C and C came to see me when C was 36 weeks pregnant. C had changed providers a couple times, but had connected with a hospital midwife that her insurance covered. However, when she went into the office for her 36 week appointment, C was told that her midwife was quitting in 8 days and would be transferring her care to a male OB. C was upset over the ordeal. Her doula referred her to me. We connected and made a plan to prepare for a home birth. At 40.3 weeks, C came in for her weekly appointment. She was shocked she made it past her due date as she had been expecting to go early the whole time. We did a cervical exam and found her to be 3cm dilated, 80% effaced and baby was low at a 0 station. C requested her membranes to be swept. I made her some pregnancy tea and had her walk my stairs to jiggle baby around before saying our good byes. I was confident she would be calling soon. Around midnight on 03/21/2013, C text that she had a few contractions 5 minutes apart. I encouraged C to drink a big glass of water and get some rest while she can so that she can have the energy for when labor became active. I did not hear from her through the night, so I checked in with her in the morning. She was still contracting regularly. I stopped by to check in on C. Cervical exam noted no change, but C was contracting every 3-5 minutes. I told her this looked like early labor and encouraged her to stay occupied, eat and rest. C’s doula had arrived as well. They decided to go walk at the outlet mall and take a nap. 6pm that night I heard from C that contractions had changed. They were harder and stronger and she wanted me to come. I headed her way. When I arrived, I found C definitely more serious in her labor journey. She had to focus and breathe with each wave of a contraction. Cervical exam found her to be 4 cm and she was having bloody show. It looked like we had moved into active labor! C was contracting every 3-4 minutes and was obvious they were strong. I suggested she sit on her ball and her doula turned on her hyonobirthing CD. C instantly drifted into labor land as she rocked on her ball. For the next couple hours C jumped positions. She rocked on her ball, then jumped to the couch and laid on her side. She walked her living room, rocking her hips. Her doula was at her side, massaging her belly and helping keep her comfortable. A little after 9pm, we had the birthing pool ready and C was anxious to get in! She relaxed well and labored in the tub for an hour. C got out and we did a cervical exam. Great change! 6cm dilated, 90% effaced and baby was at a -1 station. A nice bulging bag was felt and bloody show on glove. C was moving right along! C was amazing through her labor journey. She was intuitive with what her body needed. She walked around her house, bounced on the ball. She did excellent at eating and staying hydrated. Right before midnight, she felt a little pushy and asked to be checked. We were 7cm! Contractions were coming every 3 minutes and were strong. C felt like she needed to rest. To bed she went with her husband. She was able to get a 30 minute power nap in, before she needed to get out of bed. To birth pool she went, husband inside with her helping keep her comfortable. Contractions became noticeably stronger. C was squatting in the tub, moaning with the contractions. Her husband and doula were at her side. C got out of the tub. She emptied her bladder and used the rebozo to lift her belly to help with contractions. A couple contractions later, she requested to be checked. C was 8cm, 100% effaced and at a 0 station. Bag was very bulgy and bloody show on glove. C was ready to be done. We discussed risks and benefits of breaking her bag of water. C decided she wanted me to break her water and see if it would speed the process. C went to the bathroom and did a final hibiclens douche. We broke her water right before 3am. Baby tolerated well and was well engaged on the cervix. C got back in the birth pool. Thirty minutes passed and she was feeling the urge to push. I encouraged C to continue to let that urge build. The urge would get unbearable and the only thing she could do is push. A few minutes passed and C stated the pushing urge was unbearable. I checked and she was 9 cm and baby was at a +1 station. I encouraged patient to blow through a couple contractions until the cervix melted away. 4am came and patient felt a strong urge to push. She got out of the tub. I checked her while squatting and found her with a cervical lip. For the next hour we tried off and on to reduce the lip in various positions. First while squatting. Then while lunging on the toilet. Then in the hands and knees position. We would try a couple contractions, and then take a break. C tolerated this so well. She was amazingly strong. Almost 6am came, and we were finally complete! Praise God. We can actively push to have a baby! C pushed on her hands and knees and then moved to a semi-sitting position and did tug of war with a rebozo with her doula. Half past 6 am, and I noticed a half dollar sized amount of swollen tissue in front of the baby’s head. I watched C push a couple times, but it seemed that the tissue was in the way. I was perplexed. I told C to breathe through the next couple contractions and I would have a plan. I consulted with another midwife, who recommended trying to put C flat on her back and reduce the tissue while C pushes. At 7am, we get to work on reducing the tissue. C understood what we needed to do and was ready to have a baby. Her husband and doula were an amazing source of strength and encouragement for her through this long, hard pushing phase. It took 4 contractions, and we reduced the tissue. Baby was at a +3 station and mama could feel his head. C pushed on her left side. It took 15 minutes from +3 to get the head all the way out. I had already talked to C and her support team that once we got the head out, we would need to put her in hands and knees to get the rest of the body out. Thankful we discussed that ahead of time. C was tired from the long pushing time. Hands and knees helped get baby out to his waist and I delivered him from there. C sat up and took her baby. The look and emotion on her phase said it all. She was done and she did it! She had her natural, vaginal birth at home. The look of joy is beyond description. C got comfortable in bed and baby latched like a champ. C and her baby boy bonded and nursed. Dad was at her side, just as joyful over the birth of his son. C definitely was sore for a few days and recovery was slow, but she was so thankful for her home birth. C did not tear and did not hemorrhage and had no postpartum complications. She was a warrior. It is amazing the strength God gives women to birth their babies. This is one tough mama! And her birthing team was amazing as well! Welcome to the world baby Samuel! What a blessing you are to your family! Samuel Alexander was brought earthside on March 22, 2013 at 0737 weighing in at 8.8# and 19.25 inches long. Congrats C and C on a beautiful baby boy! I am blessed to have been part of his birthing day.
A Wee update As nighttime continues to creep sooner and sooner, the tasks of the day are not decreasing. Actually, the opposite