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The following is my own account of a birth I witnessed. The mother is a very close friend of mine. She and her husband gave me the honor of assisting them as a coach in the birth of their first child. This experience was particularly moving for me because I was not able to experience a vaginal delivery when my own daughter was born. This may be the closest I will ever come to a birth as it was meant to be.... ____________________________________________ I had a most incredible experience on Sunday! My best friend in the world was due to join me in the ranks of motherhood on Friday, May 25th, but that day had come and gone. Erika was anxious, to say the least, as she waited for her first-born to come into this world. We had discussed the role I would play as the big day approached, but Erika was unsure whether she or her husband Mark would want or need a second coach. And so, I waited for any signs of labor Erika might have, unsure how I could show my love and support for her when the time came. Saturday morning Erika called to say she had some bloody show, but she didn't want to get her hopes up. I encouraged her to get out for a walk since it was a lovely day. She and Mark took my advice, but after that she was too pooped to do much else. That evening she called to tell me that nothing else was happening, and she was sure she would be waiting forever for this child to come! Sunday morning at 6:30am, my phone rang. I knew immediately as I reached for the phone in half-sleep that this was it! Mark was calling to tell me that this would be the day their child was born. Erika had begun contracting around 11pm, and they had gone off to the hospital around 4am. Mark put Erika on the phone, so I asked her, "What do you want me to do?" She said, "I want you to come down to the hospital!" I could hardly contain my excitement as I sped down the road. In fact, I got stopped by the police doing 60mph in a 35mph zone. The officer was happy to let me go when I explained that I was a coach and my friend was in labor NOW! Whew! When I arrived, Erika was coping with the pain as she reached six cm's. Her blood pressure was perfect, her water had not yet broken... already her labor was strikingly different than mine had been. It looked as though it could go "by the book," and I was so pleased for her. Mark was breathing with her, encouraging her as the contractions got stronger and closer together. After changing positions in bed, Erika asked that one of us use pressure on her lower back. Immediately bells went off in my head. Back pain could mean the baby is posterior! Shifting in bed had knocked that darn fetal monitor out of whack, so the nurse came down to adjust it. She slid that thing all around Erika's belly trying to find the right spot, but she was only able to get a faint reading. This confirmed my suspicion because posterior babies' heartbeats are often hard to pick up since their backs are to the back! So much for "by the book," right? The nurse finally said it out loud, "Your baby may be sunny side up," attributing her idea to the fact that Erika was having so much back pain. She did not seem to agree that the heartbeat was also a factor. At this point, I was thanking my lucky stars for my VBAC group and all that the members have taught me! Erika was anxious to get out of bed and walk around as the pain became worse, so the nurse agreed. I knew that this was just what Erika needed, as she could try to maneuver that baby into a better position. It was amazing, though, how laid back the nurse and even the midwife were about this! I was the only one in a panic because I know exactly what posterior means. I stressed this point to Mark, explaining that a posterior baby will at the very least mean a most difficult delivery, or even a c-section. Now we were partners as we encouraged Erika to try different hip movements and standing positions. It wasn't long before Erika's pain became excruciating, and the contractions were coming almost on top of each other. She continued to sway her hips and do pelvic tilts as she leaned over on the bed. Mark and I were in front or back of her, one of us pressing on her lower back, the other wiping her face with a cool washcloth and breathing with her. Before I knew it, four hours had passed since my arrival. Erika's spirits began to sink, and she was exclaiming, "I can't do this anymore!" The poor thing was now sick to her stomach, retching in the bathroom and breathing through contractions on the toilet. Was this transition? She was helped back into bed so she could be checked for dilation. Nine cm's, and her bag still intact, they decided to break her water. I was out of the room fetching ice at this point, so when I got back I asked the midwife, "Did you break her water?" "Yes." And that was all she had to say?! I know she has more info than that, but she was not volunteering it! I asked, "Was it clear?" "No." Well, now Mark and Erika are alarmed, and I'm thinking why didn't she tell them? Keep the parents in the dark so they don't get too alarmed?! She went on to explain that it was just a staining of meconium, nothing to be too worried about, and that was the end of the subject. Erika was almost 10 cm's now, so we waited for her to have an "overwhelming urge to push." Needless to say, we waited only a few minutes, and the pushing commenced at 11:30am. Erika became a different woman... she just went to some other place from that point on. She pushed with all her might, and rested between contractions. I was in awe of her strength and control, and I was already feeling tears well up in my eyes. She pushed on her back for a while, and then she tried squatting (something she always thought would be embarrassing for her!) She jokes now that they could have told her to run around the block naked singing the Star Spangled Banner a few times if they had suggested it! Time passed, and more time passed, and I worried that the baby was indeed posterior. I wondered if all our efforts in the hours leading up to this point had been in vain. After all, I know of women who have worked for weeks prior to labor to turn a stubborn baby to no avail. Could Erika have done it in a matter of only hours? She had been pushing for over an hour. The baby's heart rate began to drop during each push, so much so that they put Erika back in bed. Laying on her left side with the oxygen mask seemed to take care of that trouble, and the heart rate stayed within safe limits. She began pushing from this position, never once breaking her concentration during all of this. She hung in there even when the nurses insisted upon changing her IV because it had been knocked loose. I felt so bad because Erika was told not to push while they tried to find a vein... it seemed panting and fighting the urge to push was almost harder than pushing was! It had been ninety minutes since pushing began. The midwife was quite a cheerleader, shouting with every contraction so loudly I thought she'd simply scare the baby into coming out. It seemed to be just what Erika needed, though, as we could begin to see the baby's head coming down! What a moment!! Finally the baby's head reached the point when we could see a small part even when Erika ended that push. I wouldn't say the baby had crowned because it was just a small part of the top of the head. The midwife explained that the head was now past the pubic bone, and in a few more pushes, the baby would be born. The next contraction began, and Erika began to push again with all her strength and concentration. Suddenly, Erika was screaming with pain, and her legs and arms were writhing. I knew something was wrong because the pain was obviously so different. With that, the baby's head came flying out. I knew it was too fast, and I swear I heard Erika's "nether-region" (as she fondly refers to it) tearing. We were looking at the baby's blood covered head... more importantly, the back of the baby's head! Erika had turned the baby during labor! She later reported that she felt she knew when it had happened... the pain became even more excruciating at that moment, but then suddenly the back pain was diminished. I know the midwife was caught off guard by the sudden delivery of the head, as she expected a few more pushes would be needed. She had not even broken down the end of the bed yet, and the nurse has stepped out for some reason. She loudly summoned the nursery staff to come down stat, and she attempted to suction any traces of meconium from the baby's mouth and nose. Well, there was no time for that either because the rest of the body followed just as quickly! It was such a frightening thing to see that tiny creature flying out onto the end of the bed, I forgot that we were waiting to hear if it was a boy or a girl! I looked up just a moment later to find the room had filled with people... nurses and pediatricians who should have been there in time for the delivery of a baby with meconium-stained water. "You have a girl!" the midwife explained as she continued suctioning her out. The cord had been around her neck, causing her heart rate to fall with each push. Her little hand was grasping onto the cord for dear life! She didn't want to let go! Emma Grace began to cry just a couple of seconds later, and we all breathed a collective sigh of relief. The pediatricians took the baby over to the warmer to make sure her little lungs were clear of that nasty stuff, and the midwife turned to the task of repairing poor Erika. As the baby's head was delivered so quickly, she sustained an unusual tear. Instead of the usual tear from the vagina downward to the perineum, she tore upward from the vagina toward the clitoris. I had never heard of such an injury! I held Erika's hand as the stitches were done, and it was no small task. Thank goodness for those wonderful euphoric feelings that sweep over a new mother after birth, because otherwise she would have been on the ceiling! Emma Grace suffered no ill effects from the meconium, and she was soon placed in her mother's arms. I marveled at the whole event as I recalled my own labor and birth experience. It was a bittersweet moment. I felt so many feelings all at once. I felt pride as I watched my best friend nursing her firstborn daughter, looking radiant despite what she had just endured. I felt so honored that the new parents had allowed me to be a part of such an amazing event. I felt angry that so many things had gone awry during my own labor... SROM, high BP, Pitocin, fetal distress, FTP, CPD. I felt sad that I was not able to see my own delivery through to the end. I did not get to push a new life through my body. Instead, doctors delivered her into this world by pulling her from my womb. I mourned the fact that I did not feel proud or triumphant when my own tiny daughter was handed to me that night nearly eighteen months ago. I felt hopeful that I might one day give birth to another child in the way it was meant to be. But, if I never have that experience, this will be the next best thing... the memory of my brave and powerful soul sister giving birth to a beautiful baby girl. I am a changed woman, and I weep as I write these words.
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