Three Mamas, One Birth Outcome, One Crying A*s Doula
I think I can keep this brief but don’t hold me to it.
I’m composing this with three moms who had the same birth outcome in mind.
Within days of each other I had three moms who had narrow pelvises and caesareans.
Let’s get into it, shall we!
Mom 1: Almost 42wks at the time of birth. Experiences PROM (pre-labor rupture of membranes also known as water breaking) the day before scheduled induction but feels very few contractions, if any at all.
Due date was in September, but we hit October and sis was still very pregnant. Sis was already over it and wanting to avoid induction. Water breaks the day before induction; Yay but also eh.
Yay because we bypass the induction but eh because at the most recent appointment the cervix wasn’t favorable for birth (still relatively closed and thick).
When the water breaks that makes contractions far more intense and that’s good…when you’re in active labor, at least 5cm or more and 60% or more thin.
Her cervix was nowhere near that and here we are with ruptured membranes barely any contractions.
I’m hoping baby will just do her big one, descend and she can get some relief.
No such luck.
Baby’s heart rate keeps dipping, they ‘suddenly’ discover a narrow pelvis, baby’s head it coning and swelling, no bueno so caesarean it is.
Not only was she not okay, her husband wasn’t, nor was I.
I gave them the run down on what was about to happen. I immediately cried because…DAMN!
You wait all this time and prepare your mind and heart for one thing and something totally different happens.
There aren’t enough affirmations or positive words you can truly give to bring comfort in the moment.
Fast forward a bit.
Baby is born and fine. Mom is fine. Dad is fine. Now the journey begins.
I’ll preface this with the fact that Moms 2 & 3 birthed at the same hospital.
Mom 2: Goes in for an appointment, baby’s heart rate is flat and not spiking. I ask if baby was normally chill around that time of day because that could be the reason.
Her doctor makes a valid point that even though that might be the case, there should be some type of spike. Eh, true but either way, come to think of it, the next step should have been a BPP and as far as I know, that wasn’t done.
Instead she was sent to the hospital for further monitoring. Baby picks up on the monitor and is active, spiking and whatnot.
In MY mind, they’re likely going to send her home because baby looks/sounds good and she’s not in labor.
Nah. They kept sis and induced.
Ran Cervidil, discovered a narrow, boney pelvis, at some point Miso is administered and low dose Pit is started.
Tried some different positions but baby wasn’t descending.
I suspect a short umbilical cord that isn’t allowing baby to descend but not really sure.
Hours go by, AROM happens (Artificial rupture of membranes, meaning the provider breaks the water manually), contractions get more intense, epidural administered, dilation changes, baby’s station does not.
More hours go by they determine that she is not making any change in addition to the fact that baby’s heart rate keeps dipping drastically and uncomfortably and at the AROM, there was light meconium (That meconium was only light because the placenta absorbed the bulk of it) so caesarean is the move.
She asks the doctor to check one last time, baby’s head is coning and that, with even low dose Pit and normal head compression, is a danger.
Again, crying because wtf man?!
I do my best to affirm her and her husband but feeling extremely inadequate. There just are no words sufficient enough to comfort someone in that moment.
Baby is born and is well! Mom is well. Dad is well until just a few hours after birth there is confirmed postpartum pre-eclampsia
Mom 3: Goes in for induction at 40 & 6, cervix is still ‘closed and thick.’
Their words, not mine.
After the 12hrs of Cervidil, they check again, ‘thinned out some, just a finger tip dilated and baby is -2 station.’
How you get that far in there to determine the baby is that low if you can only get your finger tip in there?
After that she lets me know that she got a round a Miso (Cytotec) and immediately I’m like alright!
Here we go!
They bouta be on they bullsh*t!
Here’s why I was really on edge: Her doctor was on some bull from the time I met her!
Told her if she wanted midwifery care she’d have to go to another practice and considering how far along she was, she didn’t want the hustle and bustle of changing and when she mentioned a doula he said “You don’t trust us?” She also didn’t want to go to the birth center (😂, insider) either.
Quick Aside: I was slightly reliving a trauma I had at that hospital around this same time in 2020 with another client.
I’ll tell y’all about it later.
And yes, doulas carry trauma from births too.
But back to the story at hand.
She only got one round of Cytotec because baby was not tolerating the medication well AND she was told she has a narrow pelvis but they just let her linger. Different positions didn’t matter at this point because she was over contracting so frequently.
I recommended that she ask for Terbutaline to slow/stop her contractions because uterine fatigue was bound to happen.
She didn’t need to be contracting every two minutes if she didn’t have a favorable cervix. By the time she would’ve reached pushing stage, her uterus would’ve been exhausted and this would have been all for naught.
There’s also womb tearing and other things.
They refused to give her the Terbutaline and literally let her linger.
I asked at that point if she would consider pushing for the Terb and packing it up and going home because her body clearly was not ready, her waters were still in tact and nothing else was happening.
So yeah, going home made sense.
I don’t really remember why they suggested a caesarean but they did.
She was so over contracting that she agreed but here’s the thing, it was close to midnight or just after midnight and they weren’t talking about doing a caesarean until 8am.
You thinking what I’m thinking? Probably so!
They can let her go home and leave her alone!
Instead they offered to run Cervidil again, to which she declined.
They told her that it was the reason her baby’s heart rate was dipping.
So let me break this down: Cervidil can cause frequent or prolonged contractions.
Excessive contractions can drop your baby's heart rate.
She also reasoned that if it didn’t work OR the baby’s heart rate kept dipping, they’d stop it anyway and she’d end up in the OR.
Fair point, sis. Fair point.
So, they give her pain meds (If I recall correctly) or maybe she took Benadryl.
And I’m expecting to hear that by 9am baby girl has made her exit.
Baby that caesarean didn’t happen until noon!
You thinking what I’m thinking?
Y’all could’ve sent her home or let her TRY to labor down on her own!
Now, I understand that this was a combination of her being tired and them honestly giving up on her.
But baby girl is here and healthy. Mom is healthy too!
And yes, I cried! Because yet again, wth?!
What can I say to ease the disappointment? The discouraging reality? Nothing seems sufficient!
To The Mamas:
Mama 1: My sawrah! We only had a short time to get to know each other but I love you and hubs big! Y’all are a cool couple and I appreciate y’all for allowing me on the last leg of the journey! 😂 You took everything in stride quite beautifully and I’m so proud of you! I know you’ll be AMAZING parents. We’re bound in more ways that one and I look forward to loving on y’all and parking on that hill some more! 🤣 Love y’all real bad!
Mama 2: I’ma keep it all the way real, sis! I didn’t think you liked me for real. 😂 You’re stuck with me now though! 😜 I appreciate you for opening up to me at the moment that you did. I understand you better, I see you better and I definitely FEEL a different side of you. I admire your strength and love your easy going nature. I look forward to getting to know you more and laughing more with you. An amazing mom is for sure what you’ll be; I’m sure of that! Love you down, my girl! Love you down!
Mama 3: Giiiiirrrrrlllll! We’ve had a time haven’t we?! 🤣 I already told you thank you for being you! The laughs we’ve shared have been pure and I appreciate the conversations and encouragement more than you could ever imagine! You have adjusted to this new life beautifully and I love that for you! Baby girl has an amazing mom and ride or die in you! I know there’s nothing you won’t do for her because that Detroit slips out every now and then! 😂 Love you big, boo! Love you real big!
✌🏾&💜,
Aeryka