T and M started care with me in the third trimester of their first pregnancy. Pregnancy was quite uneventful and progressed well. Two days after T’s estimated due date, she sent me a text saying her contractions had kept her up through out the night and were becoming more regular. I was suppose to see her that day for her 40 week appointment so I moved a few appointments around so I could see her sooner. T sat on the birth ball during her appointment and we chatted and observed the few labor waves she was having. During our talk she mentioned she kept having a lot of discharge during the morning. I decided to do an amnioswab before the cervical exam and it came back positive for amniotic fluid. I did an exam and found T to be 4cm dilated, 70% effaced and baby at a -1 station. We talked over her waters being broken. After my exam, the contractions were noticeably stronger. In fact, M and I were both doing some counter pressure on T’s sacrum as they were trying to get out the door for home. M texted me over the next couple hours and kept me informed about the contractions and that T was starting to moan and having to focus through surges. I decided to head over to T’s house later that afternoon and got their after 4pm, and found T laboring away on her birth ball, her doula providing counter pressure on her back during contractions. Contractions were coming every 4-5 minutes, lasting around 90 seconds long. In between surges, we laughed and talked, but it was all business during the birthing waves. Around 530pm we decided to do another exam. T was now 5cm dilated, 80% effaced and baby still at a -1 station. I felt some molding on the baby’s head. T was tired. I talked to her about napping in between contractions, and once she rested, I wanted her to move around and try some different positions. Close to 7pm, T was up and ready to work. I had her do three sets of the captain morgan position. I never saw a woman more determined and willing to do anything we suggested. She vigorously rocked her hips during each surge, helping her baby rotate into the perfect birthing position. T sat on the ball for a few contractions, then was up moving again. She walked around her home, leaning against the wall and doing deep dips with her hips during surges. I was so incredibly in awe of watching T at this moment because I knew her baby was at a ROT position and the movement that T was doing instinctually was a maneuver used to rotate a malpositioned baby. It was beautiful to observe. (You can catch a glimpse of what I call the Hip Dip Maneuver HERE.) At 7:45, T’s doula and I talked to her about going out for a walk and seeing if that would bring on things a little more quicker and intense. T and M got ready to go for a walk and I had her try a lift and tuck with her belly to see how it felt. She said it hurt, so I asked her to try to do it for at least 5 contractions, 10 if she could handle it. At 8pm, T came back in and sat on the ball. She said she was nauseated. We pulled out peppermint oil for T to inhale to help with the nausea. Shortly later, T said she wanted to go rest again. She got in bed and rested on her left side. Contractions were coming every 3 minutes, lasting 90 seconds and seemed stronger in intensity. At 930 pm, we did an exam and T was now 6-7cm dilated, 100% effaced and baby at a 0 station. T had made good change in the time since our last exam. I felt more molding on the baby’s head and suspected that baby had not rotated yet from what I could feel. T was asking for the birth pool so we worked on topping the water off and a little before 10pm, T got into the warm birth pool in a kneeling position. Over the next couple hours. T alternated between a kneeling and semi reclining position. She began to moan more with surges, and her doula, myself or M would provide counter pressure during contractions. As midnight drew near, we began to visualize bloody show on the floor of the birth pool. We all rejoiced and encouraged T that she was progressing so well. I knew she must be around 8cm. Things got pretty intense during the midnight hour. T told us over and over these were the worst. She cried out to God for help and we reassured her with words of affirmation and scripture that she was almost done. T began instinctively to alternate laying on each side during surges. A little passed 1am, T began to spontaneously bear down at the peek of contractions. At 1:26, I found T to have just a lip of cervix and baby at a +2 station. One contraction later and the lip quickly resolved over the baby’s head. T began pushing in a hands and knees position. She felt so much relief with pushing, like she was getting to be more an active participant during the birthing process. At 138am, T moved into a semi reclining position, which seemed to be more effective for T. For a moment, T looked at me and asked if she was too small to birth the baby. In her past, a doctor told her she should schedule a cesarean because her pelvis was too small for a vaginal birth. I encouraged T that her pelvis was the perfect size to birth her baby. At 150 we could see the head sitting on the perineum. M was at my side, encouraging T and ready to help catch his sweet baby. The head crowned at 153am, followed by the baby in the same minute. M caught the baby and placed the sweet baby on T’s chest. Welcome to the world sweet Hezekiah, born earth side on September 9, 2015 at 1:53am, weighing in at a whopping 9lbs 8ozs, 20.75″ long. So much for that tiny pelvis! T birthed her sweet boy like a champ. Such a blessing to be part of their birthing journey.
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