From a Doula's Perspective: A Transfer from Natural Beginning Birthing Center To St. David's North Medical Center in Austin, Texas
Written by Morgan Ramsey (Doula) | Photographed by Mariah Williams
Foreword by Katie Magnuson (Birth Mother):
My son is now four months old and I have been working to put my birth story to pen since he was born. My sweet doula, Morgan Ramsey, sent me her version and it literally brought me to tears… I wanted Mariah to share this version, because it was so perfectly written & reflects my own experience so closely.
Welcoming Aaron into the world was a beautiful process and I am so proud of what my body was capable of from pregnancy to postpartum. When I think back to this day, I am overwhelmed by the Lord's kindness & provision. He knew the desires of my heart, and in a much different way than I expected, he brought these desires to fruition: a clear-headed/ wise midwife, a wonderfully peaceful atmosphere to labor in (think worship music, essential oils, and glorious natural light), a skillful & empathetic surgeon, and a wonderful hospital & nurses to care for me after an exhausting labor & delivery.
I am glad to have this story written out, so that I can always return to it. The day Aaron came into the world and Eric & my world was forever changed.
On a humorous note, my son decided to come 9, almost 10 days after my due date; I attribute his entry into the world to the glass (read: 5 sips) of champagne that my midwife encouraged me to drink at my last prenatal appointment. Instead of focusing on inducing labor, she recommended that I take time to relax. About 20 minutes after said champagne, my water broke. A funny coincidence... or not? ;)
Katie’s birth story, from her doula, Morgan Ramsey’s perspective:
I had the privilege of meeting Katie and her husband, Eric, when Katie was 35-weeks pregnant. I was able to offer two prenatal visits with their family before she went into labor. During those visits, I listened as Katie shared her desires for birth, including giving birth at the birth center in North Austin. Katie decided early on that she would give birth at Natural Beginnings Birthing Center without pain medication or continuous monitoring; she wanted to be able to move freely throughout her labor. During our first prenatal visit, we discussed Katie’s birth plan, comfort measures for labor, packing for the birth center and the plan during the first stage of labor. Katie desired to stay home as long as possible, working through contractions in her own space during the first stage of labor. Katie received excellent care from the midwives at the birth center, and they were well informed about her birth plan. At the second prenatal visit, I was able to have a tour of their home - discussing the postpartum period.
Katie watched her due date come and go, without any movement from their little guy. She continued to stay positive, doing many of the things she knew would help get labor started. She was adamant about doing yoga, stretching and walking every day. With the permission of her midwife, she drank Red Raspberry Leaf Tea and black and blue cohosh tincture and applied Primrose oil. Finally, after 41 weeks, Katie began to feel contractions. Eric was great about updating me of her progress. She was up most of Monday night with contractions, but was able to breathe through them. By the early morning hours of the next day, contractions were intensifying and the time between each got shorter. Katie and Eric requested that I come to their house at that point. I got to their house around 6:00am on Tuesday and found Katie on her yoga mat on their bedroom floor doing cat/cow between contractions. I was able to relieve Eric, who hadn’t gotten much sleep over the last 24 hours, and took over timing contractions. At this point, contractions were around 6-7 minutes apart, and Katie was managing them beautifully using breath and vocalization, as well as the use of the birthing ball.
After a few hours, Katie’s contractions picked up, coming about 3 minutes apart. At that time, I woke Eric, and we called the midwife (Bridget Kenny). Upon the her direction, we packed the bags in the car and headed to the birth center. Katie requested that I ride with her on the way in order to help manage her anxiety. On the ride, we did a few grounding meditations and breathing exercises to help her stay focused and calm. Katie handled her contractions extremely well in the car, especially given that we were in the middle of Austin rush-hour morning traffic!
Upon arrival to the birth center, the intensity of contractions really increased. We were checked into a birthing room, and Katie immediately got onto the birth ball to manage contractions. Over the next 6-8 hours, Katie’s labor progressed. She spent much of the time in and out of the bathtub and shower to help ease contractions. Eric remained an amazing and supportive partner throughout the labor, encouraging her and reminding her how strong she is. It was beautiful to see the way Katie stayed focused, rhythmically swaying back and forth in the shower letting the water fall on her as each contraction passed over her body. I watched her keep her body calm and at ease, breathing and vocalizing through each wave of intensity. Katie felt strongly about not having any vaginal exams, and Bridget respected and honored her wishes.
Around 4:00pm, Katie felt the urge to push. She started in the bed laying on her back, as she was so exhausted from laboring all those hours. With
Eric on one side and me on the other, we supported Katie through the beginning stage of pushing, encouraging her to bear down, bring her chin to chest and breathe deeply between contractions. Katie quickly changed positions to all fours, hoping this would help her feel more in control and able to push more efficiently. She pushed a few times in this position and then moved to a squat on the birthing stool. Katie pushed for almost 3 hours but did not seem to be making any progress.
The baby was not descending any further through the canal, and he was starting to show signs of distress with an increased heart rate. Katie was feeling overly fatigued, and Bridget began to discuss options with us. In her opinion, the next best step was to transfer to St. David’s North Austin Medical Center (across the street), due to the lack of progress, the baby’s distress and Katie’s exhaustion. Bridget felt like the assistance of a vacuum would be helpful in order to help guide the baby along. She discussed the option of having an epidural once admitted to Labor and Delivery so Katie could experience some relief and restore enough energy to push again.
Although Katie was disappointed and tearful about leaving the birthing center, she felt confident that this was the best plan for her. She expressed that she did not feel like she failed in any way and was grateful for the opportunity to labor naturally all day in such a warm and peaceful environment. Katie agreed that the epidural would be helpful for her to experience relief from the intensity and hopefully help her to push. Katie wanted to walk across the street to the hospital instead of ride in the wheelchair, as walking helped with the pressure she was experiencing.
Katie was met by friendly and welcoming nurses who helped her get settled into the labor room. The lights were dimmed, and there wasn’t the usual hospital “buzz”, which was extremely calming. Once her IV was started, she expressed a desire to stand up instead of laying in the bed. The nurse was wonderful and quickly helped her out of bed so she could move about more freely. For about 30 minutes, we moved through different comfort measures including slow dancing, hip squeezes and light massage. The anesthesiologist came to discuss the epidural procedure, obtained informed consent and everyone but Eric was asked to leave the room so the epidural could be administered.
The obstetrician (OB) on call came to talk with Katie. She was kind and gentle as she explained that she could try to push for the next hour, but if there was no progress, a cesarean would be necessary because the baby’s heart rate continued to spike and show distress. The OB took time in explaining the reason for this – the safety of mom and baby – and showed deep compassion and empathy as Katie cried and expressed her fear of having a cesarean section. The OB answered Katie and Eric’s questions and then said she would be back in an hour to check on her progress. Bridget stayed with Katie throughout the hospital admission and as she continued to labor, which was extremely comforting for her. It was encouraging to see the hospital staff work together with the midwife. They were also extremely welcoming of me as the doula and let me continue to be involved in the process.
Over the next 45 minutes, Katie pushed with the help of her birth team and the labor nurse but no progress was made. The OB explained that because no progress had been made over the last hour, and the baby seemed to be stuck, a cesarean would be necessary. She explained the surgery in detail, obtained informed consent after answering all of Katie and Eric’s questions. Bridget and I sat with Katie awaiting the surgery and reassured her that this was still HER birth, and there were things that could be done to help her feel like she was still in control and that her body was not broken.
The hospital team prepped Katie for surgery, explaining that her husband and I would be allowed in the operating room (OR) after she was settled. I was able to be with Eric, checking in with him to see how he was feeling and answering any questions that he had before going back for the surgery. We were brought back to the OR and allowed to be next to Katie. She was shaky, extremely anxious and experiencing severe nausea. This continued throughout the procedure, and her anxiety only increased as the cesarean took longer than expected because of the baby’s position. Katie felt more pressure and pain than she was supposed to which also caused her to panic. Eric and I stood by her head, held her hand and stroked her hair trying to calm her. She was given medication to ease nausea and to calm her down, causing her to be groggy after the surgery. She was unable to hold her baby immediately after in the OR because of this, but once in recovery, Eric held him and showed him to his wife.
Katie was a beautiful example of strength and resiliency. On paper, nothing that happened during her birth went according to “plan”. Katie chose to see things differently, expressing gratitude for the amazing birth team by her side and her healthy baby boy. Although, in many ways the birth did not go as “planned”, I feel privileged to have been a part of something so beautiful.
Aaron Henning Magnuson was born on July 23, 2019 at 10:30pm, with a head full of hair - weighing 9 pounds and measuring 22 inches long.
