Wednesday, February 20, 2013

Violet's Birth and Why I Heart Doulas

While it is a blessing to have a great nurse and an attentive doctor, it is every woman’s right to have a Kind Doula. Before I was pregnant with my daughter, Violet, my dear friend, Kristin, challenged my husband, Scott and I to think about birth and how it matters. She wanted us to do research about different places to give birth and what types of procedures, policies, and statistics each have. She wanted me to figure out what type of birth experience I would want and how I might go about making that happen. She challenged me to think critically about these things and choose a path that supported my desires and goals for my birth. She and I both knew that Scott would support me no matter what.

I hadn’t quite figure out much about where I would want to deliver my baby so much as I had figured out I wanted an un-medicated birth when I found out I was pregnant with my first baby. So, like most people I thought I would go the hospital route. I found a lovely Family Practitioner/OBGYN. She did an ultrasound right away confirming our pregnancy, took a bunch of tests, and gave me some guidelines like don’t eat tuna more than once a week, it was very routine.  With a smile on her face and a great birth attendance rate, I felt like I was in good hands. As the weeks went on, learning more and more about childbirth and what I wanted for my birth experience, I began to feel unsure about delivering a baby in a hospital with a 15% un-medicated birth rate.  Although possible, I still wasn’t exactly sure how my goals of having an un-medicated birth experience would be supported in that setting and decided I wanted to interview a midwife at a free-standing birth center. We met the midwives at the Eastside Birthcenter, toured the facility, and changed care immediately. One of the first questions at our first appointment at the birth center was have you hired a Doula yet?  We hadn’t, but of course were thinking about it.
The weeks went on and we attended Kristin’s 9 week childbirth education series, and about halfway through I decided I wasn’t about to labor without having a Doula with me. We hired Kristin. Not only did she know the ins and outs of labor and birth but she had attended hundreds of births, mostly un-medicated, but had had more than her fair share of variations – pitosin, epidurals, and c-sections, and had accompanied women in labor in birth centers, hospitals, and home births.

I went into labor the evening of March 17th. Contractions were about 20 minutes apart, and fairly light. They were easy to cope with, though I wasn’t getting much sleep, mostly because I was feeling excited. Finally around 4 AM on March 18th, the contractions were getting closer together, about 7 minutes apart lasting about 50-60 seconds, we called Kristin. She listened to my contractions over the phone at first. She was feeding me encouragement and complements with her loving tone. I asked her, so, what do you think? Am I in labor, are we getting closer? She said, yes, and you sound great. Why don’t you eat something and keep doing what you’re doing.  I thought they were getting serious since I had never experienced anything like this in my life, but Kristin remained calm and politely suggested that we stop timing them and after I had a snack and to try and get some rest since I hadn’t been sleeping much.  At about 6 AM, my contractions were about 5-6 minutes apart and much more intense than before. I thought it might be time for her to come. She met us at our house. I felt this amazing amount of comfort wash over me when she arrived. We went for a couple walks, talked, laughed, listened to music, and snacked. Scott and I even got to take a nap. It was really nice to have her with me and still be in my own comfortable home.  I labored for a while longer, my mom showed up and then at about 2:30 PM, I felt pretty ready to get going to the birth center. Contractions were happening every 3 minutes or so and were really intense. We hopped in the car and headed to the birth center.

I had 7 contractions in the car on the way to the birth center. Labor was not letting up, which was a great sign! We arrived at the birth center and hung out for about an hour while the midwife and assistant set up the room. I continued to labor, I was in good spirits, getting a boost of energy by traveling to my birth place! The midwife checked me and I was about 8 cm! The amazing thing for me here was that I had labored for a good long time at home with no interruptions, because my doula was with me in addition to my husband and my mom, I felt comfortable trusting my body and giving into labor, letting it take over, and I received huge confirmation with that 8 cm check!

I continued to labor for quite some time. I was in the tub, I was swaying back and forth and walking in the room I was doing squats and sitting in the bathroom. My family was there but Kristin was really my main support, walking with me, going to the bathroom with me, quietly yet powerfully encouraging me when I was experiencing challenging contractions, she knew just what to say and just what to do. It’s like she could read my mine. Meanwhile my midwife was next door delivering another baby! The mother had arrived after me, was only 6 cm and delivered her baby before me. Ugh. After about 7 ½ hours or so of laboring, I had progressed 1 cm. Feeling my frustration, my midwife offered to break my water. We talked about the risks and benefits, and I felt good about it, I was ready to get things moving again.  Once my midwife broke my water, contractions came on strong – much stronger than before. I continued to labor for another 3 hours, and endured major back pain through transition. Kristin had me lie on my side and applied constant counter pressure to my lower back. I don’t remember how long transition was for me, maybe 30 minutes, but I remember feeling ‘out-of-body’, my mom saying “you can do this, you need to separate yourself from the pain”, and Kristin reminding me to breathe and touching me, and Scott leaving the room to eat. All of the sudden I felt like I had to pee and then bear down! I was complete and ready to push. The energy in the room was insane. Scott’s parents were outside the door of our room. My mom, my sister, Scott and Kristin, the midwife’s assistant and the midwife were all in this with me. I pushed in the tub for 2 ½ hours. Violet was born “sunny-side-up” or occiput posterior and acynclitic (Google it - it explains the long labor and difficult-lengthy pushing stage). Most babies in this presentation and position are born via c-section. Not my baby. She was born into this  world, calm and alert, neither of us were medicated, and the amazing feeling I had being sober through the whole process, brought me to an elated, euphoric feeling for the hours following my birth as I held my baby close to me, looked at her beautiful face, and eventually nursing her. Though, it was always within me to birth her naturally without medication, given all of my challenges and my lack of experience at the time, I still feel like I could not have done this without the support, respect, and encouragement of my Doula, Midwife, Husband, Mom and Sister.  Though, my Doula would say, “yes you could have,” and that is precisely why I love her.

Because of my experience, the difficulties, challenges, support and pain management offered by my doula and the ultimate positive outcome, I chose to become a doula myself. I believe that everybody has a purpose.  Doulas purpose is different from any other role in childbirth. If we want more positive outcomes, I not only believe a Doulas presence is beneficial, I believe it’s necessary. The statistics show the positive benefits of having a Doula: 60% reduction in epidural rate, 50% reduction in cesarean rate, 40% reduction in oxytocin/pitosin/induction rate, and more: http://www.beginswithbirth.net/statistics.shtml , http://www.childbirth.org/articles/stats.html.  

The last two years have been the most amazing years of my life with my sweet Violet and positive birth experience. Add to that the support of a loving husband and the beginning of a meaningful career as a Doula and my life’s path feels set. To those interested in having a positive birth experience, look into hiring a Doula. It might just be the best decision you make when planning for your new arrival. It was for me.

Kind Birth
Melissa Tuton

(Kristin Dibeh was my Doula with Kind Birth Services http://www.kind-birth.blogspot.com/)

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