My Second Birth

**I will not be sharing identifying details or photos in this post per my client's request. 

My second client came out of the blue, sending me a message one night while I was at my second job, saying she was looking for a doula. My immediate response was excitement because it was my first time officially being contacted for services. However, I was a little skeptical because I've seen posts by fellow doulas, stating that they've been contacted by individuals looking for doula services, but turning out to be scammers (if you don't believe me, go on your Facebook or Google and type in doula scams!).

When I had a free moment, I gave her a call, took down a few notes, and we scheduled a consultation for the following day. At that point, I was a bundle of nerves and already feeling anxious about my meeting because I wanted to make an amazing first impression. I spent the rest of my shift brainstorming and planning out what I wanted to take to my meeting. Thankfully, I had prepared a couple welcome folders for potential clients. I just needed to add a couple other items and I would be ready to go. 

When I got home, I added a couple articles and an informational brochure, and I was ready! 

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The first meeting was with her and her husband, which went well, I thought. I had reached out to my doula community the night before and received some warm support plus I shared the news with my wife so I had her well wishes going in. I felt ready for most of her questions and let her know that anything I couldn't answer, I would gladly get back to her. At the end of our conversation, she let me know that the two would discuss things and she would let me know her decision.

By the way, mommy was just hitting 37 weeks :) For her, this was a monumental thing because at 37 weeks in her last pregnancy, she was having a C-section because of preeclampsia complications. She recalled that Pitocin didn’t work for her and the baby’s heart rate dropped during the procedure. 

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She hired me. That feeling when your client chooses you, it just feels so good. I was just so happy and thankful for the opportunity to work with her because she was very pleasant and open-minded about her birth. This was her second pregnancy, and she was planning a VBAC (vaginal birth after cesarean) due to preeclampsia with her first. 

I supported her choice for a VBAC. We discussed pain  relief options and met multiple times to develop her birth plan. Throughout our meets, she mentioned that she was looking into hypnobirthing, as she was finding that to be helpful. She also had a friend who served as a doula and was studying to be a midwife in another state that she wanted to have as a resource for consults, which I had absolutely no problem with. To be honest, I was grateful for the extra resource myself! And, I also let her know that at that point, I was working on a hypnobirthing assignment for my training. I explained that this could be a potential extra resource for us to use if she had any questions about hypnobirthing. Being that this was my second birth, I was excited for the chance at attending a VBAC. Mom was very confident in her body’s ability and wanted so badly to try because she didn't have the option first time around. I 100% believed in her as well. 

Because mom was so close to her due date (approximately two weeks away), I made a couple home visits to get her birth plan ready. Leading up to delivery, mommy had a lot of Braxton-Hicks, but nothing unbearable. Every night, she had some form of bedtime routine that involved her listening to a medley of hypno tracks, music, or a bath. We talked about how often she was having the contractions and whether or not they were getting any stronger. Eventually, because mom had a history of high blood pressure, she was instructed to monitor her BP regularly, even taking the time to stop at local pharmacies just to get a baseline reading.

Mom also had an interest in essential oils so she incorporated them into her self-care, especially the ones known for helping with stress, relaxation, and high blood pressure. She was also big on drinking raspberry leaf tea, which I later learned helps with uterine contractions. 

Along with the prenatal appointments, we examined how prepared mentally she was for giving birth and how she was preparing for the fourth trimester. One of the things I recommended was premaking some meals so she wouldn't have to cook as much, and getting her set up in an area so she wouldn't have to walk as much since her home had stairs. (I was allowed to tour the nursery!) We also covered logistics such as whether or not the bag was packed, what items would be taken to the hospital for comfort, if the car seat was installed. Mom had a lot of details that she wanted to make sure were done, and me in true fashion, I jotted everything from our sessions in my notebook. Everything from fears to random notes and To-Dos was logged and we kept in touch regularly through text if she had questions. If she asked something I wasn't prepared to answer, I noted it, went home to research and gave her an answer either by our next meeting or in text if it wasn't soon enough. 

Mom was fortunate enough to have a big family that lived very close and would likely be around to help her after the baby’s birth; however, she was anticipating them not completely supporting her birth plan. To avoid any potential confrontation at the hospital, she tasked me with directing them to pray if it seemed they were getting restless and/or overbearing. 

In the meantime, while I wasn't with mom, I was making affirmation cards with uplifting sayings and scriptures as well as getting my doula bag ready. We also discussed her playlist that she filled with soothing hypnobirthing tracks and gospel music. I made one of my own as a backup. 

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Mom went in for a scheduled doctor’s appointment and because her BP was high, she was instructed to go straight to the hospital. Wanting to have an opportunity to calm herself and lower her pressure, mom headed home to take a bath and try to get herself together before heading in. At this point, I'm following mom via text - she's very diligent about letting us know how things are progressing. (BP is still high and rising). I asked mom if she wants me to meet her at the hospital and she responds yes so we agree to meet at her place and drive over together since we're certain the plan is to take the baby. While we're waiting for her husband to get the car together, I rub some oils on her feet and ankles and make sure she has her affirmations. She has her bag and her playlist ready for the car, along with an oil blend to smell during the ride to help with her BP and anxiety. Once everything is loaded, we're on our way. 

Arriving at the hospital, mom is checked in and sent to an examination room. After her first exam, I am able to go in and see how she and her husband are faring. We were initially seen by a midwife who told us that once the doctor arrived, a C-section would be the likely course of action because mom’s pressure was steadily rising. This was confirmed once the OB/GYN did arrive, as we were told that mom was in danger of having a seizure. 

As all of this is transpiring, I'm calling the on-call doula/friend while in the waiting area and also texting mom for updates. Mom isn’t too happy that she will be having a cesarean, but she knew it was a possibility so it wasn’t too much of a mental adjustment. 

From that point, my time was spent in the waiting room with mommy’s parents and one of her sisters. Me being me, I had some book to read to keep me occupied. 

And then finally, out of the corner of my eye, I spotted dad walking out to let us know baby had made it out safely and mom was doing just fine. The family took their turns going back to visit, and then I went back to go check in on mom. I was very happy to see the pair doing skin to skin in the recovery area and so as to not disturb them, let them know that I would follow up in a couple days with another visit.

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Anything I would have done differently?

With this birth, I feel that my role was a bit more restricted, being that it was a cesarean birth and I wasn't able to go back in the delivery room. I did spend most of my time with mom and dad in the examination room before she was wheeled back to the OR, stepping out to speak with the other doula for encouragement. We were also on a group text that allowed us to have transparent communication.

There were a couple tools mom had asked prior to delivery that I didn't have on hand (fetal doppler and certain oils), so I will work on adding those. 

I would have liked to figure out a way to involve dad more. I'm pretty sure it was his personality - being quiet - and the more we met, he warmed up to me more. But, with the way the birth changed, I would have liked to have been able to better prepare him.

When mom’s blood pressure kept climbing and showed no signs of doing down, I could have asked if she had any fears that she was not sharing. I don't know - the fact that her blood pressure kept shooting up like that may have been triggered by what the other doula referred to as ”white-coat syndrome”.  

I’m still in the process of following up, so I’ll post updates as I can! 

My doula bag(s) and affirmation cards