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Writer's picturePamela Sauls, CMT, CCE, YBHD

No one knows your body better than you do



Katie and Patrick during push phase

Katie and Patrick were an amazing team and it is such a pleasure to work with a mom and dad that are trained properly and that greatly lean on each other during the most intimate time of their lives. I am so blessed to have the pleasure to witness the birth of Grace and provide doula support to each of them during their labor of love. Congrats Katie and Patrick, you applied what you learned with great confidence.

Now, allow me to give you a quick glimpse of their initial journey into parenthood. Katie is the proud mama of two sweet boys and her first birth plan was to have "just an epidural" but we all know there is no such thing as "just an epidural". The use of an epidural is combined with what is commonly known as the "domino effect". First, your platelets and blood pressure need to be within normal range to be a good candidate; next mom must have an IV, two bags of fluid, hold still in a crotched position during contractions, hope the anesthesiologist properly locates L4 -L5, and that the meds are actually effective, do not settle on one side or the other, last long enough, it does not fall out, etc. After placement, comes a mom who is now confined to the bed and subject to a good nurse helping adjust her position, turning her in the bed after initially lying flat on her back, understand the use of the peanut ball, etc. Mom is then subjected to constant EFM monitoring and most often a second drug is used to augment labor/speed the labor back up, after a common side effect of the medication slows her labor down. Then we have the placement of a catheter, not just the small tube in her back, but also a catheter to empty her bladder. Many moms are not even aware the epidural does not eliminate all sensations associated with labor/ birth; in fact, many women struggle to even rest through the pressure, even though if working properly it does ease or eliminate the "pain" of the contraction. The epidural also commonly prolongs push phase and can lead to increase use of mechanical assistance and even surgery when baby does not remain happy and content with use of the drugs. Katie had decided with baby number two, she would simply repeat her first plan, but her second labor kicked in to high gear so quickly that the epidural was NOT even an option!

Imagine the number of folks whose birth plan consists solely of "just having an epidural" and that goes right out the window. Have you considered the "what ifs"? The anesthesiologist is tied up in another room? He happens to be in surgery and just can not get to you in time? We commonly get these phone calls for women desiring a different birth plan, even when it was not that the epidural did not work the first or second time, it was simply it could not, did not happen quickly enough or did not even kick in until after baby was born. Here is the problem when we do not educate ourselves properly: a mom whose only plan to manage labor is "just an epidural" has not even considered HOW she will MANAGE her LABOR BEFORE the epidural, DURING labor if the epidural can not be administered quickly enough, fails her, or if baby comes before it takes effect, and even AFTER the meds wear off? You see, we as women, LABOR and endure CONTRACTIONS whether meds fail us or not, whether baby comes too fast or not! Why then would we as women not properly prepare and educate ourselves in the event of such scenarios? That thought, is exactly how we came to meet Katie, because she did NOT want to go into birth number three clueless of how to manage her own labor again. This time, Katie had a different approach to her birth, a plan to educate, apply what she had learned, hire a doula team to empower and support her and rock a low intervention natural birth, with the help of her husband coach. One simple truth , "no one knows your body better than you do". An educated consumer will be calmer, have a basis of understanding of how to make good decisions and acquire informed consent, learn skills to help manage contractions, and have a coach/partner that can help advocate for her.


Birth Without Fear | natural birth

Now back to Katie. We first met this sweet mom when Tina Hayes referred her to us. Tina is a midwife here in Charlotte that we love to work with, she is the epitome of normalcy and natural child birth. She listens to and cares for the mom all throughout pregnancy, labor, birth, and postpartum. But anyways, Tina knew because of Katie's past history with quick labors that we would be a great fit to fill her doula needs.

After Katie explored our YourBirthHelper services, she decided to change her next birth story by first registering for a birthing workshop (SMART MOVE- no matter the plan to utilize pain management or not) that we had scheduled for January 14th. At this point Katie was 36 weeks pregnant with her third child. I'm sure many are thinking, why would a third time mama (with successful vaginal births) need or want to take a birthing workshop going into their 36th week of pregnancy? First, Dr. Robert Bradley (an OBGYN who fought to get dads into the delivery room and who understood the unique aspects of labor and birth) always recommended treating each pregnancy like it is your first because labor and birth for each child can be different lengths and strengths from the last. YourBirthHelper.com recommends at least one workshop, there are many to choose from, but in particular, a Labor Role Play workshop can be just what the couple needs to change their entire experience. Preparation, including mental, physical, and emotional, is absolutely paramount to achieving a low intervention natural childbirth or what we like to call a #SymbioticBirth.

It was at the workshop where I first met Katie and her husband Patrick. They are two of the sweetest people you will meet and you could definitely tell Patrick was up for the challenge of birth coach. He had already done it two times before! As I mentioned before, this was Katie's third pregnancy. She has two little boys and both have their own unique birth story. But there was a common thread in both of those births - Katie's body does work quickly! And by quickly I mean in minutes. Once her body decides it's time, it's time. She will have several hours of early labor but once she gets moving, baby gets moving too, literally. After their recent birth, Tina, their midwife remarked she now understood their urgency to arrive sooner than others and was thankful Katie and Patrick had warned her! 5cm to complete in minutes~ WOW!


Midwife & Doula Apprentice celebrate Happy "birth"day photo

The fun that can follow the unpredictability of a drug free uterus - this photo of their midwife and I says it all! A quick birth is better than coffee to wake you up at 4am, ha! I was thankful to be part of such an interesting and unpredictable labor marathon. Speaking of timing, did I mention, the couple had just found out the night before in urgent care their son had pneumonia? Nothing like the joy of dealing with a sick child at home when another one wants to enter the world.


Katie meditating in the hospital lobby

Katie's birth story began Thursday February 8th, 2018, just one day before her due date. At this point, Katie had been dilated for 2cm for a while. So given her past history and the fact she was dilating, Patrick and Katie were on edge waiting for go-time. She started to have some inconsistent contractions throughout the day. Luckily, Pam was already in town and Katie had been in constant contact with her not only throughout the day but for several days before hand as both her boys had come early too. Despite inconsistent short contractions, around 10pm, the decision was made that Katie and Patrick were going to head on over to the hospital in Matthews since they were coming from Ft. Mill and Patrick did not like the thought of baby number three trying to jump out in the car nor did he want to have a baby on the side of the road; so even though her contractions were lasting only about 30-40 seconds long and every 3.5 minutes a part, they headed to the hospital to get checked out. After speaking with Pam and Nancy (our fabulous doula-in-training who is also a Labor and Delivery nurse) who were nearby, they arrived at their birth place but made the decision to hang out in the lobby and see if she could get stronger more consistent contractions going. Pam and Nancy met Katie and Patrick in the lobby of the hospital.


Hip Flexor stretch for labor

Nancy, Tina, and Pam

For approximately 2 hours, they walked around, did some hip flexor stretching, squats, and talked about random things to take her mind off of home and eventually ending her lobby fun with having her visualize her baby moving down and out. Then they all made the trek upstairs to have the midwife check her for progress in triage. Nancy and Pam just love a reason to see Tina Hayes! Since no change of her cervix or head position, the decision was made that Katie should try and get some rest. A good rule of thumb is if you are not in active labor (6cm dilated), then you should rest when you are supposed to be sleeping and go about your day when you normally would be doing that. Since at this point it was 1230am, everyone headed home for hopefully a few hours of much needed rest.

Katie got home and settled into the comfort of her own bed mentally preparing to try sleep as much as she can. But what story would not be complete without a twist? An hour after laying down, Katie noticed a pop and some fluid leaking out. Her water had just broke! The first contraction after her water breaking lasted a full minute and 27 seconds. Remember before this point all her contractions were 30-40 seconds. Her body was gearing up to do some work! She immediately got in contact with Pam asking what they should do, Pam made contact with Tina and Tina advised to send the couple back in. They quickly got back in the car and make the trek back to Matthews, NC. This is where I came into the birth story. Pam advised me to head over to the hospital to assess the labor and doula assist as needed. Katie and Patrick arrived back in triage at 345am and the contractions were anywhere from 30 seconds a part to 4 minutes a part, lasting from 30 seconds to 60 seconds in length. She received another internal exam in triage which showed she was now 5cm dilated. They quickly got her settled into a room and Tina was told to come down to Katie's room at 355am (just 10 minutes after being checked) because Katie was already having the urge to push.


Final moments before baby is born | Husband Coached birth

At 4am, I arrived at the hospital and walked into a room full of nurses because Katie was pushing! I had made it just in time to capture some amazing birth shots. Giving birth is the most athletic event a woman will ever do. These are priceless moments much like your wedding day; a one-time event of which details are forgotten so quickly. Such an added valuable service. Did you know all our YourBirthHelper Doula contracts come with FREE LABOR/BIRTH PHOTOGRAPHY? Grace came barreling into this world at 405am. Dad supporting mom, midwife supporting baby and thus another happy "birth" day party commenced!

Just a mere 20 minutes after being checked in triage with a cervix "only 5cm dilated". This is why we try and impress on all our pregnant mamas that it does not matter how far dilated you are, it is just a number! The body can do amazing things. Like a cervix that goes from 0 to 10cm (or in Katie's case 5 to 10cm) in no time. We do not have any real way of determining if that will happen and we have to rely on our training (both as birthing professionals and as the expecting couple) to figure out what is going on with the mama and her body. A mama walking around talking and eating most likely is not going to have a baby in the immediate future. A mama who goes from 30 second contractions to 1min 27sec contractions that increase in intensity greatly, is probably doing some work. We always assess the mama's demeanor in determining how far along she is no matter what the contractions are doing.


Midwife Assisted Double nuchal cord | Delayed Cord Clamping

But let me back up a little bit and brag on Katie and Tina. I left out a super key part that is really neat to look back upon. Grace came into this world 20 minutes after mom going into active labor but she also came into this world with a double nuchal cord - meaning the cord was wrapped around her neck twice. Check out this amazing birth photo I captured.

Most OBs would have stopped Katie from pushing, clamped the cord in two places, and cut the cord to free/deliver sweet Grace.

Not Tina, many leave cords in tact and are trained to birth babies like this. With a quick move of her hand, she gently removed the cord from Grace's neck. Grace was perfect and there was no reason as to why the cord needed to be cut prior to Grace being born. It just goes to show how amazing the natural birth process, how amazing our bodies are, and how amazing midwives are! Mom did not need a c-section because a cord was around the neck, she did not need a c-section because there were two loops of cord around the neck, she did not need her push phase halted to cut/free the baby. Current evidence-based birth shows leaving nuchal cords alone and simply birthing the baby is best and this old school practice dates back to Erasmus Darwin M.D. 1731-1802 who shared, "another thing very injurious to the child, is the tying and cutting of the navel string too soon; which should always be left till the child has not only repeatedly breathed but till all pulsation in the cord ceases. As otherwise the child is much weaker than it ought to be, a portion of the blood being left in the placenta, which ought to have been in the child". Funny how history seems to repeat itself. Major props to Tina for another job well done and we commend Katie and Patrick for their dedication to not only educate themselves on the natural process, but also how to properly manage labor and work with their body, apply what they learned despite such an intense, speedy, and unpredictable John 16:21 birth journey!


The JOY of natural birth | More speedy recovery time

This mom just gave birth a few hours earlier ~ and Baby Grace had the ride of her life!

And, below Baby Grace all cleaned up!


Baby Grace | Tina Hayes, CNM  helped born me | Novant Matthews, NC

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