I had the privilege of meeting Anna and David to start work as their doula just a month before their estimated due date on January 12th. They had attended birth classes at the University of Utah and heard about my services there, and even though they were further along in their pregnancy they reached out, and it's great that they did! We quickly scheduled our prenatal appointments before our holiday calendars filled up, and by the time Anna's due date was nearing, we were all ready to go!
As January 12th came and then went without any signs of labor showing, Anna talked with her Doctor, Tiffany Weber, about the options available to her. It is not uncommon for first-time moms to go past their due date by up to 2 weeks, but just to make sure everyone was doing well, the doctor ordered a non-stress test (NST) to check on the baby --- who was doing just fine. Anna and her doctor then began talking about various induction methods should Anna decide that was the route she wanted to take, and together they decided Anna was comfortable using cytotec gel, a balloon catheter, pitocin, and breaking the bag of waters after 5 CM. Anna was thorough and did her research through reading books, talking to her provider, and talking with me about the benefits and risks of inducing, and ultimately decided to forgo any induction for the time being.
At 41 + 2 (9 days after her due date) Anna went into labor early in the morning at 0100, she labored at home for a few hours with the support of David, kept diligent track of her contractions, and reached out both to me and to the University of Utah to determine the best time to go to the hospital. 5 hours after contractions began she had a great pattern established, and admitted into labor and delivery at 7AM. I met her at the hospital 30 minutes later, and David and I helped Anna through her contractions as she labored in the tub. The warm water had a soothing effect and helped to physically comfort Anna, she was pleasantly surprised and said many times “it really helps!” After an hour in the tub, her contractions were increasing in strength and coming closer together, she labored in a standing position while leaning on David for physical support, and I was behind her doing the “double-hip-squeeze” and helping her to rock from side to side during her contractions.
At 930AM Anna was 10 CM dilated and 100% effaced, she had progressed quickly since arriving at the hospital, and before she knew it her body was ready to start pushing. For first-time moms it can be tricky to know how to push. Most often the advice given is to “push like you’re having a really hard bowel movement” but it is not quite like that, and usually we don’t have bowel movements with a spot light and an audience! Anna listened to the advice from nursing staff, Doctor Shin, and me, and after about an hour she got the hang of it and her pushing efforts began making progress. At 1230 PM her baby girl started crowning, which gave Anna the final bit of energy needed to deliver her baby, and at 1247 PM Elisa Claire arrived!
We knew a few hours before that there was the presence of meconium which happens in about 5-20% of births. The presence of meconium itself it not dangerous, but there is risk of the baby aspirating on it and having damage to the lungs or brain from oxygen deprivation, this happens in about 5% of cases. Unfortunately, Elisa aspirated on the meconium, and because of this her initial APGAR score was a 4. The Pediatric Doctors were right there in the delivery room and worked quickly to suction her lungs and give Elisa oxygen, but ultimately she had taken in so much that she got an infection in her lungs and would spend 1 week in the NICU. David was a star during all of this, he quickly took action and went right to Elisa’s side, he was with the Doctors as they transferred her to the NICU, and he was a solid support for his new baby girl.
I stayed with Anna in the delivery room as her stitches were placed and she was taken care of by medical staff. In her birth plan, Anna wanted to have immediate skin to skin and breastfeed quickly, and it took her a little bit of time to understand that she had a baby, that her baby was in the NICU, and that this wasn’t a dream, but something she worked really hard to do! This is a normal response when, for whatever reason, the mother cannot immediately hold her newborn. After about 30 minutes, David and the NICU doctor (Dr. Jenkins) came to meet with Anna and provide and update on Elisa.
Later in the day Anna had the chance to meet her daughter and was filled with love for her!
It can be tricky to discharge home from the hospital expecting to bring your baby with you, only for situations to change and to come home for a few days without your little one. It was nice that family was around to provide support for Anna and David, and that they were able to visit Elisa often in the NICU. 7 days after the birth, the new parents brought her home and made the adjustment to full-time caretakers without the support or guidance of trained medical staff around. The first few days had some heightened anxiety, especially from David who saw Elisa right after birth as she was struggling to breath. This is perfectly normal and to be expected.
Almost two months after Elisa came into the world, it is a blessing to say that she is doing just fine. The doctors predict that she will have no long term impacts from the meconium, not even asthma! Anna and David are adjusting well to their new roles as mom and dad, Elisa is breastfeeding, sleeping well, and is a happy little baby surrounded by love.
It was a joy to work with Anna and David, to be part of their journey and witness their experiences.