I really love reading birth stories.  I sometimes find myself searching for them online, because I want to hear about other people’s experiences – moms and midwives.  All labors and births are different, and for me it is endlessly fascinating to hear the tales.  The crazy ones provide the most interest, a lot of times, but the smooth/quick/easy births are wonderful to hear as well.

The most recent birth I attended was a woman having her second baby.  She called me around 9:30pm (literally the moment I put my head on my pillow, in the comfort of my apartment, after a 100% quiet day which including several naps).  She had been contracting on and off, mildly, for about a week – but now she was having strong contractions.  They were still irregular, though, and she sounded very cheerful.  After some back and forth I encouraged her to give it another hour at home and then call me back.  Her water hadn’t broken and the baby was very active.  It’s hard for me to make the call sometimes with a second baby – to decide when it’s time to come to the hospital.  With a first, depending on the woman’s plan for labor – natural vs. epidural – I usually encourage her to stay at home as long as possible.  First babies can take their sweet, sweet time, and as long as she’s doing okay at home, it’s to everyone’s benefit that she stay there.  It’s better all around if a first-timer gets to the hospital in rip-roaring labor.  But with second babies … they can come so quick.   That’s why we love them!  I think the closest I ever came to delivering a baby in the hallway or triage room was a second-time mom who called me with some mild contractions, called me back an hour later and arrived at the hospital thirty minutes after that already pushing.

Anyway – when this laboring mom came in she was 5cm, which was great, although oftentimes multips planning an unmedicated birth get to the hospital farther along than that.   Her cervix was still posterior although I could feel bulging membranes.  She was cheerful and could pretty much talk through the contractions, which were fairly spaced at 4-6 minutes apart.  This was around midnight.  We talked about how her first baby had come out with a compound arm and caused a significant laceration.  We went up to the room where she would labor and birth.  At two am, she was 7cm and more anterior, and beginning to feel less “like she was hanging out in a hotel room.”  She used the tub which helped her relax and did a great job breathing through the contractions, now closer to 3-4 minutes apart.

I considered artificially rupturing her membranes when I admitted her, which is something that is fairly standard at my hospital.  I suspected that if I broke that bag of water, the head would come right down and she would dilate quickly – oftentimes it does happen that way, especially when someone is having her second baby and her body has delivered one before.  In this case, I held off because the baby was still pretty high and she was making good progress.  Also, I have had not-too-great experiences at times after breaking someone’s water – sometimes once the amniotic fluid is gone, the cord gets squeezed with contractions and the baby doesn’t tolerate labor as well.  I feel that this intervention is used too routinely – it can be beneficial and really speed things up, or it can cause other issues that might well have been avoided.  In this case, too, she preferred that I not break her water quite yet.

At 3am she was beginning to feel a bit frantic.  She felt more pressure like she almost wanted to push, but not quite.  I checked her again, although it hadn’t been that long since her last exam … 8cm, the head had come down a lot and I felt very comfortable rupturing her membranes – which I did with her permission.  On the next contraction her body began spontaneously bearing down, which is usually a very good sign!  A few more contractions after that and her cervix was almost completely gone.  She was panicking a little and saying she couldn’t do it, pretty much par for the course at that point in labor.  We helped her get through a few more minutes of contractions and let her body do the pushing.  I reached to touch the baby’s head to see how soon I would need to get the birth kit out, and it was very low, only about an inch inside.  Mom was happy – “She’s gowning quickly, that must be a good sign.”  We told her she was almost done, and reminded her that she would soon have her baby.  I encouraged her to push long and strong so that she would be done sooner – and she did.  I told her I did not want her flat on her back.  I wanted her on her side because it is the best position for minimizing tearing.  We helped her hold her leg back as she pushed.  I could see the head rotating on the perineum as baby crowned, which suggests, I think, that maybe it was posterior throughout labor.  Lots and lots of dark hair, a compound arm just like his sister, and then he was here!  Really loud set of lungs and almost a pound and a half bigger than her daughter.  A small tear that required just a couple of stitches.  Grandma and dad in the room, aunt and uncle right outside ready to come in as soon as everyone was settled.

It was a really lovely birth.  Welcome baby.

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