Crys the Doula

Your birth matters.

The Tale of the Placenta Procurement under the COVID19 Umbrella

My Plush Placenta

Ok. I will admit that this actually not even close to the most bizarre placenta story I could tell, but it is still worth a read. 

Backstory.

Sometimes families hire me just to process their placentas. In those cases, I talk with them for a bit when they inquire, then typically do not hear from them again until labor starts. I ask to be notified, if possible, when the mom is in labor. I then ask to be contacted IMMEDIATELY when baby arrives so I can facilitate pick up in a timely fashion.  A few months ago, I made arrangements to work with a family. Their chosen place of birthing is not known for being doula friendly. The placenta is placed into a bucket with a lid shortly after birth. Typically, that bucket is set into a basin and ice is added. The whole shebang (or at least the first bucket) is placed in a massive, red BIOHAZARD bag. That is what I carry out. At this facility, they want the placenta picked up within two hours, and the family, a nurse, and the person picking up the placenta have to sign a form.

Enter: COVID19

I get a text that says water broke and they are headed in. Mom asks if current situations will change anything. This was sparked by the decision just days before that hospitals in our area were no longer allowing visitors amidst concerns of spreading the Corona virus. At the time, one support person was allowed to accompany a laboring mama, and it has to be the same person throughout. Doulas are fighting to remain with the families that hire us to support them, but that is another story altogether. *tucks soap box behind back* Back to the text. I tell her it shouldn’t alter much, but her partner would likely have to bring the placenta out to me instead of me going in to pick it up.  She said ok.

Me being the me that I am, started thinking through protocols. I wondered how the signatures would go and began worrying that my clients would be concerning themselves with logistics instead of embracing their birth journey. I wanted to get the answers and have my contingencies ready, as in these unprecedented times, things are changing hourly. I needed to reach out to a friend to set up a donor milk pick up and decided to do it right then since she also happens to be a nurse at the hospital at hand, although not in Labor and Delivery (L&D).

Exchange 1 with Nurse Friend of Awesomeness (paraphrased)

Me: I need a placenta from your hospital. Do you know how that is working today?

Her: How does it usually go?

Me: Explains the things.

Her: You cannot go in. They won’t let you. But dad should be able to hand you placenta at door where you can wait with the guard.

Me: what about signing things? 

Her: The dad maybe?

Me: Maybe? Since he is technically taking the organ out? I was thinking of calling L&D and asking, but I know they’re busy.

Her: It doesn’t matter if they are busy, it is their job to help.

The Call to L&D

N: L&D, this is NAME (I really want to say but I won’t because reasons).

Me: Hi there! I am hoping to get information on the current protocol for picking up a placenta.

N: Uhhh well…

Me: I have client there now, and I need to know how I will be able to get the placenta for processing.

N: So she’s coming in in the future or she’s here?

Me: She is there currently. 

N: You cannot pick it up.

Me: Then can someone bring it out?

N: uhhhhhhh

Me: Ma’am?

N: ::crickets::

Me: Can the dad just hand it to me at the door?

N: <terse> Well. We are only allowing one support person with laboring women.

Me: yes, I know. Could he do a hand off?

N: You DO NOT want to put him in that position. If he walks out the second set of doors, he likely will not be allowed back in. You would be irresponsible to suggest he risk being removed from his wife and baby.

Me: <rage stifle> Then HOW do I GET IT?

N: I don’t think you can.

Me: It is her placenta. She made it. She wants me to have it. We need a way to facilitate. Whether you agree or disagree with encapsulation, it is her right, and the current state of the world is clearly not an ideal time to remove a tool a mother was planning to use for her mental health postpartum.

N: This is an upper management decision and they have gone home for the day. Maybe you should call back tomorrow after 8:00am.

Me: Her waters released HOURS ago. It is possible she will still be pregnant at 8:00am but it is not probable. C’mon. You work in L&D. We need a solution before that. Could a nurse walk it out?

N: <Cold> He can risk it. He will not likely be allowed back.

Me: Seriously? Nurses are supposed to help people.

N: I can let the charge nurse know we have a situation but this is an upper management decision.

Me: <calls upon the Great Calm and the Supreme Filter> Please do. Thank you.

Exchange 2 with Nurse Friend of Awesomeness (paraphrased)

Me via message: CAN YOU CALL ME?!?!?!

Me answering phone: I AM SO FRUSTRATED 

Her: What happened?

Me: <vomits the above at her with a lot of swear words>

Her: Well. N [is not an ideal person with whom to speak].

Me: I really don’t want my clients trying to solve this on their end WHILE IN LABOR.

Her: No, they shouldn’t have to. We will figure it out.

—————>

Text from client comes through: They said it could be an issue. We’ll see!

—————>

Me: Do you know anyone on night shift there tonight? Anyone in L&D that could help?

Her: Not in L&D but I have a few people I will reach out to.

Me: Tell them I look a bit scary sometimes but I am SO NICE and I would be SO GRATEFUL if they would bring me a human organ.

Her: I will see what I can come up with.

Me: I have another friend who works at this hospital I can reach out to, and also I will call Dr. Amazing and see if she can help. I just need someone who can walk it to the door 

Her: YES! Call Dr. Amazing! I just did a surgery with her recently. But, worst case scenario, I will leave my phone on. I will put on my scrubs and go in and get it. I can go in. I will meet you there.

Me: Ok. I will call Dr. Amazing. And you are seriously the BEST. I will let you know if I get a different plan. In the mean time, I am going to make a tiny doll of N and stab it with something.

Her: You can do that. But remember your Karma. 

Me: <stalls> I will. I mean to say I will poke pain centers on her hands. I am sure she is overworked. If She feels better, she might be more helpful.

Her. You can target her feet, too.

Me: Oh yes. She’s a nurse after all. I bet N does have sore feet we could fix.

—————>

reply to client: I just talked to a nurse friend that works there. Worst case scenario, she will go to your room and get it for me. I called the nurses’ station too and they are looking into it too. Hold your ground. Things are stressful. You deserve your medicine.

—————>

—————>

Text to Doula Placenta Friend: OH MY GOSH I AM SO ANGRY! Placenta only client at THAT hospital. I can’t go in to get it. There’s security at the door. If dad brings it out, he can’t go back in. We are working on a solution (she is there in labor still)

—————>

Call to Dr. Amazing

Dr.: Hello!

Me: Hi there. I have called to exploit our friendship.

Dr.: <laughing> WHAT is goin’ on?

Me: vomits ALL OF THE ABOVE

Dr.: Expresses extreme displeasure. Asks who my clients Dr. is.

Me: Hold on

Dr.: Launches into rant with which I wholeheartedly agree

—————>

Text to client: Who is your Dr.?

Client reply: Dr. Dude

—————>

Me: Her OB is Dr. Dude.

Dr.: Okay. 

Me: Do you know him?

Dr.: Of course. Let me make a call. I will call him. I will call back.

============

—————>

reply to client: My OB friend is calling your Dr. 

—————>

—————>

reply from Doula Placenta Friend: OMG Crys Im so sorry! I picked up two today and they allowed dad to pass it through the door to me. Can security pass it to you? I’m here if you need support.

Me: night shift said no

DPF: That’s BULL! (followed by suggestions and solidarity)

me: Dr. Amazing is calling THAT hospital for me now.

DPF: Oh thank God for her

—————>

Call From Dr. Amazing (a few minutes later)

Dr.: Dr. Dude will bring it out to you.

Me: What? REALLY? You are THE BEST.

Dr.: Yeah. I called the hospital to see who was taking call for him. He is on tonight. I called him at home. I told him you are a wonderful doula that also does placentas and we need his help and could he bring the placenta out with him. He said yes.

Me: Seriously thank you.

Dr.: Ok. Here is how it is going to work. You HAVE TO be at the hospital when the baby is born. You won’t have time to get there from your house (she knows where I live) before Dr. Dude will be ready to leave if the client calls you when baby is born.

Me: OK! no problem.

Dr.: Have them call you when she is pushing, then you drive there. Then, when he is done, have them call you again to get out of your car and walk up to the doors for Dr. Dude to give you the placenta.

Me: profuse gratitude

Dr.: I told him we are both very grateful.

—————>

text to DPF: Ok. Her OB will bring it out with him.

reply from DPF: Oh Good! It pays to have contacts!

me: ::exhale::

DPF: deep breathes

Me: THIS IS NOT THE TIME TO DEPRIVE MOTHERS OF MOOD STABILIZERS

DPF: I totally agree!

—————>

Text to client: ok. please have someone call when you are pushing. I’ll leave to come to the hospital. Your Dr. will bring it to me. I just have to be there when he leaves so I need a little heads up.

client: ok my husband will call you

Me: it’s all ok!

client: Thank you so much

The Sun Rises in Pandemics, too.

I woke up to a phone call. It was exactly who I thought it would be. I got dressed, brushed my teeth (I want Dr. Dude to like me). I drive to the hospital. As the turn in to the hospital becomes visible, so do flashing lights. A lot of them. I cannot make my turn. There are emergency vehicles everywhere. A van and a sedan had met quite forcefully. I end up getting herded with gathering traffic and FORCED ONTO THE FREEWAY. For real. This far into the saga, on a tight timeline, I am getting a dandy of a delay. I, however, am having a much morning than anyone in the van or sedan so I try to shake it off. I am treating my phone like a jack-in-the-box that has been cranked a good bit; I know the sucker could go off any moment! Up to the first exit, over, back a mile, and enter the campus of THAT hospital the back way. I get myself parked. MINUTES later, the phone rings!  Dad informs me Dr, Dude is headed my way! I walk up to the maternity doors and wait all of 60 seconds. 

Dr. Dude Interaction

me: (sees man with white bucket tucked like a football) Hello!

Dr. Dude: Is THIS the package you’re looking for? (nearly tosses the bucket o’ placenta to me)

Me: <taken aback both by his nonchalant placenta flip with no giant red bag, and by the body temp sensation on my forearm from the placenta through the bucket. I usually get them cold> Oh yes! Seriously, THANK YOU! I am sure this was an odd request. 

Dr. Dude: Nah. You are going to make pills or something, right?

Me: Something like that.

Dr. Dude: It took her longer than I thought it would.

Me: yeah, but we get to see a beautiful sunrise!

I get home and get set up to process, the rest of my house still fast asleep. I have it prepped, dehydrating, and all of my equipment sanitized before 8:00am.

The capsules were safely delivered to my client’s home two days later. 

Success Discussed

Why did I write this whole thing out? So glad you asked! The first reason, quite honestly, is therapy for myself. Writing is simultaneously stimulating and soothing for me. This is a busy time mentally and emotionally. More than that though, it is to tell a bit of the behind the scenes life of birthworkers. We have our clients in our minds ALL THE TIME. There are networks and connections that are hard to fathom even from within. There are helpers. Yes, there is red tape, and bureaucracy, and garbage, but think about what I wrote. Think about the people willing to help. People that took time away from their families to help me help someone. Most of the text conversations were literally taken from my phone, word for word. That is how we talk to each other and support each other. I love that Nurse Friend of Awesomeness even called me on my karma, but allowed me space to vent. I love that my Doula Placenta Friend immediately offered ME support. I love that Dr. Dude was like “here’s human tissue. still warm. Bye!” I love that Dr. Amazing, in a later follow up text conversation said “keep fighting the good fight. and I will too.” 

Fresh Medicine

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