S and R started care with me in the first trimester of their sixth pregnancy. This was the third pregnancy I got to serve S and R through. In S’s last pregnancy, she was diagnosed with gestational diabetes and managed it with diet and exercise. It made a reappearance in this pregnancy and was harder to manage. At 38 weeks, S reported some higher than normal sugars to me, and after talking, we decided we would start working baby out. S came in at 38.0 weeks along and we did a membrane sweep. She was 3-4cm dilated, 20% effaced and baby at a -3 station. She drank some pregnancy tea with herbal tincture mixed in. Through out the day she had an increase in contractions and cramping but nothing progressed. S came back over the next day and we did another sweep, that definitely felt like it was going to be more effective. She was 4cm dilated, 40% effaced and baby at a -2 station. I felt three contractions before she left my office. I talked to her about walking when she got home and letting me know how things were. Regular, more painful contractions started around 2pm, and soon S asked me to head that way. I arrived around 3:20pm and found S in her room. S rocked on her ball and we chatted for awhile. At 4:30pm, I did the first exam for labor and found S to be 5cm dilated, 50% effaced and baby at a -2 station. S was feeling overwhelmed and asked her birth team to leave and just spent some time with her friend and me. We talked and encouraged her. At 5:15pm, I talked to S about going for a walk. She and I went outside and walked for 40 minutes. Contractions seemed to be coming about every 3 minutes while walking. The air felt cool that evening, and it was fun watching everyone putting up Christmas lights. S ate a good snack and drank some water while sitting on the bed. Contractions kept coming in a regular rhythm but weren’t seeming to be picking up in intensity. I had a suspicion that she had a larger amount of fluid in there and that by breaking the bag it might help bring a more active labor on. At 7:10pm, S decided she wanted me to check her and break her water. She had no cervical change. I ruptured her bag and clear amniotic fluid appeared on the chux, and then just kept coming and coming. Soon it filled two chux pads, poured onto the mattress, the floor and my skirt. I thought there would be a lot of fluid, but man! There was more fluid that I had even anticipated. Baby sounded great and tolerated the water breaking well. I helped S get up and get cleaned up and changed. The birth assistant and I worked on getting the birth pool ready for when S would need it. Things started to pick up. S walked around the room some, then sat through a few and then the intensity started to build and she began kneeling and breathing through some of the contractions. S’s friend who was present commented on how calm S was (she was so calm!!) and S’s oldest daughter K joked, “I thought that too (speaking about the first baby born out of the hospital) and then the end came.” We all had a good laugh. Around 8:45pm, one of S’s doulas (S had hired a doula and invited a student doula to the birth as well) talked to her about doing the lift and tuck with the rebozo for ten contractions to help get baby more into the pelvis. It was definitely doing good stuff, as the sensation of doing the lift and tuck for ten contractions was very uncomfortable for S. S stood through a few and then sat for the last few contractions. A little after 9pm, S asked for a cervical check before getting into the birthing pool. She was 7cm dilated, 70% effaced and baby was at a -1 station. S got right into the birthing pool, and snacked on a protein bar in between contractions. R got S’s playlist going, and soon the room was filled with powerful worship music. Things were intensifying. S needed some counter pressure on her back from time to time, a hand to squeeze for encouragement. I prayed over S for strength for the labor and for welcoming of this sweet, new baby into her family. S changed into a semi reclining position. R got behind her and helped support her. As the ten o’clock hour came, S began to moan and let out those primal noises that let us all know that baby’s about to be here. In between a contraction, S had us all laughing when she exclaimed, “I sound like a donkey!” The pressure began building. At 10:40 S asked to be checked. She was 9.5cm dilated, 100% effaced and baby was at a 0 station. S decided she would like me to reduce the lip and within two contractions the lip of cervix was over the baby’s head. At 10:44pm the baby began to crown, and with the next push the head was born. The shoulders got a little stuck and with some maneuvering, I got them loose. Baby was born into his daddy’s waiting hands at 10:45pm and promptly brought to S’s chest. It was such a blessing to help S and R bring a third baby into the world! S labors so calmly and beautifully. The oldest sibling, K, cut the baby’s cord, which was a special moment. I joked with K that maybe next time she will help catch the next baby! Welcome to the world Aiden! Born earthside on November 25, 2015 at 10:45pm, weighing in at 8.0#, 20″ long. This sweet boy is so loved by his five older siblings. #sacredjourneymidwifery #houston #midwifelife #homebirth #waterbirth
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