Nicole

Nicole just started her 42nd week of pregnancy and was getting anxious. The contractions started at 4 AM on Oct 15th, and were 30-40 seconds long and every 5-6 minutes. I came to her house at about 9 AM and spent an entire day helping her labor at home. Together with her husband, we walked a lot around the neighborhood. When contraction occurred, she leaned on her husband while I applied counter pressure on her low back. Back at the house I gave her back massage, applied heat to the lower back and pelvis, and counter pressure to the low back. I advised Nicole to change her position every 30 minutes. She was on the birth ball at times, sat in a cross-legged position, knelt on the floor, and leaned on the sofa. We tried to watch TV, but it was too distracting; nice slow music worked much better. In the middle of the day, contractions became longer apart and shorter, allowing Nicole to fall asleep. Later in the afternoon, we went for a walk again and her husband and I did some acupressure on splin6 and hoku points to stimulate the labor. At midnight, contractions became very intense and we headed for the hospital. She was feeling pretty uncomfortable and was very upset when the midwife checked her and announced that she was 3 centimeters dilated. At 2 AM, we took advantage of a labor Jacuzzi. We spent 2 hours in the tub room, with very strong contractions every three minutes. Warm water helped, but didn't really block the pain. Midwife Peggy joined us at about 3 AM and she was on and off in the room. At 4 AM, Nicole was at 6 centimeters. It was a very good progress, but she was really tired of laboring since 4 in the morning. She started asking for an epidural. I told her that we could walk in the corridor and then decide about an epidural. We were able to walk for about 15 minutes. Then I advised her to try the shower (something she didn't try yet). The shower really helped her; she even opened her eyes and was able to talk. At 5:40 AM, Nicole was at 9 centimeters and at 6:05 AM she was fully dilated and started pushing. At 6:35 AM the beautiful healthy baby girl was born. She was put on Nicole’s belly for 'skin to skin'. The next hour Nicole was busy trying to start breastfeeding. Everybody was happy and cheering for Nicole for accomplishing a natural birth without any intervention, exactly as she wishes for.

Even though it was Nicole’s first baby, she was very good prepared - she read a lot, attended classes, and had a birth plan prepared with clear points for the natural birth. In the beginning of her labor she was excited, so it was easy to distract her and she was able to chat between the contractions. By the end of the day, Nicole was tired and when contractions intensified, she didn’t expect such a strong pain from them. At some point she started asking for an epidural. She never said her secret word to her husband (a sign that she really needed an epidural), but he started asking the midwife for the pain relief for her anyway. Originally her husband planned a more active role in the labor, but was really scared and remained quiet most of the time. However, as soon as the baby was born he stayed with his daughter. Nicole was in control of her labor, and at the end was very happy that she was able to avoid pain medications. She really wanted to breast feed her baby and started this while still in the labor room. At the postpartum visit, the parents told me that they were glad they had doula and that without me, they probably would not be able to avoid an epidural.