The Induced Birth

My client was 41 weeks when I received a frantic call following her nonstress test earlier that day. Due to some concerning results, she was being transferred out of the midwives’ care to the hospital for an induction under their partner OB/GYN. They had been planning a home birth, so this drastic change to a medicalized induction was far from what they wanted. All of their planning was washed away, and they were now left to navigate very unfamiliar waters. I later learned that once a client is transferred out of care prior to starting labor, the doula intern doesn’t have to accompany them for further labor and delivery as we are employees of the practice. However, in my eyes, they had lost their midwives, their home birth, their entire plan and I felt that something needed to remain constant. I helped them pack up and we all headed to the hospital in the evening to begin the induction.

Over the span of the next 40 hours, I saw the whole spectrum of interventions. Lorri Walker, the CEO and Head Baby Catcher at SCM, calls interventions the snowball effect- they just keep building up. And boy, do they ever. Foley bulb induction, to artificial rupture of the membranes (increased risk of infection now), to non-progressing/ineffective contractions, to Pitocin, to an epidural, to constant fetal monitoring, to antibiotics because now mama had a fever. There were other steps along the way, too numerous to count, and probably most we all wished could be forgotten.

After 2 nights of no sleep (aka 41 weeks + 2), I felt that there was no end in sight. Please, please, I thought to myself, don’t let this end in a c-section. That was all I could hope for by the second afternoon, as I groggily gazed out the window to the gorgeous view of Newport Beach. I felt like we were fighting against that snowball, which now felt like an avalanche. It was my only goal for her, and all I could do was feed her courage and reassurance. Yet, the time came- 10 cm dilated and time to push. Despite having no feeling below the waist, my client found that beautiful, effective push. Forty-four hours after arriving to the hospital, she pushed her baby out. Nobody knew the gender prior to the birth, and during the span of our stay I had changed my mind from predicting it was a boy to a girl:

“Seeing how stubborn this baby is to come out, I’m thinking she must be a girl now!”

Sure enough, a baby girl was born. No less than 15 people were there in the room, armed for every bad scenario possible. However, that little girl cried out all on her own and her mother and I burst into tears. I cried so hard for them, grateful for the long road to have ended so happily.

This was a such a challenging birth for me. I felt stuck between worlds- the doula world with clients who hated the healthcare system and needed an advocate, and my soon-to-be-world of nursing, which recognized the procedures of the hospital, and empathized with the nurses’ normal duties. I toed the line, prompting my clients to ask questions and evaluate their options, while also helping them process the realities of birthing in the hospital, and specifically, as an induction. With the valid medical concerns present, there really wasn’t much room for choice; the interventions were necessary based on the results of the NST. This was a hard reality for them to face, but one they needed to if they were going to let this birth continue joyfully, or be weighed down with stress and conflict. I tried to validate their feelings of disappointment, while helping them release these sentiments and adjust their expectations.

Did the sight of a healthy baby wipe away the disappointment of the birth story? No, I don’t think so. For some people, I’m sure it would have. It didn’t even wipe it away for me, despite my obvious joy and relief. Who knows how it would have turned out if the NST was normal and they labored at home- would she have been slow to progress? Would she have gotten exhausted? Would the comfort of her home and midwives spurred a faster labor? All questions we cannot answer. Yet, the story does matter to me. How she will remember the birth matters- we have only one chance to support the mother in her amazing feat. I hope she will remember this birth the way I do- with fierce determination, courage, and teamwork.