Not too soon before Benjamin was conceived, I miscarried. It was an early loss, but I was devastated. As a birth worker, I knew miscarriages weren’t uncommon and believed it was nature’s way of making sure that the baby was compatible with life. Still, I couldn’t help but wonder if it was something I did. As a Lactation Educator, I believe the vast majority of women are able to conceive and sustain pregnancies while breastfeeding, but the intense contractions I experienced in those early weeks of pregnancy while breastfeeding Judah caught my attention. I mentioned it to my OB and she agreed it was highly unlikely that breastfeeding caused the miscarriage.
Several weeks later, Judah rolled over in bed to nuzzle his face into my breast to nurse. The contractions returned with the same intensity and I just knew I was pregnant again. I jumped out of bed and drove to the store in my pajamas to buy a pregnancy test and sure enough, it was positive. Even though my OB reassured me that I could continue breastfeeding, my instincts were telling me it wasn’t a good idea. I struggled with whether or not I should wean and didn’t want to make a decision based on fear. Later that day I tried hand-expressing in the shower and started contracting again. I don’t know if it was intuition, fear, or a combination of the two, but when I felt those contractions, it didn’t sit well with me. I spoke with some trusted Lactation Consultants and our pro-breastfeeding, attachment parenting pediatrician and mulled it over. Although I had envisioned Judah self-weaning, after 2 years and 4 months, our breastfeeding relationship would sadly be coming to an end. More about that here.
I loved my OB and she worked so hard to support my birth preferences through a very challenging labor with Judah, but I was a doula now and birthing outside of the hospital is where I felt most comfortable this time around. I wrote her a heartfelt note expressing my gratitude and began to meet with other care providers. I immediately connected with midwife Davi Kaur-Khalsa and also liked her backup OB who is a birth community favorite, Paul Crane.
At 12 weeks pregnant, I attended a very long birth. I was exhausted and pushed myself too hard. I thought about calling in my back up doula but I really didn’t want to leave my client. When I got home the following morning, I laid down on the couch and stayed there pretty much all day. Around 9 pm I felt some fluid leaking down my leg and ran to the bathroom. As soon as I saw bright red blood in my underwear and dripping into the toilet, my husband Jeff ran in behind me to see if I was alright. I was hysterical and shouted, “Why? Why?! Why is this happening again?!?!” He tried to calm me down and told me not to think the worst. I called Dr. Crane and he asked me a few questions. He told me to lay down in bed, try to relax and come to his office in the morning. I told him I was freaking out, wouldn’t be able to relax, didn’t want to wait and needed to know what was going on and that I was going to the E.R. He told me to meet him at his office. Bless this man.
I didn’t want to be alone or drive myself over the hill, so we woke Judah up, put him in the car and made our way to Dr. Crane’s office. We prayed the entire ride over. Jeff reminded me not to assume the worst and to try and remain calm. The bleeding had stopped by the time we arrived. An ultrasound revealed that I had a subchorionic hematoma, which is a type of blood clot found between the bag of waters and the uterus. This occurs in just over 1% of pregnancies, and it appears that the bleeding occurs when small parts of the bag of waters separate from the uterus. He told me that they usually dissolve by 20 weeks, put me on pelvic rest, said we would keep an eye on it and to report any contractions or signs of bleeding.
The next day I did exactly what I tell my clients not to do: consult Dr. Google. I read that subchorionic hematomas that bleed can cause complications such as miscarriage or pre-term labor. I called Dr. Crane and told him not to sugar coat anything. I wanted all of the details including the size and location of the hematoma so I could calculate how great the risk was. It took me a few days to realize that stressing out and worrying wasn’t going to help the situation. If anything, it would only make things worse. At the same time, I felt powerless and unable to focus on anything else. So I decided to do everything in my power to be healthy and protect my baby. I wrote down positive affirmations on post-it notes and stuck them on the wall by my bed. I visualized my baby strong, healthy and growing inside of my body. I sang to him and told him how much I loved him.
By 20+ weeks, the hematoma still hadn’t dissolved and I also learned that I had a low lying placenta and a placenta previa. This meant that the placenta was partially blocking my cervix, therefore blocking the baby from being born vaginally. It’s not uncommon in pregnancies before the 20th week and in most cases, as the uterus grows, the placenta moves higher in the uterus and away from the cervix. However, about 10% persist into later pregnancy. If it remains near the cervix as the estimated due date nears (which happens in about 1 in 200 pregnancies) there is risk for bleeding, especially during labor as the cervix thins (effaces) and opens (dilates) which can cause major blood loss in the mother. For this reason, women with a placenta previa usually birth their babies before their due date by cesarean. I had lost 500 ml of blood after Judah’s birth so this was a bit concerning for me. With the hematoma still present and having the previa, Davi said I would need to stay under Dr. Crane’s care, at least for the time-being.
By the end of my pregnancy, the hematoma didn’t fully resolve, but it hadn’t bled again. The placenta also moved out the way just enough for Dr. Crane to clear me for a vaginal birth. Even though I adored Davi, I developed a close relationship with Dr. Crane and wanted him to catch the baby. I also hadn’t made up my mind about where I wanted to birth. Dr. Crane does both hospital and home births but as my guess date neared, he could sense that I wasn’t comfortable with either option. I knew from my birth with Judah that I wouldn’t be comfortable enough in a hospital environment to have a physiological birth. Although Dr. Crane said he could likely secure one of the newly remodeled hospital rooms at Cedars-Sinai with a spacious tub (laboring in the tub was very important to me), didn’t need to have an IV, could eat and drink as I pleased, would turn down the beeping machines, etc, it was still a hospital. But I wasn’t comfortable birthing at home either. The transfer hospital by our house wasn’t the most progressive and Dr. Crane didn’t have privileges there. Some people thought because I was a doula, I was supposed to be super chilled out have no fears, but that certainly wasn’t the case. My first birth was traumatic and this pregnancy had some bumps in the road.
Dr. Crane sat me down in his office asked me what I wanted. I told him a birth center was a good compromise between hospital and home, but I wanted him to catch the baby. He told me how he always wanted to open up a birth center but never did. He knew midwife Simona Istrate recently opened a second birth center close to Cedars and said if she would agree to let him catch the baby there, he would be happy to do so. An obstetrician catching at a birth center in Los Angeles had never been done before, but Dr. Crane is well-respected and Simona was on board. It took some time to sort out the details but we did it.
As my “guess date” passed, Dr. Crane said he would let me go to 42 weeks without discussing induction, but I would have to be closely monitored. I wasn’t dilated or effaced and the baby was still quite high as I had a lot of amniotic fluid this time around. He also mentioned that the baby was measuring big, including his head. I had been hearing this for a while and it was starting to bother me so I told him, “no more vaginal exams or ultrasounds unless necessary and no commentary on baby’s size.” I was getting anxious and it was hard to not intervene with some of the more aggressive natural induction methods. Instead, I continued with my prenatal chiro and acupuncture treatments and did Spinning Babies exercises. I didn’t want this baby turning posterior (facing up) like his older brother did. This baby had already been situated in the ROT position for some time which Spinning Babies basically says may as well be posterior. I told my baby I was okay with how and when he wanted to make his way into the world, but that if he wanted to meet us sooner than later, facing down, that it would be quite nice – for both of us.
We lived walking distance from Caioti Restaurant which is famous for “The Salad” (the dressing is said to induce labor for post-term pregnancies) so I tried eating that a few times. The first time I split it three ways with my husband and his friend. The second time I shared it with my husband. The third time I ate it by myself. With an extra order of dressing. The next morning at 41 weeks and 2 days, I woke up just before sunrise to discover my water had broken. It was clear and I wasn’t having any contractions. I already knew Dr. Crane would let me go 72 hours without inducing so I gave my birth team a heads up and tried to go back to sleep but couldn’t, so Jeff made us a nice breakfast. I was feeling a little anxious so I called a prenatal acupuncturist to come over to help me relax. I dozed off in bed when I was jolted awake by my first contraction. Yes! Game on. When she left, we head out for a walk around the neighborhood with Judah. As soon as we crossed the street I had a contraction that took my breath away. Shortly after returning home it was pedal to the metal. I knew things were progressing quickly so Jeff called Dr. Crane and told our doula to meet us at the birth center.
We ultimately decided it would be best for Judah to stay home and have my parents come over to stay with him. I figured they could always take him to the birth center if we wanted. As soon as they arrived we got into the car at 3 pm and drove through the winding canyon. Thank goodness it wasn’t any later on hump day in LA rush-hour traffic. That was the most uncomfortable car ride of my life. It’s bad enough I get car sick. It was an unusually hot day for January and I turned the air on full blast. My contractions were averaging a minute and twenty seconds and were two minutes apart. All I wanted to do was open up my legs and hips but having gained 75 pounds, I barely fit in the passenger seat. I had been tracking my contractions on an app. The rhythm of hitting the button each time I felt one kept me focused and cope with how quickly things were progressing. We called Dr. Crane from the car and he insisted on checking me at his office before going to the birth center. Was he joking? Things were getting real and I knew I was further along than he thought I was. I wasn’t dilated or effaced the day before and baby was still high so he wanted to assess the situation. Fine, I told him, but on the condition that he would meet us in the underground parking garage to do a very quick check.
When we pulled in, it was 3:30 pm and I was relieved to see him waiting for us in his scrubs. I leaned over the side of the car and said, “hurry up!” Jeff was trying to hold a towel up over me for modesty as people were valeting their cars but I didn’t care. At this point I started questioning how far along I really was, and looked at Jeff and said, “we’re going to Cedars. I want an epidural.” Dr. Crane checked me and looked surprised. I was 6 cm. YASSS. Jeff usually follows my lead so he caught me off guard when he said, “we are NOT going to Cedars. We are going to the birth center!” Dr. Crane said he would meet us there shortly. Driving over, reality set in that I was doing this and there was no going back. Unless we transferred, I was going to birth this (big) baby without meds.
We arrived to the birth center 10 minutes later at 3:40 pm. I got out of the car and had two options: walk up the big flight of stairs or go around to the front of the building and wait for the very slow elevator. I opted for the stairs. I waited for a contraction to pass, walked up the stairs, and had another one when I got to the top. I must have been moaning loudly because the midwife assistant and nurse met me in the hallway. All I could say was “bathtub.” My doula helped me undress and get into the warm water. Ahhhh. I enjoyed about a minute of sweet relief when I was thrown by a colossal contraction. I knew I was in transition. Hey! What about my birth crystals? Labor playlist? Double hip squeeze? Guided meditation? Massage? Pfff... no time for that now. Dr. Crane arrived and gave me some space as I held onto the side of the tub and worked through a few more of those volcanic contractions. They felt like bombs exploding inside of my body, reverberating from the top of my stomach and down to my bottom. I can do this. I am doing this. I can do this. I am doing this. Dr. Crane said the baby would be coming very soon and that it was time to “get out of the tub and move over to the bed.” I’m sorry, get out of the tub? Move over to the bed? Now? Unless he wanted to carry 205 pounds of me, I wasn’t moving anywhere.
A few minutes later, I felt Benjamin’s head crowning under the water as I laid in the tub on my left side. After it emerged, Dr. Crane really wanted me to move over to the bed. Right. Let me just hold onto my baby’s head in between my legs as I do just that. As a doula I knew why he wanted me out. He’s an OB and even in all his years of catching babies, he hasn’t done a lot of water births and it wasn’t in his comfort zone. He couldn’t see very well in the position I was in and there was concern about a potential shoulder dytocia with Ben measuring big. I wasn’t worried. After all, if his head was as big as it was measuring, that only cleared the path for the rest of his body. I thought of Ina May’s “Gaskin Manuever” (a.k.a. all fours, which is position and technique to open up the pelvis and reduce shoulder dystocia) and leaned myself forward over the side of the tub. In two pushes, my big, beautiful, healthy baby boy was born at 4:32 pm. He weighed in at 9 pounds, 5 ounces and measured 20.25 inches long. I don’t know if we ever got a head measurement but it’s still in the 95th percentile!
Dr. Crane called the next day to see how I was doing. We had our ups and downs during the course of my pregnancy, and at times, we bickered like two family members which only strengthened our relationship. He told me that I birthed beautifully and that he learned so much from me which shows the incredible humility of this wonderful man.
This was easily one of the most challenging, testing, healing, euphoric, empowering and transformative experiences I have ever been through and I’m grateful for it all. It helped shape who I am today as a woman, doula and Mother. There is nothing more rewarding than that.
I would like to thank my Village, for without their love and support, I would not have had such a positive and fulfilling experience.
Paul Crane, OB
Simona Istrate, CNM
Jay Gordon, Pediatrician
Jennifer Davidson, Lactation Consultant
Davi Kaur-Khalsa, CNM
Ana Paula Markel, Mentor (& my BINI Sisters)
Becca Gordon, Doula
Kimme McGuire, Doula & Placenta Encapsulator
Elliott Berlin, Chiropractor
Gassia Titizian, Chiropractor
Susan Minich, CNM & Acupuncturist
Melissa Block, Acupuncturist