If You Want To Be Added...

If you want to be added to my blogroll on the sidebar, and you are a professional in the childbirth field or a mama making the journey, please email me or comment below. I think I lost some in my template move. :(

Videos!

I came across this video and love it for so many reasons: baby is born en caul, with a nuchal hand, at a homebirth, and weighs in around 8.9 lbs. Lovely!

This video is stellar! It shows a homebirth with a nice sized baby (11 lbs 12 oz). This mama is, without prompting or guidance, moving herself from all-fours rocking, to knee chest position, and back.. helping a rather large baby fit as best possible. The babies bag of waters has not broken (although MW uses an amnihook at this point), then, at the culmination of babies birth, shoulder dystocia becomes present and you can watch a midwife perform the McRobert's Maneuver.

I love this photo montage as it shows such depth of emotion, I can literally feel this woman's labor right along with her, seeing the journey through her expressions and body language is breathtaking. In addition, her partner is such a beautiful, constant support, and the midwife's role is so accurately shown as with, but not over, mom's space - a companion, even listening with her ear at one clip, wonderful!

Happy viewing!

Childbirth In the News

An Article by Ina May Gaskin brings to the forefront the issue that many of us take with the media's spin (and medical claims) regarding the reasons for some decisions in healthcare.

Hospital's Bullying of Pregnant Women Outrageous talks about the audacity of a St. John's hospital midwifery program cut being in the name of 'safety'.

Says Gaskin,

"There is no evidence that newborns or mothers at St. John’s were put at any increased risk because of midwifery care. Hospital CEO T. Michael Murray knew this, I suspect, or he would have presented some with his cowardly statement that rescinded the midwives’ privileges"

Natural Birth? Nope C-Section Rates on Rise talks about the 1 in 3 odds of a woman ending in the OR during her labor in Oregon.

“All women, when they get to the end of their pregnancies, want to be done,” Echeverio says. “Naturally, when a doctor says to them, ‘Let’s get this baby moving,’ they trust their doctor to know what’s good for their babies and what’s good for them. What they don’t know is it’s not good for them, and it’s not good for their baby.”

This particular article has me nodding on many levels - it is nothing that we didn't know already, but it glaringly and forthrightly talks about the disconjointed implications of a doctor and patient both looking to the end of a pregnancy and the outcome that that impatience brings.

This wonderful Chicago-based article gives great coverage to VBACs and the safety of them.

"Michelle Williams is three months pregnant and determined to experience childbirth the way nature intended. But because her previous baby was delivered through an incision in her abdomen and uterus — a cesarean section — she has to travel more than an hour from her home in Channahon, Ill., to find an obstetrician willing to let her try for a vaginal birth.

One out of every three pregnant women now has a C-section, the most common surgical procedure in the U.S. The skyrocketing C-section rate has been hotly debated in birthing and medical communities, yet little attention has been paid to one of the consequences: Once a woman has a C-section, she often has to fight to deliver subsequent babies the old-fashioned way, if a hospital or obstetrician allows her to try it at all.

Successful VBACs result in better health outcomes for the mother and the baby and cost several thousand dollars less than cesarean deliveries, according to the American Congress of Obstetricians and Gynecologists, or ACOG. The organization recommends that VBACs be offered in low-risk cases."

As a prior Chicago-based doula, I would love to see this article have a positive impact on the community as, in my limited experience while there, more women had a 'once cesarean, always a cesarean' mentality than other women in other places that I have lived and served.

There were actually a TON of news stories this week in the Childbirth field, including the ongoing fight to let imprisoned women birth unshackled, guidelines for diagnosing gestational diabetes getting more stringent (more women will be diagnosed with GD because of this study), and illegal's being refused L&D coverage/admission in hospitals.

But, I will leave that all for my blogging peers to cover, or have fun surfing yourself.

Education is Dangerous!

"People are difficult to govern because they have too much knowledge." -Lao-tzu (604 BC - 531 BC)

One of my favorite Black History figures is the African-American writer, editor, and activist, Frederick Douglass. Douglass, like many during that time, was born into slavery, but decided, rather than die in slavery as well, he would run away to the North. He beat all odds and succeeded in making it North and there, made more than one drop in the sea of American History.

Douglass, himself, did not date this journey to freedom from the moment he decided between life in the North and death in the South; instead, he dated the beginning of his escape to freedom back to when he was just a child. As a child, he was sent to Baltimore to serve a relative of his owner.

"The frequent hearing of my mistress reading the Bible aloud, for she often read aloud when her husband was absent, awakened my curiosity in respect to his mystery of reading, and roused in me the desire to learn… in an incredibly short time, by her kind assistance, I had mastered the alphabet and could spell words of three or four letters." (1993, 56)

The wife of his master's relative, Ms. Auld, was from the North, and she had a rather liberal stance on racial matters. As such, she began teaching Douglass how to recognize the written word. One day, though, he overheard the master of the house and his wife arguing. It ended with the master forbidding his wife to continue her lessons of Douglass. In that day and age, it was not only illegal for her to be doing so, but, as Douglass recounts the master saying, it was dangerous, "for if he learns, it will forever unfit him to be a slave!"

This was the beginning of his flight to freedom as the seed was already planted. He continued to teach himself to read, and, once his mind was freed, he sought to free his body as well.

You see, Douglass, a bright young man, knew this truth in his heart: learning and the self-awareness that it brings unfits us from second-class citizenship, it unfits us for oppression and unwitting servitude.

“For want of knowledge we are killed all the day long.” (1955, 307)

Why? Because learning raises questions. Questions in our spirits, our hearts, our souls, our deepest intellect, opening up the ability to question those dangerous practices that are engrained, without reason, in our society: why things are the way they are, why they cannot be changed, why there seems to be no valid reason behind those practices!

Let me explain: if you are able to truly educate a person to her options, she starts wanting those options.. and if she starts wanting those options, she starts seeking those options and people who will support those options. And if they start wanting, and seeking those options and people to support those options, then those women have a good chance of getting those options.

"Mankind have a great aversion to intellectual labor; but even supposing knowledge to be easily attainable, more people would be content to be ignorant than would take even a little trouble to acquire it." - Samuel Johnson (1709 - 1784)

Recently, I worked with a woman who, at our first meeting, was excited to learn all she could about her options, having just learned of doulas and independent childbirth classes. At our second meeting, she was reserved, diminutive, and resigned. Her doctor let her know, at her last appointment, he would not work with a doula, and said that independent childbirth classes were 'dangerous'.

His reasoning? Doctors could not control what was being taught, and thus, she might get 'notions' for things that simply could not be. WOW! What a throw back.

The beautiful mama and I remained friends, but she did not use me as a dangerous accomplice (doula) and didn't take those dangerous classes. She ended up with an induction at 39 weeks and 1 day, an epidural at 3cm, a cesarean for FTP, and a 'too big baby' that weighed in at 7lbs 2 oz.

I am not saying that every woman who researches the benefits of alternative birth will want one, but I am saying that, if she truly and non-biased researches the benefits of alternative birth and parenting options, she will make more informed, more personally tailored choices that will build confidence in her, her family, and, most often, they are the healthier and safer choices.

Educated families are a threat: they are a threat to the American way of birth and parenting. And well they should be because the all American way is simply not working. We are a dysfunctional society with dysfunctional birth and parenting practices. We should be questioning these practices, because they simply don't work out for healthy outcomes.

So, if you consider danger and threat to be synonymous, then yes, education IS dangerous. But for me and my family? No. For the powers that be and societal norm? Yes!

For additional research, some pioneers in the childbirth and childbearing/sexuality field:

Ayaan Hirsi Ali

Sheila Kitzinger

Dr. Martha Ripley

Janet Balaskas

and so many more...

-----

Frederick Douglass, Life and Times of Frederick Douglass. Avenel, NJ: 1993.

Frederick Douglass, Life and Writings of Frederick Douglass. New York: International Publishers, 1955[1975].

Hollywood Does It Again

Oh, how I love Jennifer Lopez... Oh how I don't love how Hollywood continues to portray childbirth... and now, they are hitting up homebirth/waterbirth and cheapening it for entertainment.

Don't get me wrong, it does looks funny. That is not the point. The point is that the average American is going to look at this film and believe that this is what waterbirth is.

I guess it is too much to ask for a good representation of birth and water birth, specifically, on the big screen?

Welcome Eason

Lani and Toby, when I met you, you were excited and anxious, happy and cautious. We spoke about your dreams and desires for this, the birth of your first baby.

On February 2nd, Lani, you called me in the early a.m. to let me know that you believed your water had broken. After discussing things, it sounded like it had, indeed, broken. I encouraged you to eat something and call a short time later if no contractions were felt. Shortly afterward, you called to let me know that you were not feeling any contractions but that you were seeing a lot of pink discharge. I reminded you to watch your temperature, stay hydrated, try walking, stairs, foot massage, and nipple stimulation.

You began using the breast pump and stayed active. Around noon, you attempted to take a nap but couldn't from the excitement. We began talking about your options, including the pros and cons of staying home vs going to the hospital. You decided to stay home and keep working on getting things established on your own.

Around 6:30, you let me know that you and Toby would be heading into the hospital sometime later that evening and that you would call me when you knew more about how you were going to proceed. Around 10:30, you called to let me know that you were having contractions every 15 minutes but were not feeling them and the plan was to start pitocin sometime that night to try to get things moving.

At 4 am, I received the call that you were ready for me. Your contractions were coming quickly (every 3 minutes) and strong. They were completely in your back and you wanted my help. I packed up and headed over immediately, arriving around 5am.

When I arrived, you were standing beside the bed, moving gracefully and peacefully through the timeless movements of the labor dance. Toby, you had your hands always at the ready to support and your voice, to encourage. Beautiful! We talked about your discomfort and where it was at. With the last exam, your cervix was still high and posterior and around 3cm.

We began with lunges, as I had strong reason to believe, from your description, that your baby was posterior as well. After a few lunges, we worked on a pelvic floor release, and then you moved right back up again - ready to get things moving toward birth.

Toby and you moved in such beautiful synchrony, alternating from quiet words of encouragement, prayer, and touch to dancing, hanging, and sitting on the birthing ball, and walking.

After around an hour of moving through this cycle, I asked your nurse's permission and unhooked your monitor for a walk around the halls. During this, I encouraged you to open your hips and sway, and during contractions, to move your hips in a figure 8 or squat. Once back to the room, they checked your progress and you had moved up to 4cm and baby was nice and low, with babies head starting to turn into the right position.

We opted for hands and knees next, and I sifted you through some contractions, which seemed to help with the back pressure, but it wasn't long before you were up and moving again with me providing counterpressure to your sacrum and lower back. Your sister, who had come to be with you through your labor, began breathing prayers over your birthing space, quoting Psalms, while Toby loved you through every contraction, praying over you and speaking life over your labor and body.

Throughout all of this, Toby leaned in close to you and you both prayed that your labor and birthing time would bring glory and be a testimony to God's grace and goodness. It was breathtaking.

Throughout labor, you had attempted to eat, but couldn't. Coupled with no sleep and hypoglycemia, you were getting to the point of pure exhaustion. We talked about options to try to get you some rest, but the contractions were coming strong and close. We talked about the pros and cons of getting an epidural and how your risks could best be minimized if you opted for the epidural.

If baby was low enough, and had turned well, you were ready for the epidural. You didn't want one before then, and wisely so, in order to let baby get into the best position possible and to make sure that there were no regrets with your choice.

At your request, you were checked and found to be a good strong 5cm, baby was +1 station and was in a good position. 20 minutes later, your epidural was in place. You soon realized, though, that the epidural that was supposed to allow you some much needed rest was not going to allow for it. You had a window of pain over your right hip. By 11:45 am, we were alternating you from left to right, working on massaging the hip joints, and opening your pelvis through different positions, including the throne.

The anesthesiologist was called back into the room and, around 12:30, he gave a slight pull on the epidural catheter in hopes to straighten it and give better complete coverage. Directly afterward, though, you mentioned lots of pressure down below, different from what you had felt previous.

You asked to be checked again and were complete, 10 cm! At this point, I encouraged you, if you didn't feel a strong urge to push, to take advantage of the time, since baby was looking strong, and try to rest. You attempted to rest but, after 30 minutes, you felt a good amount of pressure and were able to start bearing down with the contractions.

After a few trial pushes, you really began to get the rhythm, really moving into a groove that you could feel and work with. With Toby alternating on one side with your sister, I held your other leg and you began moving your baby out and into the world.

Soon, you came to that place where you had to decide if the pressure in your womb, or the pressure at your perineum was greater. Slowly and evenly pressing through, you brought your babe to crowning. Slowly, he spiraled out of your womb and into your arms.

Immediately, you and Toby both began speaking blessings and words of welcome over your new son. At 3:09, after 1 1/2 hours pushing, Eason arrived with gusto!

You were a beautiful team, wholly and completely one, working as a unit, from the moment your womb spilled it's water until the moment your son was placed, slippery and beautifully new into your arms, you were 'family'.

Congratulations family H! You are blessed!

A Doula is like...

These are some comments (with my personal elaboration) that I have heard from inspired clients throughout the years. I hope you enjoy and agree, add your own, or give constructive disagreement!

"A Doula is like birth insurance - only they don't fit in your back pocket as nicely"

Although we cannot insure that you will get the birth that you want, we will do everything in our power to help you get there. And, at the same time, we will minimize risk, give alternative options, educate, massage, move you, translate medical terminology, and give suggestions that will give you the best chance of staying out of that red zone.

"A Doula is like your best friend and mom, just not the annoying mom... or all the scary birth stories from your friend"

We will encourage, support, listen, suggest, and sometimes, if you have asked us to, put our foots down and remind you of your desires in the heat of birth when you have a hard time remembering the goal. And, if you have to detour off the path that you had hoped to stay on, we provide excellently padded and comfortable shoulders, open ears, and empathetic, nonjudgmental hearts. We truly have your best interests in mind, and are your greatest fans.

"A Doula never gets tired... unlike your husband"

Please, keep thinking that. :) It is amazing how far high protein snacks, 5 minute power naps, and lots of sleep deprivation training can get you.

"A Doula is a walking encyclopedia of pregnancy and birth information"

Continuing education and keeping abreast of the most recent medical journals/studies is all part of good doula work. When I stop learning is when I stop being all that a pregnant and laboring woman needs me to be. I do her and I a disservice by not being aggressive in my professional development. Some of my best teachers: studies and reports, Obstetricians friendly to doulas, other doulas, Midwives, laboring mamas, chiropractors, and homeopathic/naturopathic practitioners.

A Doula is whatever you need her to be, right then. (to me) Where did you learn to read minds?"

Listening to a mama, not just what she says, but what she does with her body and her vocalization, can tell me so much. A doula learns to listen with her whole body; her instincts, her ears, her eyes, her sense of smell, and her hands. If I feel a taut muscle, see a grimace out of place, smell the sweet smell of birth, hear a grunt at the peak of a cresting contraction - all of these cues speak to us of mom's needs and her journey.

So, what unorthodox description of a doula have you heard?

Nella Cordelia

What a BEAUTIFUL, heart wrenching, and raw retelling: Nella Cordelia, a birth story. Read with an open heart and a wad of kleenex!

Protecting the Space

The traditional midwife believes that birth proceeds in a spiral fashion: labor starts, stops and starts, while the baby goes down, up and down, and the cervix opens, closes and opens. Nature has no design for failure; she holds her own meaning for success.
~ Sher Willis

I know that the terminology 'protecting the space' has been thrown around quite a bit. But I wonder, how many know how to apply it?

There are so many levels to protect a mama in:

• emotional
• physical
• mental
• spiritual

But, for times sake, I am only going to really discuss the physical and emotional space, since they are both intertwined. When mom is laboring, very often, she labors in a spiral. Her hips move in spirals, her baby moves down in a spiral.. and her physical and emotional attention spirals.

Early in labor, she is aware of everything in the room, far out, at the edges of her spiral, with her at the nucleus. Everyone who comes into the room can affect the nucleus by frivolous or unthoughtful words or actions. As labor progresses, a woman pulls that spiral tighter, so that the peripheral of her attention is closer and closer to her body. Toward the end, she is only aware of those things closest to her, unless they demand attention.

A protector of the space would be able to prep family, friends, nurses, doctors, midwives, doulas, children, etc... of the need to be thoughtful, quiet, unobtrusive, and gentle; not cracking jokes, talking loudly, or otherwise 'breaking the mood'. If mama is playful, you are cautiously playful. If mama is serious, you match her mood. If it is quiet and peaceful, dark and soft, you are too.

And, as the mother spirals her attention toward herself, you do the same, moving cautiously forward into that space. And, at first, it demands the whole room be aware of that space.. but the further into that spiral she pulls herself and her awareness, the more it is those closest to her.

Likewise, support people need to understand that, the tighter into that spiral a mom moves, the more she needs your physical presence to be closer to her to be able to benefit from it. Earlier in labor, you might have been able to talk to her from near the sink while she was near the window. But now, while she is deep inside that space, she needs you no more than 5 feet away. And later, as she moves toward birthing, she will need you within arms grasp to benefit from your physical and emotional presence.

This is so important of a concept for doulas and other support people to understand. I have seen women who are progressing well, moving inward with their attention, suddenly pulled out of that spiral, forcefully, by a well-meaning joke from the grandma, a loud question from the nurse, a doulas quick dart for an elusive water bottle, or a husbands insistent questions. It then takes a good while to help move her back into that space, so that her contractions can reestablish and her attention can become refocused.

Other times, I watch all support people become very attentive to moms space spiraling inward, moving to a cumulative point of energy flawlessly; and mom is allowed to move through that space effortlessly. These experiences are much more seamless for mom and for labor - and that is our goal as support teams: protecting the space.

Now, to draw this post to a close, watch this slide show of Maya's Birth, and the accompanying story.

Birth Video

This is a great (short) birth video that I found on youtube of a standing birth at a free-standing birthcenter (how you like them apples?!)



Beautiful demonstration of mama pushing in a standing position (a position you don't see much anymore), with a sibling present, with two women in attendance.

Welcome Tres

I was privileged to be called on for your birthing time, Melanie. For the birth of your 3rd child, you had decided to look into the help of a doula, and I was ecstatic. Each pregnancy, you had desired an unmediated birth but, every time, you had opted for an epidural. I promised I would help you to achieve your desires as best I could and would support your choices along the way, it was a match!

After working with you and your husband Matt, your two daughters decided that they wanted to be there to welcome their little brother into the world. So, 1 month before your estimated due date, we held a sibling class and worked our way through a birth video and Cary York's coloring book, "When is The Baby Gonna Hatch".

Then, we waited...

On January 11th, you called around 8pm to let me know that you believed your water had broke. We talked about what it felt/acted like, the smell and color, and I recommended that you put on a pad, lay down on a towel or plastic bed covering, and try to nap until contractions started.

By 9pm, your contractions had moved up to around 10 minutes apart, 30 seconds long, and strong. I encouraged you to have a bite to eat, still consider napping, and perhaps call your husband home (who worked 3rd shift).

At 10:30, you called to let me know that it was time for me to come over because you were timing them around 5 minutes apart and very difficult to work through alone. Though your mom was there, you wanted Matt and I there.

I got dressed, woke my 9 year old (who had been invited to be your daughter's mini-doula) to get ready, and we headed out into a light snowfall.

I arrived at your home at 11:30 at night and you were working through some strong back contractions. With every contraction, you lifted your buttocks off the bed and breathed through them. Your face was flushed with each contraction and you described it as 'low pressure'. I timed a few of them and noted that your contractions were coming every 3 minutes consistently.

You decided that you were ready to move to the hospital. I let you know that your emotional markers said 'early active labor', but your contractions were saying 'active labor'. You were ready to go, so we packed up and made the 10 minutes drive to the hospital, your kids piled into my van with my daughter and all of our bags, my doula bag and their entertainment bags.

By 12:10, we were settled into the room and you were checked and found to be 80% effaced and 4 cm. As soon as you were able, you moved onto the birth ball and commenced to rock your way through a great many contractions which were consistently 3 minutes apart, and 30-45 seconds apart.

You became increasingly more tired and soon had a hard time focusing, feeling a nearly overwhelming urge to push with every contraction. You asked to be checked and found you had rocked your way to 5 cm in 1 hour.

At this point, I encouraged you to try getting into the tub to reduce the pushy feel and to try to give you some rest-time. The tub worked wonderfully to allow you to get from a semi-recline into a side position with every contraction. Matt massaged your hips, which were beginning to cramp, while I vocalized with you through the contractions. Your bloody show increased and I could tell you were making great progress.

At around 3am, baby began showing minor decels, but you had 'aaahed' your way to 7-8cm, 90% effacement, and +1 station.

Your urge to push was overwhelming, though, so we began trying different positions, from walking the halls to getting on the birthing ball, to all fours. You ended up spending most of your time on the birthing ball as it allowed you to stretch your hips without requiring you to stand (because of your exhaustion).

At the peak of every contraction, you arched your back and attempted to move away from the contraction. I tried to coax you to focus your energy forward and down, without pushing. It was your nurse, though, at this point, who was able to get you to focus all of your energy forward. As the urge was overwhelming, I sat between your feet at the base of the birthing ball and held your hands, met your eyes, and vocalized through each contraction. Your wonderfully supportive husband sat behind you on the bed, his thighs were your arm rests, and continuously traded out warm washcloths for cold ones.

Around 3:30, it was back into the tub for you as the warm water called out to your aching hips. We working on using the roll-over technique, in the tub, while Matt resumed massaging your hips. Your pushes were grunty at this point, so you asked to be checked again.

At 4pm, you were measured at 8cm, very swollen from uncontrollable pushes, and +1 station. We went for a walk through the halls at this point, and then you gravitated back to the tub. While in the tub, we talked about your options. With your cervix swelling from the overwhelming urge to push, we walked through a few scenarios: we could work extra diligently on finding a way to keep you from pushing without medication, or you could have a low-dose epidural.

You opted to get on top of the contractions.

Around that time, I went out and spoke to your nurse at the nurse's station. She didn't understand your desire for an unmedicated birth and, at one point, asked Katy and Amelie, your daughter's caregivers, why she wouldn't just take the epidural. I explained that you and I had already gone through the options, you understood the situation, and this was what you had chose, my number one job was to support your decision. Kindly, I was hoping she would understand that that was her job as well.

Returning to your dimly lit bathroom, I again sat beside you and watched as you moved through your birthing space with determination. Your tenacity and strength poured from you in waves that nearly brought tears to my eyes as you worked for the next 3 hours, with all of your emotional and physical fortitude, to climb on top of every contraction that wanted you to bear down with all of your might. The strain in your body was evident as you pushed your face closer to mine with every contraction, demanded my eye-contact, and we puffed our way through contractions that were coming strongly every 2 minutes and lasting 60 seconds or more.

Without any prompting, we fell into a rhythm: every contraction, you would move onto your side or into a frog-squat and would seek out my eyes. Then, we would deeply and deliberately breath through the climb of the contraction. When the peak came into site and your body curled around itself, trying to barrel baby down, we would 'Lamaze' puff our way through the increasing pressure, sometimes loosing the battle, most times triumphing! Matt scooped water over your rounded belly, massaged your hip, and whispered his encouragement and pride of your strength.

After every contraction, you would sag, exhausted, against the wall of the tub and close your eyes, sometimes overwhelmed to the point of tears.

At 5:45, you were measuring 8cm, less swollen, and baby was still sitting nice and low. You were showing signs of transition, saying that you didn't think you could go on and wanted to be done. Baby was showing more decels, but was still strong and moving plenty. Back in the tub you went, and we moved through more of the same.

at 6:45, your doctor came in to talk with us. He asked what I was seeing, I told him how well you were working through the contractions, what the obstacles were, with an overwhelming urge and swollen cervix, the decels I was seeing, and the possibility of a malpositioned baby.

He did a vaginal exam and said you were a beautiful 9cm! He then confirmed the decels, but made sure to say that they were nothing to be worried about at this point and that, as long as baby was healthy, you could continue working through things they way that you had been. He also noted that baby was in "deep transverse arrest" (see here for a description), though, and that, when he got back from a surgery he was heading to, he wanted to talk with you about what this meant for your birth.

He left for his surgery and immediately you stated you were ready for your epidural. I knew that we had a small window to move baby, so I said that we would get it for you if you were absolutely certain, no regrets. The nurse called up the anesthesiologist, and I asked you to get on all fours. Unlike the other times, I didn't help you, but made you rotate on your own.

When you moved onto all 4s, you had two strong contractions back to back and said that you had to have a bowel movement. You insisted that it was not just the pushiness, but something actually 'there'. I smiled and encouraged you to squat beside the bed and go to the bathroom. I threw a bed pad on the floor and you squatted on it. Immediately, you were all out pushing.

At the exact same time, the nurse peeked into your room and asked what you were doing on the ground. I replied that you were having a baby (actually, I think I said you were pushing). She threw herself on the ground and peeked up between your squatted legs. There was babies head pushing on your perineum.

The smile on my face could not have been any larger - YOU had moved your baby!

She ran out to stop the doctor from getting into the elevator. While she was gone, you climbed onto the bed onto all fours again and kept pushing. Your doctor returned and you moved your babies head out and into his hands. Immediately, babies head pulled back toward your perineum. When you had a good 4 contractions without any further dissent, he told you to flip over onto your back. In a 140 degree recline, we began trying McRobert's maneuver to move baby out. When that didn't work, doctor quickly moved onto the Wood's maneuver and, with an audible pop, Tres squeezed slowly out into the doctor's waiting arms.

He had a slow start but, with the doctor working diligently to get a response out of him, and mama and daddy calling him home, Tres let out a lusty cry!

At 7:45am, Tres was born, weighing 9lbs 3 oz and measuring 19 inches long. Mama showed one of the strongest wills I have ever seen in the face of adversity. Melanie and Matt, thank you for the honor of attending this miracle! Your family of 5 is beautiful!