ivan's birthstory

A few days after Ivan's birth, our doula Victoria Macioce-Stumpf presented us with this wonderful birth story. It's long, and covers Ivan's birth in careful detail. It may not be everyone's cup of tea, but we find it fascinating (of course!) and are so pleased to have it. So here it is, in a slightly abridged form. Enjoy!

"Do you know how you were born? Have you had the opportunity to talk to your mother and your father about the story of your birth? In many cultures, children grow up around birth, and it’s a familiar event in their lives, and they know the story of their birth. It’s such an important story..."

"It takes a lot of courage to look at what we’ve been told by our culture, by our friends, by our family, and the kinds of experiences that we have personally been through and that our children have been through, and to question ourselves and ask ourselves if things might not be better another way." - Giving Birth: Challenges & Choices by Suzanne Arms

1. BEFORE LABOR

Overall, Audrey had a fairly healthy and uneventful pregnancy. Around the beginning of her 3rd Trimester, however, she developed Gestational Diabetes.

Audrey and Adam did a great job of educating themselves about her condition and Audrey was very diligent in watching what she ate so that her condition would not worsen. She also received non-stress tests twice a week for the final 5 weeks so that her medical caregivers would be reassured that the baby was doing well.

By 40 weeks, Audrey’s midwife and back-up physician began to discuss the possibility of artificially initiating labor medically if things didn’t start on their own. Once again, Audrey and Adam educated themselves about what their options were.

At 41 weeks exactly, Audrey agreed to have an ultrasound so that an AFI (Amniotic Fluid Index) could be obtained. This was to determine if the amniotic fluid levels were still at a good level even though Audrey was now past her due date.

Unfortunately, the amniotic fluid level was determined to be quite low, so the midwife decided a medical induction was the best course of action. Audrey and Adam went home to get their labor supplies and eat lunch, then returned to Providence Hospital for a medical induction.

2. LABOR BEGINS

At approximately 7:00 p.m., an I.V. was initiated, and Pitocin [an induction chemical] was started as well. Because the Pitocin was going to artificially bring on uterine contractions, a continuous Electronic Fetal Monitor was also kept going as well. At this point, Audrey’s cervix was dilated approximately 2 centimeters and was 80% effaced.

Adam called me [Victoria, the doula] periodically with updates on what was going on with Audrey. We had several good discussions so that Adam felt that all of their options and alternatives were still available to them.

At about 2:30 a.m., Adam called me because he was concerned. The midwife wanted to perform an amniotomy, which would rupture the bag of waters that surrounds the baby. They had hoped to avoid this intervention if possible. The midwife and back-up physician’s concern was that the Pitocin had been going for over 7 hours and there had been no changes to Audrey’s cervix.

Adam and I talked extensively about Audrey’s options. I encouraged them to wait, if possible, because once her membranes were ruptured, she would be held even more vigorously to a timetable to give birth. Adam hung up when the midwife returned to continue the discussion.

Ultimately, the decision was made to wait on the procedure and for Audrey to rest further.

At approximately 6:30 a.m., the amniotomy was performed. At 7:10 a.m., Adam called me to update me once again and to ask me to come to the hospital. Audrey’s contractions were now every 3 minutes and were beginning to hurt. She was 3 cm. dilated, and the baby was at a -1 station.

I arrived at Providence Hospital at approximately 8:15 a.m.. Audrey was sitting in the rocking chair and coping beautifully with every contraction. Adam eventually got to go eat breakfast now that Audrey had some extra help. While he was gone, Audrey and I worked together through each contraction. Audrey was simply amazing. She relaxed very well with each of her contractions.

Audrey’s blood sugar level was checked again at 9:30 a.m. and was found to be in the normal range. At this point, Audrey’s midwife, Joan Lynn, did a final visit before leaving for her vacation that day.

3. ACTIVE LABOR

Adam was back from breakfast and was there for Joan’s visit as well. Once Joan left, we continued with what we’d been doing...helping Audrey cope.

Audrey was doing a marvelous job with her labor. She relaxed beautifully and allowed her body to work as efficiently as possible, even though the contractions were beginning to be quite intensely painful. She tried coping by sitting in the rocking chair, sitting on the birth ball, standing and swaying, and laying on her side in bed. Throughout, she found touch, massage, the scent of massage lotion, breathing patterns, music, dim lights, staying hydrated and Adam’s verbal encouragement to be soothing during contractions.

Adam encouraged Audrey with love and kisses before and after each contraction. Things were getting quite intense. Our nurse Katie stayed with us almost continuously from this point on. Audrey decided to try the Birth Ball. Adam would wrap Audrey in a hug during each contraction in this position as he sat behind her in the bed while she sat on the Birth Ball. When Audrey sat in this position, it gave her back pain relief, but it made it difficult for the Fetal Monitor to read the baby’s heartbeat. Katie was very gracious about not making Audrey change her position, but instead sat beside her and followed the baby by hand for close to an hour.

Eventually, the suggestion was brought up that an Internal Monitor would be more effective in capturing the baby’s heartbeat. I encouraged its use as well, because then Audrey could be more flexible and labor in whatever position she wanted without someone fiddling with the Fetal Monitor at all times. Audrey and Adam discussed it further, and the decision was made to use it.

The contractions continued to pick up in intensity. Audrey began to cry in pain during many contractions. She knew she was doing all the right things, but her fatigue and the intensity of the pain were wearing at her. She was worried that she still hadn’t made any progress and that if things were this intense and she was only 3 or 4 centimeters, she wouldn’t be able to cope if became any stronger than what she was already dealing with. Adam and I tried to verbally encourage her, but we couldn’t know for sure that she was in Active Labor, although we both certainly thought she was. Without an internal exam, we could only encourage her that everything was unfolding smoothly.

At 11:00 a.m., the decision was made for Dr. Thai to examine Audrey. She performed an internal exam and announced that Audrey was now 6-7 centimeters! We were all quite jubilated, because this was the proof that we were hoping for...all of the intensity was because Audrey was in strong Active Labor. Everything was going exactly as it should.

For Audrey, however, it was very intense. She was in a fog of pain. She would ask questions that had already been answered because she was so fatigued and in such pain. She wanted me to spell out for her every step that was coming. She was still worried that things weren’t happening fast enough. She was in "Laborland"...a description that details how women lose themselves into the experience of coping in labor, mentally blocking everything out but the job of coping with contractions.

After being examined, it was decided that a hands and knees position leaning over the top of the bed would be easier for Audrey. She initially found this quite painful, but with Adam and I massaging her during and between contractions, she began to relax again and coped beautifully.

At 11:20 a.m., Katie (the nurse) decided to examine Audrey because she could hear the pressure to push in Audrey’s voice. She was 9+ centimeters! There was now only a small rim of cervix left before Audrey would be pushing.

4. PUSHING

"Unfortunately, we live in a country that doesn’t value pain. And many cultures do. We know that pain is a state of mind, just as pleasure is a state of mind. And we can’t suppress one to the exclusion of the other. Childbirth holds them both side by side. And when a woman bears her pain~ which is not impossible to do~when you create an environment of love and support around you....labor itself is very copeable" - Roxanne Potter, CNM

Audrey felt quite a bit of pressure and began bearing down with the urge at every contraction. By 11:35 a.m., Katie had examined her again and pronounced her completely dilated! She then asked the Nurse’s Station to page Kathy Brown, the midwife that was filling in for Joan.

Audrey began bearing down while in a hand-and-knees position on the bed. It wasn’t long before we could see a little bit of the baby’s head. By this time, Kathy had arrived and the room was set up and ready.

Audrey ended up pushing on her hands-and-knees, side-lying on both her left and right side and on her back. For the most part, she pushed on her left side. Towards the end of 2 hours of pushing, the baby’s heart rate was declining while she was pushing, so Kathy would have her take a "rest" every other contraction and let the baby’s heartbeat rise again. Adam and I kept cold washcloths cooling Audrey throughout this time.

5. BIRTH

Finally, Kathy decided to have Dr. Thai in the room in case the baby was truly distressed or if there was any further difficulty. Dr. Thai arrived and prepared for the birth. She and Kathy worked together. A decision was made to perform an episiotomy to make more room for the baby.

Adam was very excited and enthusiastic as each push brought more and more of Ivan’s head down and he could see the visible progress. He lovingly encouraged Audrey to keep going.

At 1:37 p.m., Ivan was born.

Audrey and Adam were ecstatic. There were tears of happiness and joy when their son finally joined them. Ivan weighed 8 pounds, 4.3 ounces. and measured 20 inches long.

He is a very lucky little boy to have two such wonderful parents. May he always be so blessed.

Warmest regards,
Victoria Macioce-Stumpf, Doula

Photos by Alex Lumelsky

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"Audrey relaxed beautifully and allowed her body to work as efficiently as possible, even though the contractions were beginning to be quite intensely painful."

"We were all quite jubilated, because this was the proof that we were hoping for."

"Audrey was in 'Laborland'... a description that details how women lose themselves into the experience of coping in labor."

"Adam was very excited and enthusiastic as each push brought more and more of Ivan’s head down and he could see the visible progress."