Ashlyn A and R started care with me in the third trimester of their second pregnancy.  They moved to the area from out of state and were wanting a home birth for their second birth. A had her first baby at 41 weeks and was anticipating to see it again, so it was no surprise when 41 weeks came.  A set up her 41 week ultrasound and baby looked great, but the placenta did not look like we would like so the evening of 41.1 weeks, A came by and we did a membrane sweep. The next morning, A sent me a text around 630am saying contractions woke her at 530am and were coming every 2-3 minutes.  At 7am, R called and said A was contracting frequently and hard and was concerned with some bleeding she was having.  It sounded normal by phone description, but told R I would be on the way shortly to see how things are and assess. I arrived a little before 8am and found A lying on her left side in the bed.  Contractions appeared to be strong, coming every 2-3 minutes, 60 seconds long.  Vitals were good and a few minutes later we did a cervical check.  A was having some heavier bloody show.  Her cervix was 9cm, 100% effaced and baby was at a +1 station, her bag of waters still intact.  My apprentice was en route, and I told A I was going to quickly set up for delivery before she started pushing. A labored some on her right side while I began setting up for delivery.  Soon we were ready and at 8:37, A began to push.  I noticed she had a cervical lip, that we mutually decided I should help to reduce during pushing. A was pushing while lying on her side.  After a couple pushes, her water broke spontaneously, fluid was clear.  The bloody show that she had been having stayed about the same.  I suggested a position change, so A moved into semi reclining, leaning against R.  My apprentice did tug of war with A with the rebozo during contractions to help baby get under the pubic bone.  After a few contractions pushing like this, A moved to holding behind her own legs with pushes. I suggested A try a knee chest position to help melt away the sliver of cervix that kept coming back.  She moved into that position at 936am.  I requested she blow through contractions as long as she could.  The position did the trick and a couple contractions later she couldn’t blow anymore, and the lip was gone and baby was at a +2 station. A continued to push on her hands and knees.  A couple minutes after 10am, A moved into semi reclining to give her knees a break.  Baby was at a +3.  I began using warm compresses on the perineum as the head slowly began to appear on the perineum.  A couple more pushes and the head began to crown at 1012am.  I asked A if she wanted to put her hands down on the head and help catch her baby.  I helped with her perineum and guide the head into A’s waiting hands.  The next push brought baby into A’s waiting hands.  A brought her sweet boy right to her chest.  He was here! Welcome to the world Oliver!  Born earthside on February 16, 2016 at 1013am, weighing in at 8lbs 8ozs, 21″ long.  It was such a privilege to help this amazingly strong woman welcome her second baby into the world. #sacredjourneymidwifery #houston #midwifelife