Chapter 12: “Can I Keep Her Forever and Always?”

I never thought we would “click” at all. Everything was wrong from our first appointment. China complained about how awful pregnancy was. She accused her baby of hating her—why else would he kick her so much? She told me she was having this baby with the wrong man. She confided that he was a loser and she hated him; he couldn’t even find them decent housing. They were homeless and camping out at his sister’s house.

If she blames her baby for her discomfort now, what will labor look like? I wondered. And she says she wants a natural birth.

Then after the hospital tour that OB patients were offered she called to tell me that the hospital was all wrong. She could not, would not bring her baby into the world in such a depressing place—I had to find her a better hospital. They didn’t even have pictures in the rooms! I thought, Sweetheart, you’re not gonna care what’s on the walls when the time comes.

I called my supervisor at that point, asking for some wisdom. Was I the right doula for this client? Would she be happier with someone younger? Debby told me she wouldn’t choose that particular hospital either, saying, “It is depressing.”

Okay. I’d keep her.

I started going to prenatal visits with China. I needed to get to know her better. I gave her the phone numbers for some of the birthing centers throughout the city. She visited one that was absolutely gorgeous, but they were not a nonprofit and subsidized their medical ­assistance payments from low-income families by charging an additional $300 in cash up front. I told her I would find a place for her.

I called some of the other birth centers and found out that most did not take transfer clients after their thirty-fourth week. I knew I could probably get her into the midwife program at a local public hospital, but imagined she would be turned off by their “public” image. It is often seriously overcrowded, usually very loud, with standing room only in the emergency waiting room no matter what time of day or night it is. I called them and asked for the labor and delivery charge nurse. I explained who I was and what I was hoping to do for China. She explained that it was too late to transfer, but she actually knew who I was from some of the births I had been to there and asked if I would hold while she checked with the floor supervisor. She came back on the line and told me that if I could get China to the clinic the next day they would take her. I asked if I could also tour the labor and delivery area with her and silently hoped that their “better” rooms would be unoccupied so she could see them.

The next hurdle was getting her there. Medical Assistance will provide a taxi for medical appointments but only if scheduled two days in advance. I don’t drive so I was trying to figure out how to get her there in the morning. They were staying with her boyfriend’s sister in a suburb where the buses only run once an hour. It had been below zero all week with wind chill factors in the thirty-below range. Buses were out. I called Medical Assistance’s transportation number and told them that one of my clients had to get special emergency clearance to get next-day rides from here on out until she delivered. They actually approved her if I would arrange the rides for her. Great! It worked.

The next day we were in a tiny cubicle waiting for the midwife. China must have gotten out on the wrong side of the bed that morning because the first thing she did when the midwife came in was demand that she be induced! She said she was sick of being pregnant and miserable, couldn’t eat or sleep, that her baby hated her and kicked her on purpose, and that she would only stay if they got the delivery rolling . . . today!

The midwife listened and, skirting the issue completely, asked if China would kindly jump up on the table so we could hear her baby. The midwife and I both gushed about how wonderfully strong her baby’s heartbeat was when the Doppler was turned on. China just kept griping. I had had enough so I said to her, “You know, I have had ladies in the past year whose babies couldn’t move like yours can. I even had one baby who was born with half a heart. You have a really healthy baby, and I am really looking forward to seeing him, too!” The midwife was nodding her agreement the whole time.

We finished with the appointment and the midwife explained that it was not their policy to induce labor without a good medical reason, such as when the mother has preeclampsia or diabetes. China grouched a bit more but realized the two of us were not going to be moved on this one.

We walked through the midwives’ labor and delivery side of the hospital wing then, starting with a huge open room, almost a suite, with a birthing tub, private bathroom, little refrigerator and, yes, pictures on the walls. We saw two more rooms, decorated sparsely but pretty. They passed her royal highness’s inspection. Whew! I thanked the midwife profusely and we left to wait for the return taxi.

Talk about an attitude! Maybe she was feeling so very helpless being homeless and without support that she had decided to demand her rights to the tiniest things that perhaps she could have control over. She was twenty-three going on twelve.

Then it dawned on me—I would gain her confidence with love. The expression, “Kill them with kindness” came to mind. I would lay it on so thick she wouldn’t know what hit her. I would smother her with kindness. I couldn’t imagine how else we would be able to work together through this birth. I knew she didn’t have a clue how hard it was going to be. And I didn’t want to see her fall apart before she even got into active labor and had to actually work to birth her baby.

My supervisor suggested I show China a book from our library called Bonding With Your Baby Prenatally, which I had brought along. I gave it to her as I hugged her goodbye that morning. It was almost Christmas.

The following week I collected all sorts of baby clothes and wrapped up a beautiful new scarf a friend had just given me. I already had four others so I thought it was just the right thing to give her. My old heroine Dorothy Day once said that, “The extra coat hanging in your closet actually belongs to the poor.” I decided this must apply to scarves, too.

The following week I was given donations to give to some of my mothers, so I started another care package for China. She was charmed, to say the least. And we even got along well enough to talk about a birth plan and her wishes. That was better, but when I asked if she wanted her boyfriend in the room at all she said, “He is gonna be there the whole time and see what he did to me!” Oh dear, not a good reason to add him to the birth plan.

The next week she called me demanding induction. I very calmly explained that she was only at thirty-six weeks and that I would find it really sad if her baby had to stay in a NICU (intensive care unit for newborns) and couldn’t go home with her after he was born. I told her that the next couple of weeks would ensure that he was really healthy, and that at this point his lungs were not mature yet and might need extra help breathing should he come out now. She backed down. I told her to call me anytime and stay in touch.

A Korean graduate student in my apartment building was moving out about that time and asked if I could find takers if she gave me some nice but used clothes she couldn’t take with her. China was just as petite as Song Jung. I looked in the box when I got it back to my place. I never would have been able to afford the cute sweaters and dresses, even designer lingerie from Victoria’s Secret! It was a huge success. I had found China’s weak spot! She absolutely shivered and then squealed with delight as she unfolded each layer from the box. We were definitely buddies—at last.

One evening in her thirty-eighth week China called to ask if she might have lost her mucus plug and described what she was seeing. I agreed that it sounded like it and congratulated her. I cautioned her that though her body knew exactly what to do and would certainly kick into gear on her baby’s exact birthday (which, of course, only he knew), it could still be several more days. I advised her to just keep doing whatever she had been doing—resting, eating, watching movies, and walking.

Two days later she called again, screaming that she couldn’t sleep all night and she couldn’t do it anymore, that her back was killing her and she was nauseated, and so forth. I was quite excited that this might be early labor. I was really looking forward to meeting this baby. I told her to eat and rest and call me if things changed or she got regular contractions. I also told her to call the hospital and let the midwives know. They might want to check her. I hung up and went back to our supper. By the time we were washing the dishes a very hysterical China called to say she had been on the phone with her grandma when her water broke. What should she do? I suggested she call the hospital, then let me know what they said. I knew they would want her to come in, but that wasn’t my call as a doula. I made her promise to let me know.

Yahoo! We were going to have a baby! I realized then how much I really cared about China. She was the same age as one of my own daughters and I really wanted to see her succeed, to be a good mom and get her life back on track. It wasn’t until I stopped judging her and started listening that I realized how very hard she really had it: parents on drugs, foster homes, you name it. I had to hand it to her, though—she told you what was on her mind and she wasn’t bashful about letting you know how she felt that day. There was no guesswork at all—you got the whole story whether you wanted it or not.

 

 

When I arrived at the hospital, China was almost two centimeters, ninety-five percent effaced, and her contractions were picking up. This was it. The midwife confirmed that her water had broken. China wanted to rest for a bit so she lay down and closed her eyes. All of a sudden she rang the nurse’s button and sat up. When the nurse came in China announced that the room she was in wasn’t the room she had seen on the tour of the unit the week before. That room was pink. This one was an ugly tan. I tried to ignore this comment, but she wasn’t going to let it go. She dug in her heels. She threw on a robe and said she wanted to check out all the other available rooms. The midwife took a deep breath and said, “Okay,” as she led the way.

We walked into each of the other six rooms and then backtracked through each one of them once again, China leading the way with all of us in tow. She settled on a pink room and, climbing up on the bed, ordered us all to go get her stuff and bring it in.

The rest of the afternoon and evening was uneventful. She was dilating about one centimeter every two hours and the baby sounded great. It was slow, but not unusual for a first baby. By four centimeters China asked the nurse about getting something for pain. The nurse reviewed all of her options and China chose a low dose of an IV drug to take the edge off but not make it impossible to get up or get into the tub. In the end it barely helped and wore off before an hour was up.

It also affected the baby. His heart rate flattened out to a low 100 to 110 beats per minute, which isn’t all that great. When China asked for more, the nurse suggested an epidural, but she really didn’t want that if she could possibly avoid it. I backed her up and pointed out that the baby didn’t do too well with the first drug and that I wasn’t encouraging her to get more. I suggested she try the tub at this point, got her a cup of cranberry juice and filled the tub. She really liked it. I had been telling her that being flat in bed was not the best position to labor in. In the tub she found a real rhythm on her own. I was surprised and told her how well she was tuning into her body and finding a way with each rush as they rolled in on her.

Eminent author and doula Penny Simkin talks about the Three Rs: relaxation, rhythm, and ritual during labor but I had never seen ­someone find it on her own in exactly this way. It happened when I was breathing with her during a rush and her head bent down and leaned forward and rested on my knees. I automatically ran my fingers through her hair from the back of her neck and then gently pulled her hair back toward me. We did it a few more times and I asked if that helped at one point and she just purred, “Uh huhhhhh,” so we kept doing it. She changed position after awhile and with each rush ran her own hands down her neck, and rocked gently forward until it passed. For the rest of the labor she found a rhythm to add to the breathing, which I found fascinating. She had tuned into some inner strength that I had not seen before and just went with it.

Suddenly, in walked the grand matriarch of her family, Grandmama, in flowing black and purple layers of some kind of robe, antique silver earrings, and a spotted leopard hat to top it all off. Regal is a modest description. She blew me away! As she glided into the room she set out bags of goodies for all of us. She had thought of everything: granola bars, bottled spring water, snacks, and cookies. Then she looked over at China and beamed, saying, “You are so beautiful! You are a goddess! You are doing this sooooo well!”

She proceeded to unpack a huge bag of baby blankets, baby clothes, baby socks, baby shoes, all brand new and all blue! Then she turned once again to China and said, “You can’t have any more kids ’cause this all broke the bank!”

China was back in bed and with the next contraction the Dowager Empress stood by and breathed with her. Then she brushed her hair and massaged her neck. I was still sitting there in awe. All this loving on China really got things going. Soon she was saying she couldn’t do it anymore and needed an epidural now! I knew she was at least nine if not ten centimeters. I explained that this was transition, the end of the very longest part of labor, that she was doing so, so, sooo well and that we would help her with each rush until she could push. I said she should rest in the few minutes in between rushes, which she did. She trusted me by now; we were finally a really great team. I let Grandmama coach her all she wanted and hung back a bit. The lady was truly stellar.

China tried a hands-and-knees position and then went back to sitting up cross-legged. I asked the midwife if they had a squatting bar, thinking that it might be just the right thing, and it was. China leaned into it, threw off her hospital nightgown and pushed! Two more pushes and she screamed. The midwife assured her she was doing it perfectly and she could feel the baby’s head. I tried to help her reach down to feel the baby’s head crowning but she shook my hand away, grabbed the bar once again and pushed her baby out onto the bed. Still squatting, she picked him up and held him to her chest. He gurgled a tiny cry and then let loose. He was tiny, perhaps all of six pounds, but sure had a huge set of lungs. We helped her so she could lay back on the pillows as I piled them up behind her. She studied her beautiful little baby as he blinked back at her and then said, “I love you so much!” We let him do the breast crawl and latch on his own when he was ready. He was on within twenty minutes.

The next day I visited China one last time. I sat and held little Baby Boy (who didn’t have a name yet) while China filled out the evaluation form I have to give all mothers. When she was finished I took it and stuffed it right away in with the other papers in my bag and hugged her goodbye. I whispered in her ear, “You know, my love, now you can do anything!”

She looked me straight in the eye and answered, “Yeah, I can do anything!”

I pulled out the paperwork later that evening so I could finish my report and mail it the next day. As I was stapling the papers, I read the evaluation page. One question asked, “Overall, how would you evaluate the usefulness of having the doula present?”

The ratings went from “1: More harm than good” to “5: Was a big help.” China had written “10.” Then I saw her comment: “I love my doula. Can I keep her forever and always?”

 

 

 

“The most precious gift we can offer anyone is our attention. When mindfulness embraces those we love, they will bloom like flowers.”

~Thich Nhat Hanh