My Doula Journey: Birth #2, Part 1

Be sure to read Birth #1.

My journey to becoming a doula continued as my family grew. I had been a new mom for 4 months, enjoying and bemoaning all together the newness of the postpartum stage. The nights were long but the baby was so sweet. My daughter had begun sleeping for longer stretches at night and Spring was in the air, my favorite season. I found a new sense of content and discussed with my husband wanting to start trying for another baby. After two months, we were delighted to see a positive pregnancy test. The morning sickness lasted the same four months as before, only this time I was caring for a baby at home as well. We spent a lot of time at home while my body changed and grew. I felt like a mother goddess, full of life. But I also felt lonely. My husband was busy with dental school and we lived in a city with no family and just a few new friends.

Fall turned to Winter as I prepared for a January/February birth. I continued to see the same midwife as with my first birth. I had an ultrasound done this time around and was delighted to find out that we were having another daughter. We prepared for a home waterbirth this time, as I remembered how wonderful the bath felt during my previous labor. My prenatals went well and I was having a low-risk pregnancy, until one cervical check in late third trimester showed that the baby may be in a breech position. Breech (literally “bottom first”) refers to any vertical fetal position that is not the optimal head-down position, including complete breech (bottom first with feet tucked near bottom), frank breech (bottom first with feet up near head), or incomplete breech (bottom first with one foot down and one foot up). 

We had an ultrasound performed at the local hospital to confirm that she was indeed breech. Her position was called footling, in that her feet were lower than her bottom and if delivered vaginally, her feet would present long before the cervix had dilated fully for the rest of the baby to be born. These births are tricky in that 1) it takes the confidence and skill of a care provider to trust in the body’s ability to birth in less than ideal circumstances, 2) the cord has a 15% chance of prolapsing, or delivering before the baby, which cuts off the supply of oxygen to the baby in about 10 minutes, and 3) I may need to push LONG before ever feeling an urge to do so. After getting the news from the doctor, we signed a Refusal of Medical Treatment (as they wanted to wheel me back to surgery then and there) so that we could go home and discuss our options with our midwife. My midwife, having seen me labor and birth before, felt confidant in my ability to calmly birth a footling breech. She explained the risks and benefits of footling breech births and gave us the option to try an External Cephalic Version (ECV) to manually turn the baby from the outside. My husband felt a breech birth put me a too high of a risk to deliver at home. In talking to him, I saw the fear on his face, surely remnants of the hemorrhage just 14 months prior, and we decided together that we needed to either turn this baby into a head down position or have this baby via cesarean at the hospital. Not many OB GYNs are trained and confidant in vaginal footling breech deliveries, and our hospital required cesarean with no trial of labor possible. 

My midwife, along with a labor assistant acting as my doula, called another midwife for assistance as she was known as a “baby turner.” “If anyone can get this baby to turn, it’s her,” my midwife told me. At about 9 pm, the two midwives and doula were ready to begin. I laid on my living room floor on my back with my knees bent as they worked on me for two hours. They attempted to push the baby up towards my ribs and out of the pelvis so that she could rotate. My daughter’s head and body turned freely, but her feet were firmly lodged under my pelvic inlet and would not budge. Even as my midwife placed her hand into my vagina to attempt to dislodge the feet, all attempts were fruitless. They then used a rebozo technique called sifting in the hopes of jiggling the feet free, but she would not budge. Alas, this was my first glimpse at the temperament of my wonderfully stubborn baby with extremely wide toes. 

At midnight, we all agreed that this birth was fated to a cesarean. It was heartbreaking for me. I was so proud of myself for delivering my first child at home with no drugs. I passionately and naively thought that all my babies could be born easily at home. Going to the hospital for surgery felt like failure. My midwife told me that contractions would probably start soon after all that pressure on the uterus. She encouraged me to drink a big glass of red wine, take a warm bath, and try to get some sleep to help calm my nerves. I did as she suggested and got fitful sleep. At 5 am, I woke my husband up with contractions every 5 minutes and we prepared to go to the hospital. 

To be continued...