Josie's birth

written by Amara and edited slightly by me The Birth Story of Josie Parker - edited by Kelsey This story is written from my perspective as the doula, based on what I witnessed and documented. However, your parents' accounts of your birth may include details and perspectives that mine does not. I encourage you to ask them for their version. Josie, when your parents discovered they would be welcoming a child, your mom got busy looking into her options so she could insure she had established her prenatal care with an OB practice that was most in line with her thinking. We had a good discussion at our first meeting and I think they only encouraged her to make certain she chose a practice with midwives as first call. She went a step further and sought entrance into the coveted Midwifery Center, who accepted only a short list of women whose goal and intention was an unmedicated birth. The birthing rooms were outfitted with a queen bed and a warm water tub for labor. She was excited to know that her providers had as much faith in her body and the process as she did. And when your parents decided to hire me as part of the birth team they knew I would be another person who believed the same. My primary job was to support your mom on her journey unconditionally, but I also had a deep faith in her body’s ability and also trusted her instincts and intuition. We began our journey early in the pregnancy but wouldn’t see each other until the 8-week of BirthWorks classes that began months later. Those 8-weeks were filled with learning and growing, and even making friends. By the end of it, your parents were ready, or at least as ready as they would be to welcome a child. That time didn’t pass without some drama though, as is the case with nearly every pregnancy. Your mom told me that because they discovered on ultrasound that you had a two vessel cord, she was risked out of the MIdwifery Center. Your mom was disappointed and didn’t understand the logic since she knew the highest level of monitoring was just down the hall should the need arise. And to her credit, after sharing her feelings with her midwives and continuing with a stellar bill of health, she was given the happy news that she was returned to the Midwifery Center. She exhaled a sigh of relief and resumed her countdown to labor day. We had a prenatal visit within a couple of weeks of the due date and would wait and see when labor would start. Your mom had the realistic expectation that her labor wouldn’t start until after her due date so when she felt warm up contractions overnight and into the morning on January 21, three days before her due date, she was cautiously optimistic. She sent me a text to let me know and I was pleasantly surprised to think your mom might avoid the past the due date wait that can be so challenging for many expectant women. She planned to lay low, rest, hydrate, and let me know if they intensified. I happened to be at a birth when she initially texted, and while we were finishing up, I knew I would need rest before I could serve her optimally. Your mom had a wonderful attitude and remembered the importance of downplaying early labor, so she was not concerned. She had also sent your dad out for a hunting trip two hours away, she was that confident and comfortable. Around 10:15 that morning, just 45 minutes after her first text to me, her contractions were 5 minutes apart. She wasn’t thinking she needed to change anything, but she was wondering if she needed to have your dad head back home. I wasn’t sure and knew it was ultimately her decision. I reminded her that it might not even be labor and to ignore and minimize until she no longer could. She told me she couldn’t go to work with contractions like those, and that had me thinking it might be the real deal. She would update me if things changed. Three hours later I sent a text to check-in and your mom told me the contractions were still regular and gaining intensity. She was eating fruit and drinking a lot and had even spoken with the midwife on call, Karen. She advised your mom to lay on her side and rest and not do anything in the hopes it might keep her labor from ramping up too quickly. I’m unsure why she advised that whether it was because your dad was so far away or I was coming off of a long birth myself. (Karen knew that because she was the midwife at the birth!) But either way, it was a good plan. Your mom tried to eat soup and felt nauseous and threw it up. So there was no denying she was in labor. Her mom was with her and your dad would be home by 6:00 that evening. The time of our texts was around 1:45 pm. Then just past 3:00 pm your mom alerted me that she lost her mucus plug. Yes, things were definitely moving along. The contractions weren’t much closer, still hovering at 5 minutes apart, but edging towards 4 minutes. Your mom was comfortable staying at home until your dad got back and would make a decision then. Thankfully he left earlier than expected and would be home by 5:00 pm. An hour or so later she texted to say they were heading in the the hospital. Your dad was back and after talking and contracting over the phone for about 8 minutes with Karen, they decided it was a good time to leave for DePaul. Still confident and independent she told me she would update me once she got checked so she knew where she was. I admired that in her for it’s a trait not many first time moms have. I got a text from your dad at 5:24 pm saying simply, “Karen said to come now.” I knew what that meant. It meant your mom was in active labor and definitely needed her doula there! And since for the first time all day it wasn’t your mom that sent the text, that was another big clue that it was definitely game on. So I left the house and arrived to her room, 3422, at 5:41 pm. Your mom was laying on the bed wrapped in a blanket. She was laying on her side and definitely not happy anymore. She was in active labor and working hard. Karen told me her water had just broken and she was 6 cm. But she also told me that your heart rate had dipped quite low several times. I knew what she was getting at. She was telling me that your mom would be moving to labor and delivery if it kept up. Still, I rushed to her side and encouraged her and praised her efforts. Your mom made it clear that she wasn’t liking it anymore and was just ready to be done. But when a contraction came she breathed deeply and did everything right, just as we had gone over in class. I was immensely proud of her. That’s difficult to do, especially when there are concerns for your baby. But your mom was strong and steadfast and she stayed the course with great courage in the midst of such uncertainty. The decision to move to labor and delivery happened shortly after I arrived. Your mom got in a wheelchair and they wheeled her around the corner and down the hall to the room where she would become a mother, 3415. I gathered up their belongings and transported them by cart to the new room as your mom got herself settled there with your dad by her side. Her nurse was also there, taking care of the admissions details and making sure she had a good read of your heart beat. Karen ended up placing an FSE (fetal scalp electrode) on your head to make certain they knew what your heart beat was doing at all times. Deep decels were concerning and might mean you might not be able to handle labor. But I suspected your mom might not be in labor much longer since things seemed to be moving quickly. At 6:40 pm she told us she felt pressure like she had to have a bowel movement and this was almost certainly your head descending in preparation for birth. The lower you got the better your head would dilate her cervix. Your mom moved to her hands and knees upon the bed and found it easier to labor that way. Well, easier probably isn’t the right word. She found it more tolerable that way. She was burping, another good sign. And her demeanor became flustered and frustrated. She was snappy and shivering, and just ready to meet you. She needed our guidance to breathe deeply but she didn’t need a lot of help to find her rhythm. The peaks of the contractions are the hardest but your mom was handling her intense labor like a champ. She took off her shirt, feeling the heat that comes within the body with very active labor. And it was one of the plethora of other signs that she was going to meet you soon. Karen was in our room around 7:10 pm and watched your mom labor for a bit. Your heart rate dipped but remained safe enough to continue laboring. Plus your mom was moving through labor so rapidly it was ideal to let her continue. There was a nursing change of shift that brought PJ in. She would be the nurse present at your birth. And at 7:15 pm Karen did an exam and your mom was dilated an amazing 9 cm! And it was a good thing too because your heart rate did continue to dip some. Your mom was struggling through the peaks but she was getting it done. She just didn’t like it much and was ready to meet you. So I suggested she stand and lunge and she was all in. She placed her foot upon the chair and during a contraction she lunged into the pain, holding the birth ball to keep herself steady. It didn’t take long, maybe 10 minutes before another exam at 7:46 pm revealed that your mom was fully dilated! Your head had moved down too, to +1 station. So it was time to push. Karen had to step out for another delivery but PJ, your dad and I stayed with your mom and supported her as she pushed in many positions. Your mom pushed semi-reclined and she pushed on her hands and knees too. She liked that position better and so did you because your heart rate didn’t dip so much on hands and knees. We also had your mom push using the rebozo, a woven scarf, and she made some good progress that way. Dr. Dixon stepped in at 8:52 pm to see how things were going. She had been watching the fetal heart rate tracing from home and felt she should be at the hospital and ready just in case. And Karen was still at the other delivery. PJ called nursery in for delivery, and we had your mom try pushing while holding the handles on the side of the bed. Your mom rested between her pushes, breathing deeply for the both of you, and she gave it her all with each push. She pushed on her side at 9:04 pm and PJ got the mirror situated by 9:08 pm. Your mom looked in the mirror and was amazed at what she saw. And I think seeing your head as she pushed only encouraged her to push even harder. Next she moved to her right side to push. It was 9:17 pm when she pushed in that position. But your heart rate continued to dip and it had Dr. Dixon very concerned for you. She knew that you needed to be born sooner rather than later so she discussed with your mom the likelihood of assisting with the vacuum. Your mom and dad were totally on board and with the vacuum applied for just a couple of contractions, your head was born. And the next push brought the rest of your body! You were born at 9:28 pm on January 21, 2019. Your cord was around your neck and there was meconium right as you came out. Dr. Gabriel, the pediatrician, and Pamela, the nursery nurse, were present for delivery, since your heart rate had dipped substantially several times. You cried out as they rubbed you with a towel. Your mom smiled she was so happy and relieved you were born! She grabbed your dad’s hand and he didn’t let go, not even when it came time to cut your cord. He just used the other hand. You had so much dark hair! Your mom said, “I don’t know who she looks like but she’s ours.” It was so funny and brought some giggles. You weighed 6 lb. 0.5 oz. and measured 18.5 in. long. Dr. Gabriel and Pamela checked you at the warmer but you were back in your mom’s arms as soon as possible. They had a monitor attached to you to measure the oxygen you were breathing. But they were able to leave you in your mom’s arms for the magic hour. It was more important you get your breathing sorted out than breastfeed so you spent that first hour getting to know your parents. You were skin to skin with your mom and you were so happy that way. At one point your dad got in the bed beside your mom and it was truly a family bed. I even snapped a picture. Your dad was able to also get skin to skin time with you. When things died down and your parents were feeling settled, Karen returned to visit for a little while. We praised your mom for the amazing job she did laboring at home as long as she did, and then laboring in the hospital. She took the change in the plan so well. And she told Karen she was at peace with everything and so glad she was able to at least start out in the Midwifery Center. All she wanted was a reason to have to birth in labor and delivery and as it turned out she had a very good one. Your mom at some fruit and drank some limeade she had brought from home, as she let everything settle on her heart. She had done it! I gathered my things to leave when the time felt right, but not before giving hugs to both of your parents. I was so proud of them. They had taken all they learned in class and welcomed you to the world with minimal intervention just as they had hoped. No pain medication was used and your mom did the hard work her body asked of her. And she did an amazing job! I will forever be grateful to have been there to watch you take your first breath. Happy birthday, Josie Parker! Written with love by your doula, Amara Minnis