Five minutes after getting to Julie’s house, I told her, “If your water breaks, we need to get in the car and go.” Two contractions later she said, “Oh, there goes my water.” We were in for a wild ride.
(**story and photos shared with permission**)
Normally, when a couple hires me as their doula, we spend at least an hour together just in the interview process and I get to learn a lot about them – their hopes, fears, and dreams about the upcoming birth and about parenthood in general. After that, I spend time in their home for prenatal visits as we talk about coping in labor and how to handle the many ways labor could start. We plan for how long they’d like to stay home, who will be watching the pets or children, when to call me to join them, and discuss any other details that keep them awake at night. Then there’s usually a lot of texting back and forth as the due date looms, with questions and need for reassurance.
This time it was different. Julie & Brett were expecting their fourth child. Their twin daughters, age 6, were born via cesarean. Their son, age 3, was born via VBAC in a hospital with the care of a doula and midwife for the 24-hour labor. This time they were hoping for a similar delivery, but discovered that their previous doula’s availability had changed. Julie heard about me from a mutual friend and previous client, so at 38 weeks + 3 days into her pregnancy, Julie let me know she’d like my support during her birth. We planned to talk the next day about the doula services contract and to set up a time to meet.
At 6:26 the next morning, Julie texted to say she had some spaced out contractions in the night. I sent my kids off to school and told her to keep me posted.
8:45 am, Julie’s husband Brett called me to say it seemed like labor was moving forward but the contractions were only about 30 seconds long. I asked him how Julie was coping, and he said she was doing just fine. He said if things kept going this way, he expected they’d call me later in the day when they were headed to the hospital.
9:17 am, Brett called again and said contractions had intensified and Julie would like me to come to the house. Normally, this would be the time I would ask to speak to the laboring person on the phone because I can tell a lot more about how things are progressing by their voice. But since I live only 10 minutes away from this family and I hadn’t met with them yet, I thought it would be best to show up and assess the situation in person. I got my birth bag together, made a few calls to cancel and rearrange other things on my calendar for the day, and headed to their house.
9:30 am, I arrived at the home. Walking into their living room, I found Julie on her hands and knees. Her children were all sitting nearby, her son Simon singing sweetly as she labored. She was silent during contractions, and as she sat up in between, she told me she was feeling the contraction pain around her belly and into her back. I met Brett briefly as he was passing through, getting things ready for the kids and for the hospital. Even though Julie was quiet and calm and very controlled, I guessed that she was in good active labor. I went to microwave my rice heating pad for her back, and thought we’d assess how far apart these contractions were and then start heading to the hospital pretty soon. Her waters were intact, so I told her, “If your water breaks, we need to head directly to the hospital.” She sent her children outside with a friend who would be watching them.
9:45 am, I gave her counterpressure through 2 contractions, and when she rocked back on her heels at the end of a contraction, she said, “Oh, there goes my water!” I asked Brett, who was still busy arranging things for the other kids, to grab a stack of towels to protect their car from the amniotic fluid. Julie went to the bathroom before getting in the car. We noted there that her fluid was clear (no meconium). Her contractions seemed much more intense as she stood swaying on the tiled floor. She changed into dry clothes and we headed outside to the car.
Walking down a steep double flight of stairs, Julie and Brett stayed calm and focused. When contractions hit, Julie held onto her husband and breathed slowly and deeply. I sensed she was progressing quickly as I followed after them with my 22-pound birth bag and camera, fumbling with my phone to alert the hospital that we would be arriving with a woman in advanced stages of labor. Seeing the urgency, Julie’s quick-thinking neighbor offered to make the call for us.
10:00 am, Brett quickly removed the older kids’ car seats from their Toyota Sienna, and Julie got on all fours between the seats in the middle of the van. I told Brett, “This is usually when I get in my car to follow my clients, but I’d like to come along this time.” He quickly agreed.
I sat beside Julie, and Brett started the drive. I applied my rice heat pad to her lower back and instructed her to take quick panting breaths. Her behavior grew very inward and focused and I started to think that maybe we weren’t going to make it to the hospital. They had chosen their hospital, Adventist Hinsdale, for its supportiveness of physiologic birth and for the midwife program there, not for its proximity to their home. I calculated that with traffic and construction we had at least a 35 minute drive. Ever attentive, even from the driver’s seat, Brett passed a bottle of coconut water back for Julie to drink. I helped her sip the water, brushed back her hair, rubbed her back, and told her she was doing a wonderful job.
Meanwhile, my mind raced with a list of options and scenarios. We were about 10 minutes away from their home now, in heavy traffic on a busy road. I looked at the choices for places to stop: gas stations, strip malls, fast food restaurants. I thought about how long it would take emergency personnel to get to us if we stopped and called 911. How much hoopla would there be if we stopped in the Subway parking lot? How about Hobby Lobby? Or Marathon gas station? I recalled stories I had heard of other precipitous births that became chaotic with flashing lights and adrenaline-hyped first responders.
Julie said, “I can’t help it, my body is pushing with contractions.” We were probably still 20 minutes from Hinsdale Hospital. I said to Brett, “I think we may need to consider stopping at Elmhurst Hospital, as we’ll get there sooner.”
I lifted Julie’s knees one by one to put a thick towel under them. She said, “You guys, I’m sorry but the baby is coming now.”
With the next contraction, she gave a deep and guttural groan. I reached into my birth bag for my gloves, which an experienced doula friend had advised me to always keep handy. I had a surreal moment as I pulled them on: This really can’t be happening. Then Julie said, “The head’s right there.” I asked her if I could check. Julie -- elbows on the minivan seat and knees on the floor -- said yes, please check. So I lifted her dress, lowered her underwear, and saw the top of the baby’s head emerging. Please, God, let the baby be healthy. Please help us. Support the head, don’t pull. I put my right hand gently under the baby’s head and it slid out to the neck. I had a stomach-lurching flash of panic as I saw that whole cute squishy little face, basically between the two front seats of the van. Time stopped for a moment. This IS happening. Here. Now.
I saw a small section of cord, hooked my finger under it, and unwrapped it from the baby’s neck. It was loose and long. “Give me one push,” I said. Just then a shoulder emerged and the baby slipped right into my hands. He gave a sweet cry and his skin looked pink.
I lowered him softly onto the towels under Julie’s belly. “Baby’s here! Looks wonderful!” or something to that effect, is what I think I announced amid the buzz of adrenaline in my head. Brett was stunned and saying, “What should I do? Should we pull over?” What is the right thing to do? Looking up and around us, I noted the time: 10:22 am. I knew we were not much more than 5 minutes away from Elmhurst Hospital. I massaged baby’s chest with my fingers and he squirmed and cried. He looked just perfect. “Keep going,” I said, “we’re almost there.” Brett later wrote in his birth announcement, "Taking my cues from Julie and Tara, neither of whom was freaking out, I was just doing my best to stay on the right side of the road."
I knew they’d rather be at their chosen hospital in Hinsdale, but that would require more risky minutes with a new baby on the floor and an undelivered placenta. Julie was still on her hands and knees and there really wasn’t room to maneuver her around. I scooted the baby forward so that he was directly under her face, and she caressed him, talked to him, wrapped the towel around him, and announced to her husband, “We have a boy!”
About 10:28 am (less than an hour after I had met Brett & Julie), we pulled up to the ER entrance at Elmhurst Hospital. A group of medical staff awaited us outside, with a hospital bed at the ready. They had gloves on, seemed energetic and prepared for anything. I jumped out and let them know baby was born at 10:22, pink and crying. Brett, as soon as the car was in Park, turned around to hug his wife and take a good look at his new son. The medical personnel seemed to relax a bit with the knowledge that the delivery was done. The attending doctor jumped in the car to cut the cord.
A labor & delivery nurse asked permission to take the baby, and brought him onto the bed to look him over as a sheet was draped around Julie and she was helped out to the bed. I asked if we could skip ER and head straight to the Labor & Delivery floor, and the doctor agreed that since everyone was doing fine, we could go straight there.
By 10:33 we were in a L&D room. Julie, looking radiant and absolutely lovely, cradled her son in her arms, and Brett kept shaking his head in disbelief. The attending doctor examined Julie and said she hadn’t torn at all. She administered an injection of Pitocin to prevent hemorrhage. Julie started feeding her baby, and the placenta was delivered at 10:40.
Finally, everyone but the nurse left the room. All was quiet.
I fetched water and juice, took pictures, and we began to really process what had happened. Brett’s phone calls to family sounded like, “No, really, why would I lie? I promise the baby was born in the car!” Brett later wrote, "Throughout the labor and van ride, Julie was a champ. She was not hysterical, she wasn't screaming or anxious, she was totally focused on the labor. One of the things she really hoped to do was labor in a different position than the usual one. In fact, she hoped to labor mostly on her hands and knees. I guess that worked out." When the shock had worn off and they looked settled and ready to enjoy some alone time, I left the hospital. I took the soiled towels from their minivan to pressure wash at home.
On the way home I reflected on the incredible previous three hours. I thought through the many decision points that could have led to different outcomes. I marveled at the contrast between this uninterrupted birth and the highly medicalized ones I often attend. I felt privileged to hold a child as he took his first breath. I thanked God for a healthy baby boy and the sweet family who welcomed him with such love and joy.
From the family's birth announcement:
Tobias (we'll call him Toby) means "The LORD is good." We pray that Toby's life will be marked by a quiet confidence and assurance of the goodness of God, and that through him others will come to that same assurance.
That quiet confidence was already present by the manner in which he made his entrance. Calm as a cucumber, Toby entered the wider world traveling at about 45 mph down Roosevelt Rd...