Eloise's {Almost} Home Birth Story (Part 1/3)

We're back with another Delmarva Community Birth Story.  This time, it's from a special THRIVE client who planned and *almost* had a home birth.  When she originally shared this on her own blog, I HAD to ask her to share it here, too.  It's just so beautifully written and such a fantastic story of all things that encompass birth and motherhood: Joy, love, frustration, trust, patience, strength, and humility.  Enjoy!  xo--Maria

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We'd been married for just barely a year.  We weren't *trying* to get pregnant, but...I would not have minded.  It was a Friday morning, July 15th 2016.  The next day Jake and I would be leaving to spend just under a month in the mountains of Virginia for his Young Life summer assignment.  My cycle was due to start the coming Tuesday, and I decided to take a test before we left town. 

Our world was changed forever. 

I always knew that I wanted to have a natural birth. My mother delivered me and all four of my siblings without pain medication and I always admired her determination.  I devoured books and articles and all kinds of literature on the subject of natural birth and grew in my conviction that medication-free delivery was what was best for me and my baby.  I have fibromyalgia and I was nervous about the amount of pain and fatigue my body would be able to endure, so I began looking for ways to prepare myself and my body to give birth naturally - breathing, relaxation, visualization.  I also began searching for a doula to support me during delivery.  The hospital I planned to give birth in has a 95% epidural rate and an alarming 30% c-section rate.  My CNM advised me that if I wanted a natural birth, a doula was a MUST.  I made some inquiries and was connected with a wonderful doula service, and met with Chloe for a consultation.  I told her all about my determination to have a natural birth but my fears surrounding giving birth in the hospital and my physical challenges with fibromyalgia.  She was so affirming and validating towards my desires that I began to cry with relief in the middle of our meeting. 

"Have you ever considered having a home birth?"

No.  Not me.  Or at least, it sounds wonderful, but this is my first baby. My husband would never agree to it.  We need the security of the hospital for our first go-round.  I'm already over 30 weeks along, it's too late to consider something like that. 

"Maybe just think about it."

Obviously, we hired Chloe.  She never said another word about home birth but the idea was lodged in my brain and heart.  Again, I hit the books.  I learned that the US has the worst infant mortality and maternal death rates among every developed country, even though we spend the most money on maternity care.  I learned that our C-Section rate is double what the World Health Organization recommends, and that many of these are completely preventable if routine interventions could be avoided.  I learned that the developed countries who most utilize home birth midwives have the best results.  I learned that home birth recently became legal in my state, and that home births have been shown to be associated with fewer maternal interventions and deaths.  I asked Chloe to help me find more information about how to have a home birth in Delaware, and was surprised and excited to learn that she was actually a student midwife in addition to being a doula, and was working alongside a Certified Professional Midwife named Susan who lived not even an hour from my home! I knew in my heart that this was what I wanted, but was still convinced that it was too late in the game to make such a big decision, that we could never afford the fee, that there was no way. 

Jake and I met with Susan and Chloe and discussed what it would look like for us to have a home birth with them.  We both had a lot of questions: How would prenatal visits look since I'm so far along? What would cause you to make the decision to transfer to the hospital? What signs would you be watching for and at what point in the process would you make that call? What kind of emergency medication and equipment do you carry? What would happen in case of any unforeseen circumstances? I realize now after going through all of these things how difficult my questions must have been to answer, because every case is so different.  But they were patient and reassuring and even Jake, who previously had NO peace surrounding the idea, became convinced that this was the best call for our family! We were going to do it - we were going to have a home birth!

{{{PART 2 COMING TOMORROW!}}}

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

25 Reasons Why Labor & Delivery Nurses are Amazing!

HAPPY NATIONAL NURSES WEEK!  All nurses really deserve 365 days of recognition per year, not 7!  We asked clients, friends, midwives, community members, and each other why labor and delivery nurses were awesome.  We want to share some the information we collected because nurses rock!

L&D Nurses: Thank you for everything that you do and for being the best nurses to our clients!
From: The THRIVE Team—Maria Mengel, Elisha Immanuel, and Chloe French

1.     They are patient.

2.    They do an amazing job taking care of our placenta encapsulation clients so that they can just revel in their new baby.

3.    They care about their patients.

4.    They care about birth.

5.    They make birth better.

6.    They help prevent cesarean sections.

7.    They are SO smart.

8.    They have amazing instincts and follow their intuition.

9.    They are a calming presence if a woman is feeling out of control.

10.  They are fun!

11.   They take their time to make sure their patients are taken care of.

12.  They make you feel beautiful!

13.  They deal with placentas, poop, and blood daily and don’t bat an eye.

14.  They give you the inside scoop on the best (and worst) hospital food.

15.  They give the older siblings stickers and tell them how proud they are of them!

16.  They were genuinely “as much in the birth” as me.

17.  They held my hand during a tough IV stick.  That little gesture meant so much.

18.  They are amazing teachers!  They educate patients, providers, students, and administration.

19.  They are at the front lines of change.

20. They respected by birth plan, even though it may have been crazy.

21.  They took time to help me calm down when things didn’t go according to plan.

22. They were so kind when my client’s feet were so cold and got heating packs and socks and even put them on for her.

23. As a doula, I learn SO MUCH at the bedside from observing the nurses and asking questions.

24. They act quickly and calmly in an emergency. 

25. When I’m confused about what’s going on in the labor and delivery room, I always look to a nurse.  They have all of the answers.

What can you add to this list?

The Birth Center Birth of Baby Lois, One Year Later

This story in the Delmarva Community Birth Stories series is coming from a past client of Thrive doula, Elisha, and owner of Soul Yoga Studio, Eva Whipple.  Eva sent me the story of her daughter Lois' birth on her first birthday!  Enjoy this beautiful storytelling of the birthing center birth of Baby Lois.

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Perception is a really incredible concept to consider. The facts of Lois's birth have never changed. She was just about 8lbs, 19 inches, and was born at 6:52AM on May 7, 2016 at Special Beginnings Birth Center. The midwife's documentation chronicles my dilation, my intake (and output- if you really want to know), Lois's heartbeat throughout, and other objective data. Those facts are there, and they will never change. But with time, our perception of an experience evolves. That is why I wanted to revisit the story of Lois's birth after some time had passed. I wrote and re-wrote the incredible story of Lois's birth in the days and weeks after she was born. But now time has granted me a new vantage point.

From this perspective, I recall things in a less linear way... I feel less attached to the small details (like what time we arrived to the birth center, what time I began pushing, etc). And I feel like I now have a story, not just an account... So here goes.

Lois was born on her due date, right around the time that we typically wake-up now, actually. When she finally made her appearance, I had been looking forward to meeting my baby for 2 days of labor, 40 weeks of pregnancy, and 2 years of planning to begin a family.  

In the weeks leading up to my due date, I had reached 2 or 3cm dilation and had been experiencing some light, infrequent  contractions. On Thursday, May 5th, I went for a swim after work. I was swimming a lot during my pregnancy, especially the third trimester. During my swim, I began to notice that my light and infrequent contractions were becoming slightly more regular. When Bryan got home, he suggested that I ride my bike with his Mom while he ran. During the bike ride, my contractions were still present, and becoming a bit more noticeable, but not painful. In the hours after the bike ride my contractions occurred while resting, showering, or walking- so I had a good feeling this was the start of labor, but they were still about 7-10 minutes apart. I called my parents and my doula (and now very dear friend), Elisha. We decided to go ahead over the bridge. I was worried the whole time that it would be too early and that we would be sent home. When we arrived, at 12:30AM, I was right. It was early labor, but still quite early. I was something like 4cm dilated and 100% effaced, but contractions had not intensified or sped up. I will say here that it was hard to know how intense I should expect things to become. I have a pretty high tolerance for pain, and pain itself is such a subjective experience. Looking back at 12:30AM on Friday May 6th... Sitting in the bed and talking to my midwife about how I could "definitely feel the contractions now...." That was about a 1 on the intensity scale, with a 10 being the moment her giant head emerged from within me. 

So it wasn't quite time to hang our hats there, but it was good that I had come for that early labor check... I got to claim the room that I wanted at the birth center and my favorite midwife, Ashley, was able to get a heads up that I was in labor. Plus, we didn't have to make the drive later in the day when things were a bit more intense.

We checked in at a nearby motel. Elisha stayed in a room with my parents, Bryan and I had our own room. Contractions were definitely still manageable, but I wasn't able to really sleep very much. Throughout that night I slept off and on, spent quiet time with Bryan, got in and out of the shower... And the intensity and frequency did increase. 

When everyone got up and moving in the morning we went to a nearby diner. I did have a nice breakfast- I can't remember how much I ate, but I remember the pineapple was good, I took my vitamins and my Mom kept reminding me to drink plenty of water. I also remember going into the bathroom to pee and talking with a stranger who asked when I was due. This made me chuckle- because she didn't realize I was in labor. I think I said something like "hopefully any time now..."

After breakfast we went to the Annapolis mall to walk around. I had hoped to go to a lovely park, but it was raining. It had been raining for weeks, practically. The mall had local art from high school kids on display, and we enjoyed walking around looking at all of it. My mom bought Lois a nice little green outfit (we still didn't know the gender at that point- we opted for no ultrasounds or other prenatal testing). Eventually at the mall, I became unable to  walk during my contractions. I could walk as soon as they passed, but during I would stop and hold onto Bryan- leaning onto him for support as Elisha or my Dad rubbed my neck. It was time to call the birth center. I still doubted that this was "the" time... I worried they would send us home. But Elisha insisted this was real labor... She was right. When we arrived that afternoon, around 1PM or so, I was 6cm dilated and 100% effaced. My contractions were every 3 minutes apart, I think. But still, looking back, I would have to give this time about a 3/10 on the intensity scale. Bryan and I walked all around the birth center, up and down the stairs, I showered, I got in the tub while they filled the bath, then I got in the bath... I laughed, I drank water, I ate, I joked... I bounced on the exercise ball.

Actually, there was a special party at the birth center so people were painting bellys and eating food. I even walked out to the party! One lady offered to paint my belly, and initially I said yes, but then my kind and funny nurse, Laurel, informed the woman that I was in active labor and getting in and out of a tub. I guess I hadn't thought of that...

The next hours are a bit of a blur... I know that the intensity gradually increased... I know that I remained at 6cm dilation for hours... Lois was "sunny side-up..." Meaning that her face was up. Additionally, her little chin was lifted, making it a very slow journey down the birth canal. Because her head didn't reach my cervix, I was not reaching 10cm dilation quickly. I labored in the pool a lot, also straddling the toilet. Once I reached 8cm, I felt the urge to push. I tried not to. They told me not to. I knew it might wear me out. I knew that intellectually, but actually fighting that strong urge to push was very difficult. During that time, trying not to push, but still pushing- trying to coerce her out, I stopped talking. I stopped thinking, really. I can say that I wasn't thinking real words, anyway. 

With each contraction, I threw up. My midwife and my family (Bryan, my parents, and Bryan's mom) were worried that I would have to be transferred to the hospital, but I wasn't worried. Lois's heart beat was strong. And the one thought that I did formulate was a sort of mantra that I repeated to myself and my baby, "there is only one way out..." I knew that eventually, I would have my baby and she would be perfect. That carried me through.

I never questioned my body's ability to deliver my baby. I never doubted that I would be able to have Lois at the birth center. I never thought that I needed pain medication, or any other intervention. I don't even remember if Pitocin or any pain relief was offered. I know that I had asked everyone not to offer me intervention, that was specified in my birth plan. But even if they had, I know I wouldn't have wanted it. I didn't realize that anyone was doubting whether or not we should stay at the birth center. At one point, Ashley (my midwife) did say that she saw a small amount of meconium. But, still, I wasn't worried... tired, yes, but not worried. Due to the very slow descent that Lois was making, Ashley suggested that we try a few different positions to get her moving down the canal. She wanted me to labor on one side for a few contractions, then on hands and knees for a few contractions, and then on the other side. For quite some time, I had been laboring on my hands and knees, or over the toilet, or in a squatting position. The ability to bear down on something gave me some relief. So, when I had to labor on my sides- that was the most pain I felt. I had nothing to push or pull on... Nothing to feel other than the contractions. And ultimately that was the place that I had to return to in order to give birth. 

Each time I got back in the pool, or even on hands and knees, the contractions became much more manageable but also much slower. What I learned was that I had to move directly towards that very intense experience, directly towards the most uncomfortable sensations because that is where the most progress was made. Frequently, I tell my yoga students that they have to move towards discomfort in order to challenge their preconceived notions and in order to experience transformation. The same was true during labor. 

After the intense contractions on my side, which were intended to turn Lois and get her moving, she flipped right back into her sunny side up position. We tried that same process again a little later. And at one point Ashley did attempt to manually turn her (yes, reaching in and turning her), but she only turned a quarter turn. Instead she continued slowly making her way into the world with her bright eyes wide and face-up. 

Eventually, I did reach close to 10 cm and my midwife coached me through pushing. I had imagined that I would deliver in the pool and that I would know intuitively exactly when I should  be pushing. But, when left to my intuition alone I think that I was protecting myself (subconsciously) from the discomfort that I needed to feel.  Ashley had me get out of the pool and back onto my side where (after four hours of crowning) Lois's head finally began to emerge. When she was born, I had one leg over Ashley's shoulder and was sort of half on my side. 

During the four hours of really actively pushing, I would see Lois's head and then it would retreat. I would push and then push again, and then breathe... And the little bit of her head that I could see would slip right back inside me. My midwife would tell me that this is good, because it was allowing me to stretch around her head. But that didn't make it any easier or less frustrating. I hadn't spoken in hours and then finally I told Ashely, "Next time you see her head can you just grab it? Just don't let it go back again…" I'm not sure if I had the ability to physically laugh at this point, but I did amuse myself...

Of course, she didn't actually grab her head, and ultimately it was very helpful that I was allowed to stretch around her 99th-percentile-giant head. Amazingly, I didn't tear at all. I think what surprised me the most about the whole experience, other than just the sheer intensity of the whole thing, was my body's ability to open up and expand right at the very end. It was so shocking that I hollered out... Less in pain and more in just total shock. I was watching this whole process in a mirror, thinking that her head was this little peanut because that's what I had seen coming through. I had been pushing twice consecutively with each breath, but then I knew that it was time and that if I just pushed a couple more times I could get her out. So I did. I pushed, and pushed, and then pushed, and then one more big push and there was her head. And that was the shocking part, the little peanut that I had seen crowning for four hours was only the very top of her head which had formed into a cone as it pressed against my cervix. But in reality after those four big pushes my body opened up and gave birth to this giant head. I had no idea my body could do that. Once her head was born,  it may have been one or two more (comparatively easy) pushes before her body slid free. 

I have heard that when a baby is born it's like angels rush into the room. I don't know if that is how I would describe it, but I can understand that idea... It was profound. After such a long, strenuous night- to see her perfect face, was the greatest moment of my entire life. Through tears, Bryan looked at me and said "it's a girl..."

Bryan, Elisha, my mom and Dad, and Bryan's Mom- all had tears in their eyes. There were sighs, laughter, smiles and a palpable feeling of relief and joy.

I had  been pushing hard, really hard for four hours. I was pushing for hours (when I wasn't supposed to be) before that. I had been at the birth center laboring for 18 hours. And prior to that I labored in the mall, the diner, the motel. I have done a 70.3 mile triathlon, and multiple other endurance events- and I can assure you that nothing compared to the exhaustion I felt after labor. My arms were shaking from having pressed down so hard on Bryan, and on the bed, and the ground... And from pulling on Bryan, and rails... I wanted to pull my baby up to me, but I literally couldn't move my arms. Ashley placed her on my bare chest and I said "hi, Lois, I love you."

She latched soon after and nursing her was magical. It's still magical. I'll nurse her as long as she wants... For years, I hope. She was so sweet, so small, and so new. But throughout the whole labor, and during pregnancy and even still today- she is so strong. She never seemed weak; she is hardy. She is strong but still she has such a loving and light-hearted presence.

I learned a lot from the experience. It was certainly more intense than I could have ever imagined. I don't know that the intensity can be relayed through stories of other people's experiences, I think it has to be felt.

I didn't end up delivering in the pool as I had imagined, but that was okay. Things were so slow, and slowed down more each time I was in the pool. I had to get really, really uncomfortable to make progress. 

I was able to deliver completely unmedicated, without any medical intervention, at the Birth Center- despite a slow labor, a face up baby (and a little tiny bit of poop... Her's I mean, not mine)...

A few things that helped me were resting (as much as possible) in early labor, laughing throughout all of it (when I could), and continuing to eat and drink. Also, being in good physical condition throughout my pregnancy and beforehand definitely helped. I would also say that I have had my mental endurance tested through athletic endeavors and with health challenges (like having cancer) in the past.

But here is the biggest thing I learned... If you want to have a natural birth, or accomplish anything for that matter, you have to commit. When I was pregnant, or even during the years when I was just dreaming of being pregnant and reading a lot of birth books... People would tell me that it's good to plan a natural birth, but not to be upset if that didn't happen... To try to keep an open mind in case I did need pitocin or an epidural.

I understand why people say this. It comes from a good place. It comes from a desire to make sure that, if things don't go as planned, the expectant mama's feelings are not hurt. They don't want people to feel disappointed or down on themselves. I get it, I really do. And I don't think anyone should feel bad about their birthing experience. I doubt that any birth ever goes 100% according to plan, and I too want for all mamas to feel content and at peace with however things transpired. But if you want a natural birth, I would not recommend going into labor with "an open mind..." Go into labor with your mind set. If you really feel strongly that you don't want pain medication, don't even consider it an option. As soon as that option is on the table, your resolve is compromised. If you don't feel really strongly about it one way or another, than by all means- keep an open mind! Or if you feel strongly that you do want medication- that's fine too! But if you really don't want intervention, then don't be afraid to commit to that as a goal.

I have read a lot (and heard several TED talks) about the way that our society views women vs men when it comes to success, failure, and achievement. We (as a society) try to protect women, by encouraging them to play it safe... To avoid risking failure, or risking anything at all... We tell our girls to "be careful" and our boys to "be brave..." Well, women- if you want a natural birth, be brave! Of course any time that you commit to a goal, there is a chance that you won't achieve it... But I trust our ability to handle that. I have talked to many mamas who planned an unmedicated birth and ended up delivering in a hospital with pitocin and epidural... Or a c-section. And they are strong enough to handle that, too! They still have a beautiful, healthy baby. 

I know that is the reason that most people will tell you not to be too attached to the plan- because in the end you have your baby and it doesn't matter how they got there... But the experience does matter. It is transformative. So, plan for it to be what YOU want it to be. And then when your experience doesn't turn out exactly as you planned, let that be okay. Surrender to the process is essential, but so is strength, resolve and commitment. If you want to, borrow my mantra... Tell that little baby "there is only one way out..."

I am so grateful for the experience. I think it has made me more easy going. I have realized that things will happen on their own- without my interference or intervention... And often my job is just to be fully present...

Remember when I said it had been raining for weeks? Well, when Lois came out, so did the sun... And my life has been brighter ever since.

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

The Best Birth Podcasts

If you're like me, then you can't get your hands on enough birth information when you're pregnant!  There are plenty of books, blogs, articles, and childbirth classes out there.  But what about podcasts?  Podcasts are becoming more and more popular everyday.  You can download them to your phone and listen around the house, in the car, on your walk, in the shower, etc.  I've compiled a list of my favorite birth podcasts to share with you.  Click on the title or picture to get to the itunes page for each podcast.

 

Doing it at Home

Sarah and Matthew Bivens share their home birth podcast.  They're fun, funny, and super transparent about their experiences.  They share their journey to their own homebirth, some of the topics that came up for them when planning their home birth, and they share lots of interviews with other women who have had home births (including me!).  Even if you're not planning a home birth, these two are worth listening to!

 Dr. Berlin’s Informed Pregnancy Podcast

Dr. Berlin is an LA-based chiropractor and doula!!! He’s interviewed many famous actors and musicians about their birth experiences, and shares other experts and opinions. This podcast is so entertaining! Search for Kat Von D’s and Hilary Duff’s episodes!

Rockstar Birth Radio

According to the host of the podcast, Shalone, this podcast is for "pregnant mamas who are seeking a fabulous birth experience."  If that's you--then this is the podcast to listen to!  She hosts so many guests who share their passionate expertise about how to birth like a rock star!

 

Taking Back Birth

With nearly 100 podcasts in the archive, Indie Birth Association founder Maryn Green shares her perspective on a bunch of topics ranging from prenatal care to Vitamin K injections, to gestational diabetes, to how to pick the right midwife.  This podcast is for you if you're interested in out-of-hospital birth.

 

The Birth Hour

Hundred of birth stories.  Literally HUNDREDS.  Bryn Huntpalmer interviews women who have given birth and gives them the opportunity to share their stories.  There are stories for all types of births:  vaginal, cesarean, epidural, induction, natural, hospital birth, home birth, birth center birth, and more.  When you're pregnant, one of the best things that you can do is listen to or read other positive and empowering birth stories. 

The BIRTHFIT Podcast

This pregnancy podcast is hosted by a prenatal chiropractor who just wants to share "the awesomeness that is pregnancy, birth, and being a new parent"!  Almost all of her podcast episodes are interviews with other birth professionals who share their perspectives about any all topics related to pregnancy and birth.

Dr. Stu’s Podcast

A prominent and radical OB in California, Dr. Stu chats with his co-host, midwife Blyss about birth, life, being a care provider, politics, home birth, breech birth, and so much more! One of my favorites!

The Birthful Podcast

According to the host, Adriana Lozada, "Think of us as your own specialized team of birth pros!".  Adriana talks with other birth professionals to share evidence-based information to "inform your intuition".  From breastfeeding to bed-sharing to VBACs, if it's a topic related to the childbearing year, they've probably covered it!

 

The Cord

Last but not least, The Cord is a mash up of interviews with birth professionals, interviews with regular moms like you and me, and short mini-podcasts with little helpful tips and info for preparing for your childbirth.  Amy Neuhedel is fun, funny, and super passionate about birth! This podcast hasn’t been updated in a long time, but I still go back and listen to the old episodes-there’s GOLD in there!

Do you listen to birth-related podcasts?  What are some of your favorites?

2017 Salisbury Mom & Baby Expo

One day, I was chatting with Martha Ogburn, the owner of Barefoot Baby Boutique.  We had this great discussion about how wonderful it was that the Eastern Shore was growing and growing in terms of stores, opportunities, and services for expecting and new parents.  There are doula businesses, fantastic handmade health and beauty products, stellar massage therapists and chiropractors, and some really cool baby boutiques and stores.  We just hated that we weren't all connected and most people weren't even aware of their existence!  We said, "Man! I wish there was an expo on Delmarva specifically targeted toward pregnant and new parents and babies."  

The light bulb turned on above both our heads at exactly the same time.  Well, if no one else is doing it, we certainly will!  

And we started planning right away.  FINALLY new moms and families can come once per year to this annual event and meet EVERYONE that can help to make their pregnancies and postpartum experiences as optimal, joyful, and fulfilling as possible!  

Go check out the 2017 Salisbury Mom & Baby Expo!

Vendors will include: birth and postpartum doulas, photographers, home birth midwives, placenta encapsulation specialists, mom and baby classes, baby clothes and accessories, books, childbirth education classes, massage therapists, lactation professionals, photographers, chiropractors, and more!  

Tickets for the event are $10 if purchased in advance at https://www.eventbrite.com/e/salisbury-mom-baby-expo-tickets-32447941667?aff=ehomecard.  Tickets at the door are $15.  

For every ticket purchased, you will be entered into a raffle drawing of TONS of prizes including free photography sessions, free massages, free 3D/4D ultrasound session, baskets of mom and baby products, gift baskets for pregnant women, gift baskets for new moms and babies, AND MORE!

AND!!!! There will be many FREE presentations, workshops, and classes presented by the vendors all afternoon!

WE HOPE TO SEE YOU THERE!

--Maria Mengel (Owner of THRIVE), and Martha Ogburn (Owner of Barefoot Baby Boutique)

**Vendor applications are being accepted until April 6th.  If you're interested in becoming a vendor, please email me at maria@thrivebirth.org or call 410-449-0016**

The Birth That Changed My Life: Part V (UPDATE!)

We're baaaaaack!  After making you all sob and thank the stars for your healthy babies, we're back one more time with Part V of The Birth That Changed My Life.  And this time it's extra special, because MEGHAN AND WES THEMSELVES will be filling you in on all that's been going on in the last 7 months since Charlotte's infamous birth.  Enjoy!

If you haven't read Part I , Part II, Part III, or Part IV yet, hop on over and check them out now.

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It was two weeks before my due date. We had been to a doctor who specializes in high risk pregnancy for an ultrasound, and the results didn't look good. To confirm the findings, we were sent to Children’s National Medical Center (CNMC) for an MRI. The better imaging could give us more insight into Charlotte's condition.

After the MRI (which was the scariest thing ever - my anxiety had hit a new high) we were introduced to a team of doctors. They had reviewed the scans and confirmed the previous prognosis – Charlotte had no kidneys, and perhaps no bladder. We were told by the specialists that because of a lack of kidneys and therefore amniotic fluid, the likelihood of Charlotte's lungs being developed enough to survive outside the womb was less than 5%. We were advised to start preparing for the death of our baby.

In the weeks before her birth, we mourned for our little unborn baby who was still thriving inside of me. We bought her a beautiful frilly dress to take what we assumed would be the only pictures we would have to remember her by. We made hand and footprint art with our hands and left places for Charlotte's hands and feet next to ours. We even made a recording of her strong little heartbeat to put into a stuffed bear! I didn't want to regret not capturing the memories of this amazingly strong baby that I had grown.

Despite being advised to induce labor, we decided to spend as much time as possible with Charlotte and let her determine when she would like to make her appearance. Two long, horribly emotional weeks later, she decided to make her debut.

If Charlotte was to have a chance of survival, her lungs would have to be developed. We could deal with kidney issues with dialysis, but her breathing was the main concern. We were told that if she cried at birth, there was a good chance that her lungs were developed.

After a long and emotional labor (see Part IV), Charlotte was born CRYING!! Surprisingly, she looked like a normal healthy baby! After evaluating her, the NICU doctors determined she had a pneumothorax (air outside of the lungs) causing her right lung to not expand correctly. We decided to give her some blow-by oxygen to keep her comfortable and to see if it would resolve on its own. Within two days, her breathing was perfectly normal!

Hours after Charlotte's birth, she was on her way to CNMC with her Daddy as I lay in a hospital bed trying to recover from two blood transfusions, crazy blood pressures, an epidural, and Pitocin. Oh, and the fact that I just had my baby who was born alive and strong, and that she was not with me!

I think it was the next day…it’s all really just a blur, so it could have been two days later – not sure. I managed to get out of bed and shower without passing out, so the hospital staff decided I could be discharged to go see my baby! My parents, who were a great support and didn’t leave my side throughout all of this craziness (THANKS MOM AND DAD), drove me to CNMC and helped me get to the NICU to see Charlotte. She was amazing, beautiful, stunning, and ALIVE AND THRIVING! She looked just like her daddy!

At two weeks old Charlotte, went into surgery for her Peritoneal Dialysis Cather and Gastrostomy Tube to be placed. Handing my perfect little baby over to the nursesand knowing that she was going to come back with tubes coming out of her belly was the hardest thing I have ever done. I cried like a baby and wouldn't let them take her from my arms untilthe last possible moment. I was a blubbering mess. Wes was amazing; he just held my hand and reassured me everything was going to be okay. This is what we had signed up for when Charlotte came out crying and showed us she was willing to fight for her life!

Charlotte came through surgery just fine, and the next day we were transferred out of the NICU to the Heart and Kidney Unit (HKU). We spent the next two weeks watching Charlotte heal and working to stabilize her electrolytes with many different medications and supplements. At that point we could all go home together for the first time!

For two weeks , we were told we would get to go home the next day. Then that day would come, and we would be told we couldn't leave because Charlotte's levels were not stable enough yet. It was stressful and disheartening. I had not been home in over a month at this point. I was living in the Ronald McDonald House and in her hospital room; it was the only home she knew, and it broke my heart.

Then the day finally came! We were being discharged to go home!!! It was September 3rd 2016: almost a month after Charlotte was born. It was a miracle. On our way home, Charlotte began spitting up. This had been happening on and off for about 3 days prior to us being discharged, so I really didn’t think much about it. The nurses and doctors didn’t really seem concerned.

When we arrived home, it was amazing and overwhelming all at the same time! My house was a wreck… I had to measure out and organize 12 different medications that were each given several times a day. I had to pump my breast milk, measure it out, and add a supplement to it. It would bind any potassium, and then we would pour off the remaining milk. At that point, we would add the other supplements at different times. The concoction was poured into her feeding pump, and every three hours we would repeat. I didn't even have enough time that evening to cuddle my little baby.

When it was bedtime, I noticed Charlotte was very agitated and couldn't get herself comfortable. She was grunting a lot. We tried to put her in the bassinet next to the bed, but she just couldn’t settle herself.

I took her into the living room so Wes could get some sleep. I put her in the swing, which seemed to settle her down a little bit. The next morning, Charlotte was still very uneasy and restless. Neither Charlotte nor I had gotten much sleep the night before, so I chalked it up to that. A little later that morning, I noticed Charlotte was breathing rather fast and bobbing her head up and down. I immediately knew something wasn’t right. I called my mom and sent her a video of what Charlotte was doing. We decided that I should probably call the Hospital just to make sure nothing was wrong.

When I called the nephrologist (Kidney Doctor) at CNMC, she told me to immediately take Charlotte to Peninsula Regional Medical Center (PRMC) to evaluate her. It sounded like she was in respiratory distress. Less than 24 hours after coming home, we rushed Charlotte back to a hospital. We were immediately admitted to the emergency department where they put Charlotte on some pressurized oxygen, and they called Children’s National to come get her.

A few hours later, Charlotte and I got to experience our very first Helicopter ride. I am not going to lie; it was beautiful, yet terrifying.

in the helicopter

baby charlotte is in there!

view from the helicopter

We were re admitted back into the NICU at CNMC. Charlotte was extremely fluid overloaded, and her lungs were filling. The Doctors' main goal was to get fluid off of her without having to start dialysis. Her dialysis catheter, which could be used to remove the fluid, had only been healing for two and a half weeks. The nephrologists suggested we wait four whole weeks before using it. If you use the catheter too soon, the chances of the fluid leaking out of the exit site and introducing infection into the peritoneal cavity (the space around all of your organs) is very high. Most deaths from PD occur from this type of infection called Peritonitis.

Charlotte was put on diuretics to try to get her to urinate out the extra fluid. That night, Charlotte's breathing was so bad that she turned white and blue. They had to assist with her breathing and intubate her. THIS WAS THE MOST TERRIFYING THING I HAVE EVER EXPERIENCED. I was sleeping next to her bed in a chair one minute, and then the next minute the room was filled with 20 doctors and nurses. My baby was not breathing well enough on her own to survive.

Wes and I were told we might want to step out while they place the breathing tube.  We left the room, and all I did for the next few minutes (which felt like hours) was sob uncontrollably in the hallway. When we were told to come back into the room, my baby was cold to the touch and white as a ghost. WORST FEELING EVER!

Charlotte was attached to a ventilator for about a week. In that time, we had to start peritoneal dialysis (basically, the abdomen is filled with fluid and drained to extract extra fluid and toxins). At first, it was going great! The dialysis pulled a ton of extra fluid off of her lungs and allowed her to be weaned off of the breathing support. However, a few days later when I was changing her diaper, I noticed that the dressing which covered her belly button was wet. When placing her catheter and G-tube, the surgeon had entered through her belly button, which was still healing. I immediately showed the nurse, and we stopped dialysis. The nephrologists had never experienced leaking of the PD fluid from the umbilicus before, so this was new to everyone.

A few days later, Charlotte was diagnosed with her first round of Peritonitis, most likely because of the leak. Luckily, we caught the infection very early, and with lots of antibiotics they were able to clear it up!

Over the next few weeks, we stayed off of dialysis to allow her umbilicus to heal properly. The only downside to this was she became fluid overloaded another two times and struggled with breathing once again. Luckily, it was never as bad as the first time, and she only needed minimal respiratory support.

Finally, the 4 week mark of healing came around. Charlotte was now one and a half months old, and we tried to start dialysis very slowly with minimal fluid. We didn't want to stretch her cavity too much and cause it to leak again. Well what do ya know... It leaked again, and she was on antibiotics... again...for potential peritonitis.

Third time's the charm…right? A week later we tried dialysis, and there was NO LEAKING!!!!!! From this point on, Charlotte was on 24/7 dialysis. Her fill volumes were too low for a machine, so it had to be done manually. We remained in the NICU for another few weeks with one on one nurses.  Their main responsibility was to fill and drain Charlotte's dialysis fluid every single hour of the day.

I was with Charlotte at the hospital 24/7 watching over our nurses and making sure everything was done correctly. There was great risk of contamination and overfilling.  As each new nurse came to watch Charlotte, I made sure they were doing things correctly. YES, I was that hover mom J .

We gradually increased the amount of fill over the next few weeks so that we could graduate to the cycler machine that does the dialysis on its own - no one on one nurse needed. I really couldn’t wait to get out of the NICU. When we reached the right amount of fill, we were transferred to the HKU where I spent the next two weeks with Charlotte. I learned how to use the cycler machine and how to take care of Charlotte on my own. We were so close to going home! 

Wes drove into town to pick us up on November, 1st - It was finally time to head home! ...for the second time... It was much easier than before. My house was only a semi-mess this time, and I only had 6 medications to deal with instead of 12!  It was amazing to be home with Charlotte. Up until this point, I had only dreamed that this day would come. We were home, stable, and doing well!

Since November 1 2016, we have been home trying to figure out our new normal (like every new parent). Charlotte is doing well; she is growing and thriving beautifully. She currently is 7 months old, 26 inches long, and weighs 13.6 lbs. She is sitting up on her own, babbling, and has a very strong personality! Charlotte is not shy in telling you what she likes and dislikes. She is our little miracle baby, and we are so blessed to have her in our lives!

We are currently doing home Peritoneal Dialysis with Charlotte every night for 9 hours. Just call me Nurse Mommy. We will continue PD until she is eligible for a transplant: when she reaches 26 lbs.

Please join us or donate to “Team Charlotte” for the National Kidney Foundation's Kidney Walk! The event takes place May 7, 2017 in Salisbury MD. 80 cents of every dollar donated goes to research, patient services, professional education, public health education, and community services. We would love to see all of you there to support Charlotte and the millions of others that suffer from Kidney disease! Even if you cannot join us for the walk, you can still help out by donating to our team: http://donate.kidney.org/site/TR/Walk/Maryland?team_id=203238&pg=team&fr_id=8621

Thrive Spotlight: Chloe French

We're back with another installment of Thrive Spotlight.  We love when our clients really get to know us, so we are sharing some fun and interesting facts with you!  Up next, we're casting the spotlight on the fabulous doula, Chloe French.

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1. I was born in Salisbury, MD and raised in Berlin, MD. Even though I have lived in a bunch of other places over the years, this is always home. I love the Eastern Shore! 

2. I have big big love for British television - especially period dramas. Downton Abbey, Call the Midwife (of course!), the old Pride & Prejudice, Victoria...the list goes on and on. Recently I've even gotten into their modern crime shows. 

3. I have traveled to Canada, Ireland, England, France, Guatemala, Mexico, and 28 US states. 

4. I love learning foreign languages. I have a personal goal to learn Gaelic, Swedish, and a Mayan dialect just for funsies. 

5. Two years ago, I shaved my head. It was an incredible experience and sometimes I miss having no hair. 

6. I've always considered myself more of a mountain person, but lately I've been falling in love with the water. Winter has always been my favorite season, but lately I've been drawn to spring.

7. I suck at math.  Numbers just aren't my thing. My superpower is curiosity. This world is endlessly fascinating.  

8. For my whole life, I have been *obsessed* with all things vintage - specifically 1920s - early 1960s. Example: In middle school, I listened exclusively to big band, only watched old black and white movies, styled my hair in rollers, and wore red lipstick. Actually...I still do that. The 1940s are my favorite decade & style, but I probably own more 1950s clothing. I am an avid collector of vintage clothing reproductions. And if I had things my way, I would come to every birth dressed from Call the Midwife. 

9. Once upon a time, I had a private voice lesson with opera singer Renee Fleming in her home. I was a classical voice student at the time. It was amazing. She was one of the most gracious people I've ever met in my life. What a great memory!!

10. I cry when the baby is born and held in mama's arms for the very first time. Almost 200 births and it still gets me every time. The joy and love in the room is simply overwhelming! The last postpartum visit is another tearjerker. During pregnancy and birth, you become so close to the family that you don't want that relationship to end. It's a sweet bond between doula and family. And thankfully, often those clients become treasured friends. 

Read Chloe's bio here.  And don't forget to check out the spotlight on our other doulas, Terri Goslee, Elisha Immanuel, and Maria Mengel!

A Valentine's Day Birth Story

This Delmarva Community Birth Story comes to us from a friend and fabulous mother.  Amanda is a mom to two toddlers in Salisbury and this is the story of her second child's birth.

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This is a story all about how my life got flipped, turned upside down….  Wait. Wrong story.  This is the story of the birth of my Rainbow baby, born on Valentine’s Day 2016.  

February 13, 2016, 11:00 PM.   I’m 41 +2.  I’m large, but surprisingly not in charge.  I was being forced to lay between my husband and my co-sleeping and still nursing 2 year old daughter because she “didn’t like Daddy right now.”  She wanted to stay up all night.  We wanted to sleep.  We put on her favorite movie at the time.  She had been bitten by the Frozen bug.  Nothing mattered but Frozen.  There were no movies, and no music that could trump the hypnotizing magic of “Let It Go.”  My unborn child was consequently also into Frozen.  I know what you’re thinking.  He was subjected to that soundtrack since he could hear.  He would do backflips and wiggle from side to side during every song.  It was a surefire way to get him active if I was concerned about his kick count.  I had started having weak contractions.  My husband, Jason, said that they seemed pretty regular to him, and suggested timing them.  I wasn’t in labor.  I timed them anyway, and they were about 6 minutes apart at this point.  I wasn’t sure how regular they were though, because I kept drifting off to sleep between them.  There was no way I was in labor.  I was SLEEPING. I called my parents, because they live in Baltimore, and it was the weekend.  I knew they would be able to come down and spend the weekend with our daughter in case the baby decided to be born in the next few days.  They decided to pack up and come right away, because my dad said I sounded like I was in a vice grip of a giant.  I thought I was speaking normally because hey, I wasn’t in labor.  

With our first, I had an extensive birth plan.  I had to be induced, and literally EVERYTHING on that plan went out the window.  I would settle for a healthy baby this time.  All I knew was I wanted to labor for as long as possible at home this time.  If I had to make it to the hospital before my parents could arrive, we had planned to call my friend from college, who lived locally.  She agreed to be on call for labor.  I thought for sure, we’d never need to call her.  I was wrong.  “Did you call Rita?” Jason asked.  “No, but I texted her.  I told her to be ready to come over just in case this turns out to be real.” He thought I was nuts, insisting that I was in labor.  I kept insisting I wasn’t.  This was NOTHING like the contractions from baby #1.  Honestly, they were even gentler than the contractions I experienced during my miscarriage. I started fumbling around the kitchen, looking for a bowl to take in the car.  I vomit easily, and I figured if I was going to be in labor in the car, I would probably puke.  Jason went outside to call Rita and warm up the car. I figured I should probably try to pee again, because by pregnancy #3, my bladder and I had trust issues.  When my husband returned, I was not where he left me.  I hear him frantically call out for me.  I’m in the bathroom, puking. As I flush the toilet, I know this is real.  This is happening.

I want to take time to snuggle our first born.  I want to have a snack.  I want to put on my coat. Being 41 weeks pregnant, I know that if I lay down, I won’t get back up. If I start eating, I’ll need a 5 course meal.  If I put on my coat, I’ll struggle to find my other sleeve and won’t be able to button it.  I settled for kissing our daughter and whispering that when Mommy came back, her brother would be here and she could hold him.  I didn’t grab a snack because I knew I had packed some in my hospital bag, a lesson learned the hard way from 50 hours of labor and NO FOOD. I did mess with my coat, even though my husband insisted I wouldn’t need it.  It was February 13th, and there was a forecast for snow.  I’m not Siberian; I would need my coat. (I have no idea how people deliver babies in cars. What’s the sitting situation?)  I spent the ride to the hospital holding myself up, like an olympic gymnast during a ring event.

When we arrived at PRMC, it was after midnight. The only entrance after hours is the ER. The entrance desk nurse asked why we were there, and I pretty much just looked at my stomach, looked at her, looked at my stomach, and was immediately annoyed.  The nurse explained they were currently out of wheelchairs, and Jason said we could walk.  I couldn’t really sit down anyway, and I knew that it would help baby move down if I walked, but I was looking forward to crushing my husband’s hand when the going got tough.  We got up into L&D, and the contractions were starting to make it difficult to talk.  Jason went to move the car to the parking garage, and our admitting nurse got me hooked up to a monitor.  I really didn’t want her to check me, and she was confident that they could admit me without needing a cervical check because the contractions were progressing nicely.  

It was about 1:00 AM when they got me into a room.  I told them I was going to want an epidural.  With my first, I spent almost 2 days of my induction med free, before I gave in knowing I needed to rest to get our baby out.  The epidural let me get some rest, but wore off before it was time to push her out, so I had the joy of feeling everything during delivery.  This time, I was terrified of getting stuck in the cycle of my mind preventing my body from progressing.  The midwife came in, and to my dismay, I was too far for the epidural.  I looked at the midwife, and said, “F***. We’re doing this then.” It was almost 1:30.  I immediately slipped into that primal space in your brain. The one that’s in between worlds, where you are aware of everything around you, but you can’t speak. It’s your spirit and your body, sharing one space as one entity.  That’s where the empowerment of birth lives.  I don’t care about the adrenaline from after delivery.  I live for the moments I spend in that space. I transition quickly because I can connect to myself so deeply in that space.  I warned the nurses of that when I arrived.  I have to give the nurses props here, because they were incredibly silent.  Part of me wondered if I should be worried, Before I knew it, it was time to push.  Jason had one leg, the nurses had the other.  I remember him commenting on how strong I was.  I was able to joke around at this point, because that’s my coping mechanism.  I don’t remember what I said, but it was along the lines of “Obviously I’m strong, I have to keep pushing out your large headed children with no meds!”  I pushed, sensed my progress, and paused to ask the midwife if scar tissue tore more easily, or less easily than regular tissue.  I’m always on the hunt for knowledge. I couldn’t see out the window, but my husband said it had started to snow.

And at 1:41 AM, February 14, 2016, he was here.  All 8lbs, 2 oz, 22 inches of squish.

We made it.  We survived.  I spent my entire pregnancy waiting for the inevitable loss that I felt was coming.  Nothing made me question every second of every day like the miscarriage we experienced before our son.  It’s true what they say about Rainbow babies though.  He is love incarnate.  He is joy.  He is the promised light after the darkness.  He is hope.  

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

The Birth That Changed My Life: Part IV: THE BIRTH

This week in our Delmarva Community Birth Stories series, we're doing something a little different.  This story is shared by Thrive owner and doula, Maria Mengel.

If you haven't read Part I , Part II, or Part III yet, hop on over and check them out now.

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When Meghan went into labor, our hearts all sank.  

We spent that day texting and talking.  She told me she wasn't ready to do it.  My stomach was in knots and I was nervous all day.  Wes was having a rough time and didn't really know what to do with himself all day.  It wasn't like my other clients.  When they call and say they are in labor, I congratulate them, tell them to keep in touch until they need me, and we talk about how they should try to rest even though they're so excited.  This situation just felt like pure dread.  

My family was in town for a vacation and thank goodness, too.  I was distracted all day while Meghan's labor slowly increased in intensity.  Even though things were moving slowly and contractions were still pretty far apart, their care providers assured them that if they made the 2 hour trip to Annapolis, they would not be turned away for not being in "active labor".  To be on the safe side, we headed to Annapolis that evening.

Meghan's contractions were still pretty far apart and manageable.  We were all trying to be our normal selves without thinking about the inevitable.  Sometimes we were joking and laughing because really, what else is there to do?  The staff at the hospital was FANTASTIC.   They gave us a very large labor and delivery room in the corner so as not to be interrupted or distracted by crying babies, labor sounds, or the general hustle and bustle of a hospital.

In some ways, the regular "rules" of the hospital Labor and Delivery department didn't apply to Meghan.  She chose to never have electronic fetal monitoring.  EFM are those bands that you see around women's bellies in the hospital.  They have sensors on them to measure both your contractions and the baby's heart rate.  Most of the time, hospitals have policies about wearing them so that they are able to monitor the baby's heart rate and the length of your contractions.  But, we knew that it was a possibility that Charlotte, who was still alive and kicking at the start of her labor, would not make it through the stress of labor and pass away before she was born.  Meghan chose not to do any monitoring of her heart beat so that we didn't know if and when that happened.  The goal of this labor was very simple: focus on making it through labor just like any other pregnant woman would.  I learned in my bereavement training the importance of encouraging your client to take it one contraction at a time and focus on birth first, then baby later.  It makes sense, right?  How could a woman possibly push a baby out knowing that the baby may not come out alive or if it does, know that she will likely die in your arms moments later?  The hospital did a fantastic job at sending us the perfect nurses for a situation like Meghan's.  

Truly, our nurses were like gifts from Heaven.  

They read her multiple birth plans over and over and worked hard to create the exact atmosphere that Meghan and Wes wanted.  They were compassionate, attentive, funny when we needed to lighten up stressful moments, encouraging, helpful, and the most wonderful nurses I've ever had the privilege to work with.  They, along with their doctors and a midwife, inspired this blog post about what I call the Birth Dream Team.

When we arrived at the hospital, Meghan was admitted right away and the midwife on call checked her and determined that she was about 3 centimeters dilated.  She had been having contractions for nearly 24 hours at that point and they were still manageable and far apart, so we all got settled in the room and decided to try and get some sleep.  It was around 1:30am at that point.  In the room for the entire labor and birth was me, Wes, Meghan's mom Mary Ellen, and Meghan.  We all got comfortable and turned out the lights.  Before we were able to doze off, Meghan's labor began picking up.  Mary Ellen, Wes, and I took turns for the next few hours rubbing Meghan's back, holding her hands, helping her to the bathroom, and breathing with her through contractions.  She truly seemed in complete control.  Her labor was definitely becoming more intense, but she was doing a fantastic job breathing through each wave.  When the midwife came back in to check her again, she was already to 5cm.  That was reassuring.  It's a strange place to be in, though.  You wish for it to go quickly for her sake, but at the same time, it's impossible not to think about what is coming when labor is over.  And then you wish it would never happen.  

meghan and wes breathing through contractions together

Their goal was an un-medicated birth, not matter what.  It was their original plan before diagnosis,  but now that they knew that Charlotte was so compromised, they didn't want to make the experience any more stressful for her.  They declined all drugs and interventions so that Charlotte would be most comfortable. Meghan was completely educated and prepared about what to expect and how to make it through labor and she was a complete rockstar through the whole experience.  

After a few more hours of intense labor, we were all beginning to feel very tired.  Meghan had been in labor for nearly 24 hours total, no one had slept in about 24 hours, no one had eaten in about 12 hours or more, and we were so emotionally drained.  When the midwife entered again and offered to check Meghan, she was hopeful that her labor would be almost over.  Her midwife's vaginal exam was very uncomfortable for her.  And when another contraction started, the midwife did not remove her hand.  Instead, she left her hand where it was even though Meghan cried out in pain.  

When the midwife still didn't move her hand, Meghan yelled "no. no. No. NO!" and literally grabbed her hand and pulled it out of her.

I was in complete shock.  I could not believe my eyes and what I just witnessed.  It is worth mentioning that this midwife also attended the birth of my first daughter and I wasn't so pleased with her care back then either.  We were all silent and in shock and very, very angry.  The midwife proceeded to stand up, look down on my friend, and tell her that she was still only 5cm after all of those hours and all of that work.  She told her (in a polite voice) that if she was not progressing faster by the next time she came in, she might consider augmentation with pitocin and even mentioned that it could lead to a cesarean.  She was the only person in that entire experience who did not respect Meghan and Wes' wishes by honoring their birth plan.  After she left, and I realized how upset everyone was, I told them that it wouldn't be unreasonable to request another midwife.

It was just coincidence that the best midwife to ever live happened to come on shift shortly after.  Our nurse told us that they had the option to switch midwives and they jumped on the opportunity.  In the meantime, the nurse on shift took over all of Meghan's care and was absolutely fantastic, compassionate, and respected every wish.  

After another few hours and another vaginal exam, Meghan was still at 5-6cm.  That was really heartbreaking for her because she was working so, so hard.  Everyone in the room was physically exhausted, emotionally exhausted, and our bodies were beginning to fail us because we were all working hard, especially Meghan.  My arm was so sore from rubbing Meghan's back during contractions.  At one point, I woke up from a dream, looked around, and realized that I was still standing where I was a moment ago. I actually fell asleep while standing up right next to her hospital bed.  

Meghan preferred to be laying on her side while laboring, but after that last check I could see that she was wearing thin.  We all were.  I suggested that she be upright for contractions to take advantage of gravity and help her baby move down.  She hesitated because it was so much more uncomfortable that way.  When the nurse came back in, she finally asked for an epidural.  It felt like time was standing still.  The nurse understood and said she would grab the anesthesiologist.  It was only a short time later when the nurse said they were ready.  Meghan had been standing for about 40 minutes.  I mentioned that it was a possibility to get another check to see if things had progressed before she was ready for her epidural.  She agreed and was already at 8cm!

mary ellen and meghan. Mary ellen was the most fantastic support for meghan. she should be a doula.

She held off on the epidural and we kept trying to do what seemed to be working.  Standing, swaying, on hands and knees, and generally upright.  After just a few more hours, a new nurse on shift, and the most supportive midwife ever, Meghan was making grunting and pushing noises.  Sure enough, 10 centimeters.

That's when the energy in the room shifted.  

Everyone was scared for the moment of birth and now that we knew it was closer, we were all noticeably anxious.  Meghan requested to see her affirmations again to help as the fears were cropping up.  But, in the end, the affirmations were too hard to read in labor. 

I spent a lot of time holding Meghan's leg up while pushing, breathing with her, and holding her squeezing hand.  Meghan's mom was often holding the other leg.  And Wes was holding her hand and helping hold her head up while talking to her.  I cannot imagine that experience without the three of us.  Almost always, we were all actively and physically involved in supporting Meghan and I don't know how it would have worked without any piece of the puzzle.  It was so, so, so intense, painful, and scary.  During my lowest of low moments at that birth, I felt 100% sure that doula work was over for me.  I was terrified that I would never be able to attend another birth again.  

Meghan pushed for hours and hours.  She preferred being on her back, but we tried many positions to get Charlotte to move down.  Hands and knees, squatting with the squat bar, squatting without the squat bar, on her side, etc. Meghan told us that she knew that Charlotte had not moved down at all.  And she was right.  The midwife told us that Charlotte was stuck under Meghan's pubic bone.  After four hours of pushing and absolutely no progress, the room felt flat.  The midwife, who was so calm and reassuring, told Meghan that her only options were to keep it up, receive an epidural, or have a cesarean.  Meghan consulted her family and decided in the end to receive an epidural so that she could get some sleep and hopefully push her baby out after she gained some more energy.  I knew that she was feeling defeated and weak.  I tried to reassure her that she was strong and that Charlotte knew that.  I told her that it's totally okay to accept her epidural so that she could take care of herself and that she was making a good choice.  

It didn't take long after her epidural was placed for her to relax.  The energy in the room shifted again.  It was light, happier, and so much more calm.  We had all been on edge and anxious for so long. Meghan's dad and Wes' parents had been in the lobby sleeping and waiting for nearly 24 hours so Meghan's mom went to get some sleep, some dinner, and to update them.  Wes and I got Meghan settled in her bed, covered her up to keep her warm, and got her some jello and water.  A new nurse came on shift again and was, once again, the perfect nurse.  This woman was spunky, upbeat, warm, inviting, and was excellent at her job.  She brought with her the exact type of energy that we needed at the time.  Wes went to get dinner and during that time Meghan and I were alone.  We reflected on the events of the past day, we laughed a little, we cried a little, we talked about how we didn't ever expect this to be the route that this birth took.  Meghan was now hooked up to many wires and machines and just two weeks ago she was planning a quiet out-of-hospital water birth.  We got her set up on her side with a peanut ball between her legs to give Charlotte some room to re-position and move down.  Finally, Meghan was able to fall asleep.

Wes and I went downstairs to eat dinner in the lobby.  I was still so sick to my stomach that I couldn't eat more than a few bites.  Everything felt surreal.  I couldn't eat.  I hadn't slept at all in over 36 hours.  I had been there for what felt like forever and the moment that I was most terrified of hadn't even come yet.  

I think it's worth mentioning that what I was most scared of wasn't seeing Charlotte.  We knew that her features would likely be different or strange, as many babies with her diagnosis were.  We knew that if she was born not alive, she would look a little different.  And we knew that if she was born alive, that her  physical features could change quickly after her death.  Watching a baby die isn't exactly what I was scared of--although it was certainly sitting in the pit of my stomach.  I think that what I was most afraid of was watching my best friend have to go through all of it.  I still get tears just thinking about how badly my friends were hurting.  

When the originally got the diagnosis, I bought Meghan a tree of life necklace to wear at her birth.  I wore one, too.  It really helped to keep us connected and moving toward her goals.

We went back to Meghan's room and she was stirring.  We all got comfortable to take a good nap.  It was about 10pm at this point and we had been at the hospital for nearly 24 hours.  Meghan's mom was asleep on a little cot/bed, Wes wrapped up in a chair sitting up, and I was sitting on a birth ball, leaned over Meghan's bed.  I slept with my head on pillows on her legs. I was only asleep for about 45 minutes when Meghan told us to head downstairs to get some rest in the lobby since no one was really resting well.  Her mom was with her in case she needed anything.

It was then that Wes and I had a real heart to heart conversation.  We made make-shift beds in the lobby of the hospital by pushing a bunch of chairs together.  We spent some time talking about what had happened and what was to come.

Wes told me that he had already grieved the loss of his daughter and that he knew that Meghan had not yet.  We discussed how we would have to be supportive of her afterward so that she could have the necessary time and space to grieve.

We talked about the birth plans again and what each of our roles would be in each of the scenarios.  We knew that the midwife would be back at 1:30am.  It was 12:30.  We set an alarm for one hour from then, and curled up in hospital sheets on chairs.

At 1:30 we went back up, checked on Meghan, and they had started the pitocin.  It wasn't in her original plan, but her epidural was slowing her contractions way, way down.  Her pitocin started at the lowest amount possible.  She was still relaxed and not feeling contractions.  After a while, Meghan convinced me to go back to the lobby to get more sleep.  I finally relaxed enough to get two hours of good sleep.  I knew that the midwife would come back in around 5am so I went back up around then. Everyone was just waking up and the midwife came in to check Meghan again.  Our nurse had been slowly upping the pitocin over the past few hours.  When the midwife checked Meghan, Charlotte was still high and above the pubic bone, but still at 10cm.  Everyone agreed that it was time to push this baby out.  

Pushing this time was much different than it was the night before.  It was so much less intense.  Meghan wasn't in pain, she wasn't exhausted, and we were all feeling much better.  But, baby still wasn't budging.  Liza, the midwife, was so, so encouraging.  She was doing all she could to get Charlotte to come down under the pubic bone.  We tried different positions, which was really hard to do while Meghan had an epidural. But we all worked as a fantastic team to support her.  Everyone's role was needed and important.  We all found a way to come together to facilitate this birth: midwife, nurse, Meghan, me, Wes, and Mary Ellen.  A new nurse was on shift now and once again, was the perfect fit for this new phase we were in.  Finally, after a few hours of pushing and no descent, the midwife asked if she could invite an obstetrician in to check things out and give some input.  

When the OB checked Meghan, she was very honest and open.  She said that she thought there was plenty of room for baby to come down and out and that she surely would do that, but it was just taking a lot of time.  She encouraged Meghan to keep pushing (both literally and figuratively).  So, that's what we did.

Sometime during this time, Meghan stopped feeling Charlotte move.  Charlotte had been really active throughout the duration of the labor and then there was nothing.  It's not uncommon to not feel your baby move in late stages of labor, but since Charlotte had been moving for the last two days so much, Meghan started getting really worried.  She wanted to meet her baby alive.  But she knew it might not happen and she was starting to lose hope.  In-between contractions, she would poke her belly and call Charlotte's name and there was no movement in return.  No one said definitively that they thought Charlotte was gone, but I could see it in everyone's eyes.

When someone mentioned to me that it was Monday, I realized that I had no clue what day it was.  We drove to the hospital on Saturday and I had completely lost track of time.  I told them that I needed to leave to go cancel my plans that day.  I was scheduled for an online training and had an appointment that day.

Back in the room, after about two more hours of pushing and absolutely no progress, we were all wearing thin again.  We called the OB back in.  She was not as hopeful this time.  Meghan had been pushing for over 8 hours total over the course of the last day.  We had been in this hospital for over 36 hours.  She recommended a forceps delivery.  She called in her supervising OB to confirm that this was the right course of action.  It was unanimous.  After asking a lot of questions and hearing about benefits and risks, Meghan finally made the hard decision to consent to a forceps delivery of her baby.

That's when things started really picking up pace. People started entering the room and poor Meghan was still pushing with all of her might during every contraction just in case she could get Charlotte down under that bone before the OBs came back with forceps.  

We had tried to retain the services of a Now I Lay Me Down to Sleep photographer to photograph the birth and Charlotte afterwards with her parents, but no one was available.  So, another nurse on shift came with a camera to take photos.  The midwife was still there, but stepped out of the way.  Our nurse was still there for support.  An entire NICU team came in to evaluate Charlotte immediately if she was born alive.  It was in their birth plan that if Charlotte was born alive, they wanted absolutely no intervention or resuscitation--only comfort measures.  In the super rare case (less than 1% chance according to the specialists) that she was born breathing on her own, with vigorous crying and no intervention necessary, she would be transported to Children's National hospital in DC to figure out if medical treatment of her renal system issues was a possibility.  So, the NICU doctors and nurses were there to evaluate what Charlotte's condition was and then make a plan for either comfort care or transport.  There was a Catholic priest waiting in the hallway to baptize Charlotte immediately after birth and give her Last Rites. Immediately surrounding Meghan was still me, Wes, and Mary Ellen.  Then, the two OBs came back in the room as well with the forceps.  

It was going to be over in a matter of minutes.

As the doctors talked Meghan through the process, they were calm and supportive.  Everyone was waiting quietly.  It was like time stood still.  The moment was finally upon us.  The doctors put the forceps on.  The plan was that with the next contraction, Meghan would push with all of her might to assist them with pulling.  They would use the forceps to pull Charlotte down under the pubic bone, take them off, and then assist Meghan with pushing her out the rest of the way.  I had seen forceps deliveries in videos before and knew that it wasn't always gentle and easy, so I encouraged Meghan and Wes to focus on each other and keep eye contact so that they wouldn't have to watch the process.  Every 30 seconds or so, Meghan would begin to cry and shake her head no (as she was clearly anticipating the birth), but it was our job to keep her focused and encourage her that it was almost over and she was strong enough to do this one last push.  As we were waiting for the next contraction, the minutes went on and on.  Meghan later told me that she believes the reason why her body couldn't push Charlotte out and why that last contraction took a good 15 minutes to come was because she didn't want to have to go through what was coming next.  In the birth world, that's sometimes referred to as emotional dystocia.  And it's so, so real.  

I had the important job of holding Meghan's leg up and holding her hand while she pushed.  I told Wes, who was standing right beside me, that I would wait until baby came out and then get out of the way so that he could see better and get close to Meghan and Charlotte.  He said "no, that's okay."  I told him it was fine and that I would let them have the very first seconds together.  

He held my arm and said "No. I want you here."  That was truly a defining moment for me and when I realized that my presence was necessary, appreciated, and worth every second.  I'm crying just remembering how important I felt and how vulnerable I realized everyone was.

Finally, a contraction was starting.  The OB told Meghan to push.  She closed her eyes and pushed with every bit of energy she had.  The OB pulled so hard that Meghan started scooting off the bed.  I was pulling back against the pressure on Meghan's leg and trying to keep her from sliding off the bed.  It was only a few seconds before the OB was taking the forceps off.  They encouraged Meghan to push hard one last time.  Meghan pushed and I looked down.  I had it in my mind that if I was able to see Charlotte first (especially if she was already gone, which I was pretty sure of at the time) that it wouldn't hurt as bad to watch Meghan see her.  I don't know why.  Charlotte's head came out facing down.  I told Meghan to reach down and get ready to grab her baby.  As Charlotte's body turned upward, Meghan was reaching for her, and the OB began to pull her out, one of her eyes popped right open.  My jaw dropped.  I was not expecting her to be alive.  An immediate rush of dread and adrenaline filled every part of my body.  The picture below is of our faces (Mary Ellen, me, and Wes) as Charlotte was placed into Meghan's arms.

the looks on our faces the moment charlotte was born.

Then, the defining moment.  Charlotte let out a huge, loud, and healthy scream.  

The only word to describe what I did at that point was WAIL.  We all did.  Everyone in the room wailed.  There was such a minuscule chance that Charlotte would ever cry.  I backed up from the bed and all of the emotions of the last two weeks overwhelmed me.  I leaned against the wall behind me, slid down to my knees, and just cried.  I cried for Charlotte, who so clearly wanted to meet her parents; I cried for Meghan and Wes, who wanted nothing more than to meet their daughter alive; and I cried a release of emotions.  It was so hard, but I forced myself to stand up, shake it off, and take some photos for them.  Charlotte was on Meghan's chest.  She was alive and she was breathing.  It was a complete shock.  The head NICU doctor was observing closely, but respectfully allowing Meghan and Wes to meet their daughter.  

As Charlotte started showing signs of difficult breathing, the doctor asked Meghan if it would be okay to take her to the warmer to check her out more closely.  Meghan said yes.  Wes cut the cord and Charlotte went to the warmer.  The doctor was checking her heart rate, giving her some blow-by oxygen (as was indicated in their birth plan), and observing.  Wes joined Charlotte and after checking on Meghan, I hopped over to take some photos.  It was clear to me that she was struggling to regulate her breathing (more than the average newborn).  

Before the birth, the NICU docs told us that it would be pretty obvious right away if Charlotte wasn't going to be able to breathe on her own.  But, in reality, it seemed a little more confusing.  When Wes asked what her opinion was, the doctor said that she would like to do an x-ray to determine Charlotte's lung development.  It was already a shock that she was born alive and that her lungs were functioning at all, considering she was living in her mother's uterus with almost no amniotic fluid for so long.  They decided to go ahead with the x-ray and Wes could come along.  If anything changed or if it looked like Charlotte was struggling too much, they would bring her back to Meghan to be in her arms.  

But first, the priest came in to baptize Charlotte.  It was a deeply emotional and spiritual moment that Meghan and Wes did not think would ever happen.  Their Catholic faith is important to them, though, so their nurses were sure to have a local priest close by.  How many babies do you know that were baptized at only 12 minutes old?!

the catholic priest baptizes charlotte while wes is present.

They brought Charlotte to Meghan and Wes before the x-ray to get some good bonding time for a few minutes and take some photos.  Then, Charlotte was put back in the warmer and Wes, Charlotte and the NICU team left to go to the NICU for the x-ray.

Just seconds after they left, Meghan said she didn't feel well.  She calmly and slowly laid her head to the side, closed her eyes, and stopped talking.  Mary Ellen was beside her calling her name "Meghan.  Meghan!  Meghan, answer me!", but Meghan showed no response.  The nurse quickly took her blood pressure.  It was 49/24.  Things started moving quickly.  They laid her bed down, hooked another bag of IV fluids up, and maybe a bag of medicine, I can't honestly remember.  All I remember was seeing the most postpartum blood loss that I'd ever seen at a birth and being scared.  Meghan's mom got out of the way of the nurses and came and stood with me on the other side of the room. I felt paralyzed.  Mary Ellen finally told me to go talk to her.  I think she was too scared to be over there.  I got my wits about me, walked to Meghan, and said "Meghan.  It's Maria.  I'm right here and I'm not leaving your side.  You're going to be okay."  I kept talking to her and I vividly remember softly brushing her bangs out of her eyes over and over. 

After a few moments, she started making small movements with her head.  Mary Ellen asked me to ask if she was okay.  Before I even got the question out, Meghan said (in a somewhat annoyed way) "I'm fine."  That gave us all a good laugh.  We knew she was going to be okay.  That was my first and only to date experience with postpartum hemorrhage and going into shock.  It was so scary.  Meghan ended up receiving two blood transfusions after that.  

During the next fifteen minutes or so, the OB who delivered Charlotte was repairing Meghan's severe tear.  Because Charlotte was born so quickly, and with forceps, she had some pretty severe damage that needed to be sewed by a surgeon.  While that was happening, a nurse came into the room and asked for Maria.  I identified myself and she said that they needed me in the NICU with Wes and Charlotte.  I was so confused.  I said "I'm the doula".  She said "I know."

I was scared and confused, but moved quickly.  I walked out of the Labor and Delivery room, through the hallways, and out of the doors of the unit.  I was headed across the hall to the NICU when I saw Wes' parents and Meghan's dad jump up and run up to me.  They asked what was going on. I told them I didn't know but that they needed me in the NICU quickly. 

Family: "Why the NICU?!"
Me: Because that's where they are.
Family: Who?
Me: Wes and Charlotte.
Family: Charlotte is here?! Is she alive?! What's going on!!!

It finally occurred to me that they hadn't even been updated on the birth yet.  So, I quickly told them that Charlotte was alive as far as I knew, that they took her for an x-ray, and that they asked me to come and I didn't know why.  So, I ran off but not before they asked how Meghan was.  I was vague and said "she's doing better".  I didn't want to scare them about what had just happened.

When I went into the NICU, I found them quickly.  Charlotte was laying in a warmer and Wes was changing her diaper.  She had pooped twice already!  He told me that her x-ray hadn't gone so well, as her lungs were not developed normally, but that she seemed to be doing okay with the blow by oxygen.  He needed to go speak with Meghan about whether or not to transport Charlotte to Children's National, but didn't want Charlotte to be alone.  Even though no one was allowed in the NICU but immediate family, he convinced Charlotte's doctor to let me stay with her so that she wasn't alone.  I told him I would keep her company.  It was then that the emotions finally hit us and Wes and I shared a hug and cried.  

He left to talk to Meghan and Charlotte's doctor taught me how to hold Charlotte's blow-by oxygen and to cup it around my hand against her nose if her oxygen saturation went below 80 (which it did a few times).  For the next hour while Wes and Meghan were talking together, to their families, and to doctors, Charlotte and I were alone in the NICU room.  I considered it to be a tremendous honor and responsibility to spend that time with Charlotte in her first few hours of life.  I talked to her about how she was loved, how her birth was a roller-coaster, how her parents met, how we were all great friends, and about how my daughter Clara was so excited to meet her.  When she would get fussy, I sang Baby Beluga over and over again to her, which usually seemed to calm her back down.  She pooped again and I changed her diaper.  I sang to her until she fell asleep and her breathing really regulated.  She seemed calm and relaxed.  I couldn't believe that she looked like a normal baby.  We were expecting many different facial features, possibly club feet, spinal malformation, etc.  And that was only if she was born alive!  But she had none of that.  She was gorgeous.  I got the overwhelming feeling and message from Charlotte that she wanted to be here and alive on Earth.  I knew that she would be okay. Thinking about that still gives me chills. 

After about an hour, Wes and the doctor came back to take her to Meghan's room.  We strolled through the hallways with Charlotte asleep in her rolling cradle, oxygen tank and all.  We got back to Meghan, swaddled her up, and finally Meghan and her family got to meet and hold Charlotte in a calm and relaxed environment.  It was lovely.

skin to skin with mommy

After a little while, the NICU doctor came back in and told us that after sending the x-rays to Children's and updating them about Charlotte's condition, the specialists were very optimistic and wanted Charlotte transported immediately so that they could begin their own evaluations and care for her.  Meghan and her family said goodbye to Wes and Charlotte and they left to get in an ambulance to make the trip to DC.  

I stayed for a while with Meghan and her mom while we talked about how we couldn't believe what had just happened.  We were so happy, shocked, relieved, still scared for the future, and so, so grateful.  After a while, Meghan told me to finally go home to my girls.  It had been 45 hours since I had seen them, 50 hours since I had eaten anything of much substance, and 60 hours since I had slept (other than those tiny naps that totaled about 3.5 hours).  

I gave Meghan and Mary Ellen the best hugs of my life, grabbed my bags, and headed home from what seemed like a surreal and very long experience.  I was back in the sunlight after two days and walking to my car and just thanking God for Charlotte, for my friends, and for allowing me to be a part of that experience.  I drove the two hours home with so much adrenaline, energy, and love.  When I got home, my husband and daughters were outside in the August evening sun waiting for me.  Inside, my husband had the house cleaned.  We ate dinner together and I have never been more thankful for a dinner with my family.  I slept really, really hard that night.

This birth CHANGED MY LIFE because:

1. I will never take my children's health for granted again.

2. I realized that I treated Meghan differently than other clients since we were such great friends. Since then, I've found a way to connect with my other clients in a meaningful way during their births even though my clients aren't always life-long friends first.

3. I am a much better doula. After supporting Meghan, Wes, and their family through such a long and overwhelming birth, I felt like I could do anything. I've supported some women with long and difficult births since and I feel so much more prepared, relaxed, and supportive.

4. My best friends turned into my family. We share something really, really special and sacred. I wouldn't give that up for anything.

5. I learned that miracles happen.

6. I am so grateful for my husband and two daughters, because I've learned that not everyone has the privilege of bringing their healthy children home.

7. Charlotte changed my life. In that hour that I spent with her in the NICU, my brain was re-wired. I had never been in the immediate presence of a miracle. Let alone with such a connection that would be the beginning of my relationship with her.

**Click to continue to Part V: An Update from Meghan and Wes!**

The Birth That Changed My Life: Part III

This week in our Delmarva Community Birth Stories series, we're doing something a little different.  This story is shared by Thrive owner and doula, Maria Mengel.

If you haven't read Part I  or Part II yet, hop on over and check them out now.

---

We were in a really weird space.  Baby Charlotte's heart could stop beating at any moment.  And yet, there was nothing to do but wait.  Wes owns his own business which is right next to their home.  He would come home during lunch and talk to and read to Charlotte.

Wes would wake up in the middle of the night and feel Meghan's belly just to be sure that Charlotte would still kick back.  

My family spent a good bit of time with them during this time.  We looked at Charlotte's MRI photos, we talked about her and to her, and we tried to keep busy.  I remember Wes being pretty down.  But Meghan was surprisingly not.  It's hard to try to understand how she was feeling, but I think I can compare it to how sometimes people in devastating situations just do what needs to be done because there is simply nothing else to do.  She knew that there would be a time after the birth to grieve, mourn, process, and then finally begin healing.  It seemed to me that she was blocking those emotions while still holding out hope for baby Charlotte and her desire to spend whatever time she had with her in a positive way.

In conjunction with their midwives, the bereavement coordinator at the hospital she would be delivering in, the specialists at Children's National Medical Center, and me, Meghan and Wes drafted a number of birth plans to be prepared for all of the potential outcomes.  One for if Charlotte had passed before before birth (stillbirth plan), one for if Charlotte was born and it was clear that she would not be able to breathe on her own (comfort care only), and one for if Charlotte was born with vigorous breathing and crying (potential for medical care).  

Their specialists told them that there was only about a 5% chance that Charlotte would be born with the potential to breathe on her own since her lungs were so underdeveloped.  And after that, only a 5% chance that she would continue to be able to do so and medical care would actually be a possibility.  The statistics were pretty clear: It was a fatal diagnosis.  Because of this information, Meghan and Wes made the very difficult decision to only intervene with medical care if Charlotte was born breathing, crying, and made it very obvious to the medical staff that her lungs would function completely on their own.  The specialists told them that it would be very easy to be able to tell the difference.  If so, Meghan and Wes were comfortable providing Charlotte with the care that she needed for her renal system.  

There were so many text conversations with Meghan about how they came to this decision and why they were so adamant about not interfering.  They knew that if Charlotte was born alive that it was highly likely that they would only have a few moments or hours with her.  They didn't want those moments to be spent with Charlotte whisked away, hooked up to a ventilator, and away from the ones who love her.

They didn't want her to live her only earthly moments out of their loving arms. They didn't want her to die on a table surrounded by strangers.

My brain still has a difficult time wrapping around this issue.  I can absolutely see and understand the desire to want to do anything  possible to save your child.  And I know that there are parents out there who would make that choice.  As their doula, I planned to support them no matter what their decision was.  But truly, I felt so much respect for their decision to completely respect Charlotte's story and path and their desire to keep her as comfortable and at ease as possible.  

During this time, our conversations moved to her fears.  She had a few clear and distinct fears that she wanted to be able to work through before her birth.  In my childbirth education class, we talk a lot about using affirmations to help process fears and move away from negative thoughts.  I offered to create some pretty affirmations for Meghan to read to herself every day.  I'll share a few of them here.  

Before I do, I want to share that I understand that these affirmations are not within everyone's belief systems.  That's totally okay.  I made sure that the wording was something that Meghan was comfortable with and  that she completely approved.  I know that everyone will approach such a difficult subject by bringing their own life experiences, spiritual and religious beliefs, and heart with them.  As her doula, it wasn't within my scope or desire to express my beliefs.  I simply wanted to support her in processing her fears so that she would be as mentally prepared as possible for her labor and birth.

Some of the fears:  That Charlotte won't be born alive, that she will be in pain, that she will not breathe on her own.

Meghan later told me, "I wanted to believe them.  I read them over and over and over every day.  I hung them in our bathroom covering part of the mirror so I was forced to read them no matter how much pain they caused me."   

During the two weeks between diagnosis and birth, Meghan, Wes, and Meghan's mom and dad spent a lot of time at home as a family and cherished those final moments with Charlotte.  But we also did some "normal" things.  One day, Meghan and her mom accompanied me and my daughters to a small, low-populated beach.  Understandably, it was difficult to be in public because I'm sure Meghan would have received lots of "congratulations" comments and questions about when she is due, what her baby's due date is, what her baby's sex is, etc. Those would have been difficult questions and I know that she wasn't in a place to share all of the information yet.  In fact, they chose not to share any of this information with the public or on their social media until after Charlotte was born.  So we chose a more private, quiet outing.  Because Meghan knew my family so intimately, she told me that night after we went to the beach that it hit her while watching my girls play in the sand that her daughter would probably never know them, play with them, or grow up with them.  That was a really hard day.  We also had conversations about how to tell my daughter, Clara, who was only 2 and a half at the time, and who was over the moon about the baby in Meghan's belly.  

I did my very best to be her friend and her doula.  I scheduled her a massage.  I arranged an appointment with a 3-D ultrasound tech to get a recording of Charlotte's heartbeat in a bear so that they could hear her heartbeat forever. We talked so much about her birth plan and her desires for her care and Charlotte's care.  When Meghan told me she might like to have some maternity photos after all (they had previously decided not to do it), I called right away and found someone to come to their home that afternoon.  Melissa Goodyear of Bluebug Photography did a fantastic job with their photos.  She is also a volunteer photographer with the organization called Now I Lay Me Down to Sleep, so she had plenty of experience working with families dealing with loss and was incredibly compassionate.  As you can imagine, the session was extremely emotional.  

How they did that photo session, I'll never know.  How they smiled at all in those two weeks, I'll never know.  How we were still able to joke and be ourselves in spite of it all, I'll never know.  What I do know is that they wanted to cherish that time.  They wanted Charlotte to know that she was loved.  Meghan tried so hard to be happy and thankful for whatever time she had left.  She knew that her baby would feel all of her stress and anxiety, so she smiled and talked to Charlotte constantly.  In the last photo, they decided to take some photos in the nursery.  The photo of Wes wiping her tear gets me every time.

On the morning of Charlotte's due date, I woke up to my phone buzzing early in the morning.  Meghan was in labor.

**Click here to continue to Part IV**

The Birth That Changed My Life: Part II

This week in our Delmarva Community Birth Stories series, we're doing something a little different.  This story is shared by Thrive owner and doula, Maria Mengel.

If you haven't read Part I yet, hop on over and check it out now.

I received the worst message that you could ever receive as a friend/doula:

"Amniotic fluid is basically zero.  They can't find any kidneys or bladder.  Without kidneys, the baby will die after birth.  We're going to AAMC for induction.  You should come now."

Then it was followed by:

"worst nightmare"

I was completely in shock and "respond" mode.  I was in the shower, so I jumped out, toweled off, texted my husband to come upstairs now, and started getting ready.  I was in the car within minutes.  I was nervous, scared, worried about my friends and their baby, and in a real hurry to get there.  On my way, I called and talked to my mom and my doula/mentor to keep my mind from racing too much.  They both promised to pray and reassured me that I would be able to support my friends no matter what.  I told them that it wasn't fair that my first bereavement birth after receiving my certification was for my best friends.  I was still feeling pretty raw from the sudden death of my little brother just months before, and I truly didn't know if I could do it.

I didn't waste any time, but I didn't speed either.  While I was alone in the car, I tried to think about everything that I learned about babies who passed after birth.  I would need to be strong enough to explain to my friends what to expect and yet compassionate enough to support them through a potentially long induction and birth.  Two hours later, I pulled into the hospital parking garage.  I practically ran to the elevators, through the Labor and Delivery doors and down to the room where the nurse told they would be.  I quietly opened the door to my friends sitting on a couch together talking with their midwife.

I was breathing heavily from running and when I walked in it was completely silent.  

Without speaking, I walked across the room and sat down with my friends when Wes said "Well, the induction is not until Monday".  Apparently Labor and Delivery was really busy that day (Friday), so they decided to wait until Monday for the induction.  Their baby had been surviving with extremely low amniotic fluid levels and seemed to be doing fine for some time (they estimated up to 6 weeks or so), so they figured a few more days probably wouldn't make a difference.  Everyone seemed so relieved.

It was kind of awkward because we were all in shock, sad, relieved, and scared at the same time.  The midwife came back with a specialist on the phone from Children's National Health System in DC.  He expressed his apologies about their situation but offered them a pretty innovative opportunity.  He told them that he could see them early Monday morning for a fetal MRI to get a closer look at baby's renal system and lungs.  He told them that he would hopefully be able to get a more concrete diagnosis before the induction that morning so that they would know how to prepare for their baby's treatment after birth.   They decided to accept the offer and scheduled an MRI in Washington D.C. at 7:30am and an induction in Annapolis at 9am. 

We spent the next hour or so on the phone making appointments and then made the two hour trip back home to the Eastern shore.  Meghan's parents were on their way from upstate New York and they needed to stop at the grocery store to stock their fridge for guests.  Wes took my husband to the store with him while Meghan and I stayed at my house with the girls.  Meghan and I talked about how it all seemed so strange and so awkward that we just found out that her baby might die and we were doing normal things like grocery shopping and watching my kids play.   When they went home that night, I promised to stay in touch.

Guys, thank God for texting.  

We spent the time between her diagnosis and her birth texting constantly.  It was so much easier for Meghan to express her thoughts and feelings through texts than saying it all out loud.  Our relationship as friends grew leaps and bounds through those messages, many of which I saved so that I wouldn't forget.  The good and bad feelings, the fears, the worries, the logistics,etc.  It was like having a diary to process our thoughts together.  And it was so much easier to text our thoughts than say them out loud.

On Sunday, we scheduled our prenatal meeting together.  It was supposed to be a meeting where we discussed their dreams and desires for their beautiful water birth.  But instead, I got my first taste of what it was like to be a bereavement doula.  I met with Meghan and Wes and we discussed their options.  If the MRI the next day confirmed their worst fears, and baby truly did not have a bladder or kidneys, and severely underdeveloped lungs, they would have a few choices.  The staff at their hospital informed them that they could continue with the induction the next day, with the understanding that the baby might not make it through the stress of labor and die before birth.  Or they could wait for spontaneous labor, knowing that the baby may pass before labor begins, and then definitely deliver a stillborn baby.  Or, they could schedule a cesarean to guarantee that Meghan and Wes would have a chance to meet and hold their baby still alive, and then know that baby would probably pass in her arms shortly after.  

We talked about what to expect with all of the options, including the details that I didn't ever want to have to share with my friends.

They were aware that funeral arrangements would have to be made, but weren't ready to talk about it yet, so Meghan's mother and I talked through their options and I contacted a funeral home, asked questions about their options in terms of transportation of the baby's physical form and services.  I gathered all of that information and placed it in a folder in my birth bag.  They decided to wait until after the MRI in the morning to make a final decision about their birth plans.

The next morning, I knew that it would likely take a long time before the MRI was finished and they were able to talk with all of the necessary specialists in DC, so I did the only thing I could think of to pass time.  I feverishly cleaned my house.  I literally was scrubbing the freaking baseboards because if I sat still too long, I started getting sick thinking about what might happen later that day.  I had a knot in the pit of my stomach and every once in a while, I had to sit down and mentally tell myself that what they were about to go through was much harder than my role in the process, and that I could support them 100%.  I knew that there would be a lot of processing and healing time afterward for everyone and I planned to give myself the energy and space for that after the birth.  

When Meghan finally called, she told me that the news wasn't good.  They were unable to find any bladder or kidneys still.  They told her that her baby's lungs were severely underdeveloped (as a result of the low amniotic fluid) and that her worst nightmares were confirmed.  Life outside of the womb for their baby was highly unlikely.  They weren't going through with the induction. They were coming home and waiting for their baby to decide when it was time to be born.  They were aware that there was a risk of stillbirth, but they wanted to respect their baby's timing. 

Baby Rice's diagnosis:
• Bilateral Renal Agenesis
• Pulmonary Hypoplasia
• Anhydramnios
• Potential slight spinal malformation

I was absolutely heartbroken for my friends.  And I was so relieved to know that today wasn't the day.  

We didn't know it at the time, but we still had another two whole weeks before their baby was born.  They decided after the MRI to find out the sex of their baby so that at least for a short while alive, their baby could have a name.  Here is the MRI photo of Charlotte Catherine Rice.

**Click here to continue to Part III**

***Of course, I have received full permission from Meghan and Wes to share my version of this story and use their real names***

The Birth That Changed My Life: Part I

This week in our Delmarva Community Birth Stories series, we're doing something a little different.  This story is shared by Thrive owner and doula, Maria Mengel.

I don't normally share birth stories as the doula.  The stories belong to the families!  But this story is one that I couldn't keep in.  Because while it is always all about my clients, and while it is my intention during a birth to make them feel like the most important people in the world, this story had a big impact on me and my life, too.  

This is the story of the birth that changed my life.

I met Meghan and Wes nine years ago in college.  We were all studying music at West Virginia University when we met each other and our spouses.  We were in the same classes, went to the same parties, and played in the same ensembles.  We were in each other's weddings and vowed to stay in touch.  The year after my husband and I received music jobs on the Eastern Shore, Meghan got one, too!  We were so excited to be close again and for Wes to bring his clarinet business to the Eastern Shore.  

Naturally, we all became best friends again.  We shared dinners on the weekends and even lived together one weekend when their home was evacuated for a hurricane.  They were the first people we told when we had our girls.  And they have been there to watch my girls grow up and see all of their "firsts".  

Last December, Meghan and I were taking my girls to the Salisbury Christmas Parade when Meghan shared the fabulous news that they were expecting!  I knew that they had been trying for a while, and I was equally happy for them and excited to meet their new baby that would get to grow up with my girls!  

Almost right away, they hired me to be their doula.  They were planning a natural birth at the same birth center that I birthed my first daughter. I was excited to be going back and so thrilled to witness the birth of this baby, who I already loved.  Meghan and Wes were some of the first participants of the class I worked so hard to design, Thrive Childbirth Education.  They were so excited and adamant about their natural birth plan, and I had planned to support them in whatever they needed and wanted.  

While they were pregnant, I had decided to study through Stillbirthday to become a certified Birth and Bereavement Doula.  I was unlike many of my class members, as I had never experienced a pregnancy or infant loss before.  To be completely honest, I had no clue what motivated me to take this training.  But I was completely committed to it and finished the program in March.  I wasn't yet sure if I would ever put myself out there as a bereavement doula, but knew that I had learned some valuable information, should I ever need it.

As their due date drew nearer, Meghan began telling me that she was measuring small (the measurement in centimeters that they take from your pubic bone to your fundus at OB/midwife appointments).  However, both Meghan and Wes are small people, and nothing seemed too concerning.  But when her belly wasn't growing at all after 3 or 4 appointments, her midwives recommended a biophysical profile to take a closer look at baby... just to be sure.  Meghan and Wes originally wanted to decline the ultrasound, as they had declined other ultrasounds in their pregnancy.  They weren't sure whether the potential risks of a long ultrasound at 38 weeks would be worth it to find out that everything was perfectly normal in the first place.  

They decided to go ahead with one biophysical profile, just to be sure baby was still growing normally.  I went with Meghan while Wes was working on Thursday, July 21st.  It was really cute to see their baby up on the big screen.  The ultrasound tech seemed like she knew what she was doing and was busy chatting a bit, while taking measurements and snapping pictures.  After it was all over, the tech said she'd be right back.  She was supposed to report back to Meghan's midwives with information.  When she came back she said that they were busy, and as soon as they were able to connect, her midwives would give Meghan a call.  She seemed perfectly happy and didn't look concerned to me at that point (although I now know that she was).

When I got home, I had to teach some private music lessons almost immediately.  I was in my first lesson when Meghan called back.  I didn't answer since I was teaching and instead texted "Hey I'm teaching. Everything okay?".  I waited a minute and got a reply, "No.".  

When I stepped out and called, Meghan was crying.  She told me that the midwives called and told her that there was basically zero amniotic fluid with her baby.  This could be life threatening to her baby, so they wanted her to drive immediately to our local hospital for a non-stress test and possibly a cesarean that very night.  I was, of course, completely shocked.   Since Meghan lived about 30 minutes away and she was still in town, I told her to come to my house and that Wes could meet us here.  

We hugged and talked for a little bit.  She was scared, of course, but wanted to be sure that her baby was as safe as possible, so we were just calm and hanging out with my two toddlers while we waited for Wes.  He brought the whole birth bag just in case they would be having a baby tonight!

At the hospital, the midwife and nurses did a non-stress test, which showed that baby seemed perfectly fine and healthy.  The care providers at PRMC told them that low amniotic fluid alone wasn't a clear indicator for induction.  They advised them to go home and rest.  Of course, after the providers at our hospital told the midwives at the birth center, and after the birth center consulted their maternal fetal medicine (high-risk) specialists about her case, they recommended that Meghan and Wes made the 2 hour drive that very moment for an induction that night.  And they politely declined, but agreed to come in the morning for a second biophysical profile with the specialists, just to be sure.

We had dinner together that evening at my home.  We talked about the crazy day we had and how they really didn't think anything was wrong.  We were all surprised at how insistent the "holistic" midwives were that the baby come out tonight, when our doctors at our local practice told her that her baby seemed perfectly healthy on the non-stress test.

The next morning, they made the trip to Annapolis for a second opinion on the biophysical profile.  I had my bags packed to join them just in case they ended up with a baby that day, but I didn't really think it would happen.  I spent the morning pulling weeds and working outside while thinking about them and how it was going.  As I jumped in the shower after working in the August sun, I finally got a text message from Meghan:

"Amniotic fluid is basically zero.  They can't find any kidneys or bladder.  Without kidneys, the baby will die after birth.  We're going to AAMC for induction.  You should come now."

**Click here to continue to Part II**

***Of course, I have received full permission from Meghan and Wes to share my version of this story and use their real names***

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

Community Question: GBS Testing

It's our first installment of "Sincerely, Your Doula"!  We're here to answer a question submitted by our community that will hopefully be helpful to you, as well!

"I'm 34 weeks pregnant today.  My doctor said that at my next appointment I'll be tested for 'GBS'.  What is that?  How do they test for it? What if I test positive?"  -Jessica (Princess Anne, MD)

Thank you for your question, Jessica!  Every pregnant woman in the United States who is being seen by a medical care provider will be offered the GBS screening around the 36th week of pregnancy.  You may want to know what GBS is and what it means if you're tested positive for it.

GBS (Group B Streptococcus) is a colonization of bacteria living in the gut of many healthy people.  In pregnancy, it is possible that what was once a "normal" colonization, may become an over-colonization, spreading to the vagina.  The risk is when baby is born vaginally, and may pass through the bacteria, becoming colonized as well, and subsequently ill.

So, at or around your 36th week of pregnancy, your care provider will likely request a swab (Q-tip) of your vaginal tract (and possibly rectum as well) for a culture test to determine if GBS has colonized there.  If your culture comes back positive (as it does for up to 30% of pregnant women!), then your care provider will likely recommend intravenous antibiotics during your labor process to act as a prevention against illness for your baby.  

GBS colonization in your vaginal tract is NOT harmful to you and the risk of your baby becoming ill is very small.  So, as I often share with my clients: GBS is something to be aware of, not something that you should lose sleep over.

Of course, in our childbirth education class, we always suggest asking questions and learning as much about your pregnancy and body as you want/need.  There are many layers to every test, routine procedure, and treatment, and we encourage you to do your research, ask your doula for more resources, and talk with your care provider about all of your concerns and options.  Here are some of the most common questions we get from our childbirth education class and doula clients concerning GBS (click on these links for statistics if you're a research gal like me):

1. What is the risk of my baby becoming infected with GBS?
2. If my baby is infected, what are the chances that they will become ill?
3. Are there risks to antibiotic use in labor for me or my baby?
4. Do I have to be tested?
5. Can I prevent GBS colonization in my vaginal tract?
6. How accurate is the test?
7. How effective is the antibiotic treatment?

What are some other questions about GBS that you have or have had?

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If you have a question that you want our doulas to answer, please submit it here in the comments or email us at maria@thrivebirth.org.  We're happy to share our expertise about anything concerning pregnancy, birth, our services, parenting, feeding, etc!

Breastfeeding Through The Holidays: New Parent Edition

With the holidays fast approaching, we know you're probably as busy as can be preparing food, getting your house clean, purchasing and wrapping gifts, packing (if you're traveling), and oh yeah(!), parenting a new baby.

I thought that my first holiday season as a parent would be magical.   I would finally have a baby to wrap presents for and place under the tree.  Well, it turns out that my daughter was only 2 months old, nursing constantly, NEVER SLEEPING, and clearly didn't have the mental or physical capacity to tear open presents on Christmas morning.  It turned out to be a lovely holiday as a family of three, but not exactly what I had expected in my pre-parent (read: very naive) mind.

In addition to the hustle and bustle of Christmas season, traveling, and NEVER SLEEPING, I was a brand new breastfeeding mother.  We had created a pretty solid breastfeeding relationship from the start, but of course there were still moments of working on latch, figuring out how to remove a sleeping baby from my breast (who am I kidding?  she was NEVER SLEEPING), and the always-frustrating process of unclasping my nursing bra, pulling the top shirt up, the under shirt down, and trying not to expose too much skin to the cold December air.  

We were planning to travel to our hometowns for the holidays and I quickly realized how breastfeeding might impact our travel plans.  Now that I'm less of an amateur and have breastfed through three Christmases between two different babies and traveled many times, I can share some of the best tips that I've learned along the way for breastfeeding through the holidays.

1. Feed your baby wherever he/she is hungry.  This can be a hard one--I know.  Especially if you come from a bottle-feeding family.  Breastfeeding may be uncomfortable for some to see and even the most well-meaning comments may be hurtful.  I quickly realized that if I didn't learn to be comfortable with myself and my baby, I would be spending 80% of our trip locked in our bedroom.  What's the point of traveling to spend time with family if you're going to seclude yourself so much? Plus, I already spent enough time in that small bedroom, you know... NEVER SLEEPING.
2. Feed your baby in another room.  Yes, you just read that.  If feeding your baby is going to make someone else feel uncomfortable, I can get over that.  But if YOU are uncomfortable for any reason, feel free to excuse yourself and spend some time alone.  While I nursed in the company of others for the most part, I also found that my introvert-at-heart nature required some alone time.  What a perfect excuse to chill in the quiet for a bit!  There were also times when my little 9 week old babe was having a difficult time nursing or getting uncomfortable with all of the distractions and noise around.  Escaping to a quiet room and relaxing a little gave her an opportunity to calm down and eat, and gave us the opportunity to reconnect.
3. If you want to use a cover, cover up!  If you're uncomfortable with others seeing your breast and you're still working out how to be discreet, throw a nursing cover or baby blanket over your chest.  Your baby can sense your unease if you're feeling anxiety. 
4. Choose your wardrobe carefully!  If you're attending a party, event, or church and want to dress more formal, don't just grab any old pre-baby flowy dress or blouse that you can find.  Nothing is worse than being in public and realizing that the only way that your baby can access his food source is to lift your dress up from the bottom all the way to your shoulders.  And yes, unfortunately, I am speaking from experience.
5. Layer!  If you're going to be in a cold climate and sweaters are necessary, I found that wearing layers of accessible clothing made all the difference. A nursing bra, a nursing tank top, a loose fitting or flowy top and an open sweater or cardigan became my go-to winter attire.
6. Bring your own snack and drinks if you're traveling!  Any breastfeeding mama knows that it takes a lot of work to grow another human and then feed it as well.  We need to eat and drink!  But you can't always assume that your hosts will have snacks that you like or need.  And if you're staying in a hotel, you definitely need to stock up before you travel.   Packing your own snacks like trail mix or healthy bars and remembering your own water bottle can make all the difference.  Plus, if you're like me, you need extra food to keep your energy up.  You know, because maybe you're NEVER SLEEPING.
7. Plan for traveling stops.  It's just going to happen.  New babies need to eat frequently and your 4 hour trip may turn out to be 6 hours.  Plan accordingly.
8. Bring your kindle or book.   You might be like me and go through 3 books per week while you're nursing and NEVER SLEEPING.

If  you're expecting now and won't be nursing until the holiday season of 2017, check out our Breastfeeding Foundations class to get you on the right track so that by December next year you'll be a pro!

What is a Bereavement Doula?

We all know that pregnant women and women in labor can benefit from support of a doula.  But what about women who are experiencing the births of their babies in a totally different way than expected?

No one has "miscarriage" or "stillbirth" on their birth plan.    

What happens when your birth plan changes?  It's nice to know that there is a compassionate professional who will be there for this birth, provide you with resources, and give you information about what to expect during the process.  

Every pregnancy loss is different, but the support of your doula is always guaranteed.  Your doula is on call for you 24/7.  She will provide you with evidence-based information about the choices that you have in each individual situation.  She spends time with you prior to birth to process fears and share what to expect during the birth process that may be different from your original plan.  She will join you face-to-face during your labor (if you have one) and be there for you during the birth process, helping you with pain management, facilitating communication between your and your care providers and family, and sticking by your side every step of the way.  A bereavement doula is a trusted professional who is welcomed into a grieving family's space, and finds a way to make their experience as comfortable as possible.

 A bereavement doula is an expert in all things pregnancy loss, and can be your compass when it seems like you're completely lost.

If you've just discovered that your pregnancy will likely end in miscarriage, stillbirth, or a fatal diagnosis, and have questions about how you can benefit from the support of a bereavement doula, contact us today.

What NOT to Do When She is in Labor

Yesterday we shared some practical tools and tips for how to support your partner while she's in labor.  Today we want to share some equally important tools to have in your tool belt... all of the things NOT to do.

Congratulations! She's in labor and you're going to be a parent soon!  We've got you covered--just don't make these common mistakes and you'll be on the path to parenthood knowing that she's fully supported.

Don't....

• ...Ask her questions during contractions.  She's focusing hard.  Let her do her work.

• ...Offer pain medication or an epidural... even if she's planning to get one!  Let her decide when/if the time is right.  You don't want to make her feel like she is inadequate.

• ...Expect things to move quickly.  Labor can take a long time.  Even the pushing phase can take a long time.  Many times this is perfectly normal; it's important to stay patient.

• ...Spend too much time texting/calling people while she's in labor.  She needs your undivided attention and support.  Updating friends and family may need to be on the back burner.

• ...Tell her what to do.  TRUST ME.  Offering validation and suggestions is one thing, but the first time I saw a woman's eyes after her husband told her to "Relax!" while in a contraction, I thought we were in for World War III.

• ...Complain about anything.  If you've been awake for 40 hours and are exhausted or if you've been massaging her back all day and your shoulder feels like it's going to catch on fire, don't complain.  Of course your feelings are valid and you need to sleep, too.  But when I'm in labor (as harsh as it sounds), I have no brain-space for empathy, and I simply can't provide for you.  Try to nap if she is napping between contractions.

• ...Be offended.  It's okay if she tells you not to touch her.  It's okay if she tells you to stop talking.  She still loves you, but she's expressing her needs in the only way that a laboring woman can.  Listen to her needs and support them.

• ...Forget that you don't have to do this alone!  A professional doula is trained in supporting both the mother and her partner and can offer more tips and help when it comes to making sure that the birthing mother AND her partner have everything they need.

Is there anything you would add to our list?  Leave a comment!

What to Do When She is in Labor

This weekend we are celebrating the birthing partner!  Our posts are going to be focused on helping dads, friends, girlfriends, grandparents, and whoever else may be in the Labor and Delivery room while mama is bring baby into the world.  We want to give you some tools and tips for being more comfortable in the birthing room so that you know what she needs and how to make sure she's supported. 

Childbirth is a big deal. You probably want to get this right.  What can you do for your partner in labor?  How can you help?  Are you worried about not knowing what to do?  What if you do something wrong?  What if something GOES wrong?  How will you handle each situation?  We want to help!  Here are some tips for things you should do and shouldn't do when your partner is in labor and birthing your baby.

Do....

• ...Validate her feelings.  Always validate her thoughts, feelings, and mood.  If she's excited, tell her that's fantastic!  If she's scared, tell her you understand that she may be worried and that no matter what, you're staying by her side.
• ...Whatever she says.  Yep.  Even if it sounds ridiculous. She's the star of the show today and deserves VIP treatment.  Take our childbirth education class and learn the importance of the hormonal systems in place while a woman is laboring.  We don't want to disrupt them!  If she asks you to run a bath, run the bath.  If she asks you to massage her shoulders, do it.  If she asks you to prepare a grilled chicken with green beans and mashed potatoes meal immediately, run to the kitchen.  And if she's so far into labor that she doesn't eat it, just happily place it in the refrigerator for her first postpartum meal.
• ...Provide food and drink.  Labor is like a marathon!  It's important to refuel.  In early labor, bring her snacks and nutritious meals.  As labor progresses, offer her a sip of water or juice from a straw in between contractions.
• ...Encourage her to pee!  If she needs a hand getting to the restroom and back, help her out.
• ...Time contractions for her (if she wants you to).  Download a free app for timing contractions and come up with a way for her to express the beginning and end of her contractions to you beforehand.  It may be as easy as her saying "start" and "stop".  When I was in labor with my first baby, I said "Oklahoma" to let my doula know that a contraction was beginning.  #dontaskwhy
• ...Support the rhythm that she will create.  Whatever that is.  If she is moving through contractions with slow breathing and swaying, breathe and sway with her.  If she likes having you hold her hand every time, just continue to do it.
• ...Remain calm and confident.  Even if she isn't.  Your voice, touch, and presence will be enough.  If you reach a time when you aren't feeling as calm and confident, look around the room.  Your doula, nurses, midwife, and/or OB will usually still be calm.  That will hopefully soothe your nerves.  Taking a deep breath is always a good idea.
• ...Follow the mother's lead.  If she's moving through this labor quietly and without speaking, so should you.  If she's chatty and chipper, smile and talk it up.  
• ...Hire a doula!  Your doula can remind you how to best support your partner and help facilitate communication between you, your partner, and your medical team.  
• ...Cut the cord and take pictures after birth.  Enjoy meeting your new baby and marveling in the beauty of birth and life.

If you want to learn more about the childbirth process and how to be the best birthing partner, take our childbirth education class to be fully informed and excited about your upcoming birth!

Stay tuned for Part Two: What NOT to Do When She is in Labor tomorrow!

Elliott's Birth: "My Little Breech Baby" (Lots of Pictures!)

This week's Delmarva Community Birth Story comes to us from a Thrive client who experienced a big change of plans in her last weeks of pregnancy.  Catie is a nurse at Atlantic General Hospital and lives in Berlin with her husband, daughter, and two dogs.

If you would have asked me how I would have pictured Elliott's birth it would have involved me birthing however I felt most comfortable.  Maybe I would have labored in a birthing tub, or in my own home.  I would have had my husband, doula, and midwife there to support me.  Elliott might have come quickly or it could've taken hours--maybe even days until she would decide to be born.  This is why my husband and I decided to make the change from a standard OBGYN practice to Special Beginnings, a birthing center in Annapolis.  I knew that if we chose to birth there my birth plan would be encouraged and followed.  On our first visit at 35 weeks pregnant my belly was palpated for the first time, where we learned that our little Elliott was head up.  Of course we were given options to try things to make her turn but in the end we decided it was best to leave her where she was and schedule a cesarean section.  The funny thing is I realized my daughter taught me to give up control even before she was born.  She was going to come out however she was supposed to--and that would be her story.

We traveled to Annapolis the night before my scheduled surgery and enjoyed dinner with our parents.  The waiter even brought dessert out with a yellow candle in it, Elloitt's first piece of birthday cake.  We decided to not find out if Elliott was a boy or girl and I remember the night before she was born not wanting to let go of that element of surprise still.  Of course I wanted to meet our baby but I enjoyed our time of it just being me and her growing in my belly.

Of course I was awake all night in our hotel room anxiously waiting for my alarm to go off.  I remember having a hard time showering that morning with my swollen belly.  Everything felt like a workout at that point.  It was finally time to head to the hospital where we met our family and our doula, Maria.  I remember Maria telling me that I seemed very calm.  I didn't feel sacred or worried about the surgery.  I felt at peace knowing I was going to meet my baby.  I remember feeling very chatty when they were starting my IV and getting me ready.  At 1pm exactly we gave hugs to my mom and Maria and Logan and I walked into the operating room.

The anesthesiologist and Logan helped me onto the table where they gave me a spinal and started to hook me up to monitors.  I could tell Logan was starting to get a little nervous at this point.  My midwife from Special Beginnings  came in and gave Logan a chair to sit right next to me as she held my hand.  The surgery began and we were listening to the Alabama Shakes on Pandora.  Before I knew it they told Logan to get his camera ready--Elliott was about to be born!  Elliott came out butt first, my little breech baby, and the surgeon held her up for Logan to announce to the room if she was a girl or boy.  "It's a girl!  Wait, it's a girl, right?!" Logan said, and the entire operation room started to laugh.  I remember asking if she had hair and when they showed me her she had the kinkiest curly dark hair.  She was the most beautiful thing I had ever laid my eyes on.  Elliott was checked out for a minute in the room next  to us where Logan was able to trim her umbilical cord and then she was immediately placed on my chest while they finished up surgery.  Elliott screamed until she latched on to eat, where she stayed for three hours.

We didn't tell our family that Elliott was a girl until I was out of recovery.  It was so nice to have that time with just the three of us.  Our entire family screamed with excitement when they found out Elliott was a little girl.  She was so loved even before they met her, and she always will be.

Look back, my birth went exactly opposite as planned, but it was such a sweet reminder of how life goes.  Our cesarean was beautiful because it brought our baby into our arms.  This is exactly how Elliott wanted her story to be told, and it will be my favorite to read to her every year.

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

Healing from Within: Sara's Emotional Journey to a Healing Birth

This week's Delmarva Community Birth Story comes from Sara.  Sara Shultz lives in Dorchester County and is a wife, doula, and mom of two energetic boys.

For as long as I could remember I've always wanted to be a mom. I couldn't wait. So much so that 2 months after getting married, we were expecting. I was so excited to be pregnant even through the nausea. Until one night at 6 weeks I woke up to cramping and bleeding. I didn't know a lot about pregnancy yet but I knew enough to know this wasn't a good sign. I hadn't even had my first prenatal appointment yet but already had to call into the after hours on-call midwife. Her calming voice was comforting. She put scripts in for blood work and an ultrasound. I immediately got the blood work done the next day but the ultrasound was scheduled for a day after that. The wait was excruciating. But that morning to my surprise the bleeding stopped. I thought maybe I was in the clear. The next day the midwife called to tell me that progesterone was low and I needed to supplement and to go back to get more blood work to see if my hcg hormone levels were doubling. The fear I felt was overwhelming. I hated that if I was threatening to miscarry that there was nothing I could do. Thankfully my blood work said that my levels were doubling meaning the pregnancy is sustaining and the ultrasound showed a healthy baby. 

This news was great to hear but I would continue to bleed off and on for another 2 weeks. This news did not help my anxiety. I was living in fear that at any given moment my body would fail me and I'd lose my baby. I started to disconnect with my pregnancy. It was my way of protecting myself from the perceived fear of losing my baby. It seemed as if the further I got along the higher my anxiety levels were. My pregnancy was pretty low risk and I was planning to deliver at a birth center but I wasn't convinced of this. When I found out I was having a boy I wanted to be excited and on the outside I was but that made my anxiety worse because he now had an identity and even a name. As I got closer to delivery at one of my appointments I decided to open up to one of the midwives about how I was feeling. I felt immense guilt that I had spent my entire pregnancy in fear instead of embracing it. I felt terrible that I was feeling this way rather than being grateful that I got a second chance. If 1 in 4 women experience loss then I had beat that statistic and therefore should be grateful. I'm so very thankful for this midwife who took the time to help me process this but most importantly she validated my feelings. I decided at 39 weeks to leave work and start my maternity leave instead of working up until delivery. That was conveniently the last week of my pregnancy. That week I attempted to work on my psyche and address my anxiety. I knew from childbirth class that it could impact my labor and I did not want that. I couldn't control the outcome but I could control my mind. I can't say I completely got rid of my anxiety but I definitely relaxed and took time to connect with my baby boy and with my husband.  I even felt some excitement, a feeling I hadn't genuinely felt since I found out I was expecting. 

At exactly 40 weeks around 10:45pm I was relaxing in bed drinking a cup of tea when my water broke. I got up and went straight to the bathroom. I knew to look for the color to make sure it was clear then I called my midwife. Labor had not started yet and that brought back some anxiety. Thankfully it was only a matter of 20 minutes then I felt my first contraction. It was around 11pm and I sent my husband to bed and I went downstairs to try to rest. Contractions were pretty intense but I was proud of myself for how I was able to manage. I used some hypno-birthing  techniques and a lot of prayer and worship music and then when things quickly started getting more I tense around 2am I hopped in the shower. I labored in the shower for a while but could not stand the fact that I felt so much pressure. Baby boy was very low already prior to labor even starting. Around 3am I decided I couldn't take anymore and woke my husband up to have us head to the birth center. Thank God I listened to my instincts because when we arrived there it was 4am and I was already 8cm.  

I labored a little more between the shower and the birth ball. Until I was too uncomfortable and exhausted to do anything but lay on my side. That was all I could tolerate. By 4:45am I felt the urge to push. That feeling was the strongest uncontrollable feeling I had ever felt. It was then that I started to feel overwhelmed again. My mom showed up just in time because I really needed more support. My husband was great but he was overwhelmed also. And it really helped having him on one side and my mother on the other side. Together they and the nurse and midwife helped me focus on my breathing and reassured me that I could  do this, in fact I was already doing this. Pushing sucked I'm not going to lie. I pushed for almost and hour and a half. But that moment my little boy was born was magical. It was healing. It was overwhelming in a good way this time because as soon as he was laid on my chest the first thing I noticed was that he locked eyes with me. It was that moment that I was able to let go of all my anxiety and fear. It was the process of giving birth that taught me how strong I was. 

Now my little boy will be 2 and a half soon. He continues to remind me everyday that I am strong but most importantly I am strong because God made me strong. Prenatal and postpartum anxiety is real. I know now that I am not the only one. But what I do know is that I am strong enough to overcome it. 

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If you're living on the Eastern Shore and would like to share your positive and empowering birth story with our community, please email me at maria@thrivebirth.org.

These Are A Few of Our Favorite... Books

The doulas at Thrive Birth Services of Delmarva want to share our favorite pregnancy/birth/parenting books with you.  We know that sometimes the vast amount of available books can seem overwhelming when you're expecting.  We've narrowed it down to our very favorites so that you can check them out for yourself (click on each title to view the Amazon descriptions).

Terri:

The Thinking Woman's Guide to a Better Birth, by Henci Goer and Rhonda Wheeler

A fabulous resource for gathering information about all of the risks and benefits of common labor and birth procedures and interventions.  The perfect book to buy when making your birth plan.

The Birth Partner, by Penny Simkin

The BEST resource for dads, partners, mother-in-laws, doulas, and anyone else who plans to attend the birth.  You will find information about how to best support your partner and what to expect in the process.

The Birth Book, by William and Martha Sears

By the famous pediatric specialists, The Birth Book is a comprehensive guide to childbirth.

Maria:

Gentle Birth, Gentle Mothering, by Sarah Buckley

By far the most extensive and all-encompassing resource out there.  Written by an MD, the book combines clinical research and information with the beautiful stories of her own children's births.  Maria says that if you were going to purchase only one childbirth book, get this one!

Ina May's Guide to Childbirth, by Ina May Gaskin

Widely regarded at the mother of authentic midwifery, her guide to childbirth includes some inspiring birth stories that leave you excited and hopeful.

The Food of Love: The Easier Way to Breastfeed Your Baby, by Kate Evans

Funny and completely original, you won't find any other breastfeeding book like it!

Elisha:

Spiritual Midwifery, by Ina May Gaskin

Another staple by Ina May, it's a must read for any expectant parents!

After the Baby's Birth... A Woman's Way to Wellness, by Robin Lim

All too often overlooked in our culture, the postpartum time is a chance for new mothers to heal, bond, and set themselves up for health in the long-term.  Robin Lim's book takes a look at cultural traditions around the world and how to best support a new mother so that she and her family can thrive.

Hypnobirthing--The Mongan Method, by Marie Mongan

Using hypnosis techniques to help you relax and stay comfortable during labor are becoming more and more popular among birthing women.  The Mongan Method is a great way to introduce hypnosis to expectant parents.

We want to know! What are/were your favorite books?!