This is not exactly a birth story as it is the write-up I included with my certification, but the birth story was too personal to share. Instead, I am including the facts of the birth to give you a sense of all the ways a doula can assist during an epidural.
Your father called me just before 7am on Halloween to tell me your mother had been awake since around 3. Her water broke and contractions were painful and low, coming every four to five minutes. When I arrived, she was laboring in the hands and knees position, leaning forward. Since her water broke and there was no cushion between you and her, the contractions were very intense.
We arrived at the hospital—your parents, grandmother, your mom’s friend Natasha and me, the doula, Valerie, around 9am and your mom was 3cm dilated, 70% effaced. An hour later, she’d dilated half a centimeter and was 80% effaced, so she was definitely making progress, but since your mom was in a lot of pain, she made the wise decision to get an epidural At 10:35, the anesthesiologist arrived to start the epidural. Your mom leaned forward at the edge of the bed, with her head leaning against your dad’s head, a beautiful moment. It took the anesthesiologist many tries to properly insert the epidural, but by 11, your mother began to feel some relief from the pain.
Once the epidural kicked in, your mother was much calmer and quite entertaining, telling us about your father’s proclivities and how much she loves apple juice. The epidural had a calming effect and allowed your mother to relax enough that labor continued to progress. At 11:45, your mother told us about all the many wonderful things about your father that made her love him. It was such a beautiful moment.
The OB arrived at 12:20 to check on your mom and she could feel your hair. Your mother was dilated to 5cm. The OB decided to start Pitocin to accelerate the progression of labor. The afternoon continued as we watched the beautiful fall day and the sun shining on the mountains out the window of the delivery suite. We looked at photos of your family’s dogs and photos from Alaska on the laptop as well as videos. The nurse dutifully checked up on us and was a delight to work with. Your mother showed her your 4D ultrasound photos and Sherri agreed you were a very handsome boy! Natasha rubbed your mom’s back and there was a sense of peace and expectation in the room.
Labor continued to progress and your mom was very happy to have the epidural. Your father turned on some relaxing music and your mom tried to sleep for awhile. Around 5pm, The anesthesiologist administered a re-dose of the epidural as it was wearing off. The new nurse turned up the Pitocin to speed labor along. Your mother had a lip of cervix present still, so I got her to keep moving in bed, trying different positions and staying off her back to help her dilation progress. It worked!
Around 7:30, the OB arrived to direct your mother to start pushing. She turned off the epidural for a bit so your mother could feel the urge to bear down. Your mother does a great job pushing, moaning and making sounds, which help her to be more productive in her pushing. At 8:10 we can see the top of your head full of black hair.
After about an hour of pushing, you are born at 8:48 pm, crying healthily like a little eagle. Your mother did such an incredible job birthing you, she didn’t even have any tears or lacerations. Your father asserted that “You are cuter than [the dog]!” and your mother said “I can’t believe I had a baby!” Your grandmother and Natasha cried and your father had a look of utter bliss on his face. Everyone was so excited to meet you!
You weighed 7lbs 10 oz and measured 21 inches long. By 9:30 you were breastfeeding like a champ and your father fed your mother macaroni and cheese Natasha brought for you.
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My role as the doula at this birth was to keep the mother moving, despite the limited mobility offered by the epidural. I used Penny Simkin’s instructions for how to maintain movement during an epidural, as diagrammed in the Labor Progress Handbook, and I encouraged the mother to trust her body and tune in with her body without worrying what the nurses and doctors said, if it didn’t feel right for her, to remember to advocate for herself, and trust her body, even when she couldn’t feel it. There were a lot of support people at this birth, so mostly, I helped direct traffic, and helped her friends, parents, and boyfriend know how best to help her. Position changes and assurances that all was well and that she was doing a great job, even though she was disappointed initially that she got an epidural that she hadn’t planned on. I encouraged her and her partner and helped a great deal with breastfeeding support.
Once she got the epidural, she was immediately relieved. Several times she checked her own dilation and felt more connected to her body, even without being able to feel it. She ate and drank continuously, despite the hospital rules, and this kept her strong and in good spirits. Only during pushing when she felt she was losing control of her body because of the OB and nurse’s directions did she start to panic, but I helped encourage her to breathe, and she seemed to rebound and get through everything well. The most encouraging thing for her was that she didn’t tear, and this made recovery much easier for her. She fell instantly in love with her son and continues to enjoy the breastfeeding relationship established immediately after birth. She feels very positive about how things went at her birth, and says frequently that she would have been sectioned if I hadn’t been there to help her keep moving.
I was unsure initially how I would help if the mother choose an epidural, but when the OB started suggesting a c-section as soon as the epidural was administered, both Amanda and I became determined to avoid that. I was proud of my balance of confidence, and willingness to listen to Amanda’s instincts, as well as her mother’s and best friend’s suggestions, and I struck a good balance with the staff as well, coaching Amanda privately to advocate for herself so that I never had to overstep the bounds of my scope of practice. Despite the medicalized nature of the birth, I consider it one of my most successful and enjoyable births yet, because of the bond I formed with the family and the opportunity to practice my skills to alleviate pain and encourage labor progress.
