Wow that was close! I'm just the driver.

“Don’t push Lisa.  I know you want to, but I don’t think having your baby in my car is a good idea.”  I can see Lisa’s outline in my rear view mirror. She isn't sitting in the seat as much as leaning over it.  Maybe she is on her hands and knees.  She is swaying and trying hard to fool me that she isn't ready to push. We had been driving down the dark deserted county road for only a few minutes before I heard a change in her breathing. 

This is Lisa and Lamar’s second child.  I met them two years ago when they took my childbirth class.  She called me a month earlier and asked if when labor started I would take her to the birth center.  I teased her telling her she'd be better off having a home birth.  Her first baby came fairly quickly.  She replied she wasn't comfortable with a home birth. I scolded back she won’t be comfortable on the drive to the birth center either.  It is only 7 miles or so, but when one is in transition, on the rutted country roads it can feel a lot longer. My jesting didn't change her mind.

Lamar is in the passenger seat in the front.  It is 2 am on a pitch black night.  Must be a new moon because it is clear and cold, but there seems no light in the sky.  Five minutes with Lisa I can tell she is in advanced labor and will be having her baby soon.  I used my handy cell phone to call the midwife and alert her to the advanced state of Lisa’s labor.  The midwife was on her way to the birth center, but about twenty minutes away.  I asked her to call the birth center and have the nurse ready to meet us at the door with the wheelchair. 

Overhearing me, Lamar tries to hide his panic.  He is a dairy farmer, a leader in the church and a kind considerate man.  I am glad to know him well: confident he can keep his cool under pressure. He turns to his wife in the back seat, “Lisa how are you doing?”.  No reply but her breathing.  A  groan.  Lamar looks back to me we have 5 miles to go. 

My mind is all business now.  Lots of business to attend to. 

1. Keep reasonable speed

2.   Avoid pot holes and massive buggy ruts in right side of lane

3.  Prevent amniotic fluid and all manner of birth goo from getting on my car’s interior

4.   Is the minimalist emergency baggie of chux pad and gloves under my car’s seat going to be enough supply if the baby comes in the next few minutes?  How will I keep the baby warm on this January night?

5. How will I see what I am doing?  It is totally dark. (in an Amish neighborhood there are not street lights or large farm utility lights)  If I have to pull over into a drive to catch this baby, how will I see what I am doing? My car's dome light is weak at best.

I keep driving. I call the midwife again.  Update on status:  “I think she’s ready to push and we are still a few miles away.  How close are you?”  I didn’t even say hello. The midwife reassures me she is on her way as well and that she thinks we’ll make it.  The nurse on duty at the birth center is an older experienced nurse who is very good at managing a quick delivery.

My attention goes to the dark figure in the back seat.  “Lisa, I know it’s hard to do but please just keep your breaths nice and slow.  Breathe instead of push, we are almost there and they are all ready for us.”  Lamar responded to my coaching too by releasing his breath as well.  Poor guy, this scenario is a Amish husband’s number one worry (well maybe not number one, but in the top 3 for sure).

 

Seven long minutes later we pull under the overhang at the birth center.  The nurse is ready at the door with a wheelchair and a shield of confidence.  We three are so relieved to arrive at the birth center with the baby yet to deliver.  The nurses’ assessment is that Lisa is indeed ready to deliver the baby.  Her cervix is all out of the way, bag of water yet unbroken.  Midwife still en-route to the birth center I offer to stay with the nurse.  She accepts, knowing my skill set and my relationship with the patients will be of use if the baby comes before the midwife. 

Shifting into doula/birth assistant mode I wash my hands and assess the room.  Where are the supplies we will need when the baby is born?  Are the blankets in the dryer warming?  Lisa looks at me pleading from the bed where the nurse has forced her to recline for the exam.  “Can’t I get up?” she says as she reaches her arm behind herself to rub her lower back.  Teeth clenched and face wincing, she is asking the nurse for some mercy.  The nurse, older and more set in her ways is not sure she wants the mother mobile.

Lisa hesitates about two heartbeats before she is up and out of the bed on her feet.  The next contraction hits before the nurse can huff and Lisa drops to her knees on the cold linoleum floor. Swaying gently, her body is pushing. I can’t help but smile, I think the nurse notices my pleasure at Lisa’s disobedience.  Oh well.

Lamar has also transitioned into labor support mode.  His face has more color now, his shoulders less tense, he offers words of encouragement and love to his wife.  The midwife arrives, smelling like the fresh air of the night and smiles brightly.  “Ready to have this baby Lisa?” 

Within five minutes of the midwife’s arrival, Lisa is holding her squealing pinking slimy sweet boy.  Lamar stands firmly beside his wife with a huge grin on his face.  They whisper his name to each other and then out loud to us. 

Lisa for the first time that night, is back to her normal self.  Her eyes find me she smiles and says, “You thought we weren't going to make it, did you?”  She is teasing me, chiding me.  I love it.  “It’s the closest I've ever come to catching a baby.” I admit. “You would have done a fine job.”  Lisa says.  I believed her.  I pointed to the puddle of amniotic fluid and general birth mess around the room and said, “Really, I just didn’t want THAT all over my car.”  We all laughed, relieved that it all had worked out.

Joy and A Determined Love

Looking forward on my calendar next week, there is a birthday whose memories stir my heart.   It is a story of determination rewarded in great joy...  

Family Photo Kate, Jena, their son Chad and new baby Kaia.
 Brittany Ressler Photographers

Kaia is a life that began as a longing in the hearts of her mothers.  After years building a life together Kate and Jena had finally arrived at the time when they were ready to welcome another child into their family.  Kate and Jena Kennedy, being two women in a relationship, have to take initiative and be intentional in their actions to create a life. There isn’t the “woops we are pregnant” factor that heterosexual couples have.  From the beginning they planned out the conception, creation and birth of their daughter.   Their love for their child evident from the beginning. 

Jena chose to carry the baby and sacrificed much during her pregnancy as high blood pressure threatened then changed their hopes for a home water birth.  They dreamed of an environment where they had choices, were able to relax and to be respected.  One of Jena’s strengths is her determination.  She found a general physician who was willing to honor her natural birth wishes in a hospital setting.  This took research, calling, appointments, explaining- a stressful time during her pregnancy.  Her effort paid off as the solid planning during prenatal care came to fruition during her birth. 

At this point in my birthwork career I considered myself a “seasoned” doula.  Seven years in, I had witnessed well over a hundred births in all kinds of settings.  Most of my work was with Hispanic families or Amish families; I consider myself fluent in the cross cultural birth atmosphere.   The Kennedy’s may look like a different “kind” of family to many people, but I learned they are just like any married couple.  As an expectant couple committed to caring for each other and raising a child together they were excited and anxious about the upcoming birth.  As a doula supporting them through labor was no different than any other couple.  Why should it be?

The much anticipated birth-day arrived.  It was an unusually warm March.  The early spring flowers were pushing through the wet earth, it was a sunny spring morning when I got the message.  Jena’s water had broken, today is the day!  Labor was gently starting with contractions increasing in intensity over the course of the morning.  Joy infected this labor from the beginning, laughter, kisses and bright expectant smiles all through the morning.  Kate and Jena spent time relaxing in their home, took a neighborhood walk and after a long shower headed to Goshen Hospital to check in. 

Looking back I see I was hypersensitive to how they would be received.  As their doula I was on guard and ready to advocate for them to be treated with respect.  As their friend I felt nervous knowing they were vulnerable to the care of the hospital staff and because they are lesbian,  are more at risk for discrimination.  All my worry and nerves were unnecessary.  Each nurse and aid gave kind and respectful care just as they would for anyone else.  The Kennedy’s are likely more immune this unknown element of how others react to them, and didn’t spend much effort worrying about it.  Again Jena’s determination and planning paid off, the meeting that she and Kate had with the nurse at the hospital prenatally soothed these worries for them and prepped the staff of their expectations.  I can’t say enough how impressed I was with the professionalism of the nursing and hospital staff that day.

So Jena labored and Kate tended to her every need.  My role as the doula became one of prepping the environment- cuing the music, positioning the bed, acquiring comfort measures.  Kate was the hands and heart of the support.  Jena glowed.  Of course she struggled, doubted and felt discouraged all the normal hallmarks of progress through labor.  What passed between the two Kennedy women was love like electricity.  Kate projected such devotion and faith in Jena I could see it visibly propping up Jena’s confidence.  This folks, is what a loving partner contributes to labor.  Sure they read books during pregnancy, made a plan on paper for what they wanted labor to be like.  But there is an invisible element to successfully supporting your partner in birth beyond preparation; it’s the emotion and relationship that gives the laboring mom a foundation to stand on.  That love cannot be confined by laws, religion or government.  It. Just. Is.  And it brings tears to my eyes.  I left that labor feeling jealous, when was the last time my husband had so solidly demonstrated his love for me?

Remember the determination I referred to as one of Jena’s strengths?  Her effort led her to a physician willing to respect her wishes for a mobile labor free of IV and encouraged her use of the water tub.  (I will not name this physician as I am not able to reach him for permission).  At each decision making step of the way through labor Jena and Kate were able to ask questions, and decide together what to do.  They were in control of the process, not on a pressured timeline.  I was able to answer their questions, give advice and sit with them in the unknown.  The environment was just as they hoped it would be.

The mental image dominates my mind from this birth is from the transition stage of labor.  Cervix almost open all the way, body anticipating a change in labor and preparing for pushing, hormones surging, contractions increasing in intensity and frequency.  Its evening now, the lights are low in the room.  Jena is resting beautifully in the inflated tub of warm water that the nurse just set up.  Kate is as close to Jena as she can be with out acutally being in the tub.  Jena drifts between contractions almost sleeping, the contraction surges their fingers intertwined Kate’s words of encouragement and love flow.  Jena’s body responds by relaxing and giving over to the surge.  Her doubts boil to the surface.  Her wife confidently responds, “You are strong enough, it will happen, you can do this.”  This is the ebb and flow for over an hour.  It is a lovely interlude.

Finally Kaia is ready to be born.  Kate is as strong with her physical support as she is emotionally.  She helps her wife out of the tub, supports her as she walks, and then as she rests on the birth stool.  Again a foundation for Jena. The charismatic Kennedy women convince the older-taller-knee-replacement physician to get down on the floor to catch the baby.  No small feat.  The baby hasn’t even been born yet and I am so overwhelmed with all the love in the room.  Joy rears its head, that same joy from early labor, they are smiling almost giddy at the realization they are about to meet their baby.  Gender yet undiscovered name yet unspoken.  And at 10:48 pm a sweet pea of a baby girl head full of dark hair emerges into the loving arms of her mothers.  Joy of joys Kaia Rose is here 6 lbs 4 oz! Welcomed with love and celebration- a victory of life.

Dear Kennedy mamas, thank you for inviting me to be a part of your journey with Kaia.  I am a better doula and better person for it.  Our community is blessed to have your family as a part of it.

The story of my daughter's birth

Amelia’s birth story begins one year before my pregnancy began.  It was May 2004 when I anticipated attending my first birth as a doula. It was an experience with unexpected trajectory.  The hopeful first time mother and I arrived at the hospital labor and delivery room for evaluation.  From the first, it was bad news.  The baby’s heart was not beating.  An ultrasound confirmed the tragic news.  We were all shocked.  No heartbeat.  So she labored, I supported, she cried, I held her.  It went on until the next morning (Mother’s Day) her baby girl arrived dead.  It was horrible and holy.  

During my pregnancy with Amelia, I attended eight other births that resulted in health babies and happy mothers.  I did not doubt that my own pregnancy would end any differently.  My husband and I took a local childbirth class and decided we wanted to have our baby at home.  We wanted choices about who was there and how things were done. 

The plans for a home birth came together when we met our midwife Lynn.  We felt that we could trust her professional experience and midwifery skills.  The healthcare she provided was personalized and conscientious.  As the “due date” of February 23 grew closer .

It is a classic end of pregnancy story common to many in that last weeks of pregnancy were physically uncomfortable.  In the midst of the waiting I got swallowed up by anxiety.   My baby’s head was engaged, low in the pelvis and it hurt to walk.  My hips and pelvic bones ached.  The daily task of caring for our 2 year old son was all I could manage.  Emotionally weary, my fear of the pain yet to come grew fierce.  The moments of calm and peace eventually unraveled to anxiety. Will my baby die before it is born?  The thought stalked me, kept me from sleeping. I hesitated to speak the fear, sure that if it passed my lips to words somehow it was more likely to come to pass in my womb. 

Sensing that there was something bothering me during a phone call my midwife pressed, “What are you holding back?” The images and memories crept into my mind.  I managed to tell her a bit about my first doula birth and the stillborn baby.  I played down my anxiety, admitting how haunted I was induced near panic.

In the days following that conversation I became convinced my baby was not going to come out.  My contractions started, the crescendo of intensity and spacing played out over the course of an afternoon and evening.  The labor team was summoned, birth pool filled, candles lit, lights dimmed.  Then a decrescendo, winding down and calming of contractions.  I was Jonah swallowed whole in the belly of despair.  This baby would not be born.

A few days later my body awakened during the night at the return of rhythmic contractions.  By morning light it was certain this labor was here to stay, this baby to be born.  Birth team reassembled, birth pool refilled, coffee brewing in the kitchen, it was time. 

I felt safest in the darkness and close to my husband.  He was patient and stayed nearby. I could tell he was nervous, but acted with confidence and experience.  I obsessively waited for the moment it was time to listen for my baby’s heartbeat.  Always strong and steady I tentatively pushed away the anxiety.  It came back to me like a tide pulls in at the shore.  Now in the midst of labor, still I was not convinced this baby would be born. 

Contractions paced themselves over the course of a few hours without any progress in my opening.  Lynn our midwife approached me again wanting to know “What is it that is holding you back?”  I erupted a live active emotional volcano of hot tears.  Sobbing I let it all pour out, guilt, fear, shame, worry, disbelief, lack of confidence.  Silently my doula and midwife listened, holding my hands.  Passing me fresh tissues.  Raw and vulnerable I was emptied out.  Their words of love and encouragement filled me back up.  I began to believe it was ok for this baby to pass through and be born.  That she would be ok. 

My spirit renewed I expected my labor to pick up.  Contractions persisted but were not strong enough to cause me to dilate.  Lynn sensed that my labor was not improving despite my emotional release.  An enema was administered to encourage my labor to progress and it worked.  Physical sensation dominated and finally muted out my emotional brain.  Finally I was one with the surging contractions able to surrender to the ancient course of pain and relief all women in childbirth experience.

All at once I knew it was time to get into the birth pool.  The warm water relieved the intensity of the pain and eased my aching muscles.  Sheltered in the watery nest I was able to rest between contractions and stay loose as they inhabited my body.  An hour later the pressure in my hips so intense I found myself pushing.  All the sudden I got up on my hands and knew, leaning over the side of the pool.  “The baby is coming’” I mater-of-factly told everyone.  I felt it happen.  She moved out of my pelvis into my birth canal. The intense pressure eased when I pushed.  My body worked on auto pilot following its own course bringing my baby down and out of me. 

“Pull you baby out of the water,” the midwife’s assistant instructed as she helped me sit back.  With disbelief I reached down and pulled her from the warm water.  “Is the baby out?  Am I done?” I asked in disbelief.  My husband smiled through his tears, “You are done… you were amazing.” All along I harbored a hope I was carrying a girl, but we didn't have any ultrasounds during the pregnancy. The moment of truth finally upon us, sweet joy a daughter!  Amelia Elizabeth Black weighing in at over 9 pounds alive and well and breathing.

Mother’s Day, the anniversary of the baby’s death, came two months later.  I gathered with the parents and their extended family for mass, then a lavish Mexican meal.    The mother took me aside to her bedroom where an alter had been laid.  The alter held the cremated remains of her baby, photos from the birth, and an abundance of gifts, sweets, and fruit.  Tearfully we talked about her baby’s full head of hair, plump body, and perfect feet- just as you would with the mother of any newborn.  The sacredness of her loss the privilege of witnessing such love and grief was not lost on me.  Suddenly my ears perked at the cries of baby Amelia fussing in the other room.  I rose and went to her.  Nursing her I wept, grateful not only for my living daughter but with a new respect for the delicate connection between birth and life and death and gratitude for the process.