Ian’s Story: Treating an omphalocele at the Midwest Fetal Care Center

October 22nd, 2014

Leah and Todd Kempel were excited to find out they were expecting a baby boy in July 2014.

Like most couples, Hopkins, Minn., residents Leah and Todd Kempel expected to have a healthy and orderly pregnancy. They were relieved and excited after finally receiving a positive pregnancy test and soon after began planning an unmedicated, natural birth for their first child.

It wasn’t until a routine 20-week ultrasound to find out the sex of their child (a boy!) that they thought their pregnancy could be anything but “textbook.”

Watch the Kempels share the story of their pregnancy:

Meet Leah and Todd Kempel from The Mother Baby Center on Vimeo.

Ian's ultrasound

“There’s a problem,” the ultrasound technician explained. “Some of his organs are outside his body.”

“Wait, what? I hadn’t even considered that there would be anything wrong,” Leah thought. “The pregnancy was progressing normally, and I was feeling pretty good – I didn’t even have any morning sickness during the first trimester.”

Their obstetrician referred the Kempels to the Midwest Fetal Care Center in Minneapolis. There, further testing revealed that their baby boy had an abdominal wall defect called an omphalocele, as well as a ventricular septal defect (VSD) characterized by a hole separating the two lower chambers of his heart.

Impacting about one in 5,000 births, an omphalocele results when the muscles of the abdominal wall do not close properly. Leah and Todd’s baby’s liver, stomach and intestines were growing in a sac outside his body covered by a thick membrane. Baby Kempel’s omphalocele was about the size of a small melon and considered “giant.”

Baby Ian was born with an omphalocele, where a number of his organs formed in a sac outside his body.

“At the Midwest Fetal Care Center, we see approximately 10-12 omphalocele cases each year – more than any other center in the region,” said Brad Feltis, MD, PhD, surgical director at the Midwest Fetal Care Center.  “That volume makes us one of the busiest and most qualified programs in the country to treat this condition.”

“Thankfully, the hospital has scheduling coordinators who planned our visits for us, so all we had to do was show up. We met with Dr. Feltis and a cardiologist very quickly and they­­ developed a plan for us and our baby right away. Throughout our appointments, it was reassuring to see that our baby boy was growing and moving regularly despite having his organs outside his body,” said Leah.

The Kempels were further reassured that they were in good hands upon touring The Mother Baby Center, and Children’s Hospitals and Clinics of Minnesota, the facilities where their baby would be delivered, have surgery and recover.

“Though we didn’t know exactly what surgeries our baby would need once he was born, we knew a stay in the neonatal intensive care unit (NICU) was likely,” said Todd. “It was helpful to meet with the neonatologists and the teams that would be caring for him after he was born.”

“Leading up to labor, we tried to keep a sense of normalcy and did the typical things that expecting couples do,” recalled Leah. “We picked out a name – Ian – and set up the nursery even though we didn’t know when he would finally be home to enjoy it. We really had to take things day by day, preparing the best we could for the unknown ahead of us.”

Baby Ian after his first surgery to repair his omphalocele

Leah gave birth to 5-pound, 11-ounce Ian Shinji Kempel on July 14, 2014, through a scheduled C-section at 39 weeks. Immediately after, he was admitted to the NICU at Children’s where his care team assessed his condition to determine next steps.

“Though we evaluate each omphalocele patient on a case-by-case basis, typically we take a staged approach to return the contents of the abdomen back into the body,”explained Dr. Feltis. “The amount of skin the baby has around the omphalocele often helps us determine our approach.”

Dr. Feltis and Dr. David Schmeling, Children’s chief of surgery, performed Ian’s first surgery one week after he was born. The procedure included removing the membrane around the sac, placing as much liver and bowel back into the abdomen as possible, and adding a plastic pouch called a silo bag over the remaining membrane. In the following weeks, a second and third surgery attempted to close the muscle and the skin over the omphalocele.

“It was tough seeing our newborn baby go through such complicated surgeries, but he handled them like a champ” recalled Todd. “He did have a minor setback after his third surgery, where the stitches had to be undone to relieve pressure in his abdomen, but he continued to show everyone how strong he was and rebounded pretty quickly.”

Ian continued to recover in the NICU where eventually his ventilator and catheter were removed. Leah and Todd were finally able to hold him and he began to be more alert and awake. He was able to start taking breast milk and his digestive system was functioning properly, giving his parents plenty of experience changing diapers.

“It was exciting to see Ian meeting so many milestones,” said Leah. “I learned how to help change the dressings on his abdomen and was very involved in the feeding process. In early September, he was moved to the Infant Care Center – one step closer on the path toward going home.”

A few days before Ian had the green light to go home, he had a fourth but common surgical procedure for an inguinal hernia, where soft tissue protruded through a weak point in the abdominal muscles. He may also need surgery down the road for his VSD. Eventually, as baby Ian grows and heals, Dr. Feltis will perform the final surgery when Ian approaches kindergarten, where his abdomen will be completely closed and he will receive his own custom-made belly button, a Dr. Feltis original.

In the meantime, Ian will be able to do the majority of things a child born without any complications would.

“Ian’s prognosis is very positive and we expect he’ll catch up to his aged-matched peers. It won’t be long before he’s crawling, walking and running – pretty amazing for a baby who had three surgeries within the first three weeks of his life” said Dr. Feltis. “Each omphalocele case we see is different and Ian had a few bumps in the road, but he has really impressed us with how far he has come in such a short amount of time.”

The best milestone Ian has met was the day Todd and Leah finally welcomed him home on Sept. 25.

Todd and Leah welcomed Ian home on Sept. 25, after a nearly three-month stay in Children's neonatal intensive care unit.

“Ian came home with a few more accessories than a typical baby, including oxygen tanks and a pulse oximeter, but just having him here and safe in less than three months is amazing,” described Leah. “He’s settling in well and really enjoys being read to and watching us move around the house. It is fun watching him do things that any other baby his age would be doing, despite all that he’s been through. Todd and I are so grateful for medical innovation that has allowed us to start our new family despite the atypical circumstances.”

To see more about Ian’s story, watch the Kempels’ national TV interview on “The Doctors” or view our video series:

The Midwest Fetal Care Center is a collaboration between Abbott Northwestern Hospital and Children’s Hospitals and Clinics of Minnesota. As the only advanced fetal care center in the upper Midwest, the Midwest Fetal Care Center provides maternal and fetal care when a high-risk pregnancy poses challenges

Breastfeeding success creates lifetime of benefits

August 4th, 2014

To reach the goal of exclusive breastfeeding, mothers need a team of helpers and health care professionals to support them. (iStock photo / Getty Images)

By the International Lactation Consultant Association

World Breastfeeding Week is celebrated Aug. 1-7. This year’s theme is “Breastfeeding: A Winning Goal for Life!,” which acknowledges that when mothers and babies succeed in their breastfeeding plans, they can enjoy a lifetime of benefits.

Infant feeding is one of the most important decisions a family can make, and most women who choose to breastfeed have a specific goal in mind. Research shows that babies who receive only breastmilk for the first six months of life are less likely to develop a wide range of chronic and acute diseases, including ear infections, diarrheal disease, asthma, obesity and respiratory illnesses. Mothers also benefit from breastfeeding with a decreased risk for breast and ovarian cancers.

To reach the goal of exclusive breastfeeding, mothers need a team of helpers and health care professionals to support them. The breastfeeding team can include family, friends, physicians, nurses, midwives, employers and childcare providers. Together the breastfeeding team provides information to boost confidence, protects mothers against critics, gives reassurance and lends a hand to help breastfeeding mothers succeed. Team members with special skills and knowledge about breastfeeding, such as a peer counselor or an International Board Certified Lactation Consultant (IBCLC) are especially helpful.

“An IBCLC is often the ‘head coach’ for the breastfeeding team, providing unique expertise and guidance for a mother,” said Decalie Brown, president of the International Lactation Consultant Association (ILCA). “When mothers and babies are able to reach their breastfeeding goals, they also contribute to community prosperity, health, equity, and environmental sustainability.

“Additionally, breastfeeding provides appropriate nutrition for infant growth, sets the stage for school-readiness and contributes to a cleaner environment with less waste. Together all of these small contributions add up for improved global health.”

At Children’s Hospitals and The Mother Baby Center, Clinics of Minnesota, Abbott Northwestern Hospital and United Hospital, lactation consultants and staff nurses with additional education in lactation provide breastfeeding and lactation support. In addition, The Mother Baby Center and United Hospital lactation consultants see mother-baby dyads in their outpatient clinics.

Kathy Parrish, RN, a lactation consultant at Children’s Hospitals and Clinics of Minnesota and The Mother Baby Center, contributed to this blog post.

International Kangaroo Care Awareness Day recognizes bond between parent, child

May 15th, 2014

Thursday, May 15, 2014, is International Kangaroo Care Day.

This month, Children’s Hospitals and Clinics of Minnesota’s Neonatal units in St. Paul and Minneapolis are celebrating the importance of Kangaroo Care, a technique where an infant is held skin to skin with mom or dad.

Kangaroo Care promotes bonding, provides comfort for the baby and parent and has potential to improve a baby’s medical condition. In honor of International Kangaroo Care Awareness Day, a mother shares her experience holding her newborn son skin to skin.

Women more vulnerable to depression, anxiety during reproductive years

May 8th, 2014

Our cultural celebration of motherhood brings with it assumptions, leaving many women to expect that pregnancy will be a time of emotional well-being, and that caring for infants and young children will be overwhelmingly positive and fulfilling. (iStock photo / Getty Images)

By Dr. Elizabeth LaRusso

Dr. Elizabeth LaRusso is a perinatal and reproductive health psychiatrist at The Mother Baby Center.

May is widely associated with flowers, warm weather (sort of) and Mother’s Day. Fewer people know that May also is Maternal Mental Health Awareness Month.

For me, a perinatal and reproductive psychiatrist specializing in pregnant and postpartum women, May is no different than any other month: Women with mood and anxiety disorders come to my clinic, suffering, feeling isolated and unsupported, wondering where things went wrong and if they will ever again be able to feel “normal.”

Our cultural celebration of motherhood brings with it many widely held assumptions, leaving many women to expect that pregnancy will be a time of emotional well-being, and that caring for infants and young children will be overwhelmingly positive and fulfilling. The reality is that the reproductive years are a time when women are particularly vulnerable to the onset of psychiatric conditions like depression and anxiety. For example, the “baby blues,” a condition that occurs for up to two weeks postpartum and is characterized by tearfulness, mood lability and insomnia, affects up to 80 percent of postpartum women; as many as 1 in 5 women will experience postpartum depression. As joyful as it is to have a new baby, the combination of the physical experience of childbirth, the dramatic hormonal shifts, sleep disruption and the social and emotional role changes associated with becoming a mother are massively stressful. Some women navigate these transitions with relative ease, but many women, particularly those with risk factors for postpartum depression (ex: personal or family history of depression, untreated depression during pregnancy, poor social support), have more difficulty.

As with any new role or responsibility, it takes time to develop competence. In the first couple of weeks postpartum, it is common for women to lack confidence caring for their baby, to struggle to feel connected to the baby, to have difficulty sleeping and check frequently on their baby, and to feel overly emotional, worried, and reluctant to be alone. Many women experience intrusive thoughts or images of harm coming to their baby, like dropping their baby or coming to the crib and finding the baby not breathing. In general all of these symptoms should be improving over time, not getting worse.

Women who experience significant sadness, frequent tearfulness, feelings of guilt, inability to sleep even when given the chance, significant disruption in appetite, concentration, energy or difficulty functioning may be experiencing postpartum depression. In severe cases, postpartum mood disorders are associated with thoughts of harming oneself or the baby, and any woman experiencing these thoughts should be brought to her physician or the nearest emergency room for immediate evaluation. Anxiety, although less well studied in perinatal populations, frequently goes hand in hand with depression. Mothers who experience severe anxiety, worry or panic that it interferes with their ability to sleep, care for their infant or be alone may be experiencing a postpartum anxiety disorder.

The most important thing that any woman struggling during pregnancy or the postpartum period can do is speak up and reach out to the people she trusts. Letting family or friends know about mood and anxiety symptoms is the first step in increasing support and getting a plan in place to obtain further evaluation and treatment. Contacting one’s obstetrician, midwife or primary care physician to schedule a visit is the next step in seeking care. At Allina Health and Children’s Hospitals and Clinics of Minnesota, we are developing care processes that will increase the ability of women to obtain prompt evaluation and treatment for perinatal mental health issues. Other organizations such as Postpartum Support International offer information and resources to help connect women to appropriate care.

Dr. Elizabeth LaRusso is a perinatal and reproductive health psychiatrist at The Mother Baby Center.

Recognize this smiling face?

February 11th, 2014

It’s Brielle, one of the stars of our Mother Baby Center ad campaign, including our first birthday creative materials.

Brielle was born at Abbott Northwestern Hospital on July 31, 2012, and is now 19 months old. We caught up with Brielle’s parents to hear more about Brielle and how she’s grown.

All about Brielle:
Favorite food: Lentil curry
First word: Dada, (surprisingly, one of her other first words was “tickle”)
Most recent milestone: Eating well with a spoon
Favorite toy: Baby dolls, Legos, and Pete the Cat doll
What makes her laugh: Hide and seek and tickling
Most resembles: Mom
Other?: Loves being outside and playing in the snow!

A year of firsts

February 6th, 2014

Finn: first baby admitted to the Special Care Nursery

In year one, 718 babies born at The Mother Baby Center were admitted to the Special Care Nursery.

Seven weeks before their first baby was due, Alissa and Daniel Maloney began learning how unpredictable parenthood can be.

Finn Daniel Maloney was supposed to be born at a community hospital close to home. But when Alissa’s water broke prematurely, the community hospital was at full capacity. Instead, the couple was directed to The Mother Baby Center – a building that combines Abbott Northwestern Hospital’s maternal and fetal services with Children’s Hospitals and Clinics of Minnesota’s pediatric specialty care. It was Feb. 5, 2013, just one day after The Mother Baby Center had opened.

They arrived having had no tours or birth classes. They had not even had a baby shower yet. “It was chance that we ended up at The Mother Baby Center. But it all worked out for the best,” said Alissa. “I knew we were at the best place for a premature baby.”

Finn was born on Feb. 6 weighing 3 pounds, 8 ounces at birth. “We were able to hold him right away – but not for long. We had a few minutes to take pictures and then he went to the Special Care Nursery,” said Alissa.

Finn was the first baby admitted to the Special Care Nursery, an area dedicated to the care of babies born prematurely, in The Mother Baby Center. There, he was set up with monitors and a feeding tube, but he was able to breathe on his own. Alissa and Daniel joined him there a few hours later. Their private room made it a comfortable setting for everyone to get to know each other.

Finn went home about two weeks later weighing 4 pounds, 2 ounces. While healthy overall, he needed some ongoing support with feeding. Alissa and Finn returned weekly to meet with a lactation nurse. “That was incredibly helpful. I would recommend that to any new mom who is breastfeeding,” said Alissa.

A year later, Finn is a happy, curious baby. He loves being with the other kids at his day care, and he sensibly decided to sleep through the night about two weeks before Alissa returned to work.

“He’s still small for his age, but he’s healthy,” said Alissa. “We were lucky.”


 

 

 

 

 

 

 

All about Finn
Favorite food: Green beans
First word: Da-da-da-da
Most recent milestone: Pulling himself up to stand
Favorite toy: Sophie the Giraffe
What makes him laugh: Count von Count from Sesame Street
Most resembles: Everyone says he looks like his uncle because he has the same strawberry blond hair.

See and learn more about The Mother Baby Center.

A year of firsts

February 5th, 2014

Anika: first baby admitted into the NICU

In year one, 490 babies born at The Mother Baby Center were admitted to the neonatal intensive care unit (NICU).

Every birth has some drama, but Anika Hubbard’s birth may have had more than most.

It started when prenatal tests revealed she had spina bifida, a condition characterized by incomplete development of the spinal cord. That made planning for her birth complicated, especially since her family lives in the middle of South Dakota. That’s a good eight-hour drive from The Mother Baby Center where doctors referred them for the high level of care that Anika and her mom, Kassandra, required.

Weeks before the birth, her parents, Kassandra and William, moved in with a cousin in Minnesota, and a Caesarian section was scheduled for Feb. 5, 2013 to ensure a safe delivery and follow-up care for Anika. All was well until Feb. 4, when Kassandra suddenly went into labor.

By the time the couple arrived at The Mother Baby Center, a building that combines Abbott Northwestern Hospital’s maternal and fetal services with Children’s Hospitals and Clinics of Minnesota’s pediatric specialty care, contractions were five minutes apart. Kassandra was rushed into an operating room and became the first mom to deliver by C-section at The Mother Baby Center, which had just opened that day, while Anika was the first baby admitted to the NICU from The Mother Baby Center.

Within a few hours, Kassandra was wheeled into the NICU to meet her daughter. “You want what every mom wants, so it was hard to see her with tubes and bandages everywhere. But we got to see her, touch her and hold her hand,” recalled Kassandra.

But Anika’s dramatic entry was still unfolding. Just eight hours after her birth, she had neurosurgery to protect exposed spinal cord tissue and minimize the risk of infection. Fortunately, Anika healed quickly from surgery and was soon eating, gaining weight and responding to her parents like any healthy newborn.

Anika needed a second surgery before she went home at the age of 3 weeks. There she continued to amaze her parents with her happy demeanor, good appetite and willingness to sleep through the night at just 6 weeks old.  Now, as Anika turns 1, her mom said she is continuing to make progress and grow every day. “She’s a strong little personality and very determined,” said Kassandra. “She’s making great strides, and I don’t think anything will hold her back.

“We know she’s doing so well today because of the great care she received at The Mother Baby Center and then Children’s. We’re grateful to all the staff who provided exceptional care to her, and me.”


 

 

 

 

 

 

 

 

 

All about Anika

Favorite food: Strawberry yogurt
First word: Da-da-da-da (in different pitches and tones)
Most recent milestone: Army crawl
Favorite toy: Bunny rattle
What makes her laugh: The family dog
Most resembles: It changes month to month, but she has her dad’s eyes: beautiful blue eyes that stare into your soul

See and learn more about The Mother Baby Center.

 

A year of firsts

February 3rd, 2014

Gemma: first baby born at The Mother Baby Center

In year one, 5,153 babies were delivered at The Mother Baby Center.

 

 

 

 

 

 

 

 

Michael and Kristin Towle describe their fourth child, Gemma, as a real go-getter. And, one might add, she has perfect timing.

Although she was due on Jan. 31, 2013, she managed to keep her parents waiting just long enough to be the first baby born at The Mother Baby Center, a building that combines Abbott Northwestern Hospital’s maternal and fetal services with Children’s Hospitals and Clinics of Minnesota’s pediatric specialty care.

The Towles knew that The Mother Baby Center would open around the due date. “As we learned more about it, we were kind of hoping we’d end up there,” said Michael. Still, it seemed quite unlikely that their baby would be five days late.

As Jan. 31 came and went, they began to wonder. Finally, in the wee hours of Feb. 4, Kristin started having contractions. The couple was in touch with their midwife, Kathrine Simon, CNM, and at about 9:15 a.m. they decided it was time to go to the hospital. The Mother Baby Center had officially opened its doors at 7 a.m.

“Everyone was so excited when we got there,” said Kristin. The couple had made arrangements with their midwife to have a water birth, so after labor progressed, they were brought to the water birth room. “It was a beautiful, calming room,” recalled Kristin. “And Kathrine, the nurses and the entire team did a phenomenal job of preparing us.”

Michael noted that his wife had always had positive birth experiences, but during the water birth, she seemed particularly serene and confident. Weighing in at 7 pounds, 6 ounces, Gemma was born at 11:18 that morning.

Before long, Gemma, Kristin and Michael were back in their own room, soon to be joined by Gemma’s brothers, James and Michael Jr., and her sister, Sabina. “The whole experience was positive for us,” said Kristin. They appreciated that their choice of using a midwife was supported and affirmed by The Mother Baby Center, and that their desire to keep things simple and natural was respected.

As Gemma’s first birthday approached, the Towles were preparing themselves and their household for life with an active toddler. “Even when she was still in my tummy, we would always marvel at how active she was,” said Kristin. “She started to crawl at an early age, is very verbal and has a lot of energy. Of course, she’s trying to keep up with her brothers and sister.”

“It’s been a joyful and eventful year for our family – we’re grateful for all that was done at The Mother Baby Center to make Gemma’s birth such a memorable experience.”

 

 

 

 

 

 

 

 

All about Gemma
Favorite food: Anything with mango in it
First word: Ma-ma
Most recent milestone: Standing up on her own
Favorite toy: An empty box, especially if she can crawl into it
What makes her laugh: Papa goofing around with her siblings: Michael, James or Sabina
Most resembles: She bears an uncanny resemblance to her Grandma Peggy

See and learn more about The Mother Baby Center.

National Midwifery Week: A Q-&-A with Nicole Rovang

October 11th, 2013

It’s National Midwifery Week. To highlight the work of a midwife, we talked with our moms who recently gave birth. Here, they share their experience in their own words.

Nicole Rovang, a 29-year-old mom, gave birth to Camden almost two years ago and worked with Kathrine Simon and Jessie Kunz of North Metro Midwives.

You gave birth almost two years ago and worked with a midwife. Was it your first time working with one?  This was my first time working with a midwife.  Before I became pregnant, I knew that I wanted a natural birth, with little intervention, and someone to stand by me through my labor.  I wanted the freedom to move around and let my body do what it was made to do.  I found North Metro Midwives online and instantly fell in love with the practice.  When I became pregnant, North Metro Midwives was my first call.  I was excited to work with a group of midwives who are so passionate about midwifery.  I felt confident in my choice, and most importantly, I felt supported in my decision and birth plan.

How did you settle on a midwife? During the pregnancy working with the group of midwives was similar in style to a small OB practice.  I rotated through the three providers, so that I knew each person who had a chance of being with me on my son’s birthday.  My questions were always answered and further testing was explained thoroughly with all risks and benefits explained to my understanding.  The office staff knew us by name and took an active role in my life.

During the pregnancy, what was it like working with a midwife? The birth of my son was amazing.  He was a trick and a treat, arriving a little over four weeks early on Halloween morning.  Jessie took charge in the delivery room and provided my with the tools and support I needed to feel confident in my decision to birth with as little intervention as possible.  She coached me through the contractions and coached my husband to sit down when he wasn’t feeling well.  She constantly assured me that I could do this and that I was having a baby.  Just less than five hours total at the hospital, my son Camden arrived with no complication other than being a late-term preemie.

Is there anything else you want to share about your experience? My experience with the midwives extends beyond my prenatal care and the birth of my son.  I decided to stick with the practice as my primary care for women’s health.  When I found a lump in breast nine months ago, it was Jessie who felt the lump and ordered the appropriate testing.  She could have easily told me it was normal tissue for just ceasing breast feeding, but her choice for further testing may have saved my life.  It was Kathrine who held my hand and cried with me as she gave me the results of the biopsy, and told me I had cancer.  She assured me that my dream to give birth to another child was not gone and my dream to become a nurse was not over.  Both Jessie and Kathrine called me often throughout my surgery and treatment for breast cancer just to see how things were going and how I was doing not only physically, but emotionally and spiritually.  They both took an active role in my family and our lives have forever been changed by these women who are so passionate about women’s health.

 

National Midwifery Week: A Q-&-A with Emily Zimmer

October 11th, 2013

It’s National Midwifery Week. To highlight the work of a midwife, we talked with our moms who recently gave birth. Here, they share their experience in their own words.

Emily Zimmer, a 31-year-old mom of three, worked with Kathrine Simon, CNM, of North Metro Midwives for the first time with the birth of her youngest child, 4-month-old Fritz.

Fritz

You recently gave birth and worked with a midwife. Was it your first time working with one? It was our first time working with a midwife. While we had good care with our first two children, if I had known the difference, I would have worked with a midwife sooner.

How did you settle on a midwife? Our first child was breech and was born via c-section. Despite going into labor naturally, our second child was born via c-section because of hospital policy in our town. While happy to have a healthy little boy, I felt disappointed that I hadn’t had the opportunity to have a natural birth.

When I found out I was pregnant for the third time, I was determined to take control and try for a vaginal birth. I searched the Twin Cities for a provider who would work with me, and North Metro Midwives seemed the best fit.

During the pregnancy, what was it like working with a midwife? Working with a midwife was a lovely experience. Kathrine and company took time each appointment to answer our questions. We never felt rushed like we have experienced other places. Throughout the pregnancy, the midwives provided sage advice regarding diet, exercise and overall well-being. The midwives provided a holistic experience that really left our family feeling well cared for.

How’d the delivery go? Our little guy was in no hurry to come out. He was six days past due when I went into labor. And of course, the process started in the middle of the night. We got to The Mother Baby Center at 4 a.m. on June 11.

Kathrine checked to see how far I was dilated and couldn’t find the opening to my cervix. I was mostly effaced but after three additional cervical checks, staff couldn’t determine dilation.

Stumped, Katherine asked one of the perinatal doctors to check and she located the opening over to the side and was able to sweep it over.

Four centimeters dilated, we were rocking and rolling. It took another 18 hours of labor to meet our baby. Our midwife was our rock throughout the experience. There was never any question that we were going to have a successful vaginal birth. She coached us through it with the right amount of kindness and determination.

My husband and I were both grateful for her knowledge and support through the whole experience. At 4:19 a.m. the next day, our 9-pound, 4-ounce boy was born.

Is there anything else you want to share about your experience? After the birth of my first two children, I felt a certain sense of loss. While my priority was their health, going through c-sections was an unfulfilling way to bring them into the world. While with my first it could not be helped, poor hospital policy determined the birth of our second child.