H and S began care with me in the first trimester of their pregnancy.  H’s pregnancy was pretty easy and prefect.  She had no issues and worked until her due date as a chiropractor. H came into what would be her final prenatal appointment and asked for an exam.  Cervical exam found her to be 1cm dilated, 80% effaced and baby at a 0 station.  I gave her my homeopathy regimen to start two days later on her 41st week, and hoped we would be seeing each other soon. Later that night, H text me that she thought she could be losing her mucus plug and was having some cramping with irregular contractions.  Late that night they were more regular, roughly every 8-9 minutes and mild.  I was with another mom in labor so I encouraged H to take a bath or shower and try to get some sleep before active labor hit. Around 8am the next morning, H text me that her contractions were every 5-6 minutes, lasting a minute long.  She said they were still milder and she could breathe through them.  I was finishing up at the other birth and went home to shower and nap before H needed me. A little after 2pm I woke from my nap and had not heard anymore from H.  I checked in and she said contractions were coming every 4-6 minutes, lasting about 1:20 and felt strong.  I woke myself up and got myself together to head down there.  H’s doula was on her way as well. I walked in around 4pm and did my initial labor assessment around 430pm.  I was excited to find H to be 5cm dilated, 100% effaced and baby at a 0 station, her cervix stretchy.  I encouraged her to try hands and knees position for a few contractions and see if it would help baby rotate a little. Around 530pm, we decided to go out for a walk.  Contractions were coming every 4-5 minutes, lasting 90 seconds.  We walked a couple of laps through the neighborhood, pausing to breathe through surges.

H’s sister took this picture on our walk.

H came in the house to drink some water and rock on the ball.  When she felt ready, back outside we would go for another walk.  She was so calm, poised, determined. Close to 8pm, we did a full set of vitals and H was now 7cm dilated.  Contractions were coming every 4 minutes, lasting 2 minutes.  She bounced on the birth ball, then one last walk while we finished preparing the birth pool.

H had set up her birthing space beautifully.

Quarter after eight, H got into the birth pool and sat, leaning against the wall. H had taken hypnobirthing classes, and she was so prepared to tackle each surge as it came.  She was so quiet and calm, riding the wave of each surge. During the 9 o’clock hour, surges were noticeably stronger.  H alternated from kneeling, to leaning over the birth pool.  Moving into whatever position felt right.  H was surrounded by her spouse, mom and sister, all alternating providing counter pressure to her back. Quarter to 10pm, H said she thought her water broke but wasn’t sure.  I did an exam and her membranes ruptured upon touch.  She was now 8cm dilated and baby was at a +1 station.  With the bag gone, contractions got a bit more intense.  H breathed and moaned so gently during each surge. A little after 11pm, H was feeling a pushing urge.  I found she had a lip of cervix and baby was at a +2. After talking, H decided she would like me to try to hold back her lip.  For the next hour we alternated trying to reduce the lip for a couple contractions, having H blow through a couple contractions to help it reduce on its own.  She had dilated so easily and effortlessly, but this lip was stubborn!

Love this picture! 

A little after midnight I suggest to H that we should try a different position.  H got out of the tub and we labored on the toilet for a couple contractions before moving to the bedroom.  H got into a semi reclining position and I still felt the cervical lip.  I tried reducing, unsuccessfully.  My dear midwife friend J was helping me and I asked her to do an exam and see what she thought of baby’s position.  J agreed that baby felt malpositioned.  I put H on her left side in an exaggerated runner’s position and encouraged her to rest in between and blow through each surge she felt, avoiding bearing down at all unless her body forced it.  H rested well, taking sips of gatorade between every couple contractions. At 130am, H began spontaneously bearing down through surges, her body doing all the work.  Contractions were now spaced, coming every 5 minutes, lasting 90 seconds. Her cervix was now completely dilated. A little after 2, I suggest S get behind and let H lean into him in a semi reclining position to see if it would help get the baby’s head under the pubic bone.  H moved into the position and continued to push well with each surge.  Her doula played “tug of war” with her during surges to help with pushing as we got closer to 3am, and it worked well.  We could see some head now right inside the vaginal wall. At 3am, we had H try holding her own legs, curling into her baby.  We could see a little more head coming under the pubic bone now.  Caput could be felt on the head which none of us were shocked about based on her position. At 3:10 we moved H to the birth stool to push, thinking gravity might work in our favor.  H was so tired, understandably so.  She was so determined.  You could see it in her eyes with each surge the determination that this baby is going to come out. H moved into hands and knees at 330am, and pushed.  It was in this position that both J and I could feel baby’s position better than we have ever felt.  Baby had apparently chose to rotate from ROA to posterior with an unflexed head coming down in a military presentation.  The biggest problem in this situation is that H’s once clear fluid, was now with meconium, much thicker than we liked.  Birth wasn’t as imminent as we would have liked, so the decision was discussed with H that we needed to now transport to the hospital and move our birth there to insure the safety of baby. H transported and welcomed her sweet little girl earthside awhile later. Welcome to the world McKenna, born earthside on March 21st, 2015 at 5:38am weighing in at 6lbs, 11ozs and so loved by her parents.  <3