Touched by New Life

On Tuesday September 27th I helped welcome Orion Rhythm Smith into the world.  I am feeling so moved by his birth and more so by the birthing of his mother and father -Michelle and David- into parenthood.  His birth came as a surprise because his expected due date wasn't until mid November.

Last Friday David called me at a quarter to nine and I knew by the timing of the call and the sound of his voice that something was up.  Michelle was having some cramping.  When I spoke with her I was able to hold space for the whole experience she was having, not just the physical one.  She decided to see if she could get some rest and I advised her to call me and go to the hospital should anything intensify.  I got a call around four am.  They went into Dominican due to some spotting.  I met them there in the morning.  Michelle was not in labor, but having contractions every twenty five minutes or so.  She was quite effaced for 33 weeks and they diagnosed her with preterm labor.  They gave her some medications to help slow down the contractions and two shots of steroids to help with lung development.  Once the nurses were done with procedures for the moment I turned off the lights and facilitated a relaxation and visualization with Michelle and David.  We took the time to connect with the source, to tune in with baby, to slow down the breath, to listen, to relax the physical body, to see the blessings of all the care and personnel of the hospital,  and call in the knowing that all is well.  When it was complete I tucked them into bed (ordered a cot for David) and encouraged them to rest as there was nothing to be done in that moment.  (Of course they were exhausted from being up half the night.)  David thanked me for the words and images and I said it wasn't me.  I really felt like it was just one of those moments where I got out of the way and allowed what wanted to come through me.  I felt the effects of the words on my own being and left them with a sense of calm even amidst the circumstance.

They were released from the hospital on Sunday and ordered to bed rest.  We were all hoping for a good four weeks of rest and baby holding for Michelle.  Orion had his own plan.  At 6:10 Monday night Michelle called me to tell me that she thought her water had just broke.  It was quite shocking for Michelle who was alone at home in the moment.  Luckily, our mutual good friend Shawna lives next door and was able to be there within moments to be present with her.  David arrived home quickly and they rushed off to the hospital.  I met them there and Michelle was already moving into active labor.  Shawna came along as well and it was great to be together at another birth as we have shared the doula role before (as well as attending each other's births).

What most struck me about this birth was Michelle's willingness to surrender with grace and beauty at each stage of the process.  When I arrived and she was on the bed on her back I reminded her that she didn't have to hold baby in any more and that she was free to move aroud.  Now that her water had released it was time to let go and let labor happen.  Which she was already doing so beautifully.  When she arrived and they checked her cervix she was three centimeters dilated.  Shawna and I reminder her not to do "labor math", as things can change quickly.  I set up some candles (battery powered) dimmed the lights, got Michelle out of bed and standing leaning forward on David for support.  The nurses were wonderful and gave Michelle plenty of space to labor without interruption knowing that she had ample support in the room.

Michelle knew just what she needed in each moment.  We would suggest position changes which she would try out for a while - the birth ball, the shower, upright and hands and knees leaning forward on pillows.  Michelle found as she progressed through labor that she was most comfortable on hands and knees and lying on her side.  As she deepened into her relaxation she was actually quieter with each contraction even though they were clearly stronger, longer and closer together.  She entered into an altered state and let her breath carry her through.  If you were not watching closely you may have wondered if she was really progressing, but when I dropped in with her I could see that she was clearly sinking deeper into her labor.  David was by her side...giving her love, fully awed by her strength and beauty.  Sometimes he would look around with big wide eyes and you could tell he was just taking all of this in and adjusting.  Shawna or I would lock eyes with him in response with a look of "Yes, all is well.  This is where we are going and it is good."

The head NICU nurse Nancy came in at some point to check in and answer questions.  David would try to gather information but as soon as Michelle would start the next contraction he just wanted to be by her side.  Michelle was fully in the depths of active labor and was not wanting to talk about the NICU at all.  I offered to absorb some of the info for them and asked Nancy to go outside of the room with me.  She gave me a tour of the NICU and answered questions about the expectations with a 33 week baby.  The good news was that each baby is treated individually starting with the least of interventions and increasing as needed.  Skin to skin contact with the parents and breast milk and feeding is a top priority.  She assured me that baby would get immediate skin to skin contact after the birth if he was doing ok.  I carried this info back into the room with me but knew that Michelle and David were not ready to hear it.  They were just wanting to be present with labor.

And Michelle labored so beautifully.  She found that she was able to rest best between contractions while laying on her side.  She grasped Shawna's hand during contractions, while I worked on pressure points on her feet or shoulders.  David sat by her side with his love and awe.  Soon she approached transition.  (Around 11pm) She was so in present in her labor that she was actually less vocal with the contractions than earlier in the labor.  Although she would tell us every once in a while just how intense this was getting for her.  She came to her walls as most laboring women do, but they did not stop her.  Shawna and I continued to reassure her that she was right where she needed to be.  As she approached the completion of the dilation phase she would ask us, "how will I know when it is time?"  A question many women may grapple with through the transition phase.  I encouraged her to trust that her body would know when it was time. There would be no doubt and the urge to push would just happen.  (Her cervix was not being checked regularly because of the ruptured membranes and preterm baby.)

Somewhere around this time David asked Melissa the nurse if Michelle could get in the tub.  Melissa got the ok from the OB.  (A previous nurse had said no.)  Michelle said she would be open to trying it and might as well have it filled.  In this moment I knew that she would be pushing before the tub was full.  But my thought was, "Let her fill the tub and then the baby will be born."  Later, after the birth Melissa told me that she had the very same thought in that moment she went to fill the tub.  Soon afterward Michelle was pushing with her contraction.  I went to tell Melissa.  She was not surprised.  She had to do an exam to make sure it was time to get all the necessary personnel in the room.  Sure enough Michelle was completely dilated with just a tiny rim of cervix.  She was given the green light.

All of the appropriate parties took their places in the room.  We had been warned that there would be several people in the room. Their presence did not feel overwhelming just simply supportive.  Dr. Ishmael the neonatologist was a wonderful man with a big heart and a gem of a presence.  The OB said something to me about the baby needing to go right to the warmer since the neonatologist was there.  I told her that was not what I had been told by Nancy the charge nurse.  They consulted with Dr. Ishmael and he confirmed that baby would go skin to skin on mom immediately after birth as long as he was doing ok.  I was glad I had gone over that with Nancy before the moment of birth.

Michelle pushed like the powerful goddess that she is.  Full of strength and beauty.  She crowned her baby over a series of contractions.  His heart rate stayed perky throughout the labor and delivery.  He is a very strong little man.  After what felt like a long crowning he came out very quickly and was passed up to Michelle.  Dr. Ishmael was right there next to her to be present with him.  Orion cried a lusty cry immediately and was pink as can be right away.  We were all overwhelmed with joy.  Everyone asked what the gender was as they were waiting to find out.  Michelle couldn't see from her angle and didn't want to move him.  I could tell she wanted to know and I knew we may not have much time left with him on her chest, so I peeked under the blanket and gave her the news.  She and David had known and dreamed about this boy already though and I don't think it was a surprise.  I had been calling him "he" throughout the labor as well.  He was born about 1:30am weighing 5lbs and 18 inches long.  A great size for his gestational age.

Soon Orion was struggling to breath and he was brought over to the warmer to receive oxygen.  Michelle was immediately reminding David to stay with him which of course he did.  I stayed by Michelle's side while she delivered the placenta.  This part of the birth amazed me.  I have been at preterm births where it seems like it takes forever for the placenta to separate on it's own.  This one was ready to come within a few short minutes after birth.  I have heard some midwives say that the woman who births her placenta quickly is ready for motherhood.  I have to say I felt this to be true in Michelle's case.

Orion was showing signs of readiness to go to the NICU to get more help with breathing so Dr. Ishmael brought him over to Michelle for a quick nuzzle before taking him there.  Shawna went along with David to support him.  I stayed with Michelle who was blissfully high from her birth.  She was already ready to talk about it and how amazing and hard and powerful it was.  Words don't really describe the experience.  We stayed in the positive even though there was an emptiness in the room without Orion and David there.  I offered to show her the placenta because it was such a part of him and her.  She was interested so I showed her the bag of fluids her baby had lived in, the cord, the maternal side, the "tree of life" that  brought nourishment to her baby.  I had just learned about placenta readings at a midwifery workshop so I did a mini placenta reading for Orion.

Soon Michelle was fed,  had her IVs out and was almost ready to go see Orion when David and Shawna returned from the NICU saying that they had to leave because Orion was being intubated.  The oxygen they were giving him nasally was not quite enough to inflate his lungs and he was struggling.  There was more waiting for the green light to get Michelle down to the NICU.

Finally it was time and we wheeled Michelle down the hall.  Orion was in the warmer intubated with all of his tubes and wires.  How to describe this moment?  It was her fist time really getting a good look at him off of her body.  She was in love of course...yes the concern was there but beyond it huge amounts of love.  Her and David gazed at their son together and bonded.  It was so beautiful.  Dr. Ishmael came by and I swear there were tears in his eyes.  He started taking pictures of them.  I let myself take this beautiful scene in for a while and took pictures with their camera.  Then I knew it was time for me to go home to my family and my own nursing toddler.

The next day I returned to find Michelle with Orion in her arms skin to skin, latched on to the breast and starting to suckle!!  What a sight!  I could not have wished for a better way to find them.  Orion had been extubated within hours after the birth and was now breathing room air all on his own.  He was receiving colostrum through a tube in the nose but was simultaneously learning how to suckle on the breast.  Michelle was positively glowingly radiant.  What a gorgeous woman and mother!  The oxytocin was thick in the air.  She said that when someone from the NICU had come by to ask if she would like to talk about expectations for the following weeks with Orion she said no.  She just wanted to be present with him in the moment for his fist few days of life.  I just loved her strength and her empowerment to stand in this mothering instinct and ask for what she needed.

A couple of days later I came back to the NICU and found Michelle and Orion in a similar position.  (My timing seems to be opposite of when David is there but she tells me he is getting some good hours of skin to skin "kangaroo care" as well.)  Orion had his umbilical lines removed already and was slowly having less things attached.  Her milk was in and he was getting his own mama's breast milk through the feeding tube. I came to talk to her about setting up a meal calender so that she and David can have meals brought to support them in this time.  Michelle is completely dedicated to spending every possible moment with her baby.


I learned something in my journey of witnessing Michelle become a mother.  It's something so deep that words only attempt to do justice.  There is a fierce kind of mothering instinct that is so powerful.  I watched Michelle surrender into what was happening in her pregnancy, birth, and now her postpartum with such grace, beauty, strength, love and gratitude.  I am truly in awe and touched by this new life - Orion the center of her universe and all of the blessings that he brings.  He just couldn't wait to be in his mother's arms...