It was one of those crazy twists of fate
that Julie (not her real name) called me at 38 weeks pregnant and hired me to be her doula. She had attended one of my Meet the Doula Nights, she said, a few months ago and had been putting off hiring a doula because she wasn’t sure she needed one. As the due date approached, however, she began to feel like she wanted someone there, if not for her, to calm her husband and take some of the pressure off of him.
I greeted her husband with a warm “don’t worry, this is perfectly normal” smile
Two days after she hired me at 5am the phone rang, she was in labor. Having only met her briefly at a crowded Meet the Doula night months before, I had only a vague recollection of what she looked like. I listened to her describing her labor, contractions were 4 minutes apart and after some questioning I realized that her water had probably broken. I advised her to call her doctor and ended up meeting her at the hospital’s Labor & Delivery. I arrived only a few minutes after she did and found her in the hall doubled over. The doubt that I had that I wouldn’t recognize my client vanished as I greeted her husband with a warm “don’t worry, this is perfectly normal” smile and started talking her through her contractions. After the first one she looked up at me and said, “I am so glad we hired you!”A busy day in labor & delivery!
It turned out that this particular day was a popular one for birthing and all of the rooms were full. We ended up laboring on a gurney behind a curtain in the hall for two hours until a room could be found. By then contractions were coming fast and hard and she was dealing with them beautifully. Soon it was time to push and after pushing for about an hour we all started to notice that her perineum was beginning to swell. An exam by the doctor reveled that the baby was likely in a very low LOT (left occipital transverse position). Typically babies rotate out of this position into an OA (occipital anterior) position before birth however this baby was not budging.
OB was convinced she needed a Cesarean
I listened in on the conversation between the nurse and OB and gathered that they were planning on doing a cesarean. They came back to the client and prepared her for this seeming inevitability. The OB then recommended that Julie get an epidural to stop her pushing sensations and allow her perineum to stop swelling.
I pleasantly asked the OB if while we waited for the anesthesiologist, I could try some positioning with Julie to see if we could get the baby to turn. Her answer was short, “You have 45 minutes, then she’s getting the epidural” and she left the room. The nurse said, “Ok, what do you want to do?” I answered, “First, I wanna get this baby out of it’s lodged position in the pelvis, then get the baby to rotate.” “ok, just make sure the baby stays on the monitors as much as possible.” she said and left the room to go check on her other patients.
Just 45 minutes, please!!!
The next 45 minutes were spent first with semi inversions to get baby to move up, then pelvic tilts to get baby to rotate then for good measure, I pulled out Penny Simkin’s Labor Progress Handbook (which, by the way, I still use even after over 400 births and make it a mandatory part of all of my doula students birth bagsā¦thank you Penny :)) and put her in several other positions recommended for her baby’s presentation.
It’s a miracle???
After 45 minutes (on the dot) the OB and anesthesiologist walked in. In the hall I heard them asking about the status of the operating room. The OB introduced the anesthesiologist who started setting up for the epidural as the OB said, “I guess I’ll check you to make sure there isn’t a change.” The second her exam began her eyes widened, she looked at the nurse and said, “The baby’s right here!” Julie pushed 3 or 4 times and the baby was born. The anesthesiologist was still in the room packing up as first the cries of the baby were heard.
Conclusion
The circumstances surrounding Julie’s birth are fairly common, as doulas, and midwives, we know that position changes can AND DO absolutely help women avoid cesareans every day. What struck me as interesting was that no one, not the OB or the nurse, asked me what position changes or techniques were used to allow the baby to move into a favorable position for birth. I wondered if Julie and her husband knew how close they came to having a cesarean. I later received conformation that they did. Looking back on this birth, a couple of things became very clear to me.
First, when a surge of births happen at once at a hospital, nurses and OB’s have an amazing amount of pressure on them to get babies born and their first impulses can often be to follow the path that they see as inevitable.
Second, in these cases having a doula is much more than a luxury, and more than emotional support for the partner, they serve as a stabilizing force, 100% focused on the birthing woman, the calm in the storm of the chaos of a busy hospital.
Third, had I not remained pleasant and unobtrusive with the hospital staff I would not have been given the time I needed to help Julie turn her baby.
For more information about baby positions, check out Spinning Babies www.spinningbabies.com
For a link to Penny Simkin’s book, visit The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia [affiliate]
I love stories like this! I just had a similar experience! Mom was stuck at 9 and OB said that if baby didn’t turn by the time he came back he would order the epidural and cesarean.
Mom was exhausted and all the coaxing from her hubby and I couldn’t get her to try positions necessary for a rotation. I managed to get her onto her side and took her leg and motored it through the motion of a lunge. Pulling her knee as high as I could and rotating her hip for her. She actually relaxed into it very well and thought it felt good. Her hubby was just staring wide eyed. š
After about 20 minutes She hollered “I’m pushing!” so we rang the nurse and sure enough, 2 contractions later and sweet baby boy was in mommas arms! And the OB, having almost missed catching this one ends up saying, “wow, nice to see that natural childbirth still exists. You just don’t see that very often.”
I was taken witty the title of this post as I have been a “last minute doula” for many as of late and have thought about posting on my blog with the same subject š
what a FANTASTIC post… thank you for sharing.
I have a 2 1/2-year-old son that was born LOT. My husband and I endured 33 hours of unprogressive labor, basically after not returning home as the doctor suggested. I also have an 11-year-old daughter that was born completely natural in only 8 hours, but this was my husband’s first experience and was paranoid. I regret trying to settle his fears instead of listening to my own gut and going home, and what’s to follow is why. Thirty-three hours in with walking, relaxing in a tub, sitting on a ball, swaying, dancing, etc., all I had to show was irregular and inconsistent contractions, if any at all. I was given a choice of breaking my water or pitocin and not wanting a time limit, I chose pitocin. Just one hour later, the drip was only at 7mg/min and I was feeling severe pain in my right hip and entire lower back. The doctor examined me, I hadn’t progressed, but as I was lying there a pain shot right into my back like a sledge hammer. I screamed so loud, started panicking, my husband was crying with me and all I could say was that something was very wrong. I was so exhausted and in such pain that I asked for an epidural and back on pitocin. I took a two hour nap, was examined upon waking up and still made no progress. An ultrasound found that he was LOT, just for the doctor’s knowledge, and I agreed to breaking my water. Within the following the minutes, I felt a ton of pressure three times, telling the doctor as she prepped herself and the room, and in just three pushes my son was born. I felt all the pressure of him against my pelvic bones and his poor face was black and blue for the next two weeks. Plus, when he arrived, he screamed for five minutes straight and has always been extremely touchy and screaming. Only this year he was diagnosed autistic because of his behavior and developmental delays. I would love to encourage research to be done on those born facing sideways. I wholeheartedly believe my son’s traumatic birth experience has alot, if not everything, to do with his challenges. I just know in my heart that everything would have been much different had I listened to myself and let nature run its course.
Just wanted to add that thinking back I am extremely disappointed in the doctor’s not trying to relieve my husband’s anxiety and also not trying or even mentioning any attempts to make my son turn. I wish I had been in Wales, where my husband is from, with a midwife, but that wasn’t an option this time.