A and B began care with me at 22 weeks gestation in their second pregnancy.  A birthed her first baby by cesarean section due to baby being breech and her provider not offering vaginal delivery.  She was setting herself up for success this time around by taking a childbirth class and using a doula for her birth. At three days past her due date, A woke with regular contractions at around 3 in the morning, after only sleeping under two hours.  Around 6am, A and B asked me to go ahead and come, as the contractions were coming every 3 minutes, lasting over a minute and were painful.  I encouraged them to phone their doula as well, and I got ready and headed their way. I finally arrived around 730 am (thank you, traffic!) and found A rocking on her birth ball, contractions coming every 3-4 minutes, lasting 60-80 seconds, and seeming very strong in intensity.  A’s vitals all looked good.  We discussed doing a cervical check to see where we were starting from and A refused.  I went and helped get the birth pool blown up and filled, while A and her doula labored on. A sipped on apple juice and water, while alternating positions.  She walked stairs to helps baby’s position, stopping to lean over to get through each contraction wave.  At 9am, we had the birth pool ready and A happily got in and relaxed in the warm water, leaning over the side of the tub.  Her doula provided massage and counter pressure through each surge. After awhile, A decided she would like some music.  We created a pandora station based off the song “A Thousand Years.”  The music seemed to be just what A was looking for, and helped be a good focal point to get through the surges. Around 10am, A got out of the birthing pool and went to lay beside B in her bed.  The birth team (doula, assistant) and I sat in the other room, chatting and listening for the sounds of A’s contraction pattern.  By 11am, it was clear that things had slowed down.  Contractions were coming every 10 minutes, lasting around a minute long. As noon came near, A decided she was ready to consent to a cervical check.  I found her cervix to be 3cm dilated, 80% effaced and baby at a -1 station.  There was scar tissue on her cervix, and after discussion, A agreed to allow me to massage on the scar tissue.  B was at her side, helping her breathe through the procedure and encouraging her. After talking with A and B, it was decided the birth team would leave the house for a couple hours and give A and B some privacy to labor on. The birth team and myself returned around 230pm.  I soon checked A’s cervix to see how the scar tissue was broken up, and found her to be 5cm, 80% and -1 station.  The cervix was much, much stretchier now, and we all were happy that the scar tissue seemed to be broken up. Contractions were now around 4-5 minutes apart, lasting 60-70 seconds.  A was doing excellent at drinking fluids, snacking as requested and changing her positions between movement and rest.  She labored best alone with her spouse, so we left them to their work, coming in ever so often to listen to baby and make sure all was well. As the 6 o’clock hour came, A and B requested me to stay with them and help A labor, as she did well with extra encouragement as to how awesome she was doing.  A little after 7pm, I did an assessment and found A to be 8cm dilated, 100% effaced, and baby still hanging out at a -1 station. A leaned on B through surges, rocking her hips.  He prayed over her and encouraged her to continue to persevere.  A would go to the toilet to labor, then come and sit on the ball.  B would pull out her cards of affirmations and speak powerful, encouraging words and scriptures over her. Around 8 in the evening, A took a mini rest on her left side.  Contractions were quite spaced, coming every 8-9 minutes, but lasted 80-100 seconds and were strong.  A rested well between the surges to gather strength to get through each wave. Around 9:30pm, A moved to the birth pool, laboring in the hands and knees position.  Fatigue was taking over.  She was feeling discouraged that things weren’t progressing fast enough.  It has been a long day, and she had been working so hard.  We encouraged her to use her breaks for rests, and that she was progressing at the perfect speed.  The work was almost done, and she would be holding her sweet boy soon. Around 10pm, A requested a cervical check.  8cm/100%/+1 station.  After discussing risks and benefits, she decided she would like me to break her water.  A few minutes later, we augmented labor by breaking her water to see if it would help her labor to progress. I gave A a couple dropper fulls of liquid calcium to help with the intensity of the contractions.  As 11 neared, she moved into a squat, with the support of B.  Contractions were coming every 6 minutes, lasting 90 seconds. Waves of nausea soon took over, and I encouraged A that throwing up was equal to several contractions.  Such good signs that perhaps birthing time was near. At 11 minutes passed 11, B’s eyes locked mine to look at the bottom of the pool.  A small amount of bloody show could be seen at the bottom of the floor during a contraction.  A’s noises became more primal, low, a little more bloody show with each surge.  I asked A if she was feeling pushy or thought she was pushing and she said she didn’t know. I checked her at 1123 and found her to be 10cm/100%/+3 station.  I called for the birth team to quickly come so we could be prepared for delivery. I talked with A about pushing through the next contraction, but she did not feel ready.  After another contraction or two, the urge built and A began to spontaneously push. At 1130, we could see a small amount of the head on the perineum.  Seven minutes later, the baby’s head began to crown slowly, allowing her perineum to stretch. Baby’s head was birthed at 1141, followed by baby a minute later, where we found baby was quite tangled in his cord! Baby was brought immediately to A’s chest.  After stimulating, suctioning and a little oxygen, baby was doing perfect. So blessed and honored to serve such a strong, powerful woman through her long, hard labor journey.  One verse kept running through my mind through out the labor… Welcome to world sweet boy!  Born earthside on November 12th at 11:42pm, weighing in at 7.8#, 19.25″ long,  Skye is so loved by his sweet big sister and awesome parents.