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Partial Water Birth

Ischial Spines | Narrowest point of baby's decent | Zero station

This wasn't Alice & Forrest Comartos' first rodeo, but being extremely busy business owners and parents of two other children, her mama brain seemed to forget just about everything she had learned in her Bradley Method® all those years ago. It happens! I used a pelvis from her last birth center appointment (had Alice hold it up herself) to demonstrate the opening the baby has to escape and why I needed her up and active to bring forth positive changes, especially as a tiny asian. This is also why Dr. Robert A. Bradley, was adamant, you should prepare for each child as if the first. I like to call it "selfish time!" Your other children will be okay and you need some alone time & couple time, to train for the one you are carrying, as well. This #SymbioticBirth story took me all the way from Athens, Ga to Raleigh & Chapel Hill, NC. Life is busy and heck we hardly have time to get other kids fed, in bed and even speak to our coach/ husband, let alone practice for labor. I mean we know and mean well, but other things take place and before you know it labor is upon you yet again. Time for a quick refresher...

  • Refresher Tip #1 ~ Remember the First Stage Basics

I reminded her of the four things measured during an internal exam: station, effacement, dilation and presentation. We refreshed positions and what to do during a contraction. The plan being, we would leave her alone to labor as she desired and in whatever position or manner she desired, as long as as she was contracting regularly and not just burning up precious energy without some form of progress. Sometimes, mom is clearly exhausted and needs sleep/ rest in between contractions. The best tips for managing your labor marathon remain: Don't pay attention to soon, "IGNORE EARLY CONTRACTIONS" as long as possible, during waking hours, " WORK", during sleepy hours, "SLEEP/ REST", "STAY HYDRATED" day & night, "EMPTY BLADDER" at least once an hour, "NO SKIPPING MEALS". Eventually, when labor picks up you naturally won't feel like doing certain things like eating, drinking, etc.. Therefore, it is important to not skip meals early on. Walking is a great way to speed early labor. Studies have shown walking can speed labor by 27% and upright positions also encourage the baby's head to move down thus increasing station (zero station being the narrowest point of decent for baby).

Can't sit during contractions | zero station

Walking Baby Down in Chapel Hill, NC | First stage Labor

  • Refresher Tip #2 ~ Go Over Push Phase Basics

Two cleansing breaths, on the third take a deep breath and hold it. Bear down out your bottom (like a bowel movement), lift your head up, spit the air out and take another deep breath and go again. We strive for 3-4 good pushes with each contraction. Forest and Alice had decided on an "out of hospital birth center" in Ft. Mill, Sc for their first birth. It was an amazing experience despite, a challenging first time push phase- longer than she had hoped. She had desired a water birth, but unfortunately could not get an effective push in the tub. We stood, used classic, asymmetrical, side lie, basically every pushing position there is. The birthing stool ended up being her most effective push and helped complete the task. Their second daughter was born uptown Charlotte, Nc at Baby & Co. birth center and nearly caught by her Doula, (Me). I tried to express she was told she was 4cm dilated the first labor, only to minutes later, have the overwhelming urge to push. I informed the midwife at Baby & Co. to call her backup (baby nurse) when she informed us Alice was 4cm. I had formerly made an assessment of her progress at their home and determined her body was indeed signaling push phase. Now, granted the midwife at the time didn't know me and certainly doesn't have to adhere to anything a Doula may suggest, as we do not practice medicine, but I warned her the same thing happened with her first labor. Although, doula's do not practice medicine, we are the normality experts and after all its a team effort. She did not call in the nurse, despite my asking her to do so multiple times. After just ten minutes of walking, I began hearing vibrations in her voice, we walked a few short steps back to her room and minutes later, the baby's head was out. It appeared for a minute, I would have to catch. I said aloud several times, "hello head" as the midwife had her back to us and wasn't paying attention.

Sometimes, babies are completely unpredictable and Alice’s third would fall into the same category.

Helping Mommy walk the baby out

Walking to Post Office 3 miles round trip | Labor Prep

South Indian Food during labor

She planned to give birth to baby #3 (also out of hospital) this time with the midwives of Women's Birth & Wellness Center located in Chapel Hill, NC. Her experience at WBWC throughout her entire pregnancy could not have been more pleasant. The morning of her final appointment, I accompanied the couple to their appointment at the center. Talk about a small world. We walk down the hall and I look up and see this awesome gal. She said, "Pam!" I said, "what are you doing here?"

Midwife Rebeca Moretto of WBWC Chapel Hill, NC

Side Lie Relaxation in Labor

Rebeca said, "Remember me? I was the first nurse at Baby & Co. Charlotte." To which I replied, "yup and you were the last one I ever saw, too." We were in the office the day before her birth and Alice was actually contracting. Rebeca shared the choices for her visit. They included an internal exam only or internal exam with membrane sweep. The choice was hers to make. At the time, the early contractions were only lasting around 35 seconds in length. The internal exam revealed 3cm dilated. The couple decided to stay in Chapel Hill and walk, have lunch, etc., instead of returning home to Cary. That would later turn into a very good decision on their part. Alice's mother-in-law, already had a hotel room within a few miles of the birth center and had planned to stay over until the baby came. Meanwhile, after her final prenatal visit, we had some delicious Indian food. While waiting and after food was served, Alice would have to stand up to take her contractions, because she shared, "it did not feel good to sit through them, especially since the contraction is trying to push the head down. Another great sign of progress! After several hours of walking down town Chapel Hill, enjoying a cool drink a decision was made to chill for a few hours at the hotel. Alice was tired and a nap was in order. The couple decided to get a hotel room for the night and stay close to birth center. Alice was super exhausted but woke to contractions. I had her turning and changing positions every 30 minutes.

The following morning it would be go time. Her way would be over and the Doula suggestions would finish the job before she was exhausted again. We hit the gym hard the next morning in the Fitness Center of the Hotel. I had made a plan of action for Alice and Forest. It was time to execute "Baby Evacuation!" The time for rest was over the waking hours were for WORK!

Open Pelvis Lunge  for Labor

We started with a small breakfast then waarmed up on the row machine then onto the treadmill utilizing the incline. It was quite successful in generating regular contractions. We rotated back to the row machine, ball sitting and even did some back squats, lunges, full squats and then back to the treadmill. We ended with a trip to the restroom and walking up the stairs. After an hour and half the contractions were on track with active labor.

Husband Coached Natural Birth

Row Machine to loosen hips during labor

Side step on Stairs for labor

Birth Ball and labor support from Dad

The above photo represents the turning point for Alice and her acceptance that it was time for baby to come out. After a short cry, she walked with me to the truck (pausing to snap this photo as we exited the hotel) and Forest drove us to the birth center.

Most people would find it hard to believe we could get a smile out of a laboring mom in late labor/transition, but in between contractions, we often can! We arrived to the birth center, again walked in (no wheel chair) and Alice received the great news she was 9cm dilated, 100% effaced & zero station. We filled the tub and Alice was on track to finally get her water birth she wanted with baby #1... little did we all know how this would play out.

Tub Squat for Push Phase | second stage labor

She went from being perfectly relaxed and doing full squats sideways in the tub with Forest right by her side to ready to push... the second stage refresher had once again been forgotten. I reminded her of the pattern of breath control and to reach down and grab her leg and pull her legs back. She instead grabbed one leg and held her husband's hand with the other. That improper position did not allow enough room for baby.

Once she put elbow to knee and pulled both legs back the head was born with ease. What came next surprised us all. The midwife needed more room to birth the shoulders and unfortunately the tub floor was not allowing that room.

From water birth to Bed | To Free Shoulders

We had to quickly get Alice up and out of the tub and back to the bed to birth the rest of the baby. It took all four of us to execute the position change safely. The midwife instructed Forrest to reach down and support the head while she managed to free the shoulders. During the act of birth, the baby had passed meconium, it was a little messy, but totally normal. The nurse and I, helped flipped Alice over, to ready her for her baby on her chest.

Daddy Forest helps catch | Midwife assisted

We realized the issue that held her labor up, when the midwife shared the cord was super short. Once freed, the baby went immediately into the arms of her mother.

Birth Climax | Baby is Out!

Its a GIRL!  Baby Girl #3

I was thrilled to have managed to catch most of this exciting birth experience despite my cell phone taking a dip into the birthing tub while quickly removing Alice from water and getting her back to the bed. I am sure Alice would agree, the work performed in the gym that morning was exactly what she needed to finish the job. The owner of the hotel had extended an offer to her, "if she named her baby Hyatt, he would give them a free room for the night." Seeing as though it was a girl, they did not take him up on his

Skin to Skin with MOM | Birth #3

Welcome to the World Baby Clara 7lb 15oz.

You have two very tough, hard working parents! Their teamwork helped them execute another amazing #SymbioticBirth with the help of YourBirthHelper

and the amazing staff of WBWC of Chapel Hill, NC.

It was my ultimate pleasure to assist in the birth of Baby Comartos number three!

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