This mom had a normal pregnancy without any problems. On her last visit I did think the baby was getting a little big but I was not overly concerned. She called Saturday morning and said she had contractions during the night but they were short and irregular. She ask a doula in training to come to the birth to help her. The doula was great: very attentive, had good comfort measures and was alert to details, like knowing when to call me. I was impressed. Doula's are wonderful to have with you during birth. Their sole job is to help the mom in any way possible. Brenda and I usually do this at the birth's we attend but when you are the main caregiver watching over mom and baby it is great having someone focused on the mom. Doula's are angels giving selflessly sometimes for many hours to aid birthing women. Also it has been proven just having another person at your birth decreases your chance of an unnecessary Csec by more than 50%.
We arrived at the home and were greeted with 3 eager siblings ready and willing to help us unload the car. They were so helpful and attentive to their mom. Concerned was on their faces but this mom had prepared them. With her first cervical check she was 8-9 cms with a bulging BOW. We set up every thing and moved her to the birthing chair. She wasn't excited to move at all but wanted to use the chair. She adjusted. Usually any change in position during labor is not comfortable at first but after a few contractions the mom settles in and adjust.
She started pushing soon after moving and the baby was slow to come down. We decided to help her with a little augmentation just to help her along. She would have done it her self given enough time but she was getting very tired and was open to some help. After that she had the baby in 2 contractions. A little tear right along the previous episotomy. If a mom is allowed to tear and not given an episotomy she has a better chance of not tearing all on future births. The rate of episotomies are decreasing in the Wichita area but there are still a few 'old school' Dr.s ready and eager to speed up the birth and cut the mom. If you have never had an episotomy then you would not understand why you want to avoid them unless it was a matter of the babies safty. They are very painful and take a long time to heal and can be painful for years. We put in 4 stitches. The baby girl weighed 9lbs 4 oz. This mom's biggest. It was a delight to attend this birth and having it in the day time was another bonus. The siblings were soooo excited.