Sunday, April 3, 2011

A day in the doula life

I'm often asked what my fee includes. The simple answer is to say, "visit my services page and it explains it all".

The not as simple answer is best explained with an overview of a delivery week... this includes the few days prior to, including and a few days after attending a birth.

I go "on call" two weeks before her due date. Also referred to by my family as going phone obsessive. It doesn't leave my side. It is next to my plate, next to my bed, next to the shower. I "check" it almost as often as I blink.

In this case, I've been on call for 9 days already. Keeping all plans tentative and staying well rested, keeping my gas tank at least half full taking two cars places in case I have to leave in a hurry, And of course, spending an awkward amount of time with my phone.

3:43 A.M. Cell phone screams. Well, it sings "baby baby I get down on my knees for you...." but its sounds like a scream at this hour. It's momma saying she's having lower back pain and can't sleep. It comes and goes and nothing helps. I suggest a warm shower, a small bite to eat, go potty and call me back.

5:18 A.M. Cell phone screams/sings again. Its momma saying the pain stopped and she's going to try to sleep. I appreciate this because I sleep much better knowing she is resting and I no longer have to cancel my days plans. Actually, since I'm on call for her, I don't have many plans and the ones I do are all "penciled in".

7:30 A.M. I'm up and getting started for my day. I get Stacey ready for school and send CJ off to drop her there. I get the days lesson plans and start Michelle on her History assignment while I sit with Robby to study the moon.

9:30 A.M. Call momma (now that I'm coherent) and give her a few stretches and sitting positions to help sooth her back. I suggest she spend time sitting on her birth ball to help relax her pelvis and encourage baby to settle into the best position for birth.

1:30 P.M. I know this momma is likely to labor soon so I opt for a short nap. I've become queen of cat naps. I've learned not to take them in my room or I'll sleep too long, but the sofa allows for just enough rest. I also have to squeeze it in before Stacey gets home - She prefers my eyes open and will try to keep them that way. :) So I assign some quiet school work and chores and snuggle up.

2:10 P.M. Stacey's bus arrives. Up and at 'em! (love the special ed bus coming right to our door!)

6 P.M. dinner and family time. I take a few minutes to be sure I have a list of chores and independent work for the kids tomorrow. I double check that I have rides for any who need it, and childcare for Stacey and Robby if I'm gone when tomorrow comes. Obsess over my phone.

10 P.M. After a few rounds of marbles, yes, the old fashioned school yard game of flicking each others marbles out of the circle... I head to bed to get sleep while I can.

7 A.M. Up and going with a good nights sleep. Check the calendar to see what tomorrow holds so I can remember what to cancel if need be. School with the kids, run some errands. Obsess over my phone.

6:30 P.M. We take separate cars to church in case I have to leave in a hurry. Obsess over my phone.

10:00 A.M. I call momma to see if there are any signs. None. I tell her I'm going to head to Valencia (45 minutes away) for a bit and to call if even a hint so I can head back before she might need me. My feeble attempt at triggering Murphy's law - that labor would start as soon as I leave town.

2:00 P.M. I'm back home and decide to make cookies for the nurses. I'm actually hoping I can subliminally start her labor! lol. I only wish it was that simple. But If I don't need the cookies for the nurses, I'll find good use for them! Still obsessing over my phone.

10 P.M. Bed early again just in case...

4:19 A.M. Cell phone screams. I pretty much fly out of bed trying to get it before hubby wakes. Too late. He's now sitting up grunting "what? you say something? whats the racket? Is that the dog?" I have to call momma back since my arm was asleep and I dropped my phone and missed her call. This happens often. I laugh every time. The scene is YouTube worthy!

I chat with momma a bit, talk her through three or four contractions. I ask her some specific questions and tell her it sounds like real labor. I remind her of some positions and comfort measures to use and to call when she's ready for me. Given my assessment, I figure it could be in about an hour, but it also could be longer so I shower and double check that my doula bag is still in the car and none of my kiddos stole my snacks. I brew some coffee and doze on the sofa with my phone.

6:27 A.M. Cell phone sings; see... now I'm ready, its singing now and I'm ready for it! Its mommas hubby, he starts out with the usual pleasantries then suddenly interrupts himself and I hear "another one?! I think you should come" *click*

6:48 A.M. I'm tapping on the door and letting myself in. I find momma on her birth ball leaning back onto hubby. They both have closed eyes and don't seem to notice me. I kneel by her feet and watch them handle the contraction without interrupting. I see how well they are doing, but I see the look in hubby's eyes now and its saying he's tired, worried and out of ideas if this gets any harder for her.

Contractions are about 5 minutes apart, lasting a good minute and mom is coping really well but getting anxious.

They are planning a hospital birth free of any interventions so their desire is to labor at home as long as possible.

I suggest dad eat a little and take a shower to refresh. I slip into his spot and find a rhythm with momma. She is still a little chatty between contractions and she fills me in on how the last few days went and asked a few questions about her labor pattern.

She loved sitting on her birth ball, with hubby giving counter pressure on her lower back and my doing deep rhythmic rubbing on her thighs and palms.

7:15 P.M. After a day full of walks, position changes, showers, massage, snacks, and some very sweet moments between the two of them, mom decided she wanted to hear her baby's heartbeat so we made our way to the hospital.

Transitioning from home to hospital can be so distracting and stressful to moms. Especially when she is refusing most common interventions. We quickly settled into her room and within another three contractions had her calm and focused again. Heartbeat was strong and after about half an hour of listening, she asked to be free to move around.

She was sitting on her birth ball, kneeling, slow dancing with dad, walking, sipping water and going potty often.

10:45 P.M. Hours had ticked by and no urge to push. Momma had not wanted any exams to check for dilation. We chatted a bit about what might be causing this to take so long. I knew she was very close, based on certain behaviors and other observations, but she seemed to have stalled and was getting very tired. After talking a bit about the advantages and disadvantages to an exam, she decided she would consent to one exam for the purpose of knowing the position of her baby.

11:52 P.M. She was very pleased to learn she was at 9 cm., but sure enough, baby was sunny side up and staying a bit high. We had to rotate him. More position changes, lunges, kneeling, walking, rocking, rebozo, using the ball every different way possible. You name it, we tried it.

1:45 A.M. Mom is exhausted. Dad slips out to sneak a bite to eat. I chug another protein shake. The Dr. stops in after another delivery and asks if she wants him to break her water. She declines; as she knows that every intervention increases her risk of a cesarean. She believed that as long as the heart rate was staying strong and steady, she knew her body could do this. The Dr. was kind although he clearly was in a bigger hurry than momma was.

2:30 A.M. Still no urge to push. Incredible pressure and contractions are strong and wearing mom out. She has been avoiding the bed as she knows once she gets in it, she won't want to get out. She makes me promise I'll get her out after an hour. Agreed.

2:40 A.M. Mom is settled into bed, laying to her far left. She doses a little in between contractions.

3:20 A.M. I start to mentally prep mom for getting out of the bed. Dad had a nice nap and is ready to jump in. Mom can't move. She is just too tired. Emotions running high, I take her right leg by the ankle and knee and begin rotating it up high, knee towards her shoulder. Mimicking lunges, or bicycle motion. She actually likes how it feels. She has a contraction and I keep moving her leg through it. I continue doing this through the next 4 or 5 and suddenly momma yelps - "I"m pushing!"

3:43 A.M. Nurse confirms that indeed, baby has rotated and momma is fully dilated!

3:57 A.M. Tears in dads eyes say it all. His son is here!

4: 15 A.M. Baby boy nurses for the first time. I am so privileged to see this new family bonding and loving and getting to know each other in a whole new way. I'm certain mom and dad have fallen in love. Not only with their son, but with each other as parents, not just husband and wife.

5:30 A.M. Settled into the room for the rest of her stay, I help set up the bed for dad, answer more questions and make sure they are comfortable and ready to rest.

6:15 A.M. I sneak back into my house, cozy up on the sofa and check my phone. Oh ya, I'm not on call any more!
I close my eyes and the events of the last 24 hours play like a movie in my head. I can't sleep. I shower and start to get school stuff ready for the kids. Oh wait. It's Saturday. I missed a whole day. I check my email and facebook, and upload the pics I took of this birth so I can burn them onto a disk for the family.

7:30 A.M. My family is still sleeping and I know if I don't sleep soon, I won't get to. I snuggle into bed and try to think of anything but the birth. Impossible.

8:00 A.M. I hear Stacey waking up so I change her diaper and dress her. While she eats breakfast I snuggle on the sofa. I finally doze off.

10:30 A.M. I wake up to my family watching a movie trying to be quiet for me. They have no idea what time I got home.

After telling them how proud I am of the new family, I freshen up a bit and we have an early lunch. I look over the kids school work and make sure they know what needs to be turned in by Monday. Then I head back to the hospital to visit the new parents.

2:30 P.M. I'm so blessed to be greeted by such enthusiasm. They are truly excited to see me! I get to snuggle sweet baby boy and answer a few more questions. I ask if they have any favorite moments of the delivery. We laugh as we remember some silly moments, I nod in understanding of the fear and stress during the long process. They are pleased to hear me confirm they made great choices and have already demonstrated what great parents they will be. We agree not to dwell on the stress the Dr. had put on them to just give up and do a cesarean. They thank me for being there to help them stay focused and strong.

3:30 P.M. After reminding them they can contact me any time for any reason, I suddenly am overwhelmed with fatigue. It happens every time. Once I get to see first hand that all is well, my mind can relax and my body screams for rest. We say our good byes and make plans for a home visit in a few days.

4:15 P.M. I decide just a cat nap is best otherwise I won't be able to sleep at night.

5:15 P.M. I start dinner, just an ole standby for days like this. My kids tease me for being so groggy. They also think I won't notice if they try to ask for things that I'd deny them if I was more awake.

8:45 P.M. I say goodnight and head to bed.


7:30 A.M. I'm up as usual. Feeling a bit sluggish from having pulled an all night-er, but I can function. The day unfolds fairly typical for our family of 7. Busy fun. I steal another nap after lunch and hope that Monday I will feel normal again.

Monday..... feeling much better. Missing the new family so I call to check on them. All is well. I look forward to our visit on Friday. Back to my own family. They get all of me for another week and a half, until I'm on call again...... :)

Again, this was not meant to be a birth story so I left much out. The Dr. and nurse were putting a lot of pressure on mom to just give up. There was no medical reason to do so. Keeping mom and dad calm and focused, doing everything I could to manage moms pain and keeping their confidence in her body's ability to do this was exhausting. I didn't get a nap or a solid meal, but that's ok, I got to attend the birth of a family!

So, in short, what do my fees cover? My heart, dedication, and commitment to you. The sacrifices mad while I'm on call and during your labor and delivery. My energy, skills and knowledge. My concern for your well being, and helping you meet your birth goals in a healthy way.

Birth is unpredictable, and every mom deserves to have someone there who is 100% there for her

Hugs n love to ya!
Shannon =)

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