L started care with me at the beginning of the second trimester of her first pregnancy.  After researching, L felt that home birth and midwifery care was the best fit for her and her baby. At 38.4 weeks along in her pregnancy, L sent me a text saying she suspected her water had broken.  After talking, I asked L to come over to my office and see what was going on.  I confirmed her water was broken.  L was 1cm dilated, 50% effaced and baby was at a -2 station.  I swept her membranes and L’s cervix opened to a 3.  We talked and L was going to get some snacks and walk around the store before going home to nap, and would come back and see me in the afternoon. L arrived back at my house just before 4pm.  L seemed more uncomfortable, contractions coming every 3-6 minutes, lasting 30-50 seconds long, and felt moderate in intensity.  Her cervix was now 3cm dilated, 80% effaced and baby at a -1 station.  After I did the exam, things became quite intense.  L needed counter pressure on her back, and was rocking through contractions.  A wave of nausea hit her during a couple contractions.  L’s partners and I got her situated and she made the short ride back home.  I got my supplies together and ate some early dinner, as I anticipated a phone call soon. I arrived at L’s home around 5:15pm.  L was sitting, moaning and rocking through contractions.  Contractions were coming every 2-2.5 minutes, lasting 60 seconds.  Her back was bothering her.  Her doula and partners began alternating providing counter pressure to her back for comfort. I encouraged L to move to to the toilet and see if she could empty her bladder a little before 7pm.  She couldn’t seem to empty her bladder, but waves of nausea hit her from the position change.  After laboring on the toilet for a few contractions, L moved back to the birth ball. L moved to the shower to labor for a bit, leaning on her partner for comfort and support.  A little after 8pm, L moved to the birthing pool.  She labored on her knees for a few contractions and then moved to semi reclining.  We discussed doing an exam and L decided she was okay with it around 8:30pm.  Her cervix was 3cm dilated, 100% effaced and baby was at a 0 station.  We all encouraged L that she was doing an awesome job. After the exam, the birth team left to another room, allowing L to labor with her partners alone and see if that helped the labor progress. The intensity of the contractions began to pick up more.  I gave L a dose of rescue remedy to help her relax.  She was still unable to empty her bladder.  We talked about the time frame and that I would need to do a catheter soon if she was unable to empty her bladder.  A little before 10pm, L moved to the toilet to labor again, and after some maneuvering was finally able to empty her bladder. L moved to her bed when she was done laboring on the toilet.  I encouraged L to try laboring in a knee chest position for 45 minutes and see how that helped things.  L’s partners stayed by her side, providing counter pressure and encouragement through the contractions. As midnight neared, L asked everyone to remind her that she was having this baby at home.  Everyone spoke encouragement over her and told her over and over that everything was going perfectly right as it should, and she would be having this baby at home.  She alternated laboring on her right and left side in the bed. Through out the next hour, the pressure began to build.  L would occasionally bear down spontaneously with the peaks of contractions.  A few more waves of nausea came over her.  We started talking about doing another cervical exam since it was 4 hours since the last exam.  At 1:20am, I did an exam and found L to be 6cm dilated, 100% effaced, and baby at a 0 station.  The baby was putting lots of pressure on the cervix, and I could feel the cervix getting a little swollen.  I encouraged L to try knee chest for 30 minutes and see if that helped things progress.  L moved into position.  Within a couple contractions, the pressure began to build stronger. A little before 2am, L moved to the toilet to labor, pressure strong.  She moved back to the bed in knee chest and began to spontaneously bear down.  At 2:10am, L had a lip of cervix and baby was at a +1 station.  I discussed with L blowing through some contractions or I could reduce the lip.  She agreed to me helping hold the lip.  After two contractions, the lip was resolved and L was completely dilated. After a few pushes, L moved to her left side to push for a few contractions.  I suggested L try tug of war to see if it helped give her some more strength to help with pushing.  L’ s doula helped her with that for a few contractions. At 2:40am I suggested L moving into semi reclining against one of her partner’s to help with pushing.  It did the trick!  At 2:45am we all could see a small amount of head on the perineum as L pushed. L was amazingly strong bearing down with the strength within her.  Her sweet baby was crowning at 2:58, and a minute later the head followed.  At 3am on the dot, L brought her sweet girl out and into her awaiting arms. Welcome to the world sweet Evelyn, born earthside on December 24, 2015 at 3am, weighing in at 7lbs 6ozs, 19.25in long.  L’s labor was intense, but her strength and perseverance were amazing.  The strength of a woman in labor never ceases to amaze me.  It was wonderful serving this amazing lady!   #sacredjourneymidwifery #houston #midwifelife