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Posted on 07-06-2016
I am a vitalistic family chiropractor and doula with a concentration in prenatal and pediatric care, breastfeeding mother of two who has delivered via cesarean & vbac, and a passionate advocate of non-traumatic birth & natural parenting. Because of this I have the divine pleasure of witnessing miracles in pregnancy, birth, early childhood and beyond. I would like to share some of these life changing moments with you and give each mama the gift of her birth story from my perspective.
I received a phone call when I was at lunch today from a doula who was at a home birth in Cleburne, about 45 minutes from me, who said there was a mother in labor who was in a lot of distress. She said the mom was about 10 cm and had been pushing for a long time with no progress and now she was in a lot of pain in the lower part of her stomach, the baby was in a bad position, and she was almost ready to give up and transfer to the hospital. She asked if I could come and adjust the mom and possibly get the baby in a better position. She said I was their last ditch effort.
I asked my husband Eric, who is also a chiropractor, if he would cover for me at the office and of course he said yes. I headed out there as fast as possible updating them along the way. I didn’t have time to swing by my house and grab my portable chiropractic table but I did call my assistant Marnie and have her meet me at the door of my office with my vibraccusor, activator, gloves and gum to kill my mediterranean lunch!
Being a woman who has been in this exact scenario - trying to have a natural birth, baby jammed in my pelvis in a terrible position, severe pain … something is wrong and I can’t make it through this much longer without serious medical intervention & this is not contraction pain … in the lower part of my stomach - my midwife trying to reposition the baby manually to no avail - I know what is at stake. This mothers peace, belief in her body as a creator, maintainer, and deliverer of LIFE, confidence in her inner knowing that she CAN DO THIS, long term grief over all the reasons why this baby did not get in a good position and why she couldn’t push it out is at stake. My heart is beating out of my chest with this sense of compassion and urgency that is consuming me… that only a mother who has experienced this could feel. I chew my gum rhythmically to the music in the background of my thoughts and prayers for this mother as I go well over the speed limit.
They call me saying the mother wants to know where I am because she is desperate for relief. I tell them to hang tight and I'll be there in just about 8 minutes. I put my hazards on and run a few low traffic red lights maneuvering around a few cars taking their time. I finally pull up to the house. There are several cars outside as I park in a driveway on the side that seems to belong to someone else hoping that I don’t get towed - not really caring. I grab my equipment and run in. The father of the mother who’s name I don’t even know yet meets me at the door and quickly walks me to the room.
I transcend into this room of darkness with shadows all along the perimeter. As my eyes begin to slowly adjust I realize that there are probably about 10 other people in the room with me. I ask where the mama is and hear her groaning in pain on her back with her head kind of hanging off of the bed. I feel my way over to her with my hands along the end of the mattress and ask if we can turn the lights on a bit so I can see her. She responds quickly with "Just turn the lights on! Do whatever you need just please help me. I'm in so much pain."
I ask her where she is hurting and she points to her stomach right above her pubic bone in the center. She says that it's killing her and that the contractions don't hurt that much but the pain in her stomach is really bad and that she didn’t have that type of pain with the birth of her son. I ask permission to touch her stomach and as I am palpating I turn to the midwife and ask if they have done a catheter to empty her bladder. She says yes and that its empty. She says that the baby is LOP or LOT but she's not quite sure which. I ask the midwife several other differential questions about baby’s heart tones, dilation, cervical lip, childbirth history etc to rule out other possible causes of lower abdominal pain and get a decent background on this mama.
I’m feeling her baby and watching the shape of her stomach change through a contraction. I see the all too familiar C shape belly and feel the baby’s shoulder jamming up against the superior side of her pubic bone on the left causing her a lot discomfort. This baby is definitely in a left occiput transverse position. I need to get this mama on all fours to check her sacrum and adjust it - creating adequate space for this baby to make it through her pelvis and removing interference to the power of her nervous system so that the intelligence that is running and regulating her entire existence can communicate clearly with her uterus, baby, and the muscles of the pelvic floor to liberate the POWER that resides within her to deliver this life from her womb.
I whisper to her doula, “What is her name?” She replies, “Kourtnie.” I tell Kourtnie, “I know you're in a lot of pain and I'm so sorry. I promise you I know what it's like. I've had this pain before. I've had a posterior baby. I've had a transverse baby. I've had a C-section and I've also had an unmedicated VBAC. I know you're hurting really bad and I promise that I will do my best to help you.”
I know it's going to be hard for her to move but I need her in a better position so I can check her pelvis. I start giving her instructions to get on all four's and explaining that I know it will be uncomfortable but I need her in that position if I am going to help her. I ask her husband to support her by letting her lean on his chest as he wraps his arms under her armpits. He does so and I start assessing her sacrum - the keystone to birth.
It’s hot in here. I’m sweating, my mind is crystal clear, I’m asking God to work through me. I’m surrendering to His will for this mother, baby, & birth. I’m stepping out of the physical and into the energetic. Nothing around me exists. All that is here in this room is me, mama, and baby. My hands become like magnets drawn to the areas where energy is being trapped in her nervous system. After so many years of trying to feel it (not just access it and know it in my educated doctor mind), in times like this where I am in my dharma - my true calling - it shows up quickly with no effort.
Her sacrum is really posterior on the left, not moving at all, and I’m sure shutting down the POWER to this birth. This is without a doubt contributing to her baby malposition.
I start to work the vibracussor into the left side of her sacrum with her on all fours. After just a few minutes I get her sacrum moving really well and in a better position. As I feel the softness of the mattress giving way under my knees I know there is zero possibility of me adjusting her in side posture to clear the rest of her pelvis. So I do some additional positional adjusting with the vibracussor in her pelvis clearing the rotation in her iliums on both sides in the all fours position. I have her maneuver to her back where I access her pubic bone. Almost every movement is testing her ability to stay centered - keeping her head above the intense waves of sensation.
She’s wearing a sports bra and in her full feminine glory she’s to that point in birth where modesty is a thing of the past and the essence of birth is in full blossom for all to witness. I put gloves on and check her. It’s pretty high on the right preventing the baby from fully turning the occiput to the anterior position. I set my activator on the highest setting and adjust down the right side of her pubic bone 4 to 5 times working my way from lateral to medial. It clears. It’s moving now and out of the way for this baby.
Now I need her on her right side on the side of the bed. Each time I ask her to move to reposition herself I feel bad but know this is the only way to get this baby out vaginally and this is what this mother wants. I know that it will all be over soon and it will definitely be worth it for her. I tell her that. I get her on her right side with her belly hanging off the side of the bed, hold her left knee up to her chest, fold over her stomach spinning her about 45° to the floor while I'm in a full fencer stance supporting her completely with the weight of my body under her. We work through a few contractions in this position…I'm coaching her "Don't hold your breathe. Take a deep breathe and relax your bottom. Relax your leg." I place my hand on her leg and sacrum to bring her consciousness to letting it go. Her husband is behind her.
The first contraction in this position is definitely painful and we have to ease the position up a little bit. By the second contraction she seems to be in far less pain. I whisper to her Doula that she doesn't seem to be hurting as bad and I think the baby’s shoulder has moved. I tell her husband as well. The midwife squeezes in to monitor heart tones and the babies heart is beating steady and strong. Her doula leans down and whispers to her asking her about the pain and she says it is definitely better. She rolls onto her back and I palpate and look at her stomach again. It looks and feels much better. C shape is diminished but still slightly present.
I transition her back to all fours one more time to make sure the baby’s shoulder is out of the way. I use a rebozo to shift the baby more to center and reassess after a few minutes. The fullness on the left side of her stomach empties out. I have her go on her right side one last time. We wait here through a few more contractions and she says that she feels like she needs to start pushing again.
The midwife and I both check her out on her back. The remnant C shape is completely gone. Heart sounds are right above the pubic bone and pretty center. I think I can feel the baby's back a little left of center but contractions are one on top of another at this point and I’m not 100% sure. The midwife checks occiput position and says that she is either anterior or posterior but not transverse anymore. Thank God.
Kourtnie tells me she feels so tired and she needs to get this baby out. I told her I know and I ask her if she is ready to push. She says with determination and resolve, “Yes.” She pushes on her right side a few times but the midwife says she feels like she isn’t getting enough power in this position. I ask Kourtnie if she feels like she might have more power on her back with her knees to your chest and she says yes. She rotates to her back as I support her belly.
With each push she is letting air escape and I feel the strength of the push leaving too quickly. I wonder if I should let her figure it out on her own and get into her own groove… I look at her face. She has that look. The look of a mother who has given it her all and really needs to meet her baby and let the tide of birth subside as soon as possible. I know she is exhausted and I tell her if she wants to get this baby out soon I need her to take a deep breath in, trap all her air in by pinning her chin to her chest, pull her knees toward her head, and push hard sending all her energy down into her bottom. I take a deep breath in and tuck my chin to my chest and show her what I mean. She starts pushing with so much power. I keep coaching her through trapping her breath and pushing everything she has down into her bottom.
The midwife says that she is pushing good but she needs to push down into her bottom more. I ask Kourtnie if she can feel where to push. She says “I think so but I’m not sure.” So, I ask the midwife to put some pressure on her perineum so that she could feel exactly where to push. A student midwife tries to apply pressure and the main midwife shows her how to place her fingers in the right position pulling down toward the floor so that mama can feel exactly where to send all her strength. The next push is even more powerful.
She’s getting tired again and weary. I ask someone to get her a mirror so she can see that her baby is about to crown. She finds the strength to push again. Then the contractions stop. She is starring up at the ceiling searching for the sensation to build. I see she’s questioning what’s happening.. I tell her “This is your time to rest. You need it. Take it. Just relax for a second.” She closes her eyes and drifts for about 20 seconds. Her educated mind starts to stir up again - she is getting worried. She says, “The next contraction isn't coming. Why is it stopping? It’s not coming.”
I’ve been here. I recognize it. I know that this is the space our bodies takes to regroup. To bolster all the energy it needs for the ejection reflex - the moment the neocortex (the educated mind) ceases to exist and the original mother - the mother that instinctually resides in the ancient hindbrain emerges and her body takes over and expels this tiny gift of life into the world. Finally.
I reassure her and tell her “I promise your body is very intelligent and knows exactly what it's doing. Your body knows when your baby needs a break and needs oxygen or needs to change positions. Your body knows when you need a break. Take your rest your contraction will start again. It will come. She says again “It's not coming.” I keep reassuring her “I promise it will come just wait for it.” I tell her “The next one will be the most powerful one you've had. It's going to make up for this break. Just trust your body. This next contraction is going to help you push your baby out. Okay?”
A few seconds go by - maybe 30 seconds - I start to get a little nervous. Not that she isn't going to have a good contraction but just that I don’t want her to loose faith and start coming unraveled. I know this needs to be over for her as soon as possible. She looks up at me and says “I think it's coming.” I reply “Okay, let it build. Wait for it.” “Okay, its starting” she says. I tell her “Take a deep breath and hunker down over your belly and push this baby out.” She does and its at the beginning of the second push that the babies head is delivered. And then the shoulders very quickly. And to all of our surprise this baby is posterior! Not only was the baby posterior but I believe the baby was a brow presentation for most of her pushing until after I adjusted her and worked on the baby’s position.
Her doula pulls me down under the photographer so she can capture each moment for this family. As I stand up and come back into my body and start to look around I realize there are about 10 people in the room. The doula tells me she has been waiting for this baby to get here for such a long time and that it’s such a miracle. I agree! It’s an absolute miracle and wonder what she means about having to wait for so long. She tells me this story about how the dad had testicular cancer and how they have been having infertility issues and finally got pregnant. This baby is a miracle. She’s crying and I start crying. I stood back and watched their first moments together. I introduced myself to all these people who had been silently watching this beautiful mama bring forth this tiny little miracle.
After a few minutes goes by the midwife asks me if I want to check and adjust the baby. “Well of course I do! Thank you for asking.” I step in and gently check and adjust the baby’s atlas and sacrum as she is on her mommy’s chest. We all start cracking up at her cheesy little butt! I lean down and wipe Kourtnie’s brow and tell her I am so proud of her and that SHE DID IT!
Reflecting back on this day I remember the midwife giving me such a huge hug with tears in her eyes. She said “I'm so glad that you made it out here.” You know, I said the normal “you're so welcome” and loved the embrace but what I felt like saying was “No, thank you.” “Thank you for calling me. Thank you for trusting me. Thank you for giving me the opportunity to help another mother deliver a baby that probably would not have been delivered vaginally otherwise. Thank you for giving me the opportunity to live out my mission and help other women avoid as much unnecessary intervention as possible. And to top that off thank you for letting me help deliver my daughter's doppelgänger… Brow presentation baby.”
This mama was surrounded by a tribe of people. Literally, her husband, mother, mother-in-law, father, son, three friends/birth photographers, what looked like three midwives, her sister, her Doula and me. She had so much love in that room and so many people believing in her. And most of all she believed in herself. The power of birth never ceases to completely blow my mind. And the power of the human body to bring forth life is so incredible. Once interference is removed to the POWER of LIFE anything can happen. And I'm so privileged to be able to play a part of it.
Congratulations to the Sholz family! You are beautiful just like your mama Miss Lylelynn!
vitalistic chiropractor & doula
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