Wednesday, April 14, 2010

Benevolence

The Great Lady Birth was kind today. As doulas, we all want our clients to have wonderful births, obviously. But occasionally a birth comes along as a blessing for a person who is particularly worthy of it.
I attended the third birth of a lady today. I was present for her first and second births. Those births were hard. To say the least. Due to anatomical issues, this lady is unable to have an epidural work for her. Not that she's necessarily into them, but it can be scary for many women to know if, on the off chance something comes up and surgery is necessary, birth will be under general anaesthesia. To make things even more challenging, this lady's first 2 births were induced. The first birth was over 24 hours of the type of labour that is not riding waves, but being slammed with mechanical Synto contractions with barely time to breathe between the onslaughts. It was white pain, the type that makes it impossible to relax and find resources within. This is not a woman unfamiliar with pain, due to health issues in her life, and this "practice" was undoubtedly in her favour, as she heroically birthed her baby vaginally. An epidural by the most experienced anaesthetist in the hospital was attempted several times, but to very little avail, so at some point she just accepted this as her experience and went with it. Residents and nurses would come in to check in on her, and would leave the room looking white and pinched, as there was very little they could do to help with pain that was beyond the scope of normal birthing sensations. Her husband and I stayed by her side, just being present, and so thankful when it was time to push, as at least that went smoothly. She welcomed her baby with joy, but was left quite shaken by such a difficult birth.
Between babies one and two, there were experiences of potentially life threatening illness, and a terrible loss. Conception was difficult, but finally baby #2 was on his way. This birth was just like the second, though only half the time, thank goodness, but still terribly difficult. This lady remains thoughtful and kind throughout her labours, though where she finds the strength, I don't know. Baby 2 was born vaginally as well, even though she had been offered the opportunity to birth via C-section because of the nature of her last birth. Unfortunately, she had to be separated from her baby soon after because of an emergency which arose for her after the birth. This was the most traumatic part of the birth for her. Still, she weathered these situations with equanimity, always, as a very spiritual person, figuring she must be a pretty strong woman to have the universe send her such challenges. No feelings of victimization for this lady, which after all she's been through, demonstrates what a strong character she truly is.
She called me again a few months ago saying she had just found out she was pregnant...around 4 or 5 months pregnant! This was a shock, as she had been told the possibility of getting pregnant again was pretty much nil. She felt she had fully reclaimed the health and strength of her body, was in a great place with her kids and husband, and needed to take some time to adjust to the idea of having another baby. But in her usual style, she dug deeply, and looked forward to the arrival of a new baby, though the thought of giving birth again was scary. This is a lady who associates hospitals with illness and suffering, and so didn't want to have to give birth there again, but because of her history, there was just no other feasible way for her to feel truly safe. We met prenatally and had a good pep talk, and she told me a few different ways she wanted to approach labour. She wanted to avoid being induced this time if she could (due to physical concerns, it's not something easily debatable at all after a certain point), and found a wonderful Naturopathic Doctor to do some homeopathic magic with her. She did a lot of emotional/spiritual work, and took extremely good care of herself, keeping fit and healthily nourished.
Another induction was set up, but lo and behold, I got a call at 3am today, and she told me she was having some good contractions. They were not too long and not too intense, and was hanging out with her hubby and mom. She told me she'd call later. I felt a little nervous for some reason, not able to go back to sleep....when this happens, I usually call back to check in, because sometimes these little niggling concerns are intuitions. I was reassured that all was well, but that she really wanted to stay home for longer. Fair enough. I went back to sleep. At 6am I checked back in, and labour was definitely stronger, but she sounded great. She was happy. She was going to wait at home until rush hour passed. Of course I was thinking that we had an hour drive, that labour sounded strong, and her mother and hubby were becoming antsy, but she was insistent. She knew what she was doing.
I went over at nine, and she was sitting on a birth ball in a dark room full of candles, vocalizing beautifully. She looked at me, took my hand, and her eyes filled with tears. "Lesley, I don't want to go to the hospital." This being in natural labour was so different from the inductions. She didn't have the same tension in her body and fear in her eyes. The energy of Synto can be dark, making people feel like they're in a bad trip instead of a dreamy endorphin trance. She had hated that place. It had suffocated her while she was tied to a bed, IV, and monitor. Now she was labouring...well, naturally, and doing beautifully. My heart ached for her, because I wanted nothing more than to just stay there and hold the space for her and her husband to give birth peacefully and undisturbed, the way she had always wanted. But that is not the role I have signed on for. Besides, even though she was expressing this love of being home, she was resolved about going to the hospital. I think she just needed to grieve a little. We got ready to go, and in the car she could feel the baby moving down. She was still chatty with me between the contractions, so I knew we were not in a mad dash to the hospital.
My client was feeling really awful about getting out of the car and being exposed to all the people in the hospital who would stare at the vocalizing labouring lady. She was also really scared of being examined by an unknown resident. So I shielded her as best I could. Of course, the elevator was acting wonkily, and we had to wait for awhile. She just snuggled into me, vocalizing into my shoulder while her husband parked, and it just looked like we were two friends hugging, so nobody bothered us, trying to get her into a wheelchair. Finally we walked into the elevator, and lo and behold who was there? Her beloved doctor! They hugged and the doctor expressed how happy she was to see her in labour. She suddenly felt much better about being on the elevator. I mentioned to the doctor she seemed to be in pretty active labour, and a few good strong contractions proved that. It was lovely seeing Doc L., who is an incredibly compassionate, dedicated OB, really invested in her patients personally. It was also pretty great to see her do a little labour support, rubbing my client's back, and having her slow her breathing down.
As my client prepared to be monitored for the standard 30 minutes, she said, "that's pretty amazing we ran into Doc L., isn't it? That makes me feel good." I also reiterated how nice it was that her own trusted doctor was going to do a vaginal examination instead of someone she didn't know. The doc checked her gently, and said she was 4cm. At first she was a little disappointed, but the doc reassured her that the cervix was completely thinned out, and this made her a lot happier.
After being admitted, which took awhile with questions, etc., my client finally got up and really got things going. She was getting to a place where she was wondering if she could do it, and we reminded her of how well things were going, of how different the energy was from the last times....much lighter and more expansive. We went to the jacuzzi room, which is dark, warm, and humid....a perfect environment for a labouring lady. As she was standing, having contraction after contraction, coping gorgeously, I heard a little grunting happen....ever so subtly... if you weren't listening carefully you might have missed it. She really wanted to get into the bath, and I thought," hmmmmmm....I know they don't like catching babies in there, and I know she is showing signs of being in second stage....and it's a third baby....conundrum." She said she felt hot, so I ran back to the birth room and grabbed some cool washcloths. When I got back 15 seconds later, there was a puddle of brownish amniotic fluid on the floor and a clearly pushing client. The nurse popped in, and my client announced she would NOT be moving. But as the waters were brown, the nurse wanted me to get her to come back to the room. It wasn't far, so between contractions we shuffled over. Her mom was in the room and looked at us with surprise, realizing the baby was coming. My client got on the bed and of course, was being told NOT to push, though it was clear there was nothin' gonna stop her.
I just whispered into her ear to let her body follow her baby. My client really didn't want the resident present to examine her, and the nurse told him to leave her alone, that if the baby was going to come, it was going to come, and an exam wasn't going to change anything. The baby's head birthed by itself the next contraction, and the resident caught the body and lifted a pink, yelling little boy into my client's arms. No tears. Easy placenta birth. Minimal bleeding. Great start to breastfeeding. A beautiful, yummy baby, born 1 hour after arriving at the hospital. My client looked at me with a huge smile and said, "I MOSTLY did it at home!" We were over the moon. I said, "Hon, everyone deserves a great birth...but you REALLY REALLY deserved this great birth." She said, "Yup, I sure did. And I'm SO proud of myself. I love my baby."

Thank you, oh Great Lady Birth, for your benevolence today! You couldn't have picked a better person to bestow such kindness upon.

Lesley
www.MotherWit.ca