"Welcome to the Last Three Weeks of Being Pregnant."

So sayeth the midwife to my March client, who called her tonight to tell her about the wild and wooly Braxton-Hicks she's having.

This client has been a fun one; she's a feisty go-getter who's been a research hound since day one of her pregnancy. She had a loss several years ago, which she mourned; this is a very welcomed pregnancy and baby, and she's done everything she can to improve her physical life and educate herself, working toward the goal of a birth that's as un-medicalized as possible.

Her text messages tonight have been making me grin - "Am I just being silly and blowing this out of proportion??" she asked me when her body decided to practice squeeze just one section of her stomach. I replied that it's her first time around this block, and anything new and unknown can be frightening, then suggested that she try drinking some juice, lie on her left side and do some kick counting to reassure herself that her little one is okay in there. She did, and he's moving just fine.

Carry on, mama - you're performing a miracle!

The Weight

My first paying client had her baby about a week and a half ago, and I'm 99.9% certain her little guy was posterior. She had all of the typical signs, and it was a really hard labor. In second stage, she pushed for literally hours, and it was like there was no end in sight.

I've been anxious and worried about her ever since; some things she said after the birth really concerned me that her lasting birth impression was a negative one. I feel like this is the first birth where I didn't do a good enough job as a doula, and now my client has a terrible opinion of her birth experience. I keep replying the birth in my head, looking at all the points where I could have done something and didn't - for example, I should have urged her to have her midwife palpate her belly to try to get a better understanding of the baby's position. Signs said she was experiencing a posterior baby, but her water wasn't broken until she got to about 8.5 cm's and finally asked the midwife to break it in hopes that it would bring the birth to a faster conclusion. Before that, when we asked the midwife if she could help us figure out baby's position, she said she had no real way of knowing until she could do a vaginal exam after the release of membranes, when she'd be able to feel the fontanels of baby's head.

A fellow doula (whom I'm working with in a dual-doula birth next month) tried to help me keep it in perspective by pointing out how difficult and painful it can be to labor with a posterior baby. "Does she realize how amazing she is for giving birth without any medication in that situation?"

I tried to tell my client exactly that, but I don't think she was very receptive at that point, which was less than 24 hours in the wake of the experience. She said she'd call me when they got home, but I haven't heard from her. I'm acquainted with friends of hers, and they've been kind enough to let me know how she's doing - I won't go into detail, but this poor mom has her hands full, so while I'm respectfully waiting for her to call me since that's what she asked me to do, I can't stop worrying about her.

The Weight - The Band made famous a song by that title many moons ago, and my favorite interpretation of the last verse is so very appropos right now in my doula life:

And what's all this "take a load off Fanny" riff? The whole thing becomes only a little less cryptic when we learn, in the very last lines, that the pilgrim is traveling under instructions, has, in fact, been sent by the mysterious Miss Fanny. The "weight" of the title is the load of her obligations the pilgrim has been sent to discharge. The irony, of course, is that he leaves with a heavier load than the one he brought with him - "my bag is sinkin' low."

I went into that birth thinking I had the message right - that I was educated and experienced enough to help her - but I left it carrying a heavy load of doubt in my abilities and concern that I didn't give enough. Since her birth, I've been pouring over posterior labor resources, especially Spinning Babies, in hopes that I'll be more proactive and better prepared for a posterior labor in the future.

The one thing positive I can say about my assistance was that they would probably have been worse off without me if for no other reason that no one could be expected to rub a mom's lower back continuously for the entire length that her labor ran - so at least I was able to help her husband alleviate her pain in that way.