DOULA DIARIES – The Labour of Birthing by Rachel Schwartzman #wellbeingwednesday

I had been checking in with an expectant mother every couple of days as her due date came and went. We tried acupuncture and a number of natural remedies to help bring labour on. At 8 days overdue she lost her mucus plug and was experiencing lower abdominal cramping. The excitement on the phone was palpable. I recommended rest and staying hydrated as this early phase of labour can take awhile. She had a light dinner and went to bed. At 2 a.m. she woke up to intense contractions every 2-3 minutes. I met the couple at their house and the midwife had just assessed her at 3 cm. Her partner applied cool compresses to the back of her neck and massaged her shoulders. I squeezed her hips with every contraction. I reassured them this is a normal process. After a few hours of hard labour she asked to be checked again. If things hadn’t changed too much she wanted to relocate to the hospital and consider an epidural. She was still 3 cm. We packed the car and drove to the hospital. The anesthesiologist was called to administer the epidural. She could rest and hopefully dilate. Several hours later her contractions began to space out and the midwife recommended Pitocin. The drip was started and within a few minutes we can see on the monitor the baby is not tolerating this drug well. The heart rate dips then recovers. It is a watch and wait scenario. A few minutes later it dips again. The Pitocin is stopped and with that labour comes to a halt. The discussion shifts to a C-section. It’s not an emergency which allows the couple time to process and come to the decision themselves.

Women don’t want C-sections. They spend 9 months building a team that will support their desire for a vaginal birth. They may contemplate an epidural but they hope for natural birth and want to avoid a C-section. One intervention can lead to another—a Cascade of Interventions—but there are times when you put your faith in the process because there is no other choice. Labour is hard and we are thankful for help. I don’t know why one woman can labour naturally to full dilation, and another needs surgery. What I do know is that both stories end the same. Women become mothers. They hold their babies skin-to-skin, breastfeed and gaze into each other’s eyes for the first time.

RACHEL SCHWARTZMAN is a naturopathic doctor in the St. Clair West neighbourhood. She is the co-owner of West End Naturopathic Doulas, a naturopathic collective that supports pregnant women and partners with the birth of their babies. Westenddoulas.com