A Doula's reflections on the tales of many births

Born in the Caul

36 hours before I was supposed to leave for an impromptu vacation, Sabrina calls me at midnight to inform me that she thinks she is in early labor. Still out under the moonlight looking for her missing dog, I encouraged her to go home and rest.

I woke up in the morning jumping out of bed panicking that I must have missed her call, only to realize that she still hasn’t called, so I dialed her number, labor was still inconsistent she reported. An appointment with Dr. F.M Lai at 1pm showed that she was only 3-4cm dilated, so they decided to go home first to get some lunch and pack up before heading to the hospital. An hour and the half later, Jeff calls me to inform me about the nature of her surges, 5 mins apart but climbing in intensity. We agreed to meet at Mount Alvernia Hospital, with me traveling from the East, and them traveling from Seng Kang, in the pouring rain.

3.45pm They arrived at the hospital and Sabrina is 7-8cm. I arrived 15mins after they did and Sabrina was clearly breathing down but her water bag was still intact. Jeff went down to get admissions done, and the nurses were bustling around prepping the room for delivery. As for me, my eyes were on the CTG machine as it was not picking up a good trace of baby’s heart rate. I gently asked Sabrina if she could move from a sitting position to an all fours position, which could help with the tracing. As I lifted up her blanket, not having smelled any whiff of amniotic fluid which I am so good at detecting, I was caught off guard to see baby’s head already crowning. I then realized that for that split second, only Sabrina and I were alone in the room!! I reached over to bell the nurses to no avail. Sabrina was in her own world, following the flow of her body. With the next breath, baby’s head emerged fully with the waterbag still intact. Instinctively, my body took over with ease, placing one hand under baby’s neck just in time to catch Sabrina’s next breath, baby slipped out into the world into my hands. Baby started crying whilst still veiled by the waterbag. At this point, my body having experienced many births before, simply took over and reacted much faster than my head, where my hands reached from baby’s belly, where there was a hole in the waterbag, lifting the veil as though it was a t-shirt, over his head and place baby onto Sabrina’s arms immediately. Sabrina, superstar that she is, was calm as ever and she readily welcomed her baby into her arms. First birth, less than 2 hours of intense labor. HypnoBirthing rocks!

The whole scene was so bizarre. In a moment where everyone should have been in the room – for some reason, no one was around – and when I attempted to get everyone, from pressing the nurses call button repeatedly.. to calling her husband and the Doctor, I somehow could not reach anyone. It was as though fate has determined that this moment was meant to be.

I reflected upon the birth as a good omen – to have a baby be born onto my healing hands and to be born in the caul, how much more auspicious can it get? It was the blessing I needed before leaving for my 10 day fast at Koh Samui.

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Making my peace as a Doula

I jumped out of bed by 5.30am, showered, put on my make-up and quickly planned the schedule for the rest of my day. The plan to take the day off looked promising – the plans to accompany my son for his swim lesson, head off for a morning breastfeeding consultation, and take the rest of the day off by having lunch with my son and friend, followed by trial pottery lessons just to do something different together for Kieran and I, Kieran going for his martial arts class, dinner with friends, attending Ajahm brahms talk and finally, a salsa dance social at Union Square. Excited about the day ahead as I was once again, going to attempt to take the day off after my morning appointment.

And the story always starts with my phone ringing, Jo was on the line and says that she is in early labor. However, because the nature of the surges were haphazard, she’ll keep me updated. That’s usually fine except that this is Jo’s 3rd pregnancy and that I’ve only met her yesterday for the first time and for the first prenatal, her birth plan was not done and she hasn’t had the chance to read up about whether she wants a waterbirth, home birth or just an active birth. Most of all, the doctor and the nurses at her hospital of choice has yet to be informed. Her doctor only called me personally a week ago to inform me that she is referring Jo to me.

Experience got the better of me, so I quickly had my breakfast, prepared my vegetable wrap to take along with me as part of my labor food stash, contacted all the relevant people (that being the doctor, the midwife in-charge of waterbirths at the hospital and the delivery quite staff to inform them and arrange for a possible unplanned waterbirth. Then because I had only met them yesterday, I had to print their birth plan and checked with her husband if he had some of the labor tools such as a rice sock ready, in case he needs me to supply anything else. On a personal front, I had to register Kieran at his new swim school, fortunately the class today was within walking distance from my home and where I would get a cab as well, so I quickly made my way there. Just as I was done, her husband called to update me on her progress and I said we should meet at the hospital. Jo refused as she felt that she would not be able to make it through the car ride to the hospital without any support so her husband asked me to go over to their place instead and we go to the hospital from there. I called for a cab and headed over.

One look at Jo on all fours holding on to the gym ball under the running shower, I felt instinctively that we had to go soon and wanted to see the nature of her surges before we made a move. So I quickly asked her husband to bring over the draft birth plan we worked on and asked him to hand write the points that we discussed the before whilst I observe Jo to see how she was coping with the surges, if her vulva was bulging, if her anus was dilated and if there was any more bloody show. With each surge, I coached her on her breathing so she would focus more on her breathing instead of losing it during contractions. I told her husband to grab two towels for the car in case her waters broke and to take her clothes so we can dress her as we had to get ready to transfer to the hospital soonest. I texted the midwife in charge of waterbirths at the delivery quite to inform her that we were going to go in soon.

But we had a problem. Jo would not and could not move. Contractions were 2 mins apart and she started to feel like she needed to push. Usually, when a client commits to a hospital birth, I make it a point and even take pride in the fact that I will do whatever it takes to get them there. However, this time, the situation was different. I had to think quickly. Do we force her to move and get her going to the hospital OR since she can’t move, do they want to go to the hospital? In a situation like this, I would ensure that they make a move and go to the hospital BUT I wasn’t too confident that we would be able to make it in time and the possibility of Jo giving birth in the car was very real. So I explained the situation to her husband and decided that we should go. Jo still could not move and did not want to move.

Thoughts race through my mind. The hospital staff are all anticipating her arrival and her doctor even called me up personally to refer Jo to me, my reputation and relationship with the doctor and the hospital is at stake here. OR do I call the doctor who does homebirths to see if he will take on this last minute case based on complete trust in me and my judgement and if he can come over right now so that Jo, who had 2 traumatic births, can finally achieve the birth of her dreams?

Whilst the possibility of risking the relationship with the Doctor and hospital was at stake, Jo’s needs topped the list in nano second. I left Jo in her husband’s care and went to call Dr. F.M Lai who does homebirths, asking if he could come. He said yes, and I gave him all the details he needed and rushed back to attending to Jo who was in distress. She was pushing hard, and I coached her to keep blowing with each out-breath. Then I had to call the paediatrician to ask if she was willing to take a last minute case and be on standby, and she said yes. Next I had to contact the hospital’s midwife. At this point, I was without hands. Her husband had to connect the ear piece to my ear whilst he found all the numbers and called/ smsed on my behalf.

Standing just next to the running shower, with Jo grabbing on one hand and my other hand massaging her back intensively crouching over, I was getting drenched which I found very amusing. Amusing because even after attending 200 over births and always knowing instinctively how to protect myself and my clothes, this was the first time I was getting a wet shower with my clothes and make-up on after all these years! When we talk about waterbirths to the doctors and the nurses in a new environment, one of the common questions asked is if the doctor/ nurses have to go into the pool to deliver the baby. And I always say never, well, this time around, I am wrong.

Her husband at this point who busy with all the logistics, giving road directions to the doctor, getting hot water ready (what hot water is for? I dunno, but my guess is watching many too many Chinese drama series of how there would always be hot water at a birth), grabbing all the towels, protecting the bed, spreading towels on the floor so nobody slips and falls etc… he was busy as a bumble bee!

At this point, Jo was screaming the HDB block down.. and kept saying I cannot do it, I cannot do it. With a firm but loving voice, I told Jo not to waste her energies by talking, instead coached her with breathing and blowing, until the doctor arrives, with my fingers and toes crossed tightly. I caught a baby before I left for my 12 day vacation recently, which is something I do not do as Doulas do not do anything clinical unless it’s an emergency situation, interestingly, for that hospital birth, no one was around and the nurse bell even stopped functioning but that’s a different story altogether. Point being, this baby was to be delivered by the doctor.

Finally, her husband announced that the Doctor has arrived. A sigh of relieve and a huge smile came from me. Josephine was fully dilated, a point she has never made it through drug-free before with her previous 2 births. Head was low and sitting there, now she was free to push. Within a few pushes, her perineum was stretching and she started saying “its too painful”. Not having birth her previous babies before without assistance, Jo was losing confidence again. “Push through the pain” I said firmly and reassuringly. There is no where else to go, there is no help for assistance available, this is a homebirth, as you have requested. So work with it, push through the pain”. And she did.

Her husband was like a newscaster at this point, cheering Jo on whilst video-taping the entire birth. “A lot of hair!””The head is crowning” The Head is out”… A big smile flashed across Jo’s face when I told her that baby’s head is out, and with the next contraction, she just had to give one push and the body would slide out.

Baby was born and Jo burst into tears, unable to believe all that was happening. We slowly helped Jo to sit down and passed baby immediately into her arms. Even though this was her third pregnancy, this birth experience was all new to her, and she needed this experience to know that she CAN do this and more importantly, to heal from her birth trauma of her previous births. A healing circle – the rebirth of a mother and father all over again.

Reflections from the Doula:
“Even though I only met Jo & her husband less than 24 hours ago from her birth, a bond of trust was formed immediately. This birth experience gave me a split second opportunity to rethink my role as a Doula when I had to make the call between getting Jo to the hospital or arranging for a home birth. The choice was clear. My client’s interests come first, this is after all, their birth experience to keep and not mine. Whilst I risk the relationship with the doctor and the hospital, the satisfaction and healing that it provided for Jo made the decision the right decision.

As for the rest of the day, I did take the rest of the day off and the highlight of the day was at my favourite Australian Monk Ajahn Brahm’s talk and he said: “It’s the intention, and not the result.” At that point, I made my peace with my decision and my calling.

After the birth, I sat on the floor next to Jo’s bed and we were sharing about motherhood where she started asking me about the struggles as a single parent, the perception of how I was well-off because I live in a landed property etc.. I was tearing silently in my heart and feeling misunderstood. If only people knew and understood the struggles I go through as a single mom, how I put myself on the line emotionally, physically and spiritually to man the fort as a mother, as a woman, as a doula, as all that I am, and often wonder in tears and weariness, when will this struggle ever end? I once again quote Ajahn Brahm “It’s not about what job you choose to do, but HOW you choose to do the job.” Every moment, I choose with all my love and good intentions. I choose to Doula with a warm heart because birth matters, one birth at a time” ~ Ginny

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Number 2 of the Number 3s

Number 2 mom expecting her number 3, Janet had less than ideal birth experiences for her previous births. It was as though the Universe was beckoning her to awaken into consciousness through her coming birth, she found me last minute through word-of-mouth. Throughout the HypnoBirthing classes and preparation for her birth, I was not at all worried about Janet being able to do it although a drug-free birth and breastfeeding successfully would be a new experience for her even though this is her third experience. There was something coming together for her on an energetic level, and a sense of underlying certainty that she was going to have the waterbirth that she envisioned.

The big day came and Janet was feeling impatient. She was used to being induced, making her births very fast and efficient. This waiting around and waiting for labor to naturally pick up was all so new to her. Kept busy with her two younger children, she was unable to progress from early labor to active labor until her children went for their nap. Almost immediately, her neocortex switched off and she went into la-la-land. Jaren called me to ask to meet at the hospital.

When Janet came out of the car, she was still calm and composed so when Dr. Chong Yap-Seng asked me how much time he has before he needs to be there, I said no worries, he has time, and as usual, I’ll keep him updated. By the time we walked from the main entrance of National University Hospital to the delivery suite, I texted Dr. Chong to start making his way to the hospital, labor was accelerating very quickly. The usual fanfare of prepping the room, admissions etc.. were all taking place as Jaren and I quickly set up the birthing room, watertub and the other comfort measures that we needed. Janet’s waters released when she was sitting on the toilet seat, and we quickly moved her into the tub after. I called Dr. Chong to ask him to come NOW. As Jaren was filming the process, I held on to Janet, coaching her to focus on her breath and to breathe calmly and slowly, allowing her perineum to stretch. The medical officer then signaled to me that baby’s head was crowning and I asked Jaren if he still wanted to deliver his own baby and he said yes. In the next few breaths, baby swam out into Daddy’s arms, enveloped immediately into a world of love and spirituality as Deva Premal’s music filled the room, tears filling our eyes and love warming our hearts.

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Number 3 of the Number 3s

She was getting impatient and BIG, yet because she was the number 3 of the number 3s, I knew she was definitely the next and was willing to wait and let baby decide and I gave her the suggestion of doing belly lifting. The night after belly lifting, she called me just when I reached home, after clocking another 10 hour work day and we decided to meet at the hospital. As discussed beforehand, and having had a drug free birth with a Doula before, she did not want to labor in the tub.

She was in smiles when she arrived, looking radiant and beautiful as she always has and very much aware of whatever that was happening. Still in early labor at 3cm, I slowly coaxed her to get into la-la-land (labor land) by spraying aromatherapy, dimming the lights and strictly no music as per her instructions. She started getting curious about using the tub, so I filled it up, leaving it as an open option in case she changed her mind. Labor started picking up and she decided to give it a go, a little apprehensive at first as the tub was too big for her during her last birth. We got her comfortable and the water did wonders as it relaxed her even more and the intensity of her labor picked up. We helped her out of the tub and she was breathing down in no time. I called Dr. F.M Lai to ask him to come over and as fast and reliable he always is, he was with us shortly. As Julie’s head and arms emerged, one could tell that this was a big baby and 4kg later, Julie was placed in Mommy’s arms.

Quick, happy and “easy” , her husband said that this birth was the calmest of all 3 births. Yay! Mission accomplished.

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Last but not least…..

Sakinah contacted me early in her pregnancy, having heard about me from her friends who have had cesareans before. It took them 5 years to have this baby and this moment was long awaited for. It is such an honor to watch her blossom through this journey, making the changes necessary from changing doctors and hospitals just so that she can have a water birth – the first ever in her Malay community of friends. Even though she took Hypnobirthing, pain associated with childbirth has been deeply ingrained in her mind. From early labor on, she kept saying how painful it was and would burst into tears from time to time. Surges were intensifying at home, and as they felt comfortable, they stayed home as long as they could. When the surges started coming every 4 mins or so, I gave parents the option of moving on to the hospital to settle in or staying home a bit longer before going. They decided to go.

4cm dilated. We settled in the hospital and when she was ready, we moved to the tub. Sakinah was made up with a heart of gold and courage of steel as she labored with each breathe. Coaching her constantly, Shaff & I were working hand in hand, reminding her to breathe a breath for baby; a breath for her; a breath for Shaff and a breath for Allah, and with every exhalation, she would shout out “ALLAH!!!” In between moments, tears would flow, yet she would find the love and courage somewhere within and carried on, one breath at a time, focusing on one surge each time. We worked closely with Deborah, the midwife in-charge of waterbirths, who was cheering us on all the way.

Dr. Mary Rauff made in just in time when Shakir was crowning and with 2 big breaths, Shakir slipped out into this world, born in the water and placed on Sakinah’s arms as both parents burst into tears of delight and sheer joy, and as Shaff posted on his facebook status “My whole life I have been waiting for you.” We all waited so long for you dear baby as tears flow into my eyes as I recall the beautiful moment when you were in Daddy’s arms with him singing prayers for your blessing. You were so attuned and silent, taking in all of God’s blessings and the aura of love.

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Thank you all for having me there as part of your journey, as I dedicate my life to serve God, in every single one of you. Love, Doula Ginny