"Trust upholds the field of birth and invites the help of our highest guidance."
Sacred Birthing Insight

Becoming a Sacred Birthing Community Doula: My First Birth

My name is Sharon Gonsalves and I attended the Sacred Birthing Foundation’s Doula Training Program from January through April 2009. Barbara Essman was the lead instructor and author/founder/midwife Sunni Karll was very instrumental in delivering the training. There were about 10 women in the class and I learned so much from each one. Many had had their own babies and others were preparing for motherhood or healing from their own births and childhood experiences. I wasn’t sure if I’d follow through and complete the certification requirements, but once I attended my first birth I was sure I wanted to serve the community as a doula.

I had conversations with two different expectant moms before finding my first doula client. I learned in the training that it’s important that a doula be a good fit for the couple who she’ll be assisting. Although I was disappointed that those first two nibbles did not pan out, I was really happy when I found someone who definitely wanted to work with me and invited me to her birth.

My client, Joanna, was relatively new on Kauai, had 2 grown children and was about 7 months pregnant when we first met. She moved here from Denver, where she says 65% of births are attended by doulas. Doulas are not very common yet on Kauai and we’re having to educate the community about what a doula is and how having a doula can really help ease the birth process. Joanna was very sure that she wanted a doula at her birth and was planning to give birth at the Waimea Family Birth Center at KVMH. She and her husband would be attending childbirth classes at KVMH and they invited me to join them which I did.

Joanna was very clear that she wanted a natural birth without drugs. Her first 2 were natural – one at a birth center and one in a hospital – and while she knew she was able to give birth on her own, one labor went very long and she was concerned that might happen again.

As Joanna’s due date approached, we talked on the phone once a week just to check in about how close it might be and how she was feeling. Then one morning at 4:15am I got a phone call from Joanna’s husband. They were at the hospital and labor had begun. It was time for me to join them.

I showered and dressed and before getting in the car I turned on my computer and sent an email to a list of Joanna’s friends to let them know that baby Leila was on her way. I asked them to please keep the family in their thoughts. On the way to the hospital I called in all my guides and helpers, and asked spirit to surround the birth team with support.

When I arrived at KVMH, the hospital staff was expecting me and the nurses, doctor and especially Joanna and her husband, Michael, were happy to see me. Joanna was tired. She’d been up all night and was walking to keep her labor progressing. At last check she was 5 centimeters dilated and 60% effaced. Her contractions were a few minutes apart. I gave her lots of encouragement as she and her husband and I walked the halls stopping for every contraction. While she leaned on Michael, I gave her some back relief by pushing her hip bones together allowing more rooms for baby’s head to move down. We spent most of the next several hours this way. I gave Joanna water to drink after each contraction as they made her very thirsty. Periodically the doctor checked her progress. She stayed at 6 centimeters dilated for a while as she became more effaced. Her waters were broken to help keep things moving along. When she was hooked up to a monitor for a few minutes we could all hear the baby’s heart beat – the first time I’d heard that sound. No signs of distress at all.

Contractions were getting stronger and Joanna was getting more uncomfortable and more tired. She labored on a birthing ball for awhile, resting between contractions. I saw ‘bloody show’ for the first time and finally understood what that was. I suggested she try laboring in the shower for a while to see if the hot water would help her relax a bit. After her shower she labored in bed for a bit, actually sleeping between contractions as she was thoroughly exhausted. She was now almost fully effaced. Within an hour she went from 6 to 9 centimeters dilated, then things started happening pretty fast.

Joanna started feeling the urge to push and she seemed a little scared. Her contractions were becoming more painful and she said she didn’t want to do this any more. She wanted drugs. This was our clue that the baby would be here really soon.

In the doula class I learned that often as women progress through labor they start saying “oh God, please help me”. Then they start asking for drugs. Then they push and the baby is born and they are totally in love with their child. Well, in this case that’s exactly what happened.

So the urge to push set the hospital staff in motion. The bed was readied. The doctor’s instruments were laid out. The lights were turned on and the doctor was in position to catch Leila as she entered the world. Joanna was sitting up at about a 45 degree angle, and Michael and I stayed on either side of the bed and told her what a great job she was doing. One of the nurses coached her through the pushing – chin to her chest, hands behind her knees. I let one of the nurses know that they’d been doing perineal massage to stretch her tissues and no episiotomy was performed. Within 3-5 pushes the baby was out and Leila was on her mom’s chest.

The actual birth was the most intense time for me. I didn’t want to look between Joanna’s legs at all. I just wanted to stay right at her shoulder encouraging and supporting her. The pushing was a bit uncomfortable for Joanna and the nurses were so great in the way they coached her to push into the burning sensation that was making her hesitate. She did great and I was really happy for her that things had gone so well. Leila was born at 11:26 am September 13.

Then came the really cool part. Joanna and Michael met their daughter for the first time in the light of day and they loved her. Meanwhile, the doctor prepared the cord for cutting (which dad was invited to do), then he put some gentle pressure on the umbilical cord and placed a pan at the end of the bed to catch the placenta. Within about 20 minutes after the birth, a placenta the size of a very large grapefruit was expelled along with more fluid from the uterus. Wow! Fascinating!

The hospital staff cleaned up in a flash and mom, dad and baby got acquainted. Mom was encouraged to breast feed which would start the uterus contracting to stop any bleeding from the placenta detaching from the uterine wall. Baby latched on right away – a successful beginning to a new relationship.

At this point I made myself scarce so that very important initial bonding could take place. Before leaving the room, doc gave me a ‘thumbs up’ which brought tears to my eyes. Everything went really smoothly.

I felt really welcomed by the hospital staff and very high from the whole experience. Some of the staff had met Barbara and Ronda when they visited the Family Birth Center a few weeks before. This really made me feel good, being associated with a group that intended to work together with a hospital to ease baby’s transitions and support mom, dad and hospital staff through the birth process. It felt like a good beginning for all of us.

Please follow and like us:

Ginger & Lilly Dawn’s Birth Experience

11/2/09 Tonight Ginger noticed a lot more moisture coming from her vagina, wetting her pants. After needing to change her clothes twice, she put on a pad. On the toilet, she saw some tan-ish mucous. She also felt some new discomfort in her lower back and pelvis. It didn’t take us too long to clue into that either her water had broken or her mucous plug had released or both.

Full Moon 11/3/09, 12:30am Ginger came to tell me her labor had begun. I moved into Lily’s room to be closer while Ginger experienced the acceleration of her surges. Partner Colin slept but there was not sleep for Ginger or me. Midwife Ruth told Ginger to meet her at 5am based on Ginger’s surge timing and intensity.

5am: Colin, Ginger and I go to the Birth Center. Ginger’s step-dad Steve was there to meet us. Midwife Ruth checked and found Ginger only 80% effaced with nearly no dilation. Her cervix was still facing more towards her back and baby was posterior. Ruth sent us all home (30 minutes away) Ginger was somewhat disappointed but meeting it.

8:25 am Surges were approximately 1 minute 15 seconds in duration and 4 ¾ minutes apart. Midwife Ruth was called, a message was left. She called back shortly and said we could come to the center if we wanted. The Center’s Clinic was opening around then so Ruth would be there. The ride was really hard for Ginger. She started the ride lying in my lap but the Honda was small and she couldn’t stretch out so soon she was sitting up.

We arrived at the Birth Center around 9am. Upon checking Ging’, Ruth told her she was only 3cm and that she couldn’t officially admit her. She said that since the clinic was now open, Ginger could choose to stay but at the close of clinic at 2 pm, she would have to leave if she wasn’t progressed enough. Ginger chose to stay but Steve went and got a hotel room in case Ging’ would need to leave and so she wouldn’t have to travel far again.

Ginger chose to get into the shower first. When she got out and a surge would come on, she got onto her hands and knees. She then labored on the bed for a while in the lateral or side position. She had chosen to bring some music that I gave to her when she was a baby and that she listened to at bedtime all through her growing up. “Fairy Ring” was the background music for this beautiful birthing. Jackie came in after a while and told Ginger she should get up and walk. I had said the same thing but I could see that coming from Jackie had more clout. Ginger went outside on that beautiful Fall day and walked the rolling lawns around the birth center. It was a lovely area with lots of trees. One huge Oak that overhung the Center was the perfect guardian as it looked to me like the “tree of life” image of the placenta. Ginger and Colin went outside and walked and labored together. Ginger either hung on Colin or went to her knees when a surge came on. They were outside for about a half hour. They were so beautiful to watch! Steve and I held back taking pictures.

Back inside, Ginger had on one of Colin’s COD shirts (all the men on his father’s side of the family had initials COD). She lay on the bed again and labored for a couple of hours. At some point during this time, Ginger required someone; Colin or me, to lay a hand on a particular spot on her lower back as soon as she felt a surge coming on. She could have no pressure but needed the hand on a very specific spot, just lightly but perfectly placed. Ginger’s labor was hard and pretty painful but she kept her focus and labored really well. She toned through many surges and when tensing, was responsive to mine or Colin’s light touchmassage and reminders to relax.

Grandpa Steve was on camera duty throughout the labor; both video and stills.

Around 12:45pm. I looked at Ginger and saw her energy flattening out, the skin below her eyes turning dark and something in me spoke loud and clear “if Ginger isn’t going to have to leave, she’s got to rally and put all her power, body and intention into bringing Lily into position, opening her cervix and moving Lily down. I had suggested she change positions several time before, but Ginger had not been responsive to my suggestions. I felt a familiar inhibition in speaking with authority to Ginger; a life-time dynamic between us. This time, I stepped over that pattern and put clarity and power behind my words; telling her exactly what I was seeing and what she needed to do. Ginger heard me and responded. She got up, went into the other room and tried numerous positions for turning Lily, creating space and using gravity so that Lily could move down.

About 30 minutes into this, Ruth came in to check on Ginger. She asked Ginger what she was experiencing and from Ruth’s words, it seemed that she thought Ginger was not progressing that much. Ruth spoke again about the possibility of needing to leave. She watched Ginger through several surges and at one point asked Ginger if she was feeling some bearing down sensation in her surges. Ginger wasn’t sure.

Ruth left, going back into the clinic portion of the center. Ginger continued to labor. The position that worked best for her through most of this time was on her hands and knees; still with a hand needed on her lower back.

Just before 2pm, Ginger told me she felt Lily was coming and asked me to go get Ruth. I went into the center where Ruth was standing talking with Jackie. When she saw me, she said she’d be there in a moment. When she came in, she checked Ginger and was surprised to find Ginger over 8 cm. open.

Things started to happen fast then. Jackie came and joined us. When a surge came on then, they looked like huge waves; Ginger’s eyes got really big. Ruth instructed her to take a deep breath and exhale by blowing slowly out. It was clear; Ruth wanted to slow things down. She asked Ginger whether she still wanted a water birth as the tub would need to be filled, the water pressure was low and it would take a good half hour for the tub to be filled enough for her to get in. Ginger said yes, she wanted the tub. As they filled the tub, Ginger’s surges got bigger and she began to vomit with most of them. It was a very intense time! A couple of times, the bigness of the waves swept her up and she’d yell. Ruth and Jackie brought her back to blowing and she kept her focus. Amazing to watch her!

Finally the tub was ready and when Ginger got in, she felt more comfortable. (How nice it would have been for her to have gotten into the water a couple of hours earlier!) The next couple of surges went as they had on the bed; deep breath in with blowing exhale. Then Ruth gave Ginger the cue to go for it and push Lily out; to push only when she felt a surge and then push hard. Colin got into the water with Ginger and sat behind holding her for this time of pushing. Ginger followed her midwife and doula’s lead to push rather than the HypnoBirthing way of breathing her baby down and out. She pushed well.

We watched Lily crown in the step fashion; a little forward and than moving back; each time moving forward and out a little more. Ginger reached down twice and felt Lily’s head. That brought on such a wonderful smile to her face. This pushing phase only lasted about 15 minutes before Lily was born. We saw she had a good head of light colored hair. She had some cord around her neck that she rolled out of in the water. She was pretty quickly put onto Ginger’s chest and her nose and throat were suctioned with a bulb syringe. Ruth didn’t want the placenta to be born in the water and got Ginger out of the water pretty quickly; less that 5 minutes after the birth. Ginger was compliant and got out and back onto the bed. Mommy and Daddy and all of us were so very happy! And Lily was doing really well. She did squawk with the suctioning but settled down well. She was very present and quiet; taking in her new world, especially her Mom and Dad. She had a lot of thick vernix on her skin and a little bit of merconium had been seen at the birth but no problems arose. She has beautiful red hair!

Ruth waited what I would consider an extremely minimal time before having Colin cut the cord. She said the pulsing had stopped and Lily showed no reaction to the cutting. She breathed well right from the start.

With the help of Colin stimulating Ginger’s nipple, the placenta was birthed shortly after the cord was cut (maybe 10 minutes after) and was in perfect shape.

Lily latched on well after about a half hour of birth. Nurse Bethany helped Ginger with the latching and positioning.

Everyone was high and happy and Lily was alert and peaceful.
Ginger and partner Colin with newborn Lilly Dawn
We left the Birth Center around 5:15 pm. The car seat we had was not set up right and really was imperfect for a newborn. Colin did his best to secure the seat which satisfied the Birth Center Folks. Our plan had always been to leave the Birth Center with Lily in the seat for the sake of the birth center folks and then take Lily out of it around the corner so Ginger could hold her for the ride home. This is what we did.

My brother Doug just happened to be in Sacramento that day. In fact, before the birth, we had scheduled to get together with him the following day. He called while we were still at the Birth Center to tell us he wouldn’t be able to see us the next day and it needed to be that day. I informed him that Lily had just been born. He was astounded at the timing and so happy! He is one of Ginger’s favorite people and so he was privileged to be invited to meet us at the house to meet Lily Dawn.

At the house, Colin’s Brother Cliff and Dad Cliff Senior were waiting to meet Lily. Uncle Doug came shortly thereafter and everyone was high in the birth bubble energy. The Cliffs went out to dinner and a movie and Doug stayed for a nice long visit. He and I then went out for dinner and to bring food home to the new Mom and Dad. The new little family was all sound asleep by the time we returned.

NOTE: It was clearly the best option to birth at the Birth Center; all things considered. Though Ginger would have liked to have had a home birth, Colin was not familiar or comfortable with that idea. Also, The Birth Center took MediCal, so that was a great plus. All went well. The main thing we would have liked different is the midwife being more connected to the labor. Her judgment about Ginger not progressing wasn’t accurate and if it weren’t for me and Steve and Colin being there to hold the energy, it would have been much more challenging for Ginger. It certainly reflects how important and beneficial it is to have a doula and a loving and attuned birth companion present at a birth. Bottom line ~ it was a wonderful birth! Thanks to all. Well done new Momma!

Please follow and like us:

Birthing Sisters: Our Community Doula Monthly Gathering

The Sacred Birthing Community Doulas meet monthly as a way to support each other in our work and continue to learn and grow. We met last night and shared several birth stories. I see very clearly how our presence is making a difference, not only on Kauai, but anywhere we go.

Eight of the women from the first doula class were there along with our teacher, Barbara Essman, and one woman from the second class. It was a reunion of sorts as some of us hadn’t seen each other in several months. Because the course is so intimate and so much is explored, we really got to know each other and care about each other. What a great way to build community!

One of us is pregnant, due in a few weeks, and we’ve witnessed her blossoming into a beautiful, confident mom-to-be. Her blessingway was an outpouring of love and support. She recently assisted at a birth and watched with wide-eyed wonder at the baby’s head emerging from mom’s yoni realizing that soon that would be her. Great preparation for her upcoming birth.

We heard about two hospital births where doulas were welcomed, moms were fully supported in their wishes and the birth experiences were very positive. Happy moms, happy bright-eyed babies. Good news!

We talked about baby whispering and how responsive babies are to our communication with them. Telling the baby what’s going on at all stages of the birth and postpartum is really helpful and brings peace.

We heard about placenta previa and placenta abruptia – how to recognize them and their repercussions.

One doula, while visiting a pregnant friend who lives in a rural area on the mainland told of a community where several miscarriages have taken place recently and the concern on the part of women who live there. This real-life example got us talking about the environment and possible reasons why this might happen.

One mom was having problems breast feeding due to inverted nipples so this sparked a discussion of methods used to support lactation from nipple shields to breast pumps to formula feeding combined with nursing.

Barbara reminded us that it’s a privilege to be at a birth. It involves a lot of trust on the part of the family to allow us into their homes and their lives. What we’re doing as community doulas is a spiritual practice. We must let go of any attachment to outcomes. We bring an energetic infusion that will be there after we leave so we must take great care in preparing ourselves before we enter.

The next doula training program begins on January 8. Please see the calendar for a course description and details. I look forward to our next community doula gathering. Will you be there?

Please follow and like us: