M and J started care with me at the start of the first trimester of the first pregnancy. I will never forget the day M called me. She had just taken a test and she was excitedly calling to set up a consultation. Pregnancy was uncomplicated until the 39th week started. I saw M for her weekly appointment at 38.5 weeks, and found her blood pressure to be borderline high. I asked M to monitor it over the next couple days and to let me know what it was like a few times through out the day. Monitoring the blood pressures showed us that this was a continuous problem through out the day. I had M meet me at the office two days later in the afternoon to talk about a plan. I gave her homeopathy to start taking that normally works by day 6 to start labor. I encouraged M to go to an acupuncturist for labor encouragement and to help the blood pressure. I did an exam, and after working with her cervix, M was 2cm dilated, 50% effaced and baby at a -2 station. I gently swept membranes and made plans to see M the next day after her acupuncturist appointment. I saw M the next day and did a much deeper sweep. She was now 3cm dilated. M continued to feel crampy through out the night, and woke up the next morning (now 39.2 weeks) with regular cramping that was coming in waves. I saw her that morning and did another deep sweep and had M drink some pregnancy tea with an herbal tincture and honey mixed with it. She was 3-4cm dilated, 50% effaced and baby at a -2 station. The head was more applied to the cervix. M looked more uncomfortable and I was hopeful this was going to put her into labor. The crampings continued to get stronger through out the morning and early afternoon. At 2pm, M decided she wanted to try and take a nap, but she soon realized a nap would not be happening. The waves were coming on strong. We chatted about her pattern, which seemed to be every 2-2.5 minutes, lasting 30-40 seconds long. M said she wanted me to come do an assessment so I headed her direction. I arrived around 4:15pm and found M sitting on her couch, blowing through a contraction. I sat with her and talked and noticed her contractions were definitely frequent and short. I did the initial set of vitals and first cervical check of labor. At 4:45pm, M was 6-7 cm dilated, 80% effaced and baby was a little lower at a -1 station. She has been working very hard! Soon M’s doula and the birth assistant starting filtering into the home. I encouraged M to try and move around the house some, since her preferred position was sitting. M reluctantly started walking around the house for a few minutes. We had a little issue getting the birth pool initially. M and J’s hose adapter wasn’t connecting. J got it connected to the washer and we got the pool starting to fill for M so it was ready when she needed it. M sat through a few contractions, then layed on her right side, her doula placing the peanut ball between her legs. Her doula used a warm rice sock and counter pressure on her back with each contraction wave. As 6pm neared, I asked M to try and do three captain morgans with hip circles on each leg to help baby move down. M was such a trooper. Even though it was uncomfortable, she did it to help with the progression. At 620pm, M moved back to laying on her right side on the couch. Right away I could see her contraction pattern shifting and changing. Contractions were every 2 minutes, lasting 60-70 seconds long and appeared to be stronger. I encouraged M that she was doing everything just right to help things progress perfectly. The birth pool was soon ready, and M happily got into the warm birth pool at quarter to 7pm. She sipped on apple juice and water in between contractions, that were coming quite frequently. M alternated from sitting, to resting on her left and then her right side in the birth pool. She held J’s hands as she gently moaned through each contraction. She kept saying that she was feeling a lot of pressure at the peaks. A little after 7pm, I could tell M’s body was bearing down on its own at the peaks. After talking, M asked for a cervical check and I found her cervix to be 9.5cm dilated, 100% effaced and baby at a +1 station. I encouraged M to blow through a few contractions to finish dilating her cervix, or I could hold it back. She decided to blow through a couple. A couple contractions later at 7:06pm, M said she couldn’t hold the urge and her body began to spontaneously bear down. Three minutes later, as she pushed, M’s water broke. We saw clear fluid speckled with vernix in the birthing pool. Baby had a slight shock to his system with his comfy water bag gone, but soon his heart beat sounded perfect again. M continued to push laying on her side. Around 7:20pm, I recommended to M to try pushing in hands and knees. She moved into that position and seemed to get her pushing groove going there. Each wave she pushed, bringing her baby a little bit closer. The head was visible at 7:43 pm and soon was crowning three minutes later. With one swift push, M birthed her baby’s head and soon followed the rest of his body. He had a loose nuchal cord that I unlooped from the baby as his mama held him on her chest. Couldn’t have been a more perfect birth or postpartum period! Such a gentle, peaceful birth followed by sweet bonding time mom and dad got with their son. When M and baby were ready for nursing, I went to help and on the first try the baby opened his mouth wide and grabbed right on to the breast. Welcome to the world Vincent, born earth side on November 14, 2015 at 7:48pm, weighing in at 7lbs 4ozs, 19.5 inches long. Such a privilege to help this sweet couple welcome their first baby into the world.
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