M and M started care with me at 11 weeks along with their second pregnancy. They desired a much different, intervention free pregnancy and delivery. M’s pregnancy progressed beautifully. It became very clear near the end of the pregnancy that M was going to have a bigger baby than her first little one, which we all expected due to M’s fabulous diet! Two days past M’s estimated due date, M had her last prenatal appointment with me. I had this nagging concern that we might deal with shoulder dystocia during M’s labor. I never had this concern present to me so strong. At that appointment, M asked questions about shoulder dystocia and how we would manage it at home. We reviewed the different maneuvers and talked about how we would manage it if it came about. M decided to have her first cervical exam of the pregnancy and was happy to know her body was changing appropriately from all the nights of contractions. Five days past her due date, M’s husband called me at 2am, stating M began having contractions that woke her up around 11:30pm. They were now coming every 6 minutes, lasting close to a minute. She was able to rest well in between each contraction. I encouraged M to help M to rest and to eat and drink, and to let me know once contractions were every 3-5 minutes, lasting a minute long, for about an hour. I fell back to sleep and woke to M’s next call at 6:20. He said contractions were now every 2-3 minutes, lasting over a minute long for awhile now. I clearly could hear the primal moaning sounds of a woman in transition in the back ground. I thought, “Oh no! I think they waited too long to call.” What concerned me most is that I live in Cypress, and M and M live in Sugarland. I got out my door in minutes, with my birth assistant hoping into my vehicle. We hit the road. I text to check in about M’s water being intact and if she was feeling pushy. Her sister text, about 6:31, that M’s water had just broke and that she was feeling very pushy. I instructed M’s sister to have M blow through contractions, trying not to push. I thanked God all the way for 99 which made the drive much quicker, and for favor with the stop lights. I walked into the door at 7:15. My birth assistant went to work getting things set up, and I went looking for M. I found M sitting in her birth pool, in her bathroom. Earlier that week M had mentioned to me that she wanted to labor in the water, but she absolutely did not want to deliver in the water. No matter what she said in labor, M and I had to get her out of that pool. After the surge passed that M was working through, I told M it was time to move out of the pool. It took a bit, but M and I got M out of the pool. I asked M how and where would she like to have the baby and she did not know. 7:20 mom began squatting in the door way, not bearing down with the surge. A clementine sized amount of baby’s head was seen on the perineum. M stated it did not feel right to push, so I did a quick assessment, and confirmed that M was indeed 10cm dilated, 100% effaced and baby was at a +4 station. We talked about trying different positions to see what felt right to M. M tried pushing in hands and knees for a couple contractions. Then stood up and moved closer to her bed. Gravity was definitely what M needed. Beside her bed, with her husband beside her helping, M began bearing down and baby immediately began to crown. Followed quickly by the head, and then the beautiful (big) girl. Praise God no shoulder dystocia. God’s design in the woman’s body is truly amazing. Quickly got M to the bed to watch her bleeding. Bigger baby’s can sometimes cause women to have increased bleeding. I managed M’s bleeding, birthed the placenta and helped M get in a more comfortable position to get baby girl to nurse. 
After quite an active, intense postpartum period, things smoothed out and M and M got to enjoy and bond with their sweet baby. Welcome to the world Piper! Born earthside on August 15, 2014 at 7:41 am weighing in at 9.1#, 20.5″ long. Her mama was amazing! Blessed to have served this sweet family!
