As told by both Sarah Beth and her doula, Bianca Wooden IBCLC
(Bianca’s comments in parenthesis)
(When Sarah Beth reached out to me, I wasn’t really sure if I was taking any doula clients. But, a former client had recommended me to her, so I went ahead with an interview. I was in love immediately. Sarah Beth is funny and has some serious sass. I knew I wanted to be a part of her labor and birth. Her and John attended my childbirth class and we met a couple of times to prepare for labor. Sarah Beth was determined. She did not want to be induced, wanted her body to labor naturally and be free of medications and any other interventions. She also knew that often, labor and birth throw us curveballs. No matter how much you are aware intellectually of the unpredictability of birth, it still catches you off guard)
At 37 weeks, I started developing gestational hypertension. Week 39 Dr. Moore said we had to discuss induction. Of course, this was the last thing I wanted to hear. I spoke with my wonderful doula, Bianca 🤩🥳, who said she would dig up some information about hypertension vs. preeclampsia and at what point is induction necessary. She gave me tips to lower bp, including increased protein intake and Epsom salt baths, which the last week I did every day. At this time, I also started looking up good ole wives tales of how to naturally induce labor. I read about Evening Primrose oil, which I started taking 1 pill every night, and I would rub 1 pill into my perineum. This supposedly made you efface.
Sunday, I asked my boss man to let me leave work early. And thank God, I did. Looking back, I was doing that last minute preparation. I went to the store and got snacks, pads, witch hazel. All the things.
(Sarah Beth was coming to terms with the reality that her blood pressure was high and not going to come back down. Current ACOG Practice Bulletin (number 202, 7/23/2019) guidelines recommend induction when a diagnosis of gestational hypertension (BP of 140/90 or more on two occasions at least 4 hours apart that developed after 20 weeks gestation) has been made and the person has reached 37 0/7 gestation. If you find yourself with gestational hypertension please discuss the latest evidence and guidelines with your provider. Ask to see a copy of the latest ACOG Practice Bulletin (it is not available to the public online).)
Monday morning Bianca came over an hour before my 39w6d check in at Dr. Moore’s. She gave me information about induction, and then and there, it dawned on me I would have to be induced!!!! I didn’t want to risk my baby’s life or my own. (My grandmother almost died giving birth to her third child with Toxemia (which I believe is what old people called preeclampsia back in the day??) and my biological father died in his 50’s of stroke and aneurysm) So induction was happening!!!!!😟☹️
Bianca, John, and myself came up with a plan to firstly let the doctor check my cervix and see if any effacement and dilation had happened. I think he said I was 80% effaced (which I contributed to the Evening Primrose oil (whether it worked...who knows) and 2 cm dilated.
Then I allowed him to do a membrane sweep. Fun stuff. Honestly, as a woman, it was pleasant to feel a small dose of discomfort and see BLOOD. That’s what we’re accustomed to every month! I was hopeful that was just the push my body needed to jumpstart this process and go naturally.
The next step Bianca, John, and I discussed was foley bulb. We knew Dr. Moore practiced this procedure often, and it made sense to us. So, I consented to do a foley bulb that Monday evening, 23rd of December. John and I headed to the Ocean Springs Hospital. A nurse asked me some questions, then I requested John to come back in the room, then the doc showed up. They laid me back on the table and put me into...almost an inversion. The nurse applied pressure on my fundus and doctor Moore pushed and pulled and yanked and snagged at my cervix. Lord have mercy!!! His whole arm was shaking as he tried to grab my cervix with his fingers. Finally, he did. Sheeeeeesh. He said “Well, she’s tough. I give her that.” They put the bulb in, filled it up with 60 cc of saline....then the part no one discussed with John and I.....from the bulb is a few hard plastic, stretchy, I don’t even know...but they attached it to your freakin’ knee. This is supposed to create tension and apply pressure to cervix to dilate. Ok. I tried sitting up, and as I went to move my leg, I could feel this thing tugging in my vagina. It was raking across my labia too. More fun stuff. I told Doc “Hey man, this thing is about to pop out!” And he said “then it will have done its job.”
Oky doky. I slowly lowered down into a squat, and it didn’t come out so I thought, “huh....?!” ((I told john to imagine having a nipple clamp attached to his nipple that attached to a piercing in the penis (forgot the name for those) but imagine it is pulled so tight you didn’t want to stand erect.))
I immediately felt like I had to take a bowel movement. So I went to the restroom. I sat there. I had bowel movement and then pressure pressure pressure POW 💥 goes the foley bulb and all the bloody show I had looked so forward to seeing one day!!!! Great!
We loaded up.
We went home.
We packed our bags.
We got in bed.
I tossed and turned all night long. I kept going back and forth in my mind.....
“Doc is going on vacation day after Christmas. He just wants to induce to get me out of his hair. My blood pressure isn’t even THAT high. I’m not going in tomorrow. I’m going to stay home and take some castor oil and go into labor naturally.”
“Okay. I’m doing this for the health of my baby. For my health. I do not want to endanger us. This is the best option. I still don’t have to get epidural. I won’t be tied down. I can still do this.”
Next morning, December 24th, John and I arrived at the ER again. When we walked up a lady said, “Awe, you’re like the 4th pregnant lady in a row we’ve checked in this morning.” 😡😩 Induction. It made me so mad. Just lining us up like cattle.
We got to the third floor. I told them my name. They buzzed us back, and we got a room on the old side of the floor (with The fancy commode and hot tub) because I actually called the night before and reserved it. 🤣🤣🤣🤣 The nurses were awesome to me!!! I want it known. The staff was A1!!!!
Alright. So basically they start me on 2 of “Pit” as my nurse, Yolanda, said. Low and slow....go up 2 every 15-30 minutes or so.
(At 9:20a, Sarah Beth was checked and found to be 5cm dilated and 80% effaced.
At 11a, Saraha Beth was checked and found to be 6cm, 80% effaced and -2 station.
1:30p, Sarah Beth was checked and found to be 6cm, 80% effaced and -2 station.
By 1:30, Pitocin was up to 16, but she was not feeling any contractions, was not in any discomfort and was not having any cervical change. By now, we are all realizing that this Pitocin is not doing what needs to be done. We had done all the things both Sarah Beth and I could think of. )
...........fast forward to 5p, Pitocin on 30, and still no pain. It was scary! The nurse kept mentioning breaking my water, which I was sooooo opposed to, because as y’all know once the bag has burst, you are really on the clock!!! Finally the doc came in to discuss our next step.
(According to the package insert that accompanies Pitocin, dosage is .5-1mU/min to start and increase 1-2mU/min every 30-60 minutes until the desired contraction pattern is reached. It goes on to say that “infusion rates up to 6mU/min give the same oxytocin level found in spontaneous labor. At term, higher rates should be given with great care, and rates exceeding 9-10mU/min are rarely required.” Starting at 2 and going up by 2 every 15-30 minutes is typically what I have observed as a doula. In my experience the rates often go to 16, 20 or 24 with an induction. However, that is not the dosage recommended by the manufacturer. The rate of increase that Sarah Beth received was not particularly slower than is typical with an induction. But it did go higher than I have ever seen. I genuinely surprised that it was not causing painful contractions. As a doula and childbirth educator, I had never heard of someone receiving pitocin at such a high rate of infusion and not feeling contractions. Contractions caused by Pitocin are known for being more difficult to cope with than natural labor. )
I love my doctor! I do. But (now mind you he had 8 inductions Christmas Eve! EIGHT!!!!!! 8!!! Freaking 8!!!! The entire L&D floor was packed. There were 11 mothers giving birth total. 🤬Anyways...) he got short with me. He said, “We need to break your water and we need to break your water now, basically.”
And my baby, John, went head to head with him....
John questioned him, “If we don’t want to have water broke, what is our next step? Can we turn off Pitocin, cut it in half and restart it. What are our other options???”
I was total deer in headlights. I cried.
John was my hero, my champion, my biggest advocate. 🤪🤩😍 it was really freakin sweet.
So, Bianca spoke up and said let us have a few moments to discuss. Doc and nurse left the room. I cried. They nurtured me. We realized the moment we got to the hospital we were “on the clock” Sooooo, this was our best option. This was happening. My water was about to get burst. And Lord please let him come down my birth canal. Please!!!!
(Every birthing person has their own priorities and values. For Sarah Beth, not having her water broken artificially was a big priority to her. Just as she struggled with the decision to go in for the Pitocin, she had to face the decision of having her water broken (AROM).)
Doc came in. I told him not to nick my babies sweet head!!!! Water burst. And I sat up in bed with the bottom half lowered all the way down. Was told to stay that way for 15 minutes or so because we didn’t want a prolapsed cord.
That happened at 4:52. By 5:30 the fun began!!!! And I mean boy, was it fun!!!! Full on contractions. We moving and jiving. Mind you, I’m still plugged up to the Pit. So every new position required Bianca and jOhn to reposition my IV. Also, because of the high bp every 15 minutes I had to be plugged up to check that also. But....we made it work. Me, in my raggedy gown working through each one. They really got intense. I went to the restroom. Bianca told me to try and relax on the commode (I miss that warm seated commode.) That helped. Then all of a sudden, I needed to brush my teeth. Did that. Then I threw up! Nurse was concerned I was going to push little Waylon out on the bathroom floor. Ha! Transition was bloody awful. There was no comfortable position. I think I was mostly on all fours with my face buried into a blanky we brought from home.
The two of them created counterpressure which was wonderful. I didn’t get much rest inbetween to the next hard contraction.
(A nurse checked and said that there was just a small bit of cervix not yet dilated on one side. Sarah Beth was laboring beautifully. She was moving with her body. We provided counterpressure, massage, heating pad, wet cloths, fanning, aromatherapy and lots of love and support)
Then all of sudden....nothing. I got scared. Dear Lord, please don’t tell me labor is stalling. No, no, no. I even remember asking Bianca, “Where did they go?”
Then BAM 💥 it was pushing stage. Just a little grunt here and there. Things were really getting FUN now!!! The more I pushed, the more I felt like my clit was about to bust wide open. Also, it felt like my b hole, rectum, large and small intestines were going to just fall right out of me, to be frank. So, I asked John to apply pressure to my anus. And he did!!! Bianca was applying warm compresses to my perinium. So every contraction there they were. The freakin 💫 DREAM TEAM ⭐️ where were the nurses, you ask... they were in the back row, just watching. At one point I asked one nurse to please spray Eucalyptus in the air. Because every time I pushed, a little feces would come out. Oh, fun!!!! And John would clean me up.
(At 8:15p, with just John and I in the room, I started to notice just a little pause at the peak of the contractions and with each contraction it turned into a stronger grunt and push. No one told her it was time to push or when or how to push, Sarah Beth just trusted her body. Around 9p, I started to see just a bit of the baby’s head at the peak of each contraction. I stepped away to the nurses station to give them an update. Dr. Moore and some nurses were in surgery, so the nurse manager and a nursery nurse came in to the room. The nurse manager very calmly told Sarah Beth that Dr. Moore was in surgery but to keep doing what she was doing, they were able to catch the baby if he did not arrive. No one told her to stop pushing or hold it. This is a wonderful thing and I wish every mother had this experience.)
Anywho, that pushing stage really
Sucked. It sucked. The doctor ffffffiiiiinally decided to make his way into the room. He was doing a C-section just prior. I was his last patient of the day. Hahaaaaa! (John said he could give us the 2019 Biggest Pain In My Ass Award 🥇) anyways, Bianca said The doctor is here if you were holding back before.
(Sarah Beth pushed squatting, and laying on her side. Then suddenly, she readjusted herself and got situated with one foot up on the squat bar and that was what she needed - Waylon was born just moments after the re-position.)
9:29 here comes Waylon. Slippery little .... they put him on my chest. John was laugh/crying. And I was like “whaaaaattttt theeeee fffffuuuuucccckkkkk was that?!!!!!’n” excuse my language but seriously. PTSD. I had it for a while after. I mean I really did. The pain was so real. So terrifying. Bianca and John said that on the outside I looked so calm and peaceful, moving around and using my tools we learned. But on the inside....it was a perfect storm. I cussed, I screamed, I writhed in pain. Just using the bathroom was scary. My vagina was soooo so traumatized.
Not to mention when they got me up to pee the first two times, I passed the hell out. Lord have mercy!!!!
I was emotional . I kept crying. I couldn’t stand straight up. I had really wrenched my spine during the pushing!!!
Rewind a little bit.....I tore. Hell yea, I tore. Grade 3 I believe he said. So after all the pain from pushing this little 8lb 6 ouncer out, he sticks me with numbing stuff.....which hurt. I was so tired of pain. Then he stitched me up. I swear I could feel the last couple and the tugging. Horrible. And not to mention I could see him doing it. Across the room was a colonial picture of mother and baby, and it was acting like a mirror with that bright overhead light on full blast.
(I am pretty sure it was a minor to moderate tear. Dr. Moore commented that it was possible to heal on it's own, but he recommended stitches to get everything lined up correctly.)
It was a bloody mess!!! John said it looked like a slasher movie 🤣 Anyways. One thing I thought was particularly horrible was after allllllll that after all that, the nurse has to rub down your uterus. Which freakin HURTS!!!!!! Still having contractions....whyyy? I know why. 😭 but geeeeeze. When would the pain be over.
I told my sister the next day, adoption was the way to go!!!!
I love my baby boy!!! He is the best thing that ever happened to me. I could not have done it without Bianca and John!!!! Fact. Everyone needs a doula for birth. Everyone needs a partner to stand up for them!!! Advocate for yourself! Educate yourself! Be the mother who will stand up for themselves and for their child. Have a voice! Be empowered! Our birth plan “went out the window” to a certain degree, but I still got the end result....healthy baby boy, healthy mamma, with options explained and my voice heard.
(I asked Sarah Beth what she would tell a mother who wanted to give birth without and epidural but is afraid of the pain. Below is her response.)
Pain is temporary and with time the memories will soften. Before you are to experience the GREATEST PLEASURE of your life, it’s only right you should experience the greatest pain. Because one can not exist without the other. You have to respect one to appreciate the other.
True active labor and pushing only lasted 4 & 1/2 hours. It was because of the intense pain I felt that allowed little Waylon to make his way down the birth canal. I was allowed to move, being without epidural. I changed positions. I rocked. I got on all fours. I sat on the commode. I walked. I laid on my side. I pushed my leg into the birth bar. All of that moving allowed shifts in my pelvis, which allowed Waylon to wiggle his way down. I honestly believe that.
I could NOT imagine being in pain and being tied down to a bed. I can NOT imagine.
Just because you have an epidural doesn’t mean you’re without pain. I have a friend who got an epidural and it only took to one side. Imagine that!!!
Also, research showed epidurals can give some mothers a spinal headache. This sounds miserable to me, as I have lived with migraines my whole life. Imagine bringing new life into the world...your heart and joy...finally meeting your baby for the very first time.....and you can’t even enjoy it because you have to lay completely flat due to side effects of the drug.
Also, research shows babies are more alert and HUNGRY, ready for the tit 🤠 when they haven’t had pain medication. This was also important to me because I wanted breastfeeding to be successful. That was just another hurdle I could avoid. Waylon was placed on my chest, both of us naked as jay birds, and he picked his little big head up and started searching for my nipple!!!! It was incredible. Just like I’d seen in all Bianca’s birth videos. He latched on, no problem.
You’re a woman!!! Which means you’re already way stronger than you think! Don’t underestimate yourself. You were made for this. God intended for us to feel pain. One of my favorite scriptures is Psalm 139:14
I will praise Thee; for I am fearfully and wonderfully made: marvelous are Thy works; and that my soul knoweth right well.
Fearfully and wonderfully!!!! That sums it up right there. Trust in God! Trust in your own strength!
(Sarah Beth faced an unexpected complication and continued with confidence. She listened to her body and looked inward for coping techniques. It was a wonderful Christmas gift to me to be witness to the power of a baby and mother being born.)
Vitamin D is important - as we all know it makes strong bones. But there is so much much more. Vitamin D is actually a hormone and plays a critical role in our immune systems.
When you are pregnant, you are building an amazing little human from the resources in your own body. If you have low vitamin D, you are building a baby that will be born with low vitamin D levels. But perhaps even more critical is what happens at the very beginning of pregnancy - the development of the placenta. Researchers are now learning that low vitamin D levels in a mother puts her at higher risk for placental problems. And the placenta is the organ that keeps your baby growing and thriving in the womb. When the placenta isn’t working right health problems show up for mom and baby.
When you have your own Vitamin D at a healthy level- you reduce the risk of preeclampsia, reduce the risk of pre term birth and deliver a baby with a healthy vitamin D level (which is critical for the immune system).
Here is what you do: Get your Vitamin D Levels where they should be.
Just go ahead and take the supplement, not knowing what your current level is. Research tells us that pregnant women who 4,000iu/day and get enough vitamin D for everything to function as it should.
Or.....If you can, get your vitamin D level checked. (If it’s costly or not feasible with your Care provider, order a kit directly from Grass Roots Health). Then, supplement appropriately to get you into a healthy level. You want to be at least 40ng/ml. (The vitamin D Council has this great chart to help you determine how much supplement you need or this calculator that takes into account your body weight)
So, what if pregnancy is a thing of the past and you are breastfeeding. Same idea: An exclusively breastfed baby is relying on the resources of your body to get what they need. The American Academy of Pediatrics recommends that all breastfed babies receive a Vitamin D supplement. Why is that? Because sooo many mothers are vitamin D deficient.
But you are now officially informed. If you, the breastfeeding parent, has healthy Vitamin D levels, then your baby does not need a supplement. Why give the baby a supplement (which is a pain to do by the way), when you can give your self a supplement and take care of two people at once. Yay!
Research shows that a breastfeeding mother should take 6,400iu of Vitamin D per day. When she does this - both her and her baby have the amount of Vitamin D they need for their body to function as it was designed.
Learn more on this great podcast on "Born to be Breastfed" with Dr. Carol Wagner - Vitamin D expert
Or, here is the link for apple podcasts
For information and support during pregnancy, birth or breastfeeding, contact Bianca Wooden, IBCLC for a consultation.
Of course, I am not a physician. Every person and every situation is different. I am providing some general information, no a diagnosis or specific recommendation for you. Take the information you learn here and talk to your care team about how it applies to you.
Robbie's Birth Story
A note before we get started: I had two lovely, vaginal births with very little medical intervention prior to this birth. This was a traumatic experience for me. Despite having a healthy baby. Despite having compassionate and professional care. Despite surviving. Yes, there is much worse in this world than a difficult birth. That is beside the point. This birth was hard for me. It led to a hard postpartum period and it causes me to mother differently. I share this story for all the women who are disappointed, angry or depressed. It is OK to have negative feelings about your birth and at the same time be thankful. We, as humans, are complicated, able to feel a variety of emotions. You are not alone in your difficult birth.
Thursday, February 16, 34w2d
“The baby is laying with his head on one side and his butt on the other”, but “no need to worry” I calmly texted my husband while my mind raced. Minutes earlier, I had finished my 34 week prenatal appointment. My midwife, Wendy Shaw CNM, assured me that as baby grows, he will run out of room and either his head or butt will go down. When she said it, her calm confidence was convincing, but as the hours passed my anxiety grew. By the afternoon, I was feeling panicked. Sure, he will turn one way or the other, but which way? I was certain, I could push a baby out head first or butt first, but I didn’t want to have to convince an OB that I could (and would). Head first would definitely make everything easier.
That afternoon, I came up with a plan. I would see my chiropractor several times a week, if needed. I would do stretching and exercises from my Spinning Babies training and all would be fine. Do the work and get the results, right?
Friday, February 17, 34w3d
I met my friend and Doula bestie, Natasha Woodard for lunch. I was telling her how overwhelming it felt to be the patient reading the Spinning babies website, rather than the professional. I had even been to a Spinning Babies doula training – yet suddenly figuring out what to do for myself seemed impossible. Natasha did her doula thing and reminded me that there was no need to panic. Exactly what I would tell my own clients. I spoke with Dr Pitchford, my chiropractor, and we made an appointment for Monday. And, I spoke with my Doula, Lindsay Huckabee who also assured me not to worry. Friday afternoon, I walked into my knitting class at the library with mixed emotions. Wondering if sitting in that chair knitting was a waste of valuable time to coax this baby head down. But, I was determined to learn to knit before baby arrived so I could make him a Christmas stocking.
At this point in the pregnancy, I was pretty used to people telling me not to worry. My previous pregnancy ended in a miscarriage at 15 weeks. This pregnancy was clouded in fear. Every single time I went to the restroom, through my entire pregnancy, I looked at the toilet paper with trepidation, worrying that I would see pink (and quite a few times I did). I protected my heart and would not give myself over to this baby. I longed for my first pregnancy. Thirteen years earlier, I didn’t appreciate the wild optimism that comes with youth. With my first pregnancy, I couldn’t have imagined anything going wrong. This time, I worried and then worried about worrying.
Step 1- swim more. Swimming is great for pregnancy and helps baby get into an optimal position. So, I swam. My body was achy, and I was tired, but I went to the pool Friday night. The girls were playing happily and I found myself alternating between swimming and then resting in front of the water jet. The thought of having a baby early never crossed my mind. So, rhythmic visits to have the water jet on my back, didn’t register either. I was having contractions and didn’t notice. After work, my husband, Graham joined us at the pool. I told him I was just worn out, but was figuring out what to do to get our baby head down. We were walking laps back and forth in the pool, just chatting and relaxing. Eventually, I told him, that I was going to get out and take a long hot shower. He could get the kids out in a few minutes.
I rushed into the freezing cold locker room to gather my towel and head into the shower. Every few minutes, I felt water trickle down my thigh. “Ignore it” I repeated to myself. I got out of the shower and stood on a towel in the Kroc Center locker room. “Ignore it” I repeated.
That’s amniotic fluid
It’s just a little leak
It will just seal right up
No big deal
Just a droplet
And then my mind gave in and my heart spoke up:
My amniotic sac is broken, something must be terribly wrong. Is my baby alive? My fear from the moment I saw the positive pregnancy test months earlier.
I texted Lindsay (7p) and after some back and forth we came to an assessment: My water was leaking, It is clear, I don’t know if I can feel the baby, I don’t know if I am having contractions. I am going home to drink water, lie down and listen to my body. I walked out to the pool and told Graham. My deameanor was calm and my conversation to the point. This was not my first time acting this way – This is my “survival mode” that I deploy when I am really, deeply scared. I went ahead in his car while he got the girls cleaned up and followed after me.
It only took a few minutes in the quiet car. I hadn’t even gotten out of Bioxi. It was obvious, I was having consistent contractions. This could definitely not be ignored. Lindsay and Graham met me at home. Lindsay’s role changed from doula to healthcare provider when I asked her to use the dopplar to listen for the baby’s heartbeat. There it was strong, and steady as always. Breathe, Bianca. Your baby is ok, I said to myself. Over and over.
8:20p Lindsay called Wendy with an update. Wendy was able to answer my questions: Is there medical treatment for preterm labor at 34w3d? YES, steroids and magnesium. and Should I go to Garden Park Hospital as planned? NO. If I do not have the baby immediately, I would be transferred to Memorial or if I have the baby and he needs NICU care, he would be transferred. I needed to go to the hospital best equipped for preterm birth. And, with OBs providing care, rather than a midwife.
Standing at the foot of my bed there was a moment of stillness as reality sunk in. The decision was made. I was going to the hospital, in labor. “I guess we need to take the car seat?” It hit me, next time I was in this house, I would have our new baby with us. Not what we were expecting at all.
By 9:30p Graham and I were driving down the beach toward Gulfport, with Lindsey following close behind. In 2 1/2 hours, I had packaged up my big emotions and was focused on the work of preparing for the arrival of our baby boy. I was in work mode. I texted my friend Tina Fritz (NICU nurse and IBCLC) asking, “Where can I find documentation for the best care for a baby in the NICU?” If only such a document existed... I did read a few research articles and quickly realized I could not prepare from what was ahead. I would have to trust and depend on the professionals at Memorial Hospital. Contractions continued.
Since Caprie was born in 2009, I have been at over 30 births as a doula. I have helped about 100 families prepare for the birth of their baby. Of course, I had a vision of how I hoped my baby would enter the world. I wasn’t at all concerned about managing painful contractions. In fact, I was looking forward to the hard work of labor. My dreams for this birth were all about greeting my baby. I hoped to be more “aware” at the end of labor, then I had been at the births of my daughters. I wanted to feel my baby crowning. I wanted my daughter Caprie to catch her baby brother. I wanted to lift my baby to my chest and cover him with warm, soft blankets. I wanted to greet my baby in total peace. I wanted my daughter Luci to cut the umbilical cord. All of this had been discussed with my midwife and doula. Now, I was thrown into an entirely different world of possibilities.
We arrived at the hospital and I was still hopeful that my baby would be born in peace. I had my family, an excellent doula, and the confidence to communicate with my new care providers.
With a mix of confidence and fear, I walked into Memorial Hospital. The security guard proceeded to ask questions for what felt like forever, until my Doula did her Doula duties and said “She is in preterm labor, we are going up to L&D now” and off we went. We walked into labor and delivery and a wave of familiarity washed over me. I remembered standing confident next to my laboring clients as they moaned through contractions, eager to be assigned to a room. Now, here I was, feeling vulnerable and not interested in speaking for myself. The nurses spoke back and forth about which room to put me in. Standing, waiting, worrying for just a minute and yet I felt like I was intruding in something, interrupting their plans for the night. I just wanted someone to take care of me, to take care of my baby.
(This is the point that my memories get really fuzzy, perhaps a mix of medications and self preservation)
I went into room 1. I was offered a hospital gown but explained that I would continue to wear what I was wearing. I would just lift it up for monitoring. My nurse was Michelle. She did a vaginal exam. I felt relieved before she even told me what she was feeling – I knew right away that I had some time before the baby would be born because my cervix was still posterior (she had to really reach to do the exam). I don’t know how dilated I was, but I later sent a text to loved ones saying “I was so relieved to find out that I had dilated very little. As this meant I had some time to wrap my head around this change of plans AND get the medications going to help give this baby a good start.”
It felt weird not seeing a doctor to discuss the care plan. I know that is how it goes, but I was eager to speak to a doctor. I was connected to continuous electronic fetal monitoring, given a shot of steroids, and started on a drip of magnesium sulfate. Steroid shots help the baby’s lungs develop. Magnesium Sulfate does two things, it can slow or stop contractions and it helps develop the baby’s neural system. My baby’s transverse position was a blessing. If his head had been pressing on my cervix, those contractions would have resulted in dilation. His position helped delay birth and give us time to administer these beneficial medications.
Magnesium Sulfate impacts people differently, but it almost always has side effects. The best I can remember was that kind of discomfort when you have a fever. I seemed to be fading in and out of lucidity. I was hot (my nurse was kind enough to bring in a box fan that was blowing directly on me). My skin was sensitive and hurt. I couldn’t think clearly. I was just miserable. I have asked my husband if he remembered if we slept any that night. Neither of us can remember.
Saturday, February 18, 34w4d
I continued the magnesium sulfate and steroid. Sharon was my nurse. My children came to the hospital to see me. It broke my heart that their experience with birth involved feeling sick and getting shots. At aged 12 and 7, the birth of their brother would impact their perception of birth. I had wanted to show them the hard work and joy of labor. Instead, they saw me sick and in bed. My heart was breaking for the lost opportunity for my daughters. But I also felt so much better just having seen them. I was worried about them because I didn’t really have a chance to say goodbye yesterday. During their visit, we listened to the baby’s hiccups on the monitor. Caprie held my hand as I got a shot.
I had an ultrasound done and the baby was head down. YAY!!!! What a huge relief. Lindsay came to spend time with me and we talked about a birth plan and wrote one out on a notepad. I had visits from Dr. Robinson, Dr. Taylor and Dr. Gaddy, each on different days (Saturday, Sunday and Monday). Each one spoke with me at length about my birth history, desires and concerns. We discussed breech birth, premature birth and induction.
With my amniotic sac ruptured (preterm premature rupture of membranes pPROM), the primary concern was infection. I was taking antibiotics, taking my temperature frequently and having blood drawn to measure white blood cell count. Each doctor explained that the longer the baby stayed put, the better the outcome. There is a pretty big range of health status for a baby born around this time. Babies born 5 weeks early, often have short and long term health concerns. And we had no idea what the health status of our baby would be. He could be perfectly healthy or need a lot of medical care.
I decided to count every 12 hours as reason for celebration. Every 12 hours, my baby was stronger and more developed than before.
Saturday night at 11:30pm the magnesium sulfate treatment was complete and the IV was stopped. I also had another steroid injection. I wondered if contractions would start as soon as the magnesium sulfate wore off, but they didn’t. I was able to get some sleep.
I was pretty sure that everyone in the field of birth work that knows me was pulling in favors to make sure I got the best care. Maranda Nybo stopped by to see me. I had a feeling she asked the nurses to be extra kind to me. Each of the nurses and doctors completely respected me and my knowledge and history. Not a single nurse appeared to be bothered by my plan to use as little intervention as possible, even if a breech birth happened. I wish every woman got such wonderful maternity care.
Sunday, February 19, 34w5d
We moved out of labor and delivery and over to the postpartum area. After the frequent assessments from nurses and medications, this felt like I was suddenly on my own. And the fog was lifting from the magnesium sulfate induced haze. I could finally think straight. I asked Graham to get me some Vitamin C, echinacea and garlic to help keep me healthy and fight off infection (along with the antibiotics of course). I also started wiping with alcohol pads to try and keep that area as clean as possible. I was communicating with Lindsay who confirmed that Vit C, hydration and regular vulva cleaning were the best ways I could reduce risk on infection. We also chatted about a birth plan if I did start showing signs of infection but was not in labor.
My blood was drawn several times a day and temperature taken, to assess for infection. My family visited me. The OB reminded me that I could be there a day or a week or more. As long as baby was healthy and I was healthy, staying pregnant was the best thing. I focused on being still and relaxed. I counted every hour pregnant as a success. Graham continued to stay with me. I believed baby to be in a head down position, so I was prepared for a vaginal birth. I thought of how I would keep my premature baby skin to skin so he would have the gentlest transition- kept warm and calm by my body. I stopped worrying that he would need special care. And, it didn’t cross my mind at all that we may face breastfeeding challenges. I envisioned a healthy, peaceful, vaginal birth. Just the day before I was expecting a NICU stay, but now I had decided that wouldn’t be needed. My determination would keep baby in the womb until he was strong enough to be in my arms.
In the afternoon, I felt some mild contractions, but they didn’t get stronger. Around 5:30p, I went to the bathroom and saw a dark red glob in the toilet. Having seen many mucus plugs in my time and being certain that I would not have this baby tonight, I decided it didn’t mean anything. The power of the mind to deny reality is pretty remarkable. I texted Lindsay a photo (doulas love photos of mucus plugs, haha). She said “It’s safe to say you are dilating at this point.”
I found this in a book and read it over and over
I surrender my birth over to the Divine Mother. I let go of all my expectations, my plans and my desires. Thy will be done. As I do this, I birth a human being who is unencumbered by fear. My highest and best unfold when I learn to let go and let God. I am eternally immersed in God and God is eternally immersed in me. I enter the sacred space of nurturer and sustainer of my child, and the triumphant sound of gratitude rings through my baby’s voice, my action and state of being. So be it. Amen.
Certainly, a beautiful prayer. And as I read it, I believed it to be true. In reality, I was still planning a birth on my terms – vaginal and peaceful. I had not handed over the reins to the divine.
Eventually, I fell asleep and hand another night of rest.
Monday, February 20, 34w6d
I felt settled and confidant. My job was to stay healthy and calm. Don’t get out of bed. Keep baby safe and secure in my womb. Dr. Taylor came to see me. He said that if I were to start getting an infection, my body would know before they would and my body would go into labor. This was good news, because I did not want to develop an infection and then face induction. He said when women are in the hospital with water broken, the average time to birth was 7 days. I hoped for me it would be even longer. He ordered the leg pressure cuffs to my calves to prevent blood clots. He also ordered another ultrasound to assess fluid level and position again. The ultrasound revealed that my fluid level was 6.6 - which is great because I didn’t even have clinically low fluid despite the constant leaking of fluid. But, I couldn’t even hear that good news because baby had moved back to transverse. I cried. I said “I know everything will be ok.”
I told Graham to go home for the night. I was sure that I wasn’t going to go into labor. He needed rest and the girls needed to be with him. I don’t know why I was sure I wouldn’t be in labor. I was having contractions all afternoon and even told Lindsay that they were uncomfortable.
My last message to Lindsay was at 11:38p – “Well, the contractions are keeping me awake.”
Tuesday, February 21, 35w
Lindsay arrived in my dark, quiet hospital room to find me leaning over the end of my bed, swaying side to side. It was obvious that my baby would soon be born. “Have you called Graham?” I think she was a little surprised by my answer of no. I hadn’t told a nurse or Graham or even myself the reality of what was happening. Part of me wanted our baby to stay put and keep growing, in the place he was supposed to be. But mostly, I was enjoying being alone in the quiet room, savoring each wave of tightness across my back and wrapping around to the front of my belly. Having given birth twice before I knew the bliss of completely turning off my mind and letting my body take the lead. I fell into that state of mindlessness easily. I wanted to stay in that moment, where I didn’t need anyone.
The moment was short. I called Graham and told him I was in labor and for him and the girls to come to the hospital. He must not have been ready because he said, in groggy sleepy voice “Are you sure?” – Yes, I am sure. Lindsay alerted the nurse that I was having contractions. She wheeled in the electronic fetal monitoring system and proceeded to strap on the monitor for the baby’s heart beat and another for contractions. The nurse wasn’t in a hurry at all. I could sense that Lindsay was starting to get frustrated.
It was obvious I was in labor and yet, this nurse said she must verify that I was in labor by having it printed out on the EFM strip. I was wondering if this was her first day on the job. She was having difficulty picking up the baby’s heartbeat and even more difficulty picking up a contraction. Lindsay, being that she is a trained midwife, knew what to be listening for. She marked on the EFM printout when I was having contractions, so that the printout would be useful to anyone who saw it. Lindsay urged the nurse to notify Labor and Delivery that I was in labor. The nurse said she couldn’t do that until she could get the contractions on the monitor. Lindsay knew that the baby’s position was uncertain and regardless what the monitor said, I WAS contracting. I too was frustrated with the nurse, but felt a level of comfort having Lindsay with me. She would know if the baby was in distress.
Thankfully, Lindsay walked down the hall to Labor and Delivery and returned with a nurse. A nurse who knew me from a just a couple days earlier. She asked me to lie down for a cervical exam. The exam seemed to take forever. Finally, she looked at me and said that she felt arm/shoulder as the presenting part. A cesarean would be necessary. Suddenly, things started moving very quickly. And suddenly, I wasn’t enjoying the contractions. Fear led to tension which led to pain.
I called Graham (or maybe Lindsay did) and told him I would be having a cesarean very soon and he needed to arrive quickly. My friends and family later told me that they had received a text from Graham announcing that the baby was coming and it seemed like only minutes later that I was having a cesarean and not long after that a baby announcement. This was all moving quickly.
My bed was wheeled down the hall to the Labor & Delivery department. I was asked if I wanted to change into a hospital gown and I did not. I want to wear the short nightgown I was wearing. The nurses said it could get dirty with blood and I said, it didn’t matter to me. I wanted to wear it. It’s funny how something as simple as a familiar nightgown can make you feel safe. With everything moving so quickly and not having any loved ones there with me I felt like nothing was familiar. I was in unchartered waters and I needed something to hold on to – and that was my nightgown. The nightgown I bought at Walmart along with 4 others for my mom and 3 sisters for our girls weekend at the beach a couple years earlier. That nightgown connected me to the people I loved and I wasn’t going to give it up.
The nurses gave me a dose of sodium citrate (Bicitra) to drink. This is supposed to neutralize your stomach acid and reduce the risk of lung damage if I were to inhale stomach contents if I were to vodmit.
Over the last 77 hours at the hospital, I had considered many possibilities of how this birth was going to unfold. I was prepared for a breech vaginal birth or even a cesarean birth. I was not prepared for what Dr. Taylor told me when he arrived. He was kind and considerate, but that didn’t change what he was saying. Due to the fact that my water had been broken for some time and my white blood cell count was elevated, he prefers general anesthesia for this cesarean surgery. I couldn’t believe what I was hearing. I said to him, “After this is done, I don’t want to research this and discover that epidural would have been just as safe.” He assured me that he was confident that general was the way to go and avoid the risk of introducing infection into the spinal fluid. I believed him. I believed he was advising me of the safest was to deliver my baby. But, I was really scared and feeling very alone. He said we would be going to the OR very soon. Lindsay spoke up and asked if we had time to wait until my husband arrived. He said, well, it depends on how long it will be. I called Graham again and with my voice shaking. I urged him to hurry because I needed to go into surgery right away. He said he was in the parking lot.
They explained that as soon as I was under anesthesia, they would need to move very quickly. So, they needed to have everything ready for surgery before administering the anesthesia. The nurses shaved the area where the incision would be. And then inserted a bladder catheter. It didn’t feel good.
Graham, Luci and Caprie arrived. The girls were tired and groggy, but eager to meet their baby brother. Graham leaned in to give me a hug before I was quickly wheeled to the operating room. All I could say was, “I’m scared.” In my mind I was thinking, I hope I don’t die. I can’t leave them without a mother. I don’t know why I was thinking such catastrophic thoughts. Perhaps because my mother died when I was a child, so it is always a little fear tucked away in my heart. Or maybe it was just that everything felt so out of control that anything was possible.
I was wheeled down to the OR and lifted off my bed and onto the operating table. I was freezing. I was scared. I was crying. I was shaking. Wendy Shaw, was in the room with me and the only person that seemed familiar at all. I held on to the sound of her voice. Everyone was busy going about their work. Suddenly, I remembered PEACE. There is a phrase in one the guided meditations that I have read dozens of times with my childbirth class. “Breathe in Peace and breathe out anything that is not Peace.” I said it over and over and then I was asleep.
3:19a – Robbie was born. I was later told that it was a difficult cesarean. I did not handle the anesthesia well. I was fighting and trying to get up off the bed. I needed to be restrained. A nurse needed to push Robbie’s shoulder back up from my vagina. The doctor was trying to remove him quickly due to the general anesthesia. The OB said during the surgery that if he didn’t come out with this last try, an additional vertical incision would be necessary. Thankfully it was not. The baby was taken directly to the warmer and then the nursery. Graham was taken from the hospital room to the nursery to greet Robbie. Lindsay followed to take pictures (which I had told her were very important to me). Caprie and Luci were left in a room waiting. Caprie was very scared and now, even two years later remembers being scared as the primary feeling of the day her baby brother was born.
I did not die. My baby was healthy. I would recover. I acknowledge all of that. However, my baby did not arrive into the world in peace and love. I have done my best to show him peace and love every day.
Robert Todd Wooden
Born at 35 weeks
5 pounds 0 ounces
(postpartum and breastfeeding story will follow, eventually)
FAQ For Potential Volunteers
Several people have asked me questions as they consider volunteering. I am happy to share my personal experience volunteering with Nurture Project International. I would like to remind you of the limitations of sharing my experience because of the ever changing situation at the work sites and the diversity of volunteers.
How did you make the decision to volunteer?
When I saw the initial advertisement from Nurture Project International for lactation consultants, I was immediately interested in going. I sent an email to NPI right away. Having never done any work of this nature, I had many questions. Most of the questions I had to answer within myself. My most pressing concern was if I would actually be helpful. I wondered if I was the right fit for the work. I haven’t traveled internationally much. I worried that I would not adapt to working in a culture and circumstance so difference than my own. It ended up not being a problem for me at all. My second concern was my personal safety. I visited the US Department of State website to look for travel advisories to Greece. The US did not have any recommendations against visiting Greece. I believe I first learned of NPI in mid-March 2016 and booked flights in mid-April. I started my trip to Greece on June 2nd and returned home on June 16th.
How long do you recommend a volunteer stay?
I asked this same question to NPI. I was advised that 2 weeks is the recommendations because longer stays become increasingly more challenging. Not knowing what to expect, I decided to stay 2 weeks. Leaving to go home is hard for everyone. I felt like I was doing good work and developing relationships with refugees. I was sad to leave them in the hands of other volunteers. I wanted to stay longer and I still wish I had stayed longer. However, I understand the 2 week recommendation. The work is emotionally tiring. I could see from others that after working longer, frustrations begin to grow. Those frustrations can prevent the volunteer from being effective. With a stay of two weeks, I was able to work everyday. If I had stayed longer, I would need to take a day off at regular intervals.
How much does this cost?
As a volunteer, I was responsible for travel, food and lodging. My airfare from New Orleans, LA to Thessaloniki, Geece was $1300. I rented a car in Thessaloniki (which was optional) for $286. I purchased travel insurance through Seven Corners for $108. NPI rented a house for volunteers. I donated the recommended $10 per night to NPI to cover the house rental. I borrowed an “unlocked” smart phone from a friend and purchased a SIM card with phone minutes and internet. I think I paid about 20 euros. Food in Greece cost less than the US. On a tight budget, you could get by on a few euros a day. But even eating out for most meals, the cost is under 10 euros a day.
What did you do to prepare?
I applied for a passport and international driver’s license. I met with a physician who specialized in international travel. She recommended several vaccines that I compared to the vaccines recommended by NPI and decided which ones I wanted to get. The doctor provided a prescription for an antibiotic just in case I fell sick during my travel (thankfully I did not need it). NPI provided a list of required on-line reading and training that focuses on the topic of infant feeding. I completed the training and uploaded the documents required by NPI. Deciding what clothes to take was a challenge for me. I needed to pack light and make sure I took the right things. NPI requires covered shoulders and legs to be culturally sensitive. I think it also projects an image of professionalism which is important for gaining respect from the authorities and the refugees. I chose to wear long skirts, short sleeve shirts and sandals. I carried a small backpack, but I wish I had also taken a bag to wear around my waist for my phone and passport.
What was the work like?
As a lactation consultant, my job was to meet with individual mothers of children under two years old and support them in safe feeding. I worked at 3 different camps (Hara Hotel, EKO, and Kalichori at SK Market) and the arrangement was different in each. Whether, I went to their tent or they came to us, my goal was to establish trust with a mother and learn about her children and how and what they were eating. If it was a mother we already had a relationship with, I asked for an update. Every day was a little different, but I will share an example of a “typical” day. We would start to get the team together around 9a. It always took longer than expected to get everyone and everything together. Each day there were supplies to be loaded in the car, along with anything we needed personally during the day (perhaps a packed lunch or cold water). We arrived at the camp and set up our tent (base of operations) around 10a. During the work day, we had busy times and slow times. As women stopped by, we would greet them and sit down for a conversation. Depending on the camp and supplies available, we give mothers various items. We visited with the mother to discover if she had any concerns we could help with. If we couldn’t help, we simply provided a kind ear or a referral to a different NGO. We usually started packing up for the day around 3p. It would take some time to clean up and pack up. Once back home, there were always tasks to be done; sometimes researching something for a mother, purchasing supplies for tomorrow, washing furniture coverings for the tent, or speaking with the NPI site coordinator about a specific case. After all the teams were back at the house, we would gather together for a debrief. These are important for several reasons. The meeting provided a much needed ended to the work day, it was a time to pass along any new information or updates to the team and is helpful for the emotional health of the individual volunteers. After the meeting we would often eat dinner out together. More often than not, we were saying goodbye to a volunteer or greeting a new arrival. By the time dinner was over, it was time for bed.
Who is a good volunteer for NPI?
When I first learned of NPI, I wondered if I would be a good fit for the job. Each of the volunteers I met and worked with were absolutely wonderful. They were able to work in an environment that changes constantly, they were willing to jump in and make decisions in the moment, but also knew when to collaborate with NPI coordinators. They were self aware and could recognize their own limitations. A good candidate to volunteer with NPI is smart and kind. If you are considering volunteering, I am happy to visit with you and help you understand the work environment and if it is a good fit for you.
Why Me? Why You?
One month ago I was traveling to Polycastro, Greece a step into the unknown. I left my wonderful husband and two children at home in Mississippi to do something I had never done before. I was going to provide lactation support to Syrian refugees.
That last sentence sounds so simple and straight forward. I am a mother who breastfed her own children. I am a volunteer lactation counselor with La Leche League. I have helped many mothers breastfeed. I knew the two weeks in Greece would be full of new experiences. What I did not know was the intensity with which my heart and spirit would change.
Last year, my dad died unexpectedly and a few weeks later I miscarried a baby girl at 15 weeks gestation. Both came with such a shock, my happy world was changed. As I emerged from those devastating events, I found myself with a feeling that is difficult to describe. I was restless. I didn’t trust what I had previously believed to be true. I wanted more from life. I had discovered emotions deeper than I knew existed. I wanted to put the depth of my heart to good use.
While mindlessly scrolling through facebook, the ad shown above appeared. It was speaking to me. Someone, somewhere needed the skills I had. Someone needed my raw heart. Someone was in a deep unexpected pain and I knew what that felt like.
I didn’t know anything about Syria, Greece, refugees or the entire Middle East. I stopped watching the news years ago. I quickly discovered that Syria was in ongoing, complicated war. After years of fighting and hoping for a resolution, thousands upon thousands of Syrians were leaving. They packed a bag, picked up their kids and walked out their door in search of a safer place. I know if I had to do that, I would want a friendly face on the other end of that journey. I decided to go to Greece to offer an empathetic smile and a hug to the mothers who made that journey.
I am happy that Nurture Project International found me. As an organization, we share the same values. We respect mothers and recognize that through supporting mothers we can make the world a better place for generations to come. We know that breastfeeding not only saves lives though better health, but has the power to build strong mothers. While working in refugee camps, I met with mothers one on one. I offered technical assistance and breastfeeding support. But more often, I showed that I cared. The refugees are in terrible circumstances and the kindness of a Nurture Project International volunteer can give them hope to keep going – to keep hugging their children – to keep waking up – to keep hoping for a bright future. Nurture Project International volunteers save lives.
When I told people about my trip to Greece, they wanted to send things. Baby carriers, diapers, clothes, formula, bottles. There are all kinds of important reasons not to send stuff. More importantly, I can tell you what the refugees in Greece need: They need YOU.
I know you have reasons why you can’t go. I had reasons too. You don’t have money. You have family to take care of. You have school. You have work. You don’t have a passport. You don’t speak Greek or Arabic or Farsi. You are scared to travel overseas. You have people at home that need you. You feely panicky when you think about walking into a refugee camp. You don’t know about refugees. You don’t know about Muslims. You are scared.
Take a breath. Breath in Peace. Breath out fear, pain, anything that is not love and peace. The families in refugee camps escaped a terrible war. They ran away from terrorists. The world is stuck. Tens of thousands of people are looking for a peaceful home and the world was not ready for that. World leaders don’t know what to do. But, you can do something. You can save a life. You can spread love and peace simply by your presence.
I am asking you to go to raise your hand. Be brave. Be part of the change. I will help you.
Bianca Wooden, IBCLC