulas to discuss back up arrangements. It's exciting to have the freedom to take on more clients and know that even with a nursing job, I can continue to do what I love. My pricing is going to get a revamp in the very near future to reflect my nursing degree, pending certification, and to add some package deals with a few more services than I currently offer.

I need to get on top of creating some releases to send to my last three clients so I can post their birth stories up here! Stay tuned for that!