Marina

Marina was having some light, irregular contractions for several days, but she was able to fallow her regular daily routine. She called me on Sunday around 7 pm, saying that her contractions were more painful now; even between them she was having back pain and it was difficult to measure them. We agreed that she should talk to her midwife. Around 10 pm Marina called me, saying that they were going to the hospital as per her midwife’s advice. At 11:35 pm she was checked and monitored in triage. She was 4 centimeters; the baby was fine and they let her go home for several hours. We met at her home around 1 am. She was really excited to try TENS unit. As soon as we set it, her back pain was gone and she was very happy. She could measure contractions now; they were 12-20 minutes apart and not very strong. Marina, her husband, and I went for a walk. We walked for about an hour and she continues using TENS. We came home, where she decided to rest. Around 4 am we went to the hospital and she was admitted. She was still 4 cm; contractions were 6-8 minutes apart and pretty strong. She was using a ball - rocking side to side, leaning on it, walking, and doing slow dancing with her husband. Around 7:30 am her contractions were 4-5 minutes apart, very painful and even though she was increasing the intensity of the TENS, it was not enough at this point. She started to mention an epidural. Her husband was very supportive; he was begging her to wait with the pain meds. The doctor checked her again and announced that she was 5 cm, but she stretched her to 7 cm. Marina was exhausted and started asking for an epidural again. I convinced her to try shower first and she agreed. Only at this time did we take off the TENS unit. She felt a little bit better in the warm shower, but contractions were very strong and every 3 minutes. After 20 minutes she said that she could not handle it anymore and wanted an epidural. I talked to her and she agreed to be checked again. She was 9.5 cm. Soon she was fully dilated. After 20 minutes of resting stage she felt the urge to push. Marina pushed for about an hour. At 1017 am, a big healthy boy was born. When the doctor finished all procedures with the mother, the baby was put on her chest for skin-to-skin.

My role at this birth was a lot of emotional support. Since Marina really wanted to avoid an epidural I reminded her of that and assured her that she was doing well. I did shoulder massages, guided her through contractions, and reminded her to breath. She really felt relieved from the counter pressure after we took TENS unit off. During the pushing stage, I suggested different positions; she was using a squatting bar, pushed on all fours and in a semi sitting position at the end. I supported her leg and head, and navigated her during pushing.

In the very beginning Marina was excited that she was finally in labor; she expected a big baby and didn’t want to be overdue. She handles the early labor pretty well and especially was happy with the TENS unit, feeling that it is really helped her with back pain. She did not want to give up TENS in the hospital and was glad that the staff was okay with it (her doctor signed the TENS consent form without any problem). She was upset that she didn't have much progress between her first check and the time she was admitted to the hospital, but I explain to her that her contractions were stronger and more regular and this was good progress already. Encouragement and reassurance worked for her. She was coping well with contractions, was willing to try different positions, the birthing ball and walking. She had hip-lock and was monitored intermittently, which gave her possibility to move freely. Marina started panicking when she got closer to the transition and started asking for an epidural, but in the end was very happy that she was able to avoid it.

The biggest thing I learned from this birth was that the TENS unit really works; it helps with low back pain, contractions become manageable and you feel more in control, which is very important. Another thing is how important it is to have a supportive husband; a doula cannot always convince a woman to wait with the epidural, but an understanding husband can. I saw the natural birth of an 11.5 lb. baby and now know that it is possible.