I met J and K at the 2012 Houston B.I.R.T.H. fair. (Don’t know what that is? Check it out. www.houbirth.org) We talked for quite awhile. They moved here recently and were looking for a midwife that would be okay with their wants for their pregnancy and birth and that they connected with. We met again shortly after and they signed paperwork. K had a beautiful pregnancy. It was such a blessing to get to get to know J and K and be part of their pregnancy. K text me on the afternoon of 02/05 saying she was contracting. Contractions came on fast and furious, which made it clear that we might be dealing with cervical scar tissue. After reviewing K’s health history, we knew that scar tissue might an issue. K did evening primrose oil and 5W to help things, but even at her last check up her cervix still remained closed. K labored well for several hours. Around 10pm that night, she thought her water had broken. I loaded supplies and headed her way. We did our first assessment at midnight on 02/06. Her cervix was anterior and thin. I was able to get one finger inside barely, but it was evident we were dealing with cervical scar tissue. We massaged it with evening primrose oil and arnica oil trying to help it break up a few times during the night. Her amniotic sac was not ruptured. Contractions remained strong and coming every 2-3 minutes through the evening, not allowing K much chance to sleep. We changed her position often, encouraging baby to move down and open the cervix. K did well remaining calm through the contractions. At the 24 hour mark from when contractions began, we were at 3cm dilated, 90% effaced and baby was at a 0 station. A nice bulgy bag could be felt during a cervical exam. Still had a tight cervical band and scar tissue. We continued to massage on it during every exam. K was able to nap a little in the afternoon, which spaced the contractions to 5 minutes apart, but still they were strong when she would have the surges. The nap was just what she needed to re-energize her and help her keep laboring on. By 10pm, everyone was exhausted. There was no further cervical change. I recommended that K and J sleep. They agreed that I should go home and sleep and would call me back if they needed anything. No calls through the night, so I got up on 02/07 and started heading their way. K and J got some sleep. Contractions were feeling different now and K said she was feeling some pressure. We did a cervical exam around 10am and found K at 5cm, completely effaced and baby at a +1 station. Bag was nice and bulgy and her cervix felt somewhat softer, although still had a bit of a band and some scar tissue could still be felt. K was excited to hear she had made such good change. It renewed her strength and her energy as she continue to get strong surges every 3 minutes. Around 2pm, we found no cervical change and caput forming on baby’s head. Suspecting positional issues, we encouraged constant position changes to encourage baby to rotate his head to help him get through her pelvis. Baby felt to be 7.5-8 pounds and K had a roomy pelvis. As the afternoon rolled around, K was getting very tired. I was so proud of her at how strong she was through her entire labor and how she pulled strength that she didn’t think she had to get through labor. We were now at the 50 hour mark since contractions started. Still about 5cm and a larger amount of caput felt. K continues to feel emotional. Surges are so tough. She hasn’t had a good amount of sleep in quite awhile. She states she does not see the light at the end of the tunnel. I encourage her. She is so strong. She is being very intuitive and doing everything right. I discuss three options with K and J: 1. We try some inversions, rebozo work and position changes to encourage baby to move his head. 2. Break her water. 3. Transfer to the hospital for pitocin and epidural. None of the ideas sound pleasant to K. I leave J and K to talk. It is now around 6:30 in the evening of 02/07. J does not want K to transfer. K is feeling hopeless through everything. I suggest we bring in another midwife to assess things and make a plan after getting another opinion. J and K both liked that idea. An hour passes and midwife M arrives. 4-5cm, edema in cervix and growing caput. Water breaks right after, light meconium noted. K and J talk through things with M and me and decide that going to the hospital would be the best. After talking with family, K decides she wants to transfer to St. Johns. She packs a few things and soon they are on the way to the hospital. After getting the apartment cleaned, I head to the hospital. K just had gotten admitted. K had to go through the process of paper work and lab work, all through strong surges. Three hours after arriving to the hospital, K finally got her epidural. She felt so much better once the epidural set in. The nurse started the pitocin on 2 mu. Soon it was bumped to 4mu, but baby did not like the pitocin. We soon put K on her left side and the nurse gave K oxygen. An hour passed, it was now around 1:30 in the morning of 02/08, and the doctor came back to do a cervical exam. 4cm, swollen cervix. Doctor wanted to do a cesarean. She began turning off the pitocin and telling the nurse to prepare for cesarean, despite the fact that K and J did not consent to the cesarean and that she did not discuss with them about doing a cesarean. I was so proud of K for standing firm, but gently stating her desires. K refused a cesarean. The doctor was obviously annoyed. She stomped out of the room and said she would be back soon. K and J were untrusting of the doctor and asked me to perform a cervical exam. I found K to be 4cm now with a very swollen cervix and a large amount of caput on baby’s head. J sat by the monitor, watching the heart tones. Making sure baby looked good through everything. Around 4am, K consented to the cesarean. J and K both asked me if K would be a good VBAC candidate if she went in for the cesarean. I assured her that as long as everything was good with the surgery, there would be no reason why she could not try if they had another baby. James IV was born by cesarean section a little after 5am on 02/08 at 8.2#. It was four hours later when K got her baby back, but that did not matter. James IV latched on like a champ and nursed right away on both sides. During the final weeks of pregnancy, K was very concerned about the pain of labor. She stated that when she stubbed her toe, she would scream and cry. She could not imagine how she would handle labor. K labored for 58 hours with intense, strong contractions before she got pain medicine. She was so strong. She got in the labor zone, and was able to focus and breath through the wave of the surges. She was one of the strongest women that I have been blessed to serve as midwife. K has so much to be proud of and I know I am certainly very proud of her! Congrats K and J on a handsome baby boy! James IV born on 02/08 weighing in 8.2#.