We had just moved to SF, when we found out I was pregnant again. My first thought,  knowing the reputation of the US of being very prone to medical interventions, was ‘oh no, now I do have to deliver in a hospital!’

My first daughter Seva was born in a so called Birthing Hotel in Amsterdam. As a real ‘Dutchie’, I wanted to labor as natural as possible, without any medical interventions, and I was fortunate to have this wish become reality.

I was extremely happy to find out that San Francisco had opened a birthing center just half a year before. So I called and scheduled a meeting with midwife Nancy. Upon arrival I felt immediately at ease. The labor rooms were beautifully decorated, as if you were going to deliver at home. Nancy expressed a lot of expertise and understood our wishes of a complete natural birth without interventions immediately. We know this was the place to be for our second one. Little did I know that this wish would be tested many times in the next 9 months. It turned out that everything with our second girl Nahla would become quite a rollercoaster, far from resembling my peaceful experience with Seva, her sister’s, pregnancy.

The first surprise during Nahla’s pregnancy was that my chronic bowel inflammation (Ulcerative Colitis / ‘UC’) flared almost exactly when we found out I was pregnant. It had been years since my last flare, and I also had no flare with Seva her pregnancy, so I somehow assumed the UC belonged to my past. Soon in my first trimester I was quite worn down by fatigue and nausea, which I knew is normal during the initial period, but I felt it worsened due the UC symptoms. The UC took a lot of energy from me, which upset my stomach a lot, and I lost about 5-6 pounds in my first couple of months.

During that period I also realized, that the magical feeling and excitement that I felt the first pregnancy, were not as strong with Nahla’s pregnancy. Honestly, most of the time I just didn’t enjoy it at all. I just felt miserable and in low energy. In retrospect, I think as a reaction to feeling so worn down, I was unconsciously ignoring the pregnancy, instead of really embracing it. I tried to keep up my workouts (running and yoga), signed up for an online marketing course (which put on another stress level) and kept myself busy developing new business ideas and daydreaming about what I would do as soon as I could start working again. As I knew was turning 40 at the end of the pregnancy, and it felt there simply was no place and time for physical changes and low energy… Silly but true!

As I kept on pushing myself, my UC symptoms suddenly started to worsen quite drastically in the second trimester. My gastroenterologist was not available for any advise or change in medication, until 6 weeks down the road. The strict diet – no sugar, no gluten, no dairy – did not help anymore, so my only remedy was trying to find a way to stay emotionally calm and confident, and try to ease into what was happening. I realized around the sixt month that I needed to quit all the workouts, studying and future planning. I guess I only needed to be present in the ‘now’, instead of focusing on how I wanted things to be. It felt like I had a wake-up call and really wanted to save my energy and focus for my recovery and the little girl growing inside of me.

I decided to take prenatal yoga classes with Britt Fohrman at Yoga Tree. Every time I entered the yoga studio, it felt like a little present to myself. Her yoga classes were very different from the more active and down to earth (Critical Alignment) yoga style I am used to practice. But I loved it! It was exactly what I needed, as it provided me tons of pregnancy & labor information, affirmations and exercises that helped me to ease into my constantly changing body and emotions. I also picked up my breathing exercises and meditation as much as possible at home. It helped me to stay calm, even when Seva brought a debilitating stomach flue and shortly after a persistent cold into our family in the last two months before my due date.

About 1,5 months before my due date, there was a growing concern about the little growth of my belly and the baby herself. Obviously, it was important to know if my placenta was still working well, so I had to enter a cycle of growth ultrasounds and Non Stress Tests (NST). They found out, that the growth of Nahla’s belly was quite off from the growth of her head and limbs, which could be (but was not necessarily) a sign of limited nutrition flow to my baby. It led to a constant discussion about an early induction in the hospital, which felt far away from our plan to have a natural birth. I really hoped that Nahla could choose her own timing and I would not need any medical interference. But this information also worried us.

It is important to understand, that my ‘gut feeling’ constantly reassured me that Nahla was doing well and that she was healthy and strong. I could feel her movements, which felt exactly like Seva had felt. The fact that my mom also carried a very little belly with both her pregnancies (which at that time had also been a growing concern for her doctors), but delivered two perfectly healthy babies, reassured me again and again that I should keep opting for more time and give Nahla time to grow. Although my midwives at SFBC shared some of the concern of the hospital that Nahla may not get enough nutrition, I was very happy that they eventually trusted my instincts and respected our wish to wait with an early induction.

Although my UC was far from stable, I decided to taper the Prednisone that I was using two weeks before labor, so I would avoid an IV  Prednisone ‘stress dose’ during birth (which also would have made it necessary to deliver in the hospital). I did though decide to use a preventive antibiotic IV for my GBS positive diagnosis, as I had a so called ‘heavily population’ of the bacteria, which would have put the baby at risk of major inflammation diseases. Luckily this was possible at the Birth Center. Although I was quite concerned about the effect the antibiotics would have on my and Nahla’s gut, we decided it was more important to avoid any chance for severe distress caused by the GBS. The midwives also advised to give Nahla probiotics in her first weeks of life, to help built up a healthy microbiome.

Eventually, being 39.4 weeks, we decided to use natural ways to thin down the cervix and get the baby ‘going’. This felt like a good decision and timing, as I felt stronger and prepared for the labor ahead. More importantly, it felt like Nahla and me stayed connected and it was time to work towards meeting each other.

I started by doing some acupuncture session with Jeannie Bianchi (from the SF Acupuncture Group), who impressed me with her genuine care and palpable effects on my energy level. She also gave me tips on acupressure points, so I could continue to stimulate the points related to opening up my cervix. I loved her and would recommend her to anybody who needs pre/post pregnancy care. On day 39.4 Julie came to my house to sweep my membranes, and the next day I used my breast pump to stimulate contractions. At day 39.6 I followed the advise of Nancy to place a Foley Balloon in between my cervix and the head of Nahla, to hopefully start dilating my cervix.

The next day, on Sunday morning 6 am, my water broke, and after consulting with Nancy, we gently pulled the Foley Balloon out, only emptying some of the water. It was clear by the size of the balloon that I was about 3 cm dilated. As I had to place an IV for the antibiotics for the GBS, and there was still a chance that Nahla would experience stress issues during labor due to her little growth, Nancy advised us to take a walk outside and then meet at the Birth Center at 9am. My contractions significantly increased during that walk, which felt good as I was not looking forward to a long labor.

Nancy placed the IV shortly after we entered the Birth Center, warning the penicillin could give a burning sensation, but I (always in fear of any needles) was very happy to notice that both the placement of the IV and the penicillin did not bother me at all. Nancy is a star in placing IV’s!

We moved to the birthing room around 10am, from which point the labor and timing became a little blurry. I remember not being comfortable in many positions, moving from standing in front of the bed, to leaning on the bed, to lying down, to using the bath tub in various positions. The contractions were pretty intense, which I somehow tried to grunt out vocally. It was so helpful when Nancy reminded me that the pushing would be stronger and more effective, if I would keep my mouth closed and move those intentions down into pelvis with every contraction. Not only was the pain more bearable, it also felt the downward movement of the baby was more effective.

At some point I truly felt stuck in the labor process. The contractions were slowing down and suddenly not as strong and overwhelming as I remembered with Seva, which I found very confusing. Also, the time in between the contractions slowed down significantly. At some point I remember I kind of fell asleep in between the contractions, and Nancy advised me to lay down and take as much of a rest as possible. I really felt I lacked the force to get Nahla out, so I tried to focus on resting. There were periods of intense trembling, which I learned to accept from the yoga classes of Britt. I constantly heard a voice in my head, which was questioning if I lacked the energy due to my UC flares for the last couple of months. This thought actually scared me. I realized that this mental state was not helping me to stay focused, as I knew that labor was mainly a mental game.

When the contractions became less and less strong, I asked Mano and Nancy for mental guidance, as I became very anxious I would not be able to get Nahla out. Mano did not leave my side once during the whole labor, always reassuring I was strong and capable of giving birth to Nahla. Nancy opted for nipple stimulation, so Mano and her started working each on one breast. Although in real life this would have been quite awkward, it felt very natural and effective in labor. Mano and me definitely had a big laugh after labor about this ‘threesome’! More importantly, the nipple stimulation did work and my contractions became stronger again.

I knew from past experience that, when you emotionally hit rock bottom and have the feeling the birth is never going to happen, the baby is about to be born. But when I hit that moment, I was truly convinced it would never happen. And the next second, after Nancy put me into a full squat position, Nahla’s head was suddenly showing. I felt the ‘circle of fire’ (which was a huge relief as I knew the end of labor was near) and I could slowly guide the rest of Nahla’s body out.