Meet Kate Holbrook! Photographed in the clouds, just 3 days prior to giving birth. She successfully climbed the tallest mountain in the state, full-term and in sandals, I might add. Since our YBH blog has readers from various parts of the world, let me be a little more descriptive.
For those of you not familiar, Brasstown Bald is the highest point in the U.S. state of Georgia. Located in northeast Georgia, the mountain at the highest peak is, 4,783 feet above sea level. It was known to the native Cherokee people as Enotah. How did she come to climb the mountain days before having a baby, you might add? Well, her fiancé, Dyla Cantrell, had tricked her into a day out to celebrate one last time before becoming parents. What he really meant was "date of trying to hike their baby down and out"...lol.
Both, Kate and Dylan, grew up in the area. They had been sweethearts for years, prior to attending Piedmont College. Both, had also heavily trained for endurance sports in recent years. Since these two were no strangers to preparing the body for competition, it just made perfect sense they would also train to "GIVE BIRTH." They had created new life together and they would also train together to bring forth life.
Kate's mother had researched birth training options and the couple made a decision to train twelve weeks in The Bradley Method ®. Their dedication to increasing their knowledge in the natural process also included an hour and twenty minute drive into Athens, GA once weekly. They desired to train Kate's body for labor & birth, as well as, train Dylan as the Coach. Shown here with their classmates, The Mosher's and YBH Doula Apprentice Diana Rutledge and Nikki Reeves. They also made a decision to have the #AthensDoulaDreamTeam present to assist them in overcoming any obstacles that might present during labor.
Their training would entail learning how to meet her nutritional needs, teach Mom how to physically relax, acquire a skillset of proper positions, teach Dad how the coach can help, both to avoid what makes labor harder, do the things that speed and make labor easier, learn how to effectively push a baby out, etc. This should be a piece of cake right? I mean after all, Kate had formerly ran over 30 triathlons! Dylan, a cyclist, who has raced thousands of miles, but this time, he would need his endurance to simply stay awake for however many hours her body took to get the baby out.
What the couple had going for them is they both understood the labor marathon would be just that, "a marathon.
To be more frank, bringing new life into the world naturally is the most athletic event in which a woman will ever participate in! Requiring both MOM and DAD to be in proper shape, having toned and conditioned birthing muscles for Kate, having toned and conditioned muscles needed to assist the laboring woman in a variety of positions, for days of labor, for Dylan!
First babies have a way of making us work for them, they don't typically come quickly or easily. Simply put - WE WORK FOR THEM.
Let the work begin...
Prior to labor, Kate met with me in Athens. We enjoyed or tried to enjoy, a breakfast biscuit full of jalapeno peppers #FIRE..lol, walked the greenway, we enjoyed a dip in the pool, pressure points for labor, etc.
Kate and Dylan were adamant about actively working to get into natural labor. They did their homework and finished strong. Formerly, Kate had been reminded, multiple times at her OBGYN office, that her baby was big, measuring big, etc. In fact, Kate did appear larger than most, but as the educator, I often have to remind women, ACOG agrees the laboring woman should be given an adequate amount of time in push phase, before accurately diagnosing CPD, a baby truly too large to clear the narrowest point of moms pelvis. Women who schedule surgery, in advance ,based off an ultrasound measurement, could be enduring major surgery without a true medical reason. In exchange for skipping labor, they now have increased risks also have 6 weeks of recovery time, instead of only 2 weeks and a lot more risks involved for mom and baby.
Note: the only thing they could've done differently in the final weeks of pregnancy to possibly change the outcome of labor would've been to decline the internal exam. Although most doctor's will gladly do internal exams weekly beginning 36 weeks, if you are not experiencing danger signs or signs of labor, the internal exam is not medically necessary. You have a choice to simply say, "no thanks." The group B swab necessary at 36 weeks, does not have to include an internal exam.
For this couple, the direction in which her labor would play out, began with a decision to have an internal exam during her weekly appointment. Although, informed Kate was only 1cm dilated, her bag of waters broke during the exam in her OBGYN office... this initiated the first crossroad...
Do they go home and remain home while trying their best to bring on natural contractions? Or, what the OBGYN suggested, report to their chosen birth place, Northeast Ga Medical Center, immediately (which was way sooner than they had hoped, have the hospital create contractions. Their decision was to go home grab their bags and head back to their birth place and go from there. Kate first utilized the foley catheter to try to avoid Pitocin and maintain freedom to move about. Her labor marathon was a total of 28 hours of labor, all in a hospital setting, with zero time to work free of an audience, let alone free of constant disruptions, which also contributed to a much longer labor. All of nature prefers to labor away from other animals, in a quiet, dark area they walk around, lie down when necessary and change positions often. It just makes sense, because relaxation equals labor progress.
There are many benefits to labor, from releasing mothering hormones, colostrum (baby's first food & natural vaccine) to stimulation to take their first breath,
to helping jump start organs not formerly functioning, just to name a few. We are all grateful for life saving techniques when truly medically necessary to protect mom & baby, but we do have to be aware many C-sections performed today sadly are not truly medically necessary at all. Kate made a very wise decision to keep intervention to a minimum and to be active and do her part to keep labor progressing.
I'm extremely proud of Kate and Dylan for choosing labor. The couple did an amazing job managing contractions drug-free. Utilizing good positions, walking, new mommy dance, lunges, squats, etc. and when Kate took breaks, it was to sit on the birth ball, recline, toilet sitting, use peanut ball, etc.
Kate summed up her Labor Marathon this way...
When I run triathlons, I am putting my own body in pain!
But, when I was in Labor, my body put me through pain!
In Kate's labor, once the foley ball had fallen out, IV Pitocin followed to continue strengthening her contractions. The use of Pitocin greatly challenged her body. Despite her former level of athleticism and birth training, exhaustion, missed meals, contractions not picking up yet increasing blood pressure, landed us back at another crossroad. The cervical dilation and station of the baby's head had not changed. We needed a stronger contraction to push the head down to finish off the cervix. She and Dylan continued to face every obstacle together, always staying focused on the main question: "Is Mom okay, is baby okay?" From there, choosing the next step to keep her labor progressing and keep her eye on her birthing goal: A VAGINAL BIRTH!
During this challenging phase, her mother was adamant her daughter needed a C-section. I quickly suggested her mom step into the hallway to compose herself. Kate was struggling to sink, remain limp and relaxed through her contractions and we needed complete focus and only positive energy to coach her through this difficult time. This is a very challenging scenario for the mother of the laboring woman to stand idle by and witness the level of pain their child is in. We don't stop labor and choose surgery just because Mom/Dad or their relatives are worn out, tired of laboring, overwhelmed, etc. The good news, Baby Emma was still doing just fine, despite stronger contractions. Kate's body, not so much. Clearly, Baby Emma, is very strong and capable of endurance racing just like her parents!
Note: I always suggest to client's, the best time for family to be present is toward the end of push phase. Most just want to view the birth and the majority do not handle hard labor well, especially if mom is drug-free like Kate. Often relatives mean well, but they are sleep deprived and not thinking clearly either. The key to natural birth and/or low intervention #SymbioticBirth is to overcome ONE obstacle at a time! We do not skip bases. There is an order to the proper use of interventions.
As a doula, I often find the majority of the time, the hold up is what is going on between moms ears, not what is going on in her uterus. However, for Kate, the use of Pitocin changed everything. After two bags of fluids, she successfully utilized the epidural to stay out of the operating room.
They made the following decisions after receiving informed consent:
- allow the midwife to remove a forebag of water (in effort to drop the head against the cervix).
- utilize an epidural (to allow Pitocin to be increased to strengthen contractions and lower Kate's blood pressure and allow rest).
We turned her every 30 minutes and used the peanut ball to give baby every opportunity to get her head engaged lower into the pelvis. Kate did not find the epidural brought her much rest, she was aware of each and every contraction, but it did allow her to release her perineum and although she still had the sensation of growing pressure, she was able to keep from rising up and tensing her gluts.
When the midwife made rounds, the good news followed. Kate had successfully relaxed, opened up, labored down and the head was sitting in the birth canal +2 station. Time to PUSH!
Immediately, with those words, TIME TO PUSH, a renewed positive energy completely filled the room. Kate's body did work right and her uterus had the power to expel a child despite all the obstacles. The negativity had been replaced with shear excitement with each and every push a little more head presented. Teamwork was evident and everyone began assisting to some degree, we even rotated two moms helped hold legs, and Dylan and I took either side. The growing anticipation of Emma coming out of Kate's body intensified. With each push, Kate continued to grow stronger, conserving energy in between. Allowing the contraction to build, then joining in with use of her abs, the head moved two steps forward and 1 step back each time she exchanged her air. In approximately 45 minutes of contractions, every 5 minutes or less, baby Emma emerged...
Next push, Kate uses little grunts and easily bears down to allow baby to ease out in effort to help prevent damage to her perineum.
Kate shared, "Labor is by far the hardest, most painful race, I have ever done, except this finish line was by far the most rewarding!
Kudos to Dylan and Kate, for completing the most important marathon of their lives, with as few interventions as medically possible. Their baby weighed in at 8lbs 14oz and 21 inches long she found the exit just fine by herself! Another, fabulous #SymbioticBirth ~ the entire Your Birth Helper Doula Team could not be more proud!
Welcome to the World Baby Emma Grace! No doubt you are Loved!
Note: on average, women with PROM (premature rupture of membranes) if left alone, 92% of them are in natural labor 72 hours later. Induction is most often encouraged for fear of infection. Both are evidence based options. So choose wisely what is the best choice for you. Remember, anytime you can have a spontaneous start to labor and keep your bag of waters intact, it's a much milder felt contraction for Mom and way easier to manage.
Considering Kate had to endure both induction and amniotomy, she did a fabulous job remaining drug-free for the majority of her labor and only utilized epidural when it was truly medically necessary to avoid unnecessary surgery ~ hurray for Symbiotic Birth! Special thanks to LDR nurse Ashley, midwife, Kim Blasingame, CNM and the staff of Longstreet Clinic OBGYN for their support of Kate and Dylan's birth plan.
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