The virtual doula: Story of a VBAC mom in COVID times

This is a great inspirational story for all VBAC moms out there and more so because it happened during the lockdown. Also, this was my first time supporting a mom virtually. As they say, “Any support is better than no support!” This couple came to me for classes when the mom was 35 weeks pregnant and for the second time. It was a precious pregnancy as the doctors called it because it was an IVF conception. The first birth she had was premature at 27 weeks and it was an emergency c-section. 

I still remember at the end of the first session the dad asked me in all sincerity, “Why are we trying for a normal delivery, won’t a c-section be safer right now?” The answer to that was a long one spanning 3 other sessions but I am glad he asked that question and even more glad that he became the pillar of support for the mom in her vbac experience.

We covered everything in the classes including healthy birth practices, comfort measures in labour, labour positions, interventions, breastfeeding and post partum care. At the end of the session I remember telling them that here you have to fight for your choices. There will be doctors ready to walk all over you, but you need to be well informed and confident if you wish to have the birth you desire.

There was clear gain of confidence in the couple after just 3-4 sessions. The dad was also more ready and prepared about his role as the doula. Due to COVID lockdown, doulas were not allowed in the hospital. So I was their doula virtually on calls and messages.

On 6th of June she started with some minor signs of labour onset. She was going to pee often and she had an episode of urine dribbling while sneezing. She was having Braxton-Hicks on and off but nothing regular. She passed bowel movements four times that day! (It’s always fascinating to see the body prepare so well for labour. And doctors still feel the need to give enema these days!)

That evening she had a bloody show. Great news! Labour was progressing. I asked the mom to rest as much as she could and not to get too excited in anticipation. On 8th June morning, that is after a gap of one day she said she was having light contractions every 10-20 minutes. There were pretty mild and not regular. A little more mucus plug had come off. By afternoon, contractions became more regular, more intense and more frequent. At 4 PM that day, she said she had her water break and good amount came out. This was great news! And I told her to inform the doctor and go to the hospital if she recommended.

Within the next 4 hours, she dilated pretty fast and by 9.30 PM she was 8 cm dilated and in the labour room. In the next half an hour she was 10 cms dilated and was pushing her baby out! The pushing stage was not managed well by the hospital. Even though she was progressing extremely well, instead of letting the mom be, they decided to intervene. She as asking to lie down in lithotomy position, given an epidural without indication, and was given fundal pressure to push the baby out. Her legs were pinned to the abdomen and she was yelled at to push. She was also threatened that she might harm her baby if she doesn’t do so. The mother was also handled roughly during the early post-partum period and the stitching up.

Sometimes it is not the big things, but the smaller details that can disturb a very serene birth. The mom was a champion and she beautifully labored through her pains. She was so focused on having a vbac (and I am glad the doctor also supported this) that this was a big win for her.

In the mom’s own words she said “I will any day take the episiotomy stitches over a c-section.”

It’s sad that women have to choose their battles and they can’t have it all even though these are within the framework of healthy birth-practices. Moms should not be penalized for asserting their choice or requesting for an alternative. Moms should be spoken to with care because they are in their most vulnerable period. Of course every mother is strong and she will come out of any experience for the sake of the baby. But why should she be put through this ordeal? As a doctor myself and a doula, it’s my sincere desire that doctors are able to learn through these stories and understand how their small actions can affect the mom in a big way.    

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