Sunday, April 29, 2012

A First Time Doula Becomes a First Time Aunt!

When my sister, Janelle, and brother-in-law, Jamie, asked me to attend the birth of their daughter as their doula, I was overcome with emotion. Knowing that they not only wanted me to be there for the most important day of their lives, but that they trusted my knowledge about birth and my ability to support them through it was one of the greatest compliments I’ve ever received. As Janelle’s pregnancy progressed, I helped them develop their birth plan and explained the various options available to them. When Janelle had questions about certain interventions or procedures, I gave her the pros and cons, told her what I would do if it were my birth, and reminded her that I would support and advocate for whatever decisions she made.

As my niece, Harper’s, arrival drew closer, I can now admit that I was a bit anxious and nervous. I have no training as a doula, just the knowledge I acquired throughout and since my own pregnancy. My only firsthand experience of birth was my own cesarean birth. I wondered what my role would end up looking like, and wondered how the experience would impact me. If my sister’s natural water birth went according to plan, would I feel jealous or resentful that she experienced something I’d longed for so much? If it didn’t, would I feel a sense of failure or inadequacy? Only time would tell, but I knew that whatever happened, I was going to be there for my sister and do everything in my power to see that she had the birth experience she prepared for.

On the morning of April 25, 6 days past her estimated due date , Janelle e-mailed me and expressed frustration and growing fear that she’d be pressured to consent to an induction. I replied:
I know it's easier said than done, but try not to worry too much about induction. Put your energy and focus on the birth you do want and it's more likely to happen. When you are tense and worried, so is your birth canal! Harper and your cervix want you to be relaxed and confident so they can do your work! I love you and have faith in you!

We e-mailed back and forth a few times, and then she e-mailed me asking how my labor had started, because she was feeling “crampy”. We spoke on the phone and what she described sounded like early labor to me! It wasn’t long before she decided to leave work and get ready for labor. I arranged to have coworkers cover my work for the following day and checked in with Janelle and Jamie occasionally. At about 6:00 pm, Janelle informed me that her contractions were about 5-6 minutes apart. I asked her to let me know if she decided to try to go to bed for the night so that I could too. I occasionally sent text messages to her or Jamie, giving reminders that she needed to stay hydrated (as I knew she wanted to avoid an IV) and to rest as much as possible.

At about 8:00 pm, Janelle texted to let me know she was going to try to go to sleep. I went to sleep at about 10:00 pm, and woke up to my phone ringing at about 3:30 am on April 26. Janelle told me that she was going in to the hospital to get checked, then her voice got panicky as she said “What if this is false labor and they send me home?” I assured her that I could tell just by the sound of her voice that it was not false labor, and that I’d meet her and Jamie at the hospital.

When I arrived and was shown to the exam room where Janelle and Jamie were with a midwife and nurse, I waited and listened for a little while before knocking. I heard Janelle breathe through a contraction and was impressed with the rhythm she’d found. I’d come prepared with the notes I took from the Lamaze video she asked me to watch, but it turned out that she’d found the pattern that worked for her and I didn’t need them! I entered the room and the midwife checked her; 7 cm dilated, 0 station, and fully effaced! The nurse and midwife were impressed and congratulated her for doing all of that hard work at home. The nurse then gave Janelle the good news that the birth center suite was available; I didn’t hesitate before asking her to start filling the birth tub, please.

We got settled into the birth suite at about 5:00 am, and Janelle got into the tub as soon as it was ready. Jamie set up the music she’d brought for her labor, and brought over the jar of bath scrub that she likes to smell. The mood in the room was light and happy, we helped support Janelle through her contractions and laughed and joked together in between. Jamie noticed that as each contraction came to an end, Janelle would hiccup once. Her hiccups became our cue that the contractions were ending, and we all giggled every time it happened! The hiccups were also my cue to remind her to sip water or Gatorade to stay hydrated.

The nurses on duty were helpful, supportive, and respectful. The first nurse asked if she wanted any medication by IV, “to take the edge off,” and Janelle immediately responded “no”. I took that opportunity to remind the team that she had a birth plan on file and did not want to be offered pain medication. We all helped Janelle move back and forth between positions that might be most comfortable for her, and lightly splashed water on her back and abdomen. Her labor slowed down a bit in the tub, and she eventually moved to the bed to labor on her side for a while. When a new nurse came on, she encouraged Janelle to spend some time up and moving around to help things progress. She tried leaning against the birth ball as well as supporting herself on the edge of the tub while swaying her hips back and forth. At one point, it occurred to me that I was unintentionally swaying myself, the way I automatically start to do whenever I hold a baby. The contractions were more intense and closer together when she was up and moving around, and when the nurse went to get the midwife to check her progress, Janelle laid on her side on the bed again. Her contractions slowed down and she was able to doze off and rest for almost half an hour.

The midwife came in at about 9:00 am and waited for Janelle to wake up before checking her. She found that she was nearly fully dilated and that her bag of water was bulging. She mentioned that things would go faster if she broke the bag of waters, but that she wanted to respect Janelle’s wishes for no interventions. Janelle looked at me and asked me to remind her why she didn’t want her water broken. I reminded her that once her water breaks, the hospital will put her on their time table, but that since she was so close, it was up to her. I told her that if she tried getting up and moving around again, it might break on its own. She was having a hard time deciding what to do, so she said she was going to go to the bathroom first and then decide.

When she went into the bathroom, we heard a splash and her say “Well, there goes the water!” Jamie and I laughed and I was relieved that she didn’t have to make the decision to have her water broken. It was about 9:30 am at that point, and Jamie added some hot water to the tub so she could get back in and get to work!

My Brother-in-Law freshening up the water in the birth tub

Janelle’s contractions were much more intense after her water broke, as Harper descended into the birth canal. At first, Jamie and I were on either side of her, each holding one of her hands, and using our free hands to support her back and shoulders when she leaned forward to bear down and push. Janelle was starting to doubt her ability to push her baby out, and I reminded her to “Trust your body, it knows what to do.” After a few contractions, the midwife suggested that Janelle hold on to the handles instead of our hands, and that the nurse and I each support one of her legs while Jamie supported her from behind. From my position, I was able to see the top of Harper’s head start to appear. The midwife asked if she wanted to reach down and feel her head to see how close she was, and Janelle just kept saying “I don’t know!” Janelle got discouraged when she could feel Harper move back up after a contraction ended, but the midwife assured her that it was normal, and that with each contraction, she’d get back down to where she was at the last one and a little further. Janelle exclaimed “She’ll have a conehead for sure!” and we all chuckled.

Getting situated before another contraction starts
After we all switched positions, things moved very quickly. After pushing through two contractions, I watched in awe as Harper’s head came out, followed almost immediately by the rest of her perfect, tiny body. My first instinct when the midwife pulled Harper from the water and placed her on Janelle’s abdomen was to reach out and touch her, but I caught myself and took a few steps away and watched as a family was born. The look of surprise and pure love on my sister’s face took my breath away. I watched as Jamie gasped and then got choked up, clearly experiencing a feeling of love that he never had before. I grabbed my camera to take a few pictures, knowing that even though Janelle had said earlier that she didn’t feel “cute” enough for pictures, she’d want them to look back on.

A Family is Born
Jamie cut the cord and Janelle delivered her placenta right in the water. The midwife noted “Hey, no conehead!” while they took in the beauty of the life they’d brought into the world. Janelle tore her attention away from Harper for long enough to shout “Hey! My sister wants to see the placenta!” I explained to the midwife that I didn’t get to see mine, since I’d had a cesarean. She took the time to explain it to me and let me thoroughly check it out. The student in the room who’d just witnessed her first birth looked shocked that I wanted to see it, and I smiled at her and shrugged and said “Yeah, I couldn’t talk her into eating it.” I think that just about sent the poor nursing student over the edge!

I hung around long enough to help Janelle get Harper latched on to nurse after the midwife finished stitching her up. As hard as it was to tear myself away, I knew that Janelle and Jamie needed time to rest and get to know their newborn daughter. I have never felt closer to or more proud of my sister. Sharing in the experience of the birth of my niece has been one of the most incredible things I’ve been a part of. As I told her, it has changed me in a way that I can’t find words to describe, and I will forever be grateful that she and Jamie trusted me to be a positive presence at the birth of their daughter.

I’m happy to report that there was no bitterness or jealousy on my part. Seeing a natural, normal birth take place in a supportive and respectful environment was very empowering and healing. It strengthened my resolve to experience a natural birth of my own one day and affirmed the power and wonder of a mother and baby working together to create a gentle entrance to the world. I truly hope that I have the opportunity to be a part of more births like my sister’s, including my own!

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