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Thirteen

Written by a doula and spoken by the mother

The Birth of Abraham Kyle

Abbi and her husband Tommy were expecting their first child when we met in February of 1999.  Abbi is a clear-eyed, calm woman, and I looked forward to helping her with her first birth experience.  Tommy, Abbi's obviously devoted partner, furthered that good impression.

Abbi and Tommy had chosen to birth at Puget Sound Birth Center.  In late February, the amniotic membranes ruptured four and a half weeks early.  This was a frightening time - fear of having a premature baby, fear of needling to give birth in the hospital, fear of losing the hopes for an out of hospital birth - all swirled around while Abbi went on bed rest and medication to prevent the onset of labor.   Abbi's perseverance during this challenging time paid off.  The baby stayed in its uterine home.  If Abbi and her child could hold out until Friday, March 5, the baby could safely be born at the birth center.

On Thursday, March 4, 1999, Abbi learned from her doctor that the amniotic fluid volume had fallen.  It was recommended that labor be induced.  Consequently, Abbi discontinued the Tributaline, and was given Cytotech to hasten the labor.  She took a tablet at dinnertime and began contractions by eight p.m.  The contractions were strong and frequent from the start.  Tommy phoned me at about 10:45 p.m., and we made a plan to meet at the birth center at midnight. 

Not insignificantly, we met at midnight of March 5, the first hours of the day that Abbi could birth outside the hospital.  The room was candlelit and comfortable, and Abbi worked well with her contractions.  In our prenatal meeting, Abbi had envisioned herself as a centered and internally focused laboring woman.  For much of labor, this was exactly what she was.  She breathed slowly with contractions, eyes closed, face calm.  She labored in the chair, and moving about the room.

At 1:40 a.m., Hildy (the midwife) checked her cervix, and found it had opened to five centimeters, and was fully effaced.  This was good progress, and we were all cheered.  Hildy also reported feeling a lump on the baby's head, which she decided was possible swelling because the baby had been pressed into the slightly open cervix for many days, without the cushioning of the bad of waters.  In any case, it was time for Abbi to enter her waters, the tub was filled.  The warm water wasn't quite as deep as she wished, but with the help of a low stool, she found a comfortable position to tide through the contractions.

One of the challenges of an induced labor is the need to accommodate the changes of pace.  In Abbi's case, the labor came on strong, and the first centimeters of dilation were quickly accomplished.  Then, just when she thought the labor might be rapid, her progress slowed.  This was compounded by a great deal of back pain, more than Abbi had anticipated.  It was a great deal to adjust to.

We tried walking and abdominal lifting.  We tried cold packs.  We discussed and made one quick attempt, at subcutaneous sterile water injections.  We used the tub freely.  Abbi and Tommy showered together, working through the early hours of the morning.  As I observed Abbi, I became aware of just how much labor pain this woman was feeling.  Her composure and internal focus were swept away, and she became more dependent on the help of her supporters to manage the labor.  In retrospect, I wonder if this might have been the hardest thing about labor for Abbi, how different it was from her expectation.  Though this learning was uncomfortable, it does cultivate a common ground between women and their babies.  When else do we feel so overwhelmed and dependent in our lives than when we are born, or labor to give birth?

This link with the baby was one I used freely with Abbi.  Despite her pain, she was always receptive to talk about her coming child.  I have a fond memory of labor with Abbi, stretched beside her on the bed, telling her about the beauty of a newborn's fingernails.  Her smile in response to this conversation told me how much she was looking forward to her baby.

At 5:15 a.m., Abbi's cervix was examined again.  She was now open 7-8 centimeters.  She returned to the tub, and continued to find her way through the pain, following the path to her baby's birth.  Two more hours, fifty more contractions went by.  Finally, I suggested Abbi lunge, which she did in the doorway between the tub and the toilet.  After three lunging contractions, she sat on the toilet.  There was another escalation in the labor - it seemed that the contractions were nonstop, and very, very intense.  She returned to the tub, and began sounding like a woman in second stage labor.  It seemed to me that Abbi's cervix opened the last two centimeters and the baby began its rapid descent all in the space of a few contractions.

Abbi's second stage labor was very rapid.  She pushed on the toilet, in the tub, and on the birthing stool.  At 8:26 a.m., Abraham Kyle completed his descent, crowned, and was born.  It took him a minute or two to make sense of this rapid transition, and begin to breathe.  Then he was in Abbi's arms.  Abbi's first words to her child were, "Oh, you're so beautiful!  Oh, you're so wonderful!"  Tommy contemplated his newborn, realized he had a son, asked, "What's your name?"

Abbi was soon tucked in bed with her baby, holding him to the breast while he nuzzled and licked.  Then he latched.  They looked so sweet there together, a princely reward for all the work Abbi had done in giving birth.  Tommy was very moved by the sight of his wife and baby.  He contemplated them together, said, "I'm just going to stand right here and look!"  It was time to give this new family quiet, uninterrupted time to become acquainted.  I bade my farewell, and went into the morning feeling so pleased that Abbi got the birth she's wanted, proud of her efforts and our shared womanhood, and delighted by the way that Tommy had seen and been moved by a new dimension of his wife.  Abbi, Tommy and Abe it was a pleasure being your doula, and I wish you a family life as sweet as your child's entry into it.

Love,

Danielle

With my second child, (in the tub) I pulled something out of the water and my mucus plug came out.  So by the time we were in the car, I could feel the back labor coming on.  We got there I'm like, "Oh my, this is the exact same back labor I had with Abe".  And it freaked me out, but I was open to the idea of taking an epidural, that's why I was in the hospital.  So when the midwife came in I said, "I really need an epidural now because this is painful, and I know where it is heading".  She checked me; I was only two centimeters and I was already in so much pain from my back labor, I already have a kind of funked up back anyhow.  So when she said that, I was so discouraged.  So we kept pacing the halls and thank God, a half and hour, forty-five minutes later my water broke. So that sped up everything, and she was like, "Okay".  By the time she called the anesthesiologist, and then he came in, I was starting to progress a little more.  But still she said even then I was only three, but they were willing to do it.   I think by that time probably I was at like a four until I could finally get it.   Then it was so easy!  I just lied down and Tommy went to sleep in the bed across from me (laughing).  I sat there and I watched my contractions on the monitor.  There was a nurse right next to me, watching them and watching my blood pressure and all the other monitors.  And then, it was the strangest thing, they were like, "Okay it's time to push".  I mean, maybe I knew the contractions were closer together, but like I can't even really remember that sensation.  Because it was so different from being able to totally feel everything.  The midwife came in just like right before that.  I didn't have any interaction with her the whole time really, because it started in the middle of the night.  I think everyone was tired; they start in the middle of the night just to warn you! (Laughing).  Push, push, push maybe three times and out she came.  I looked at Tommy and I said, "Oh, I could do this again!"  I mean, immediately; that was so weird and I was so happy!  I held her.  With Abe, "I don't know if I could ever do that again," for a couple years afterwards.  It was really hard for me.  I was so nervous through the entire pregnancy with Elena because I was so afraid, so afraid of experiencing that again.  There are certain things in my pregnancies which are a little more unusual.  I get really intense side stitches.  I would walk every morning and I would have to like lean over onto something to release that pressure.  I was doing yoga through my whole pregnancy, even doing inversions and everything.  I did an inversion a day before my water broke.  I mean a full head stand, but I was doing them through my whole pregnancy.  They say in Iyengar that it's fine as long as you're doing it continuously.  But maybe at that point I was doing it only once a week, so my body still was in transition just doing it once a week.  Part of me thinks, "I probably wouldn't do that again," who knows.  You don't want to have your baby early.  Elena was two weeks early, which is considered to be normal.  I was really in a lot of pain after I had Abe.  She (midwife) didn't have to do any stitches or anything, which is surprising because I was in so much pain sitting down for months.  I couldn't sit down on the floor without feeling intense pain, or even in a chair I could feel it.  So there must have been a tear and she didn't stitch it, or a small enough one that was irritating for me.  It was just such a different experience the second time, I didn't really feel like I needed a coach.  There was no doubt in my mind that I didn't really feel like I needed a support person there for me.  I had experienced it there before, and it's just different in the hospital because you have a nurse there.  But I think the first time with anything, you just don't know what to expect, and I think it is so good to have some one there supporting you, other than your husband.  If it's a long birth, everyone gets tired.  The whole reason I really wanted a doula, was for someone to rub my back and my feet, like the whole time.  I thought that would take my mind off of whatever I was experiencing, but I was in so much pain with Abe that I didn't really want any one touching me.  I mean, there was times when she would rub my shoulders a little bit, but it was just like over stimulation.  With a doula, it's just so nice to know that there's going to be all these women around you.  It's a piece in our culture that's missing, that they used to have in a tribe or when relatives lived together.  You would have sisters and aunts and grandmothers and mothers.  Every one is younger and they're all going through it together.  You know, people are just so separate (here).  My parents weren't even here for either birth! (Laughing).  When you're pregnant, you just focus on the birth.  You focus on contractions, and all these things, I wish someone said to me, "What are you going to do afterwards?  How are you going to get sleep?  Do the laundry?"  I think, ideally, you could do that for like a month with a doula, who would come to your house and they would hold the baby while you could take a shower.  I just don't think very many people do that because they don't want some one in their house they don't really know.  It's different with a mom or something.  And you just want to be able to do it all yourself, it's something in this culture like, "Oh no, I can do it".  You just want to prove yourself, that you can do everything.  It's so ridiculous.  I think it's interesting in other cultures, is it Japan where the mother isn't supposed to leave the house for three months?  The grandmother comes in and just takes over so the mother can just hold the baby and rest.  It's supposed to be focused on resting and not taking the baby out anywhere.  I think that is so important, and that's definitely missing in our culture too.  Let's see, oh there was a bidet at the birth center, and she (doula) didn't write that down.  That was actually fabulous, I had never used a bidet.  I used the birthing stool a bit and I actually birthed on the stool.  The regular toilet had something with the pressure, and being able to be in a squatting position but relaxed instead of supporting all your weight, because you're just exhausted in the middle of the night.  I'm not a night person.  I was so out of it and in so much pain.  Tommy might be able to remember more of it.  I fell asleep during my contractions at the very end.   For a while the contractions were kind of close together, and then they slowed down, and then it was like right in between each contraction I was so exhausted I started falling asleep in the tub.  That was weird, she didn't write that down either; I had never thought of that.  I was in the tub most of the time.  We took a few walks down the hall, but not a lot.  Tommy was getting in the shower with me, and that was okay, I mean they had the jets of water on the back.  But the tub was really helpful.  With my second birth, I thought for a long time, that I would want to have birth at home so I would be sitting up in the tub, with my body immersed.  The problem with the tub is that you have to get down kind of low and I needed to be able to squat in the water, instead of having to lean down.  I don't know, it was just kind of uncomfortable.  I would have to kinda kneel down to get my back immersed in the water to kinda relieve that.  The water definitely helped, but a big tub would be ideal.  They have those blow up inflatables they can bring to your house, but they said the only concern is if your hot water tank can really heat it up enough.  I was hot and cold, hot and cold and actually, I was kind of more chilled than anything.  They would have to drain the tub and fill it up when it got too cold.  I was naked the whole time, but it doesn't really matter when you're in that much pain. 

Lily:  With the second birth, did you find that you could enjoy the experience more, and afterwards as well, since you weren't in so much pain with the epidural?

I wasn't nearly as exhausted, and you know, I think it is so hard to really compare a first birth to a second one.  I mean maybe, you could compare a second and third, but they're just like apples and oranges.   The first time you just don't know what to expect.  Like when you get home, you don't know what to expect with the no sleeping, until you're actually in it and dealing with it; that is like that hardest thing.  With the epidural, you're totally there and you're in the moment.  Where with Abe, I think I had experienced so much pain that it was harder to enjoy the moment.  But at the same time it was just like the hugest incredible relief, and all these emotions came out.  I mean, Tommy and I both experienced so much emotion.  I was like climbing Mount Everest and experiencing all these emotions along the way. Then finally, this huge relief.  And then seeing him, it was just like amazing, but that part of it was just the experience of having a baby come out you, you know, for the first time you're like, "Wow!"  And with Elena I'm lying down, it was different.  It wasn't as emotional.  Yeah, probably that pain, something your body does through that whole process, it's like you're meant to experience more of the emotions.  I don't think it changes the bonding experience at all, and afterwards I feel like I was probably more with it with Elena, just because I hadn't gotten so drained.  I mean afterwards with Abe, I was like, "Get a pizza, I'm hungry!"  And I just wanted to sleep, but I was so wound up after having this baby.  They kicked us out and we had to go right home right away.  That was the other thing, it's so much better being in a hospital because some one is there to pamper you, give you meals, and you can have a few visitors, but it's you and the baby.  You can just stay put and rest.  At the birth center it was, "Okay, your time's up.  It's time to go!"  We had to leave within two hours, yeah it was terrible. Here we are driving on the freeway with this little baby.  We're like, "Oh my God, don't get in a wreck!"  And here he is strapped in a car seat, and I just wanted to hold him.  At the hospital, we went in close to midnight and then delivered at six in the morning.  Then I had that whole day and I didn't have to go home until the next day, so we were there not quite 48 hours.  One thing that was interesting is that my doula (for the first birth) was by me every second; she met me there at the birth center the same time as the midwife.  I had two midwives actually cuz the assistant was in training, Alexis.  So Tommy and the doula were by my side the entire time.  The midwives, even though there was two of them, they were sleeping in the other room down the hall.  The assistant came in a couple times to check on me, maybe every couple hours because she knew that the doula was there to wake them up.  My doula had so much experience that I'm sure they knew that she knew when to come get them.  Hildy, my real midwife, I think she only checked once, if that.  Actually, she might have been sleeping the whole time.   I felt like boy, if I didn't have a doula I think they would have been more compelled to be in there or checking more often.  So in some ways it was kind of confusing for me.  I really did want my midwife there too, but would that have been too many people, I don't know.  It doesn't really matter I guess, but I'm glad that I had a doula because through that whole thing it was nice to have someone talking to me.  Like how the whole time I was in pain, she kept on talking about how he was coming out.  Actually, I didn't know I was having a boy at that point, for some reason I thought I was having a girl.  I couldn't even concentrate on that and she reminded me.  Tommy, or any husband, would never think of kind of focusing on the details of the baby fingernails like that.  So that was a different perspective (laughing), it was good that I had her.  Midwives are so kind of hands off.  It was like, "Oh here they come right when I'm delivering!" "Okay push!"  That was weird, because I think in some ways that I could have been ready like an hour earlier, but they just happened to come in and they were like, "Oh yeah, you're ready to push".  So thank God they came in then, I think I was in so much pain I didn't know I was supposed to push or what that was supposed to feel.  They had to get me out of the tub, go on the birthing stool and tell me to push.  He came out like after two pushes, so I think I might have been ready earlier, and they might have known had they been in there more. 

Lily:  Did you find that your doctor more involved in the hospital than the midwives had been at the birth center?

No, they were both pretty removed and resting because it was the middle of the night both times.  They're on call all day and it makes sense that they would need to get their sleep at night when they can, so that they're alert for the actual birth.  Which I understand, but I didn't really expect that, no one ever told me that.  I was expected to rest as much as I could at the hospital.  I couldn't really sleep through the whole night, I mean I could still feel contractions a little bit but it wasn't painful.  It was just like I could feel them and then I was watching this monitor thinking, "What if my blood pressure goes up?"  I was kind of in and out, and Tommy's snoring (laughing).  The nurse didn't really talk to me, even though she was sitting right next to me.  I mean it helped to have a warm body, but they turn the lights way down.  They want you to focus on getting rest, but that was kind of weird; that was so different from the other.  But you are kind of left on your own.  I can't imagine without a husband, then I would feel really kind of deserted.  And then afterwards women really feel deserted, because your husband goes back to work and you're alone with baby.  There you are!  And how are you supposed to sleep or shower or anything because hearing your baby cry, your nerves go up, your tension, and emotions.  You just want to cry when you hear your baby cry.  It's just stressful.  I keep on going on tangents.  The other thing they tried during Abe's birth was these water injections because with back labor, injections are supposed to kind of numb that area.  Well I have to say I didn't want any one touching my back; it was so painful.  I mean a needle, when it already felt like needles were back there?  They started two and I was just like, "Uh huh".   I had music going the whole time; I cannot listen to Sarah Mclachlan or Enya ever again.  Afterwards, if I turn it on, all these emotions would just start coming out.  After experiencing that birth, I couldn't listen to that music.  I still have a hard time; it brings out all these emotions.  But the water injections sure didn't work. Actually once I started really getting into that labor, I remember thinking in my mind, "I would love for some one to drive me to the hospital, so I can get some drugs".  But the thought of walking down the hall, getting in the car, and I was in so much pain that I could not think about being in a car.  All I could think about was relief immediately from the tub, the short term.  Maybe if I knew some one could come and give it to me right then, enough to get me over to the hospital, I would have done it because the birth center is just down the street from Evergreen Hospital (laughing).