Catching up!

This year has been pure madness. Some good some bad, but all in all necessary. I haven't had a ton of inspiration on the blogging front, but my Instagram game is pretty steady. Check out my World Doula Week Birth affirmations, for some insight on my year so far. Thanks to my avid readers. Please feel free to contact me personally with any insight or questions you may have!

Bali, A Birth Story

I had the opportunity to visit Bali this year. I was there for 3 weeks working with a family and experiencing my surroundings when I had some time off. The streets in Bali are lively with motor bikes by the hundreds flooding the streets, even the sidewalks in times of congestion. The people smile, and busily sell their services to tourists on the streets. I had the opportunity to visit the city of Ubud, known to some from the book turned movie, “Eat, Pray, Love” by Elizabeth Gilbert. I did my best to live it up during this very unique experience. I haggled with men on mopeds for transportation services, walked, and prayed in a temple. I rode on the back of a motorcycle through the rice paddies, watching the flags and banners waving as we cruised by, the sun beating on my skin as the driver stopped and went with quick decisions through busy road ways. I’m not going to lie, I was concerned for my safety, but only a little. I spent an afternoon at a beach club drinking margaritas and listening to good tunes while meeting different people from around the world at a swimming pool bar. I even got to wash a grown elephant and feed a baby one. I mean, dream vacation, right? Funny thing is- none of those experiences topped the one I had at the Bumi Sehat birthing center.

While visiting Ubud, I had the opportunity to visit Bumi Sehat, a community birthing center started by Robin Lim. When I arrived in the city, I began asking around about Bumi Sehat, interested in hearing a story or two of births that had happened at the center. I was able to speak with two different gentleman who provided me with transport. The first gentleman in his 60s told me of his daughter who was receiving care at the center, and how grateful he was for the the facility as well as the staff. The other man was in his 30s. He and his wife in the process of trying to conceive. They attend fertility counseling offered in the center. He discussed how grateful he was for the affordability of the care. The center accepts whatever you can pay. How beautiful is that? Everyone receiving the same quality of care, for whatever they can afford.

I planned on getting there and simply offering my hands in any way. I was prepared to check in on postpartum recovery mamas and help them swaddle up a fussy baby, or establish breastfeeding. Heck, I was open to prepping food or folding some laundry, Wherever they needed me, I was ready to serve. The PR woman showed me around the center. Upon introducing me to the midwives on call that day, they immediately said, “Oh, you can support our birthing couple!!” I honestly did not expect this. I was floored. It turns out that this couple had wished for a doula, but were unable to attain one. The staff asked the couple if they would be ok with me providing doula services for them. They said, “Yes.”… I couldn’t believe it. Due to the nature of the work I was doing in Bali, I was only available to stay for 5 hours, so when I arrived I made it a point to make that very clear to them. It is important that boundaries are set, to not leave clients with disappointment. They still felt the time valuable, so I joined them in the room they were in, introduced myself, and got to work.

It was like a dream. The mother was originally from the Netherlands, her partner born and raised in Bali. She smiled at me with the glow of a laboring mother. Still talking and smiling in between contractions. It was a different dynamic than my other births, of course, as this was happening in a culture that exists on the other side of the planet from my usual domain. I get more time to get to know my state side clients before the birth. This birth support required a subtle dance between present, quiet support, and getting to know each other through conversation. One of my favorite aspects of international travel is the constant obstacle that language barriers provide. The art of communication is really chiseled down to the very raw details. Body language, eye contact, and listening. As a doula, I utilize these very aspects of communication in my work. As mentioned before, I make the time to meet with my clients a few times prior to the birth. However, there is still that aspect of uncertainty in the air. The unpredictability of birth permeates all aspects of the birthing room when the time comes. There is no way to know how one will react in that space, until we are actually there. I enter every birthing room with an open heart, ears, and eyes. When listening with all my faculties, intuition guides my hand and body where it needs to go. So, walking in here I felt virtually the same emotions as my state side births. The only difference is the comfort in imminent changes this community has. Imagine only having access to just what you need. No overabundance of materials or services to choose from, simply being comfortable with what you can have at that very moment. This couple welcomed me with trust and confidence. That confidence allowed me to just jump in and help, despite having just met at that very moment..

The environment was warm and muggy. The back door to the room open wide with curtains blowing in the wind.  The sounds of motor bikes, children’s voices, and generations of families housed together, thriving as their own village. I could not believe what an opportunity this was for me, and how enriching it felt to participate in this one of kind experience. Aside from her partner, she had some close friends present at her birth. Very relaxed with them in and out making sure mom and dad had everything they needed. Her girlfriend even snapped some of my only photos present at a birth.  

Applying counter pressure to mother's hips while she rest off of her feet.

Applying counter pressure to mother's hips while she rest off of her feet.

Mama was sitting on the bed when I came in, which was low enough to allow the space for her hips to ease open. As we were quickly getting acquainted, she began pacing the room. That is one of my most favorite aspects of birth. In staying present in that space, birth itself begins making certain choices for you. As a doula, this allows us the opportunity to get a sense of the mama’s rhythm. The last thing I wanted to do was walk in there and stand in the way of all the progress already done, so I just watched for a minute. I then began implementing some counter pressure during her contractions. She would beautifully float from bed to wall, placing her hands on it as a contraction came on. Her knees would weaken a bit allowing her to naturally squat into each surge as they came on. I acclimated her to my touch for about 30 min allowing her to brush the edges of active labor.

She asked for some relief for her hips and mentioned feeling sort of stuck. Feeling stuck can happen for all sorts of reasons, it could be the position of the baby, a nagging thought in your head, or maybe just an aspect of the waves of emotion you are feeling, keeping you from moving you forward. I got her on her hands and knees on the bed and went to my bag for my rebozo, calmly explaining to her how I would be using it. I wrapped the rebozo around her hips, tightening just enough to grip and gently shimmy them back and forth. This forced her muscle tissue to let go, easing baby lower. We stayed there a little bit after, swaying her hips back and forth while I applied counter pressure during contractions. We became a unit on the bed, with dad spotting us. She soon grew tired of this position, so I got out the birthing ball, giving her the chance to rest but still able to work her hips.

Applying counter pressure in an active labor position.

Applying counter pressure in an active labor position.

Before we knew if it, she mentioned feeling fluid leaking down her leg. This is a good indication of what we in the birth world refer to as SROM, or Spontaneous Rupture Of Membranes. For this mama it seemed more like a small tear, slowly emitting amniotic fluid with each contraction. This is can also be an indication of possible transition. When the waters break, the cushion between the birth canal and baby’s head disappears, which can intensify the birth considerably. This was true for this mama. She slowly stopped talking, and began pacing even more than before. Her close friend cut up some dragon fruit for the room and mama would stop and snack as often as possible. I was watching the clock pass time as she slowly drifted off into the most intense place she had been since the beginning of this journey. Her midwife, Robin came in to check on her. She was pleased with her progress, and without any intervention, other than some suggestions on birthing techniques, she took her leave to allow this birth to unfold. We got mama in the shower on a birth ball. She rocked her hips more intensely, dad and I taking turns running warm water down her back as she moaned beautifully. Her restless feelings grew bigger as she furthered her progress so she switched back to pacing, clearly her favorite method of laboring.

Her friends and husband spent some time observing me, and I teaching them some of my techniques so they could assist her closer to pushing. Soon, it was time for me to leave. Without taking away too much from their current moment, I gave them some words of encouragement and gratitude, and left knowing that they were soon to meet their little one.

Staying active in a supported squat on the birthing ball.

Staying active in a supported squat on the birthing ball.

The last couple of weeks there consisted of long hours as a babysitter, and quiet evening swims in the moonlight. It wasn’t long before I was packing my bags to return home. As beautiful as this island is, my heart belongs to Texas. The trip home is well over 24 hours, including an eight hour layover in Korea. I was exhausted by travel, my tummy sour with the acidity of my fourth cup of coffee, but I couldn’t help but smile at the joy I received in spontaneously supporting a beautiful mama through her transition from early labor to active labor. My life is forever changed for this experience and I will be forever grateful.

Surrender, a birth story

I have had the pleasure of attending several births in that last 2 years. All of them beautiful, in their own right. As mentioned in my last post, I will be sharing one birth story a month. My intention is to empower and educate in the diversities of pregnancy, birth, and doula support

Today I am going to share with you the most recent birth I have attended. To uphold privacy we will call mom Carrie and dad Eric. I met this couple through Enlightened Baby's doula date night. Living in Austin has really offered up great resources in being paired with new clients. Carrie had shared with me a sizable list of concerns, and I did my best to help alleviate some of her anxiety. She was diagnosed with pre-eclampsia early in her pregnancy. This immediately labeled her a high risk pregnancy, which for a first time mom can be very scary. On top of that, she also has a list of allergies that needed to be advocated for, and is not a candidate for an epidural. This couple was facing a little more complicated situation from the beginning, so they set out and learned more about birthing. I hope to share more on Blissborn, the practice in which Carrie and Eric learned in their birth class. In a nutshell, it consists of a list of things that partner reads to mom, with the intention of guiding her to a meditative state. 

With pre-e, majority of physicians will induce around the 36-40 weeks depending on the stability of your blood pressure. Carrie was induced at 39 weeks, this is incredible for pre-e mamas. This meant that her blood pressure was remaining stable. The OB even made a comment during labor about Carrie's BP making her look silly with how well it maintained. 

Carrie had a pitocin drip and broken waters early in the morning, so she was experiencing some sizable contractions when I arrived. Her choice methods of relief were heat on her lower back and counter pressure/massage. She seemed motivated, so I suggested we do hands and knees, so I could use my rebozo and shake her hips for a bit. A rebozo is a large scarf native to Mexico, I anchor it around mama's hips, and shake it (sort of like those old cellulite shakers from the 50s) in order help relax the muscles of her cervix and hips. The more relaxed your body, the further baby can come down. She felt the position had her too engaged, so I recommended the birth ball for a more supported position. We spent a good amount of time here, rubbing her back and encouraging moans. Eric was insistent on stepping in and helping massage and hip squeezes. I really appreciated it physically and mentally. 

What a testament to their love for each other.  It is certainly common for a partner to participate, but this was my first experience with a partner that insisted upon helping. Carrie's cervical check was slightly disappointing for her, she was still -2 effacement and only 3.5 cm. It just didn't seem like enough to her with the level of contractions she was experiencing. It's not uncommon for laboring mamas to feel discouraged by cervical checks, luckily some OBs and LD Nurses try and avoid them as a means of support.

With most every cervical checks comes the discussion, what to do next. In any case with previously broken waters, labor gets put on a schedule due to the risk of infection. Majority of care providers will give you a full 24 hrs before recommending any serious interventions. So, for Carrie they suggested doubling her dose of pitocin in order to avoid the drastic options down the road. Carrie calmly obliged, with a look of defeat. I suggested she lie on her left side, with a peanut ball between her legs so she could take a moment to catch up after all that work. I asked Eric to read some of the material from their Blissborn class, while I applied counter pressure during contractions. The reading walked her through an activity step by step. It begins by describing your environment and how that feels as you go through each suggested motion(all visual of course). The most amazingl thing happened, she looked like she was sleeping... I mean the monitor suggested avalanches of contractions, but she was calm and restful. It was like magic, and you best believe I praised partner for such an awesome job he was doing. They really had to dedicate some time to this practice in order to get such excellent results.

Soon, Carrie complained of feeling fully engaged in her pelvis even between contractions. I was stumped, how is she still so engaged in a rested position, and how can I alleviate this for her. I tried some more hip shakes, but by this point is was hurting more than helping. So, I asked the nurse what she thought. This is the beauty of having your doula, they can utilize your nursing staff in ways you never thought. They have seen everything, so when all else fails we ask for help. She suggested a rocking chair...huh...a rocking chair, how simple. In my head I thought, "well okay, we'll try it, although it seems it wouldn't allow for enough space for baby to come down..." Thankfully, the nurse made an executive decision to reduce her pitocin back to the original dose. The combination of all our efforts offered a form of relief for Carrie, and opened a space for her to trust her body.

The Rocking chair made room for Eric and I to apply massage on her lower back, it even made for a space to hang a towel with peppermint oil on it near mom, in order to help cleanse her space and clarify her air. Doulas make it their mission to create an environment for your birth. This process begins in our discussions leading up to labor and delivery. Essential oils are just part of what I bring to help augment the space. I also have a play list of binaural music (mostly white noise tone, and rain drops), I often put this on when mom hits active labor and doesn't already have something filling the space. It's a magical playlist, I use it to soothe myself to sleep and have had partners asleep within moments after proclaiming, "there is no way I can get any sleep right now."  I was in no way prepared for the effect it had on Carrie. 

Soon after she settled into a rhythm with the rocking chair, she began humming a lyrical tone in between contractions. Eyes closed, jaw dropped, and almost a wavering rocking in her voice carrying her away into the abyss. She was so in it, I had to reassure Eric that she is in the zone and doing amazing. There soon after the wavering humming turned into big wide open moans, I knew then she was making incredible progress. I was so floored by her focus and beauty in sound, it was clear this was one of the most indigenous births I will ever witness. I'm not joking, it was as if she was calling on her ancestors to carry her boy lower and lower!! Her nurse kept coming in to adjust the monitors, which is always a good sign. This means we have action and baby is moving. Such grace this nurse had, you could see in her face she knew it was going to happen soon. So, she slowly closed the gap in between visits and finally calmly asked, do you feel like you're pushing? The answer was yes!!!

It all happened so fast, Carrie got up mid screams to get on the was obvious that her baby boy was right there...CROWNING!!! Dr is being called, baby nurses coming in, surgical tech comes in.... I'm looking around and Eric has decided to go to the bathroom, so I hold my breath so as to not alert Carrie. I did one of those panic stricken reactions where you grab your phone to call, then take two steps, and then look at your phone... and then decide to go get them.... luckily him and Doctor had met in the hallway and returned soon after. I got Eric over to Carrie's side, Doctor sits down throws on gloves and 3 pushes later baby boy arrives. She had gone from a discouraged state of mind, to zen focus, to being completely enthralled in her labor, and finally pushing in a mere 5 hours! An entire 6.5 impressive centimeters!!

I'm so proud of Carrie and Eric, they are a true example of perseverance. Their road to meeting their boy was a rocky and sometimes unsure, but they harnessed all the knowledge necessary to help empower their very own birth experience.