Ask any questions that are relevant

• Is she certified?
• When did she become certified or why is she not?
• How many births has she attended?
• How many clients does she usually take in a month (any more than 5 clients in a month is a red flag)?
• How much will she charge, does she have a sliding scale, what is the payment schedule?
• Does the payment change if she is unable to attend or if  you end up needing a c-section? If it doesn't work out can you get a refund or find someone else who might work for you?
• Does she have other services available like belly casting, placenta encapsulation, photography, breastfeeding services, babysitting, or postpartum services?
• Does she have a back up, can you meet them?
•  

Get to know your doula on a personal level

• Is she married, if so how long?
• Does she have children, how many, how does she feel about her birth experience?
• Why did she become a doula?
• What is her overall philosopy on birth?
• Did she breastfeed, how long, how does she feel about it?

Build a relationship

You should have at least 2 prenatal appointments with your doula. During these appointments you'll probably go over things she'll do to help you along during labor and if complications arise. Also during these times you should begin to get comfortable with her touching you in case massage, hair stroking, or counter pressure are used to comfort you during labor so you can let her know what you do and do not like beforehand and to build the comfortableness with her. If you would like she may have relaxation techniques to practice too which would be helpful so you know you can completely relax in front of her. Personally, I found an included belly casting session really helped me open up and get comfortable with my doula. 

If at any point you are not comfortable with your doula: First determine if the issue can be resolved and try to fix it. If you think it is something that  will affect your ability to remain comfortable with your doula for future appointments and/or during labor, birth, or postpartum then you should talk to her respectively and tell her you just can't do it; She may know someone else available that you may be comfortable with. 

If you are a doula or want to become a doula: The steps also apply to you but from a different standing point. Try to give your client as much information as possible so that the family can feel comfortable with you; like a friend rather than business. Reassure partners that you aren't there to take their place, but rather to help them help the mother or step in when they need a break. Beware them that you can not speak for them, you are not a medical professional, and can not give medical advice; You are simply there to support the family and help comfort the mother. 

A Midwife, Doula, and Postpartum Help for Healthier, Happier Mom, Dad & Baby

Who uses a doula, midwife, and postpartum help?

Barefoot hippies? Hollywood divas?

Yes, and millions of everyday, hardworking people around the world who have decided either through their cultural heritage or personal research that for them, a natural childbirth and postpartum care with the support of a midwife, doula, and other services makes for the healthiest, safest, and happiest ways to give birth to and care for the new spirit in their lives.

Natural childbirth in a hospital, homebirth, and postpartum care have become so uncommon in the U.S. (and increasingly in other countries) that they are now considered by many to be too difficult, unnecessary, or even frivolous.

But, just a glance at the number of women in the U.S. who fail to have a natural childbirth (when that’s what they intended), fail to breastfeed (even when they wanted to and tried), and who suffer from mild to severe postpartum depression offers a clear indication that the now standard, mechanical template of childbirth and postpartum care is gravely inadequate.

And it’s not that millions of women wouldn’t want a natural childbirth or magical postpartum time of healing and bonding.

It’s that a great majority have no idea what hospital protocol they’re up against when they enter Labor & Delivery, or what kind of postpartum care is considered standard and necessary in countries around the world (and that women experiencing loss—miscarriage or stillbirth—also have postpartum leave and care[i]).

Countless women go into labor having said for nine months, “I want a natural childbirth.” And they mean it. But then what happens?

Here’s a look at just a few of the standard procedures upon entering the hospital[1]:

• When you enter the hospital, you will either be placed in a wheelchair or you will walk to a labor room. The routine is being hooked up to an IV, one or several monitors, denied food and even beverages (other than ice chips, which in many cultures are considered something to avoid in labor). Depending on how “progressive” the hospital and staff are, you will be allowed or encouraged to walk around and work different labor positions to encourage the baby into the correct position and allow labor to progress, or you will simply be advised to stay flat on your back—which is considered by many in the birthing world to be one of the most painful and least effective ways to labor.

• Around the time you start experiencing stronger contractions and the pain sensations are increasing, hospital staff [strangers] will appear at your door encouraging the use of drugs.

• You will be checked periodically by doctors, residents, and/or nurses and student nurses [more strangers]. When you’re dilated far enough, they will move you to the delivery room where your doctor, or a stand-in if he or she has been called away to more pressing matters, will stay with you as the baby and the placenta are born.

This is all assuming that you’re not put on additional drugs to speed labor (if in their estimation you’re taking too long). While 24 hours or longer is a common length of time for a mother to labor—especially with her first baby—many hospitals encourage drugs to speed the process if it passes 12 hours.

It is also assuming that nothing has happened to encourage the doctor to perform a cesarean section (now at 30-50% of deliveries in the States, varying by doctor and hospital).

• All in all, as Jennifer Block states in her book Pushed: The Painful Truth About Modern Childbirth and Maternity Care, a mother—even in a “routine” birth in a hospital—may have “up to 16 different tubes, drugs, or attachments.”[2]

• After the baby and placenta are born, they are both taken away in most instances. The baby to be washed (unnecessary and considered by many to be stressful for the newborn who’d rather be on her mother’s chest and latching!), weighed, measured, and treated with various pharmaceutical products.

The placenta will be taken to an incinerator.

Postpartum care?  Women are sent home from the hospital with a few formula samples and a diaper bag.

That’s how we care for new families?

The most sacred rite of passage has become cold, mechanical and offensive.

Fortunately, the pendulum is swinging back. 

Many new parents are discovering the mind/body/spirit benefits of hiring various support/services to help them on their journey either at home or in the hospital.

There are many (and increasing numbers of) people who serve new mothers in pregnancy, delivery, and postpartum, and I wrote about several—doulas, midwives, postpartum doulas, maids, cooks, and nannies—in my book New Mother.  Since publication and through interaction with readers, I’ve discovered even more services.

For example, a service called Best Fed Babies offers breastfeeding support with a certified lactation consultant 24/7 via phone or Skype to mothers anywhere in the world.  I would have loved to call them when I woke one morning at 3:00 AM with a plugged duct—and how many of us have similar questions or issues in the early days and wee hours of nursing!

Mother’s Concierge services are another wonderful and flexible source of help.  One company called Pampered Mamas in Baltimore, Maryland offers in-home pre/post natal massage; nap Nannie; in-home baby proofing consultations and much more.

A company in Los Angeles, CA called MotherBees doesn’t just deliver any old regular meal to postpartum mothers, but combines traditional postpartum foods with locally sourced seasonal ingredients. Replenishing and restorative foods—at your door!

In our modern culture with nuclear families living in isolation, many new parents lack knowledge of what will happen during childbirth, what procedures they can accept or decline (in the hospital), what they’ll need postpartum, or what is available to support them.  Just knowing the names and types of services will help mom and dads-to-be to research better and find exactly what they need to create their childbirth vision.

Ora na azu nwa, or It takes a village to raise a child, is a Nigerian Igbo proverb made popular by Hillary Rodham Clinton’s book published in 1996. Birthing and raising healthy happy children does require support, but we don’t live in villages. 

However, we can create our village—hopefully with the support of nuclear and extended family members and long-time friends, and also with the help of people trained, experienced, and specializing in mother and baby care. With so many different services available, everyone can find the perfect fit for their needs, budget and desire.

May you be surrounded by love and support, and may you experience abundant peace and joy on your blessed journey of motherhood!

*No affiliation or compensation associated with the services mentioned in this article.
Illustration, I See You, used with license from Healing Art, Jane Delaford Taylor

Here we are...a place I hoped we’d never be... it’s 3:30am and time to discuss a hospital transfer...

I’ve been out of the birthing pool for just over two hours and am laying on our couch wrapped in all the towels and blankets we could find. I’m freezing cold and shivering as I hear my midwife say, “It’s time to discuss the options.” We had previously selected a specific hospital for transfer – if needed – but that no longer seems to be our best option so we run down a list of nearby hospitals. The house suddenly turns into a command center. Both of my midwives and my doula are walking around the first floor of our townhouse calling hospitals to see who is on-call and how they will handle my case.

You see...I’m breech. Well, my baby is breech, and I’ve been in labor for 48 hours now. I’m 7 centimeters and entering transition as we decide to make the transfer. All the nearby hospitals say they will do an automatic C-section if I’m brought in, but I don’t want a C-section. I know I can deliver my baby vaginally even with a breech presentation. The midwives begin calling OBs directly. They know of one female OB in the area that will allow moms to deliver vaginally for breech presentations, but she says she won’t take me because it’s my first baby. The odds are against me. It isn’t looking like I’ll be able to deliver vaginally after all. I’ve worked so hard these past two days to get to where I am and can’t believe I’ll have to be cut. The feelings of defeat begin to set in. There is one more possibility though. It’s a male OB that is in another county. It’s an hour drive to get to him. We make the call and wake him. I’m not expecting him to say anything different than the others, but within a few minutes my midwife enters my living room and says, “He’ll take you! I told him you were breech and wanted to deliver vaginally and he said to bring you in.” Thank you God! Off we go...

It’s after 4:00am, and my midwife is driving at the head of the pack. We’re on the Florida Turnpike with a general idea of where the hospital is. We’re relying on her memory for what exit to take. My husband is driving me, and my parents are following us. Behind them is my doula. It’s a four-car caravan in the middle of the night driving north for my last chance to deliver our baby naturally.

Surprisingly, I remember most of the drive. My pain is more intense and constant than it has been. I’m shivering cold and telling my husband to turn off the A/C one minute and taking everything off and asking for the A/C colder the next. I can’t get comfortable. I ask him to slow down. Each and every bump makes the contractions all the more difficult to manage. I’m screaming in pain. I’m in and out of sleep the entire ride.

My parents must think I’m crazy. I didn’t prepare them for this. They don’t know that there’s plenty of time before the baby arrives. They must be scared that I’ll have the baby in the middle of the road. I had told them I’d go to the nearest hospital if I needed a transfer. That hospital is a 3-minute drive from my house to the emergency room entrance. But I can’t go there. I can’t walk in there knowing that I won’t be given a chance to birth my baby. I have to make this journey to the one place where I have a shot at a natural birth.

About an hour later, we arrive at the hospital and I am admitted. The OB enters my room and does an internal exam to check how I’m doing. I’m still 7 centimeters. He then announces, “This is an automatic C-section.” In that moment the last bit of hope that I had remaining of delivering my baby naturally disappeared.
~
Over 48 hours ago, my mucus plug released, and my contractions started at 6 minutes apart. I wasn’t expecting it to happen like that. I know plenty of women who lose their mucus plug and don’t go into labor for days or even a week. I settled into the couch downstairs and kept timing the contractions to be sure this was the real thing before I woke anyone up. It was 4:00am, and I was certain I’d meet my baby within this day.

Two hours later, my contractions were going strong at about 4 minutes apart. I woke my husband with the good news and texted my midwife to give her a heads up. I began what turned into a marathon of vomiting. My contractions continued. My midwife and doula came by. Halfway through the day, I was 1 centimeter dilated and 100 percent thinned. Seemed unreal, but I knew better than to let the actual number disappoint me. It could be worse, so I took it in as progress.

My midwife left to return later in the day. My doula stayed. I rode out the contractions sitting on my recliner with my husband on his knees in front of me. The warmth of his hands on my thighs alleviated my pain more than he could understand. I slept, if only for a few seconds, between each contraction. My midwife returned. Time passed. I showered. Then, it was nighttime. I thought, “This should do it. I am more of a night person anyway. I’ll feel more relaxed and make good progress once the sun is down and I’m surrounded by darkness.” We all spent this first night together as my contractions continued. The TV was on, and although I was not focused on it, I was relieved that it was helping the time pass for everyone else. Everyone (except for me) took a few hours to nap. In the morning, I was 3 centimeters—progress, but a long way to go still. My midwife and doula left for several hours. My husband was exhausted. I decided to call my mom and ask her to come stay with me while everyone rested. I didn't tell her over the phone that I’d been in labor for over 24 hours already, but she suspects something is going on.

I continued to vomit and feel tremendous strain as I got every bit of liquid bile out of my stomach. The next time I went to the bathroom, I saw a dark colored discharge that I hadn’t seen before. I was concerned it might be meconium. I called my midwife. My other midwife was closer to my home and got there quicker to check my discharge. It was meconium. My contractions continued. My mom spent the day with me while I continued to labor. She left in the early evening to return later on with my father, who stayed upstairs without my ever seeing him. Nighttime arrived for a second time as my midwife and my doula returned. All were present now along with my husband, who was able to get some rest upstairs. They were concerned about the marathon vomiting and were trying to get me to drink and eat as much as I could keep down. I managed to keep down some drinks and miso soup, but only temporarily.

My pain was increasing. The sleep I'd gotten between each contraction over the last day and a half gave me the stamina to continue. But the pain was increasing, and I needed to try something else. I asked for my birthing pool. My husband and doula prepared the water. I got in. It was absolutely magical! I was so happy to be in the water. I was so impressed with how much pain relief it provided. I enjoyed this stage of my birthing process as much as one could while experiencing the mounting contractions. My contractions intensified and my body temperature began to fluctuate. This was one of my concerns (the other was fear of having a migraine during labor). As a thyroid cancer survivor, my body’s temperature tends to fall lower than normal. I was hot from the birthing pool, but my entire body was shivering.

I had been in the birthing pool for some time, and it looked like my midwives felt things were moving along. I heard them preparing for the birth. They started to set up the table with all the birthing supplies they would need when the baby was born. My midwife wanted to check me again while I was still in the water. I was now 5 centimeters. Five centimeters! Five centimeters...unreal. I had the stamina to continue. I was not giving up. But I became aware of the time. I saw that we were about to hit the 48-hour mark. And I started to worry about what that meant...

My emotions began to speak. Internally, I called upon every woman that had ever birthed naturally. I asked for their support, their wisdom, their guidance and their presence. I called upon the spirit world to give me the strength that I needed in this moment. I found myself getting upset as I silently screamed for help. I heard myself saying, “Where are you?” as if the generations of women birthers had forgotten to come for me. I called on my own birth experience, as I was born weighing almost 12 pounds to a 5-foot mother who birthed me without drugs or interventions. “It’s in my genes! I can do this!” And as I was going through this catharsis internally, my baby’s heart rate started to rise.

I was no longer in the comfort of the birthing pool. I was cold, wet, and shivering, wrapped in all the towels and blankets we owned, laying on the couch as I heard the words I never wanted to hear. “It’s time to discuss the options.” “Options,” I thought, “what options? I don’t want options. I want to birth my baby. That’s my only option.” But I trusted my midwife wholeheartedly. She didn’t use the words, but I knew if she was saying this, then it really was time to discuss a transfer. And a hospital transfer was what we did at 4:30 in the morning, just over 48 hours from the time my contractions started on that early Tuesday morning.
~

It’s now almost 6:00am on Thursday morning, and my one last chance at a vaginal delivery has just announced that I should be given an automatic C-section. You see, my baby is not just breech, but a bit transverse. My water has broken, and I have meconium present. I’ve been vomiting for days, and apparently I broke a fever on the drive up. My baby’s heart rate continues to reach peaks that are too high and begins to plunge below the norm, and let’s get real...I’ve been in labor for two days now and am still at 7 centimeters.

As the sound of the word “C-section” rolls off the OB’s lips, I hear my husband’s voice. He’s speaking with full certainty and with a clarity that I’ve never before heard from him. He says to the OB, “We drove an hour for YOU!” My heart stops. My leg kicks my husband. I’m not breathing. I’m thinking, “Shut up!” Such few words, but so much is implied. I’m even beginning to feel fear. I think it’s because I don’t want my husband to lose his temper with the OB. I think it’s because I don’t want this OB to be upset with us since we need him on our side. But the truth is that those words have solidified our destiny. What I feel is the power of those words and how in that split second my life has taken the path that I was born to take...

The OB doesn't skip a beat. He says, “OK, let’s see what she can do” and leaves the room. He too must have felt the power of those words. By now my concept of time is nonexistent. All I know is that I’m in the hospital room with my husband, midwife, and doula. The hospital nurse also comes in and out. She insists I lay on my back. I beg to be able to sit up. My midwife turns me on my side. I’m no longer vomiting, but the pain is unbearable. I’m hardly awake. All I remember is darkness and the voices of my birth team. They say I’m doing great, but deep inside I am waiting for my C-section. You see, I begin to believe that it’s over. It’s not so much that I believe that I can’t do it, but I feel the C-section knocking at my door. It’s in the air. It’s seducing me, and I surrender to it – emotionally, I give in.

The OB returns, and I’m 8 centimeters now. I fall back to sleep and don’t hear if there is a decision made. More and more time passes as I wait. I’m confused. Why are my husband, midwife, and doula encouraging me? Why do they want me to keep bringing my breath and energy down? Why do they want me to keep laboring? Don’t they know I’m having a C-section? Don’t they feel the devastation that I’m feeling? Aren’t they in as much disbelief as I am in? I’m awake for so little time between contractions that I can’t ask them why they are saying all those things to me. I remain confused and continue waiting to be taken away to the OR.

I manage to get some words out and ask the infamous, “How many more?” referring to contractions. I know there is no answer, but I can’t help asking. I hear the OB's voice pierce through the darkness: “Do you want an epidural?” Before I even get a chance to consider, he says “No? Ok.” It’s as if he doesn’t want me to have one. He asked, but wasn’t really offering. That’s interesting. And why did he say, “No?” Don’t I need one for my C- section? I fall back to sleep before I can think this through.
~
I’m lying on my left side facing my husband and midwife. They are holding my hand and touching my thigh. I see their faces go blank. I feel the fear that just came over them. I suspect it has something to do with what I just felt. I see them staring at the external monitor—there is no heartbeat. I know what has happened and do my best to get the words out. My baby’s heart didn’t stop. I look at my midwife and say, “I PUSHED! I can’t not push! I HAVE to PUSH!”

It was such a divine feeling. My body had to push. It wasn’t mental or even physical. It was divine. I was moved by spirit to push. My body knew exactly when and how. It was time for my baby to be born...

Because of the baby’s breech position, I knew I’d be checked again. Everyone had made it clear that they needed to be certain that I was a full 10 centimeters before pushing to avoid the baby’s head getting trapped once the body had come through butt and feet first. A possible complication with breech births since the head is bigger than the body. The hospital nurse checks me, but neither my husband nor my midwife feel confident with her so we wait for my OB. My contractions stop and in those moments I feel a rush of life and absolute ecstasy come through me. After all we’ve been through, after giving in emotionally to a C-section, after more than two days of natural labor...the moment is finally here. I am going to PUSH my baby out!

About 7 minutes later, at 7:55am on Thursday morning, I give birth to a baby boy weighing 5 lbs, 14 ounces and measuring 19 inches long. He is born in front of an audience. Seems that the rumors had spread across the hospital that there was going to be a vaginal delivery of a breech presentation, and the hospital staff wanted to witness something they thought they’d never see. My husband recalls hearing a few of them say, “She’s going to do it natural? But they didn’t teach us natural birth for breech presentations in medical school!” to which he responded, “Watch her do it”. And I did it. Our son came out butt cheek, foot, and testicle first. A strange sight indeed, but a true testament to all that birth can be when allowed to take its natural, raw course.
 

My son is about to turn one and is as healthy and full of life as can be. Over this first year of his life, I have come to fully understand the power of those words my husband spoke. Those words that he spoke for me when I couldn’t speak them for myself. Those words that set us on course for a natural, vaginal delivery when we came as close as one can possibly come to getting a C-section. It was those words that paved the way for me to slip right through the massive “C-section Net” that catches so many of us. It was those very words that saved me. Not just from getting a C-section, but also from losing a piece of myself that I know I’d never get back. Had I ended up with a C-section that day, an essential piece of me would have died on that operating table. You may not understand, but I know I would have lost the very piece that makes me who I am. I would not have been aligned with what I know to be truth. The self-betrayal would have cut so deeply that I would have remained wounded for life far deeper than the scar I would have had on my abdomen. I would have been changed in a way so profoundly that I would not have survived the experience as myself. It would have affected my mothering, and it would have affected my marriage. My life would not be as it is. I would not be as I am – as I was born to be.

We live at a time when it’s the norm to make people feel comfortable about what happens in their lives. A time when we allow people to feel like they’ve done everything they possibly can even if things don’t go their way. But I feel we do each other a disservice in doing this. I didn’t need my birth team to make me feel ok with getting a C-section...I needed them to hold my vision of a natural, vaginal birth when I couldn’t do it for myself. I needed my husband to speak my truth when I couldn’t. I needed to be able to surrender to the devastation of having a C-section at the depths of my inner being while my birth team held my destiny in check so that I could peek out from within the disparity I was feeling and still feel the presence of the possibility of having a natural birth.

We are survivors. With that said, we adapt to what comes our way and make peace with it in order to continue to live. I assume I would have done some form of this had I ended up with a C-section and would today be a profoundly altered version of myself. But in all honesty, I thank my midwives, my doula, my OB, my baby, myself and most of all, my husband, each and every day because I don’t have to do that. It is because of this that I know birth. It is because of this that I know birth in the way that I was born to know it. It is because of this that I know myself.

As I prepare for my son’s first birthday I feel into the gift my husband and I gave him on his BIRTH-day. I remind myself of what we transmitted to our son with every choice we made and I remind my son to never betray himself as we did not betray ourselves throughout his birthing journey.

I thought I would share a little background about myself before I jump into my story. I'm a military wife. My husband and I were stationed at Marine Corps. Base Hawaii when I gave birth to our little angel in April 2011. Because we were so far away as a military family, it was just the two of us for the birth. Especially now and looking back, I feel so blessed to have had it so private and intimate. I gave birth at Tripler Army Medical Center, and although military hospitals generally have an awful reputation, I personally had an amazing experience. The hospital had a midwife program for low risk mamas and I opted for a midwife the first chance I got and after a terrible first experience with one of their OBGYN's. I could not have had a better hospital birth thanks to the wonderful midwives. And here is my story...

I suffered pre labor contractions for a week before I finally went into active labor. I became extremely impatient, frustrated and increasingly dissapointed when it wasn't the real thing. The day before I went into labor, I went in for my 38 week appointment and I told the midwife (who saw me about my contractions) so I allowed her to check my cervix which was 3 cm dialated and if I remember correctly about 75% effaced. She then told me she expected me to go into labor within the next 24 hours.

The next day on a beautiful Saturday morning, I woke up to my husband's alarm clock. I had no idea why he set an alarm for 6 am on a Saturday morning (later he explained to me he just "had a feeling"). I rolled over to ask him why and.. my water broke. HUGE gush. I told him I thought my water had just broken and...another huge gush. Definitely broken. I began to get so many butterflies in my stomach and couldn't believe after all my frustration and disappointment in the last week, it was FINALLY happening and I was about to experience what I'd been preparing for so long for. Most importantly, I would soon meet my precious baby girl.

I then found the business card with my midwives pager number and gave them a call. When she called me back and asked if I had felt the baby move since my water broke, I told her "no" so she suggested to get to the hospital as soon as possible just to be safe. I honestly may have felt her move and had just been to excited to notice.

So we got our things together and got on the road. The contractions at home and the entire way to the hospital were very tolerable. Not much more than what I'd been experiencing the week prior. It was a half an hour or so drive, no traffic and a beautiful and sunny day (like most days on the island). My husband and I were so giddy the whole way there with excitement; singing, laughing, and sharing our feelings about what was to come that day.

We arrived to the hospital and the labor and delivery seemed to be a ghost town. It was very quiet and it didn't seem as though they had many patients to attend to that morning. They took me to a small room in triage and checked to make sure my water had indeed broken, asked me some basic questions, did some fetal monitoring for about 30 minutes and all was well with Lily.

My midwife, Rosemary, then read a copy of my birth plan. She saw that I was planning a completely natural birth and said "Ok those are pretty common requests." The whole time I got the feeling she didn't have much faith in me because she "heard it all the time." She discoverd I had regressed a little to 2 cm and a little less thinned for some reason but she admitted me anyway since my water had broken. I got in my gown and they wheeled me to my delivery room where I met my nurses who were Godsends through my entire labor. I was still feeling fine at this point, smiling and answering all their questions with no problem. Once they checked my blood pressure and set in my heplock. I didn't allow the IV to be attached and they were perfectly fine with that as long as I stayed hydrated. They allowed me to walk around and do what I needed to be comfortable (anything but getting in the jacuzzi because it could have regressed my labor by relaxing me too much.) So my husband and I went for a stroll around the hallways in l&d. My contractions were getting a little stronger and I couldn't walk through them anymore. We went back to the room and my midwife asked if I had taken any lamaze or bradley classes or anything similar to cope through the labor. I hesitated for a moment to tell her "no" because I felt like she'd really have low faith in me then and assume that I wasn't prepared.

After that, I got on the birthing ball which was my the most relief I had during labor. The nurse continued fetal monitoring every hour for 20 minutes which was extremely annoying but she at least let me stay on the ball, which made it more bearable. After a few hours of that my midwife asked her why she was checking me so much, that I didn't need to be checked that often. I couldn't believe what I had just heard and that it took so long for someone to notice. I didn't know enough then to think to say something myself to the nurse and she did try to make me as comfortable as possible during the process.

As I mentioned before, my husband is a Marine so he was my only support person. He went down to the car to get our bags and while he was gone I talked to my mom on the phone while breathing through contractions on the ball. Later, I finally got permission to get in the jacuzzi which I was really looking forward to but unfortunately it didn't help me as much as I expected. It relaxed me between contractions because at this point I was utterly exhasted, but during the contractions it was almost as bad as laying on my back in the bed. While I was in the jacuzzi I came to a rock and a hard place. I told my husband "I can't do this" He encouraged me and told me I could do it and to remember that I didn't want any pain medication. I told him "I don't want an epidural I just want to die." I realize this statement seems dramatic but I think most, if not all women get to this point during labor. I had mentally prepared my self so well for a natural birth that the epidural was not even a thought in my mind, although that's what my husband thought I was referring to. I was just in so much pain and so tired I didn't know how I could carry on. But of course I did, one contraction at a time I got through it. One thing I had to remember is that it wouldn't last forever.

Eventually, I decided to get out of the jacuzzi and try something else for relief and shortly after I started going into transition, the most painful and intense part of labor. The contractions were increasingly difficult to breath through at this point and my back labor was excruciatingly painful. My nurses and husband were massaging my back, which I wouldn't have survived without, during my contractions. If they weren't already massaging I would grab the nearest hand I could find and press it as hard as I could into my lower back because it was the only thing that helped whatsoever. The contractions became so long and close together I had no break in between. The nurses were trying to take my blood pressure and were waiting until a contraction would end to check it but right as one started fading away, another would pick back up. I was feeling helpless and honestly terrified of the pain every time a contraction would pick up. The pain would start in my lower back and wrap itself around my body, tightening more and more until I felt like I would burst. I think if I had the strength to I would have cried.

At that point, I started feeling an urge to push which was truly unbearable at that point. Since I had the urge they checked my cervix which to my dissapointment was only 6cm! My husband told me "You're so close, you're almost there" but in my mindset I felt like it would never be over and couldn't understand why he would say that.

The nurses and my husband helped me get into different positions that might help ease the pain but nothing gave me relief anymore and the urge to push was getting stronger, my body literally forced me to push. There soon came a point when I couldn't change positions anymore because my contractions paralyzed me they were so strong. For a long time, I was stuck with one leg standing on the ground and one leg on the bed because while trying to climb in it, I was unable to move through back to back contractions. At this point I also ripped off my hospital gown because it continued to fall off my shoulder and the feeling of it hanging on me was extremely annoying and uncomfortable. I didn't have a care in the world who saw me naked and it was truly the last thing on my mind at the time. When I would get a short break between contractions, I hurried into a postion I was trying to get to before a contraction would start and leave me stuck.

As I was getting onto my side in the bed, my midwife noticed I was crowning, picked up my leg (I was still on my side which was the best position for me at the time and I couldn't even move if I wanted to) and she told me to just do what my body was telling me to do. So I pushed through the pain, exactly like they say, and after being exhasted through the labor I got a huge adrenaline rush while I was pushing. I pushed with all my strength. I even got mad when my contraction would fade away because I just wanted to keep pushing so it would be over. While pushing, I told my husband "I'm doing this, I'm actually going to do it." The reality of it all was just starting to hit me.

In about 5 contractions of screaming and squeezing my hubby's hand (poor guy, he said he almost cried he felt so bad that he couldn't help me) I delivered a perfect little baby. Lily Elizabeth. 6 lbs 3 oz 18 inches long. When she was finally out, the most euphoric feeling overwhelmed me. There was suddenly no more pain, and the room was completely still and quiet. I looked up and saw my midwife holding up my baby and she layed her on my chest. She came out with her hands by her face which tore me a little but I got two stitches and couldn't even feel it being done while I was on cloud nine holding my baby girl. It was the most empowering and beautiful experience of my life and I get teary eyed just thinking about it.

After I gave birth the nurses and my midwife were just in awe that I had actually done it. They kept saying how amazed by me they were and asked when I was going to start teaching a childbirth class at the hospital and saying "You were made for this!" They made me feel so good about myself but I did it for Lily and it was completely worth it. In fact I wish I could do it all again just to experience that moment of seeing and holding her for the first time all over again.

Lily latched on within minutes of her birth which was another new and beautiful feeling I can't find words to describe. She was so beautiful and perfect. My husband and I were both in tears as we met her. We were, and still are, simply in awe of her.

Since posting Malachi's birth story, I have had a lot of requests to view my birth plan. So here it is! Here's how I came up with it:

I started by doing a Google search for "natural birth plans". I came across a birth plan from "Earth Mama Angel Baby" that had a lot of the options I was looking for. I filled it out, saved the document, and printed it. I was looking it over, and I felt like it had to much "junk" on it: things that I just really didn't need that made it look longer than it actually was, and less professional. I wanted something nice and simple for my doctor to quickly look over. So I copied and pasted the parts on there that applied to the doctor on to a Word document. I also added a few things.

After my prenatal appointment where I went over everything with him, I decided I really liked the idea of having a plan that just applied to him and I wanted to expand that for the rest of the staff. I figured I'll have a better chance of the busy hospital staff reading my plan if it was simplified and broke down into categories that just applied to them. I also wanted "baby care plans" to hand to every single person that walked into our delivery room to make sure they all knew what not to give our baby that is routinely given. (My third baby was given a vitamin K injection when I didn't want it because the nurses handling her didn't know our plan as everyone was focused on me since I had some problems after delivery.)

After I did all that, I wanted something explaining to the staff that they didn't need to read the whole thing and to share a few kind words. I didn't want to come off as having an attitude. I just figured a nice introduction and a few compliments couldn't hurt! So I made a cover letter to go with my plan.

I haven't seen a birth plan like mine, and I'm pretty proud of it! I hope it'll help you make a layout for yours and you have as much success with it as I did!

Cover Letter for my birth plan:

Birth Plan for Jessica Mehu

Husband’s name:

Address:

Phone:

Doctor:

Due Date:

Thank you for looking over our birth plan! I tried to make it simple and quick to look through by breaking it down into categories, so each staff member can just look at the areas that would apply to them. I am flexible, and understand that lots of things can happen that would change my plans. If everything is going perfect though, I have a few specific wishes and greatly appreciate them being respected! I am a huge advocate of natural birth and hope to have a beautiful, natural birth experience at Allegiance Health! I know from my previous three births that I’m working with a great team!

My birth plan. Each category had a separate page, and I had printed several “baby care plans” out to hand out at delivery. There was a copy in my chart at labor and delivery, and I had a copy with me just in case.

Labor (for L&D nurses):

• I prefer minimal internal vaginal exams or at my request only.
• Please, no residents or students attending my birth.
• I request the following people to be present during my labor and delivery:
  1. Husband (I added names too)
  2. Mother
  3. Friend/doula
• During my labor I would like to use:
  1. A birthing ball
  2. Jacuzzi tub
  3. Squatting bar
• I prefer intermittent monitoring to allow for as much mobility as possible.
• I need to have dimmed lights.
• I need people entering the room to speak softly.
• I would like to wear my own clothes during labor and delivery. (I have a special delivery gown)
• Please do not offer me pain medications. I have been through three induced labors without asking for pain medications.
• I am prepared to handle pain with these natural methods:
  1. Breathing techniques
  2. Deep (or guided) relaxation
  3. Water (soaking in Jacuzzi)
• I need to be able to walk around and move as I wish while in labor.
• Please always keep my door closed while I am in labor.

Delivery (for L&D nurses):

• Please read “Baby Mehu’s care plan” as well.
• I would like to be encouraged to try the following different positions for labor: Whatever feels right at the time
• I would like to have my birth photographed and videotaped.
• My husband and I would like to touch my baby's head as it crowns.
• I prefer to have the lights dimmed for delivery or, if it is daylight, to access only natural light.
• It's important to me to push instinctively. I do not want to be told how or when to push. (I need encouragement, not direction.)
• If there are no problems with baby, DO NOT remove him from me after birth! I wish to bond* with him before his assessments are done (weight, measurements, etc.). Any immediate assessments that are needed can be done while he is on my chest.
• I will be taking home my placenta (Paperwork for this is in my chart). *

*We are delaying the cord clamping and allowing the placenta to be born spontaneously. I would also like to breastfeed him during our first bonding period, so it may be a while until his assessments are done.

Doctor (delivery):

• I would like to be encouraged to try the following different positions for labor: Whatever feels right at the time.
• It's important to me to push instinctively. I do not want to be told how or when to push. (I need encouragement, not direction.)
• I prefer to have the lights dimmed for delivery or, if it is daylight, to access only natural light.
• I prefer to have no episiotomy and risk tearing (unless I'm having a medical emergency)
• To help prevent tearing, please encourage me to breathe properly for slower crowning.
• My husband and I would like to touch my baby's head as it crowns.
• If possible, please allow the shoulders and body of my baby tbe born spontaneously, on their own.
• My husband and me would like to help "catch" our baby.
• Please wait for the umbilical cord to stop pulsating before it is clamped.
• I would prefer for the placenta tbe born spontaneously without the use of Pitocin, and/or controlled traction on the umbilical cord.
• I do not want Pitocin to be given unless there are signs of hemorrhaging.
• I will be taking the placenta home. (Paperwork for this is in my file)
• I would like baby to be held by either me or my husband while doctor is finishing up with my needs, and then for baby’s assessments to be done (any immediate assessments can be done while he’s on my chest).

I understand that if there are any medical issues that arise during the birth that some of these requests would not be safe. This is what we hope for if there are no problems. We want this to be a special, calm experience for all of us. Thank you for respecting our wishes and helping us achieve the birth experience we’re hoping for! It will never be forgotten!

If a C-section is needed (for doctor and staff):

• My husband is to be present at all times during the c-section.
• I would like to remain conscious during the procedure.
• I would like the screen lowered a bit so I can see my baby being delivered.
• I need to have immediate skin to skin time with baby placed on my chest after delivery (even before the surgery is complete).
• I need to have contact with the baby as soon as it is possible in the delivery room.
• I will need my hands free to touch the baby.
• I would like for the cord to be clamped after it is done pulsating
• We would like to photograph or film the operation as the baby comes out.
• I need to hold my baby and nurse it immediately in recovery.
• I will sign any waivers necessary to permit me to be with my baby in recovery.
• As long as my baby is healthy, my husband will be the baby's constant source of attention until I am free to bond with him (i.e., holding, skin-to-skin contact, etc.).

Baby Mehu’s Care Plan (L&D nurses and anyone that will be caring for baby):

• In the past I have had problems because of shift changes and multiple people stepping in and out of my room not knowing our plan for baby. I’m hoping to avoid this with a care plan for our son. We greatly appreciate our wishes being respected and followed. (I am willing to sign a formal waiver for any of this.) Thank you very much!!
• If there are no problems with baby, DO NOT remove him from me after birth! We need to bond with him before his assessments are done (weight, measurements, etc.). Any immediate assessments that are needed can be done while he is on my chest.
• I would prefer for his assessments to wait until the doctor is finished with me, so I can focus on baby during his assessments. (My husband can hold him during this time if I’m in to much pain to hold him.)
• We are DECLINING eye ointment AND Vitamin K injection. (I would like only the orally administered Vitamin K to be given to my baby.)
• Baby will stay in the room with me throughout our stay.
• I’d like all newborn procedures to take place in my presence.
• My husband is to stay with the baby at all times if I can't be there.
• We prefer for his bath to be done in our room. If this isn’t possible we will bathe him.
• He is exclusively breastfed. NO bottles.
• Please discuss with me everything you need to do with my baby before doing it.
• I’d like my other children brought in to see me and meet the new baby as soon as possible after the birth.

Thank you!

Postpartum Care:

Mother:

Father:

Baby:

• Malachi is exclusively breastfed. NO FORMULA or any artificial nipples.
• We will not be receiving any immunizations in the hospital. (No Hep-B).
• We are not circumcising our son.
• Baby will stay in the room with me throughout our stay. I’d like all newborn procedures to take place in my presence.
• My husband is to stay with the baby at all times if I can't be there.
• My husband will be staying with me for the duration of my hospital stay.
• I prefer that my hospital stay be as short as it can be.
• I have three beautiful little girls that will be visiting throughout our stay.

Thank you very much!

In between contractions I had Marcel set up our video camera on a tripod because I wanted the whole birth process captured; everything that was said, every sound, everything. It was hard for him because I needed him right there with me through every contraction, so he had to run back and forth to set it up!

8:45 pm The doctor is here!!

I remember so clearly the moment he walked in the room. I could smell him before I even heard his voice (he wears very strong cologne!) and I was instantly relieved! I said,

“You made it!” and I must have had the biggest smile on my face. He said he had a feeling I’d have this baby in the next day or two, and I reminded him that I told him I wouldn’t have this baby when he was on vacation! There were a lot of smiles and laughs and I felt very safe and secure. He asked if I was ok with him checking to see where things are at and possibly breaking my water and I said that’s fine. He said after that I can get in the Jacuzzi or back on the birth ball; whatever I feel like doing. He estimated I was about 6.5 cm along now. I told him I was feeling rectal pressure. He said, “Well maybe you’re a little further along…” He reassured me that he reviewed my birth plan again and is on board with everything.

I climbed on the dreaded bed and lay down so he could check my cervix. That hurt bad. I didn’t like lying down at all, but I was ok with him checking me so it was fine. He patiently waited through a contraction so I was comfortable. He said, “Well that’s why you’re feeling so much pressure… you’re about 9 cm dilated and at about a +1 station!” Haha, I knew it! He broke my water which I was totally fine with and guessed with me about how many more contractions I would have till we had a birthday.

I was smiling, everyone was laughing and joking, it was so fun. He complemented me with how well I was in control. The lights were still turned down like they were the whole time, and I felt so powerful, happy, and peaceful. He asked me what I wanted to do now, giving me some off the bed suggestions, but I just wanted to stay where I was for the time being. He just said no problem, do what I need to do and he’ll just be hanging out here doing his “doctor thing.” I was told by the photographer and my husband that it seemed like he was meditating or sleeping on his stool, just hanging out with us. (I guess this was in between all his funny jokes… he had us all laughing and I still laugh when I watch the video, which I had Marcel start when I was lying down for the exam and we taped all the way till a couple hours after birth.)

The contractions were so very intense. After maybe two contractions after he broke my water I felt a small urge to push but fought it. I told him I felt a little pushy with that one and was holding back. He didn’t do anything about it, which is what I wanted, but I found myself a little scared to push without being told I’m complete and can push. It was amazing. Here I had researched so much about trusting my body and listening to my instincts and there I was, looking for direction to push! Thankfully the doctor knew my plan and just left me alone.

So I was searching for the strength to listen to my body and trust my ability to birth this baby without a doctor’s direction. It did take a few contractions to get there. It felt like forever, but realistically I think there was about 10 minutes of contractions with no urge to push. I realize now this was the time it took for me to gather myself and follow my body’s direction. I reminded the doctor not to clamp the cord right away, and he said absolutely and he didn’t forget. It was like I was making sure everything was perfect and in order before I brought my baby earth side. I still didn’t fear each contraction like I did with my other labors. They did hurt and were very intense, but I was aware of everything going on and felt like I was in total control of everything. It was an amazing feeling, especially knowing how close I was to giving birth, and still felt so calm and secure.

The doctor told the nurse to remove my contraction monitor because he could clearly see when I was having a contraction. I laughed.
I remember clearly the moment I realized I wanted to raise the bed more. I realized I didn’t want to give birth on my back and that’s exactly how I was at the moment! So I put the back up a little at a time. Every time I raised the bed, I had more pressure with every contraction and that urge to bear down was coming back; only this time I felt ready for it. I didn’t feel the need to strongly bear down, but I liked the feeling and wanted to continue letting my body bear down on its own. It felt great. I was grunting through the contractions and toward the end of them quietly moaned “oh yeah” because just felt awesome!

The doctor, who was still leaving me alone, could tell I was getting close and started getting things quietly ready. He said he had a feeling that when it’s time this baby is gonna get here like “gang busters” (whatever that meant!) so he wants to get ready. He told me he wanted to eliminate some of the chaos by not breaking down the bed, but instead we can just lower the foot part of the bed (as a precaution in case he needed to do something with the shoulders) and he tucked in the bag to catch all the “shtuff” under my bum.

My grunts were getting pretty loud and the nurse asked if I felt like I could push (which I ignored because I didn’t want to hear that). The doctor quickly corrected her and said my body is naturally bearing down right now and he thinks baby’s head is “right there”. A couple contractions later he checked to see if he was right, and he said “oh yeah, the head is right there”. He asked if I could move my bottom to the edge of the higher part of the bed. When I did that I couldn’t lean on the back of the bed anymore so I was straight up in a squat and held myself up with my arms off the back of the bed, and my feet were on the lowered part of the bed. I had one contraction in this position and it was the first and only one that I felt a strong urge to bear down with and it was the most amazing, powerful, and gratifying contraction I have ever had. I could feel his head moving down as I pushed and he was right there, and I did all of this on my own, with no I.V., and everything was going exactly as I had hoped, and it all lead up to that moment. I felt like I was a goddess and could conquer anything. I was moaning very loudly, screaming “Oh yeah” over and over. If anyone heard me in the hallway, they must have wondered if I was having a baby or making love. It was the most empowering moment of my life and also brought my baby’s head low enough to see!

That baby was right there, ready to greet the world. The doctor wanted to follow my plan of having my husband help with the delivery so he had him get gloves on and told me I had to lay back some if I wanted him to help. I really did not want to do that, and it hurt to lean back, but I really wanted Marcel to have an active part in receiving our son. As a struggled to lean back, I heard the nurse say to someone “no one can come in right now, she’s in the threshold!” I yelled, “who is it?!” and heard my mom say “it’s your mother!” I knew how badly she wanted to witness his birth, so I said, with much relief and shock that she made it in time, “she can come in!” I told her where to stand and with that hit the crowning contraction.

Now that did hurt, really bad. I screamed because that ring of fire was SO intense! I recognized that this was the crowning ring of fire so many women talk about (not sure why I didn’t notice it with my other births… maybe because I wasn’t as aware of what was going on?) and said, “he’s crowning isn’t he?!?” I heard everyone say “oh yeah, he’s right here” and specifically remember Marcel looking up at me and saying “he’s right here baby!” and that was so comforting.

The next push I birthed my son's head into my husband’s hands. Again, everyone was talking, but what I remember is seeing Marcel’s face. He kept me centered through the pain. He was so amazed and excited and said “Oh my God, oh baby, here he is!” I tried looking down so I could see him, but I couldn’t see around my belly. I’m so happy that I was so conscious and aware of all this and I think it’s so amazing that all I remember is Marcel. It felt so natural to have him down there telling me what was going on and encouraging me. I think God meant for it to be this way; for the father to receive his child and be involved in the birth in this way.

Then doctor told me he needs me to push again for the shoulders. I didn’t feel the urge to, so I asked if I had to do that right now. He said yes he needs to get this shoulder out, and I knew this was a crucial time and trusted him (I found out later that one of his shoulders came out with his head, something that we had discussed prenatally as one of the reasons he’d tell me to push the shoulders out without the urge to do so) so I pushed as hard as I could and ouch did that hurt! I never had pain when I birthed my daughter’s shoulders, but this boy has some broad shoulders!

9:16 pm I heard everyone say “here he is!” and I opened my eyes and saw Marcel handing my beautiful baby boy to me! I immediately said, “Oh sweetie, oh baby, oh my God, hi sweetie” and fell completely in love.

Words just can’t describe this moment. I’m so thankful for these pictures though, because my photographer perfectly captured this moment for us and they perfectly show how I felt! I was laughing and crying and felt like I was floating on a cloud.

I cleaned off Malachi’s face while I was in awe at my beautiful baby that I birthed, after months of growing him inside of me! I did it! I felt so strong and amazed at how perfectly my body created this child and brought him earthside and so thankful to God for giving my body this ability!

Just a few minutes after he was born, the cord stopped pulsating and the doctor asked me if I wanted to double check and make sure I didn’t feel any pulsating. I enjoyed feeling the cord, and it was indeed done, so Marcel cut the cord.

Aside from the nursery nurse checking his breathing and putting on our bands, no one touched him. No one took him from me at all, just like I stated in my plan. There was no resistance or problems with this. No one even tried to take him.

Malachi was so calm and peaceful in my arms.

This image is very powerful to me. This was the first birth my mother was able to witness, and I love how she looks over at our initial bonding, looking so satisfied and happy for us.   Pure, raw, excitement and joy!

I was so happy to be able to kiss his sweet head before he was cleaned off and handed to me like a little burrito.

Look how excited the RN was for us… The only people in the room during his birth besides Marcel and I were my birth photographer, my mom, my doctor, the RN and LPN who was aware of our birth plan, and one nurse from the nursery that was told to read our plan as well. We had no need to give anyone else our “baby care plan”. Everyone knew exactly what we wanted and followed it perfectly. If there was anything they weren’t sure of, they asked. Everyone was very respectful of our needs. Once the placenta detached and delivered, the doctor worked quickly to finish up so he could get out of our way. He checked me for tears, thinking I might have torn more since Marcel delivered the baby, and I only had a small skid mark in the perenium area. After numbing me up really well he gave me a couple stiches, made sure the nurses knew what we were doing with our placenta, gave us tons of congrats, and had the nurses turn off the overhead light so we can peacefully get baby to the breast.

9:30, less than 20 minutes after birth, I was able to breastfeed my baby. He hadn’t even been weighed yet!

The nurses would check in on us to see if we needed anything, and to monitor my bleeding and blood pressure.

He latched on perfectly, and stayed on for an hour!

The nursery nurse told me to let her know when I was ready for her to do his assessments and said she can just do his bath at the same time. I let her know I just wanted his hair washed with my baby wash, and she said that was no problem.

Enjoying my calm, peaceful bonding time!

At 10:30 the girls meet their baby brother! (He still had not left my arms!) He was so alert and peaceful, as soon as they stood next to the bed and he heard them, he turned to look at them and checked them out. A beautiful sibling bonding moment!

Proud daddy!

Photographer momma… haha

Malachi decided an hour wasn’t enough time to eat… so he nursed on the other breast for another 45 minutes!!

After the girls left I was so curious about how much he weighed, so I paged the nursery nurse to come in and do his assessments.

She came in around 11:30 pm. He was so content and peaceful he didn’t even fuss while she was checking him out, and I was able to watch and focus on him.

He weighed 8 lbs. 14 oz.! (Notice he’s still not crying)

His head was 14 in. around and he was 21 in. long

Happy baby getting his hair washed with momma’s organic baby wash.