Do you know what it means for me as your doula to be on call for you? It means: backup plans for my work and fun outings both -- it means people one step removed from me having to have backup plans for if I can't show up. It means not being able to go on family vacations, saying no to camping trips that are out of cell range, lugging birth supply bags in and out of the car day after day when I go to town just in case I get the call so can drop everything and get to my client quicker. It means carrying 24 hours worth of food and water in case I'm stuck at a long birth where I can't leave my client even for a minute. It means not knowing if I get to sleep through the night. Living in limbo about where I'll be tomorrow.

​It means friends and family knowing birth comes first for me. It means wolfing down Thanksgiving pumpkin pie sitting in a bathroom while watching a woman push outside the door (because I finally got a breather with care providers stepping in after hours of my support). It means spending my own birthday welcoming a new little soul into the world, or missing one of my family member's birthdays entirely. It means keeping my pro CPR license up just in case I am needed to step outside my scope in an emergency to give a breath. It means constantly checking my phone to make sure I didn't miss a call from a client going into labor.

And when I go on call two weeks before a due date, with just 2-3 births a month my life can look like this much of the time. This is what you pay for when you hire a certified birth doula. Experience. Devotion. Just peeling the window back from my professional veneer to get real with you. This is the on-call life. And it's worth all the sacrifice to have the honor of standing by your side.

Heather hired me after sharing the story of her previous birth and knowing she wanted something different this time. With her firstborn, she labored sitting rigidly in the hospital bed gripping the rails with white knuckles the whole time. She described the contractions as intense and overall it was an unpleasant experience.

As I started talking with her and her partner in our initial consult, I explained the fear, tension, pain cycle, and how we can actually decrease pain in labor by breaking that cycle. I shared with Heather and her partner how I like to join my clients in their home if possible before going to the hospital so she could let early labor blossom in the comfort of her own nest. I described how birth is a lot like getting a cork out of a bottle--you and baby both have to wiggle back and forth, so moving during the contractions can be a helpful coping technique. It was like a lightbulb went off in Heather's head as she realized how different things could be this time around. They hired me on the spot, and we began to prepare for the birth three months later.
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When the day rolled around, Heather contacted me in the evening and let me know that contractions were 8 to 13 minutes apart. I suggested she get in a warm bath and see if contractions continued (a good way to tell if this is labor day or if it will peter out). They continued, so I headed out and arrived at their home at 9 p.m. to see her sitting on the edge of her bed with contractions coming much closer together. She looked at me with fear and disappointment in her eyes and said, "I'm just falling right back into the same tension habits! It's going to be the same as last time!" 

"Oh no it's not," I encouraged her, "we just need to help you find your rhythm." I jumped right in, coaching her to let every muscle relax into the next contraction. That made it feel more manageable, as did standing, leaning into the wall and swaying her hips. She remarked on the noticeable difference. 

We utilized a lot of different positions at home, giving baby every chance to get into the best position possible for birth. Heather found lying down to be a good spot for releasing tension and breathing through the contractions.

Finally, at 11 p.m., Heather said it was time to go to the hospital. Her partner had been running around loading things in the car, and helping put their firstborn to bed for the grandparents. In such situations, it really takes pressure off for dads to know that mom is supported by a doula who is totally keyed in on her needs. 

​Breathing through a contraction on the way to the car...

Before heading out, I pulled the dad aside and gave him my typical spiel, that this was not an emergency, we had time, so to drive safely to the hospital and watch out for deer (instead of recklessly like in the movies). He wasn't certain which door was the hospital night access once we got there, so it was decided they would follow my car. As soon as we got going, I regretted my words. I drove the speed limit, but way behind me, creeping slowly along at 40 mph. was their car. "Come on! We've got a baby on the way!" I thought to myself, picturing Heather saying "go faster" and him arguing, "but Melanie said..." Finally we got there, and I heard the real story. At every crack in the pavement, my client was saying, "careful! slow down!" Phew. At least we made it before she started feeling pushy.

We were able to establish a good coping rhythm by laboring at home first, so once at Mercy Regional Medical Center, we fell right back into that rhythm. Checking in at 8 cm. dilated was perfect for staying in the zone. My client was oblivious to the monitors; she was totally focused on staying relaxed, and connected with her baby. You can see dad doing the hip counter pressure here that helped relieve intensity. And notice mom's relaxed hand here compared to last time when she gripped the rail with clenched jaw.

Before an hour passed, it was time to have a baby! The obstetrician suggested breaking her water, but Heather had that happen last time and it made things much more intense for her (by removing the cushion between baby and the pelvic bones). She didn't like it, so this time she looked to me. I stayed quietly supportive, knowing she knew just what she wanted to say, and she got to take the reins and ask the Dr. if it would be ok to let the water break on its own. And break on its own it did! With a waterfall upwards! 

Baby Eva was so big, it made the victory celebration all the bigger--9 lbs., 6 oz! 

Look at how big Eva is. She's the size of a three month old! 

The night before Sage's mom went into labor, her water broke. She tried to get some rest even though there was so much excitement and so many unknown possibilities on her mind. After a few hours, contractions started. By morning, they were 12 minutes apart and 44 seconds long. Finally, 12 hours after her water broke, my client decided it was time for her to go to the hospital, where I met them. After monitoring baby for a while, the nurses released us to walk around in order to encourage contractions to pick up even more. My client was hungry, so her feet led her to the cafeteria to fill up on strength for the marathon to come.

Contractions down the hall, contractions while picking out food that might be appetizing. Stopping and breathing through each. So much excitement. This was finally the day we had talked about together for the last seven months since I came on board the team!

Pacing hallways, walking stairs. Always counting on her man to be there to support her when a contraction came. 

Back in the room, essential oils wafted through the air. 

Sitting on a birth ball by the bed for a few contractions so the nurses can have baby on the monitor, the sun streaming into her face, giving her strength. 

Focusing on relaxing every muscle, breaking the fear > tension > pain cycle. 

The squat bar can be a helpful tool to use during the pushing stage even if a woman ends up in a different position to actually deliver. Use gravity to help move that baby down! 

And then lean back and totally rest in between contractions. Good time for a quick monitoring of baby's heart. Baby Sage was strong and ready to come out of this beautiful henna-decorated belly to meet her parents.

Dad cutting the cord...

I get that women are amazing, but come on, how do you look this beautiful (below) only an hour or two after pushing a baby out of your body?! Maybe it's the endorphin high from having natural birth, or maybe it's that stunning gown. I think it's a woman who has just locked eyes with her destiny--motherhood.

The strong arms that supported mom in labor will now be there for you,
​little girl, throughout your life! You are blessed with a good daddy.
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Congratulations to my client on facing her fears and turning them into stepping stones that propelled her forward! You guys will be great parents after conquering this rite of passage.

Isabella was brought into the world through a peaceful, natural hospital birth. Yes, it is possible to create your own comfortable, cozy, birthing cave even in a hospital setting. Some candles and a string of lights help with that. 

When I joined my client at home before going to the hospital, I was happy to see that she was in strong active labor, with dim lights facilitating that. Some friends loaned my client a home so she could labor for a bit closer to the hospital than where they live. I love the emblem on the wall that captures that relationship. On the table you can see a jigsaw puzzle that my client picked at in early labor to help distract her mind and save her endurance for the end of the marathon. When we were walking out the door (pausing for each contraction), I quipped, "You didn't get far with that puzzle!" 

After the car ride, it felt so good to my client to lean back in the bed and relax while baby was on the monitor for a bit. Checking in at 6 cm. was a great place to start the hospital portion of this laborland journey.

One nice thing about having SW Midwives as a hospital care provider is that their clients have the option of waterbirth with a big jacuzzi tub that has ideal seating, grip bars, and foot holds.  

Hot water, with cool cloths on one's forehead. Relief at last. 

Digging deep, finding her power to push! A surprise gender reveal was around the corner!

It's a girl!

Below you can see the midwife's hand gently squeezing the cord to see if it is done pulsing. When a baby is born, 1/3 of its blood volume remains back in the placenta. Delayed cord clamping basically gives baby a blood transfusion full of iron-rich stores and stem cells.

Sending out announcements!

Childbearing (the whole chapter: pregnancy, labor, and postpartum) is no picnic, but it is so worth it! Welcome to the world sweet Isabella, and thanks as always to my clients for their willingness to share some of their images. 

I love repeat clients, because of the history we build together. In 2014 I was honored to support Kelsey through Solomon's home birth, and then last year I got to capture memories of their oldest boys' adoption. So they asked me to join them on the journey to expanding their family once again, I was thrilled! Then we found out it was a girl. A girl after three boys!!! So exciting.
​After a long labor the first time around, Kelsey's early labor stretched out similarly this time, but then she was surprised when it kicked into high gear. Active labor went very quickly and her birth team all arrived only a half hour before Sarah was born.

Kelsey got to experience the thrill of catching her own baby (with the midwives right there just in case)!

Midwife Beka Blythe doing a routine check of baby's vital signs.

Look at that vernix! And the cord still connected to the placenta, pulsing the final third of baby's blood volume to her.

I love watching midwives at work when they are pregnant themselves. 

Did you know that both mom and dad doing skin-to-skin with baby not only promotes bonding but also jump starts baby's Microbiome? Baby needs bacteria from her own family as well as antibodies from colostrum to form the beginnings of an immune system.

The three of us, together. Thanks, Beka, for capturing this image.

Witnessing my client's confidence in her body during this birth was such an honor. She was the one in charge, and her birth team was there to offer guidance only if she asked. We held space for her to labor peacefully and to trust the normal process of labor even though it was somewhat different than her previous two labors. It was also very important to her to have her children be able to witness the miracle of birth. Fortunately the timing worked out perfectly for them to not bother her too much in labor but to be present the moment their baby sister came swimming into the world. I was able to jump around in my roles from shoulder massages and comfort techniques to childcare to photography. A lot to juggle, but it worked out! If you want to view the marvels of vernix, a pulsing blue umbilical cord, and a tree of life placenta, scroll on! 

By the way, most people don't realize what Certified Professional Midwives bring to home births. Just out of sight from the laboring mom are oxygen, IVs, shots, AMBU bags, etc. in case they are necessary. Increasing numbers of low-risk moms who choose home birth are deciding that the benefits of being able to labor in one's own environment (with the oxytocin benefit which promotes the progress of natural labor) with a skilled midwife present can possibly outweigh the risks of not having interventions immediately available in a hospital setting. (Here is a study on home birth safety that covered 17,000 home births.)
Pictured here is a typical set up with an oxygen tank, baby blankets at the ready, a bowl for the placenta, and a variety of ice cold drinks.

Essential oils wafted through the room, providing comforting aromatherapy. In transition, my client asked to breathe the blends Transformation and Release.

I love the trickle of water captured in this image. Pouring water over a laboring woman can be a soothing comfort technique.

Me preparing the three-year-old, soon-to-be big sister for what she was about to see. Reminding her the noises mom was making on the other side of the room were good, baby-birthing noises! In a soft voice, I read to her the book On the Night You Were Born while her mom labored away. (Thanks, Joy, for picking up my camera, unasked, and capturing this moment.)

Waterbirth, nature's "aquadural!" The warm water decreases painful contractions, thus the term aquadural. Babies don't take their first breath anyway until air touches the cord (they've been in water in the womb for nine months).

Seconds old:

I absolutely love the image below. Mollie was born with so much vernix (the amazing lotion that keeps babies from turning prune-skined in the water of the womb). It got all over her mom's hands, and I love how this image almost looks sculpted. 

The placenta is an amazing organ. You can see the "tree of life" clearly in this one. Grantly Dick-Read, author of the 1944 book, Childbirth Without Fear, once told one of his patients after handling her placenta: “Madam, when man can make one of these, he will have reached the footstool of the Creator. As I hold this discarded mass in my hands, I am humbled by the limitations of science.”

Joy of Life midwives performing the newborn exam. "Patent nostrils, no hip clicks, normal palmar creases..." I love the gentleness with which they work. When measuring baby, they tell her, "Little one, we have to measure you, but it doesn't matter how long you are. You are loved regardless." A baby's spirit is very receptive to how they are treated in the golden hours following birth. If we want a less violent society, why not start with gentle birth?

Thanks to all my clients who have let me have a window into all different types of beautiful birth experiences. And thanks to those who are willing to share those images.

Did you follow April the giraffe through her long final weeks of pregnancy and watch her birth? There's so much that we can learn and apply to human birth from April's birth (here's the video, with sound). Birth is innately an instinctive primal wild event, but like this situation, most human mamas birth in "captivity" these days (the hospital). As April shows us, it is still possible to have a beautiful birth in that setting, given a few conditions.

#1, #1, #1. PATIENCE! How many humans in April's place would have been induced way before the baby was ready to be born? And then during the delivery itself, how many would have had interventions such as pulling the baby out. Slow birth (as long as there are some signs of progress) can be wonderful and safe. So many moms are focused on having fast labors these days, but they don't understand that often fast labors can be much more intense. Be patient and trust the process even when it stretches beyond your comfort zone timeline (as long as there are no signs of distress obviously).

#2. The keepers in this video are guarding the birth space, not taking over the atmosphere. Notice how quiet the keepers are (and how few of them are present--they easily could have had 30 people in there, but they realized that would not be conducive to labor progress (if you wonder why, look up the Sphincter Law)). No loud chit chat about what they ate for breakfast or April's "failure to progress" when just the legs hung out for quite a while. By their silence, they allowed April's birth hormones to flow and not shut down. Yet they were present so if there was truly a problem, they could step in and quickly help. When human moms are in labor, they also need (it's a NEED) a quiet, peaceful labor space in order to focus on birthing and tapping into their intuition as far as how to cope with labor. When we do a lot of talking in the birth room, asking mom questions, remarking on her progress, discomfort, etc. it pulls a mom into her neocortex (the thinking, decision-making part of the brain) and out of the primal, instinctual part of the brain ("the zone") where she really needs to be in labor.

#3. Yes, most moms (giraffe or human) poop in labor sometimes. Don't hold back because you're afraid of that. Your birth team has seen it all before.

#4. Notice April's involvement with the whole delivery process--constantly licking her baby off during delivery, looking at the baby and seeing how much was out, etc. If nobody was observing you in labor (I'm not suggesting that, just asking the question to get moms connected with their instinctual side), would you be less squeamish about involvement in the delivery? Would you touch your baby's head as it comes down the birth canal? Would you stimulate yourself with your hands to feel pleasure during birth (which increases oxytocin and helps dilation and blood flow to the perineum)? Would you keep your hand there to feel exactly how much you need to push and to help you guide your baby's head into the world slowly?
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So we see that ultimately, our bodies in 21st century hospitals know how to birth as well as a giraffe in captivity does. Do you trust your body as much as everyone trusted April's and didn't step in to fix a process that wasn't broken? What additional lessons have you drawn from watching April in relation to human birth?
Love,
Melanie

...And the triplets are one year old! 2016 was a year full of the love that these three precious babies brought into the lives of all they came in contact with. Happy birthday, Ryker, Katie, and Charlie (sitting left-to-right in that order in the first picture below).
(Check out their newborn and six month photos if you missed them!)

Big sister Addie:

Charlie:

Katie:

Ryker:

​Here they are in the same basket they were in as newborns and 6 month olds (below)!

A friend hand knit these sweaters just for these three.

Love you triplets, you have touched my life forever!