Everyone tells us that the first birth will be the long one, with loads of early labour. This is usually true, but sometimes even that first labour can seem to start out with an advanced labour feel. When it is your first and you have nothing to compare it to, it can feel a bit overwhelming and confusing to know what to do, when to go? For this birth team that was exactly the story. She had been having prodromal labour and pelvic discomfort for ages and then suddenly one day she woke up to minute long contractions coming every 3-5 minutes. Her body had jumped right in! It always takes the hormones a bit of lag time to catch up with the endorphin release, so these intense starts can feel like too much. He was right by her side helping her cope but it seemed like so much so soon. We chatted and agreed I should come keep them company, she hopped into the shower and I headed over.
She was having so much back pain that we knew baby was trying to find a better position. So we did all the pelvic opening things we could think of. Pacing around, belly lifts, ITB stretches to release the pelvic floor tension, side lunges, and the favourite all fours position. Then she headed up the stairs to try the shower again and it was hard to navigate those steps. She took them one at a time, slowly. She didn’t feel good in the shower, things have changed somehow, so much pressure, we decided it was time to go in and see what was what.
Five and a half hours after this labour started in earnest, she was 6-7 cm dilated! That intense back pain had not let up but she was staying focused, breathing and moving and trying all the things to make space for that baby. We only had to wait 30 minutes for a room, and as soon as we got in there she asked for the nitrous oxide to help take the edge off. Even with the gas she kept on squatting and leaning up against the back of the bed swaying and moving to the demands of her body. Then she was in the 
shower for a bit, feeling so much pressure and the labour certainly looked more intense. But that cervix wasn’t changing. It had only been two and a half hours but it felt frustrating to be told there was no change because the labour had certainly changed! She kept feeling that pushy feeling in certain positions. The nitrous wasn’t really cutting anymore by this time so she opted for something stronger, and then at some point she went for the sterile water injections to dull that back pain. She didn’t even flinch when they went in! And they seemed to help, so we went back to trying all the positions. Her determination and willingness was impressive. He was always at her side. At some point she was in that all fours position but with one knee forward and one knee back, and was actually getting a bit of restorative rest between contractions. The pressure feeling just kept intensifying.
Four hours after we got to the hospital her cervix was now dilated to between 8 & 9 cm with bulging waters. The Doctor discussed breaking the waters but after examination determined that baby was likely facing up and not fully engaged, so it wasn’t time for that intervention. She kept moving and changing positions with such persistence! And then an hour later she was clearly bearing down involuntarily. A cervix check confirmed that she was now fully dilated, but baby was still high. So we all helped her to breathe through that pressure and let her uterine muscle do the work of bringing the baby down into the canal a bit more. Back to all the positions again, this woman was incredible with her tenacity. Suddenly when she was using the squat 
bar her amniotic sac ruptured! She was bearing down now with every contraction and it seemed that the baby was coming down or moving in some way. But after an hour and a half of bearing down the Doctor came to check on our progress and noted that this baby was turning it’s head to an optimal position during the pushing, but then turning back to a transverse position during the rest time between contractions. Baby was low down, on his way but we were seeing some heart rate dips and the Doctor felt he could assist this baby to come the rest of the way safely with the help of forceps. No one ever wants to face this decision, but here we were. Their Doctor explained the options clearly and felt strongly that this would be safer than a belly birth at this point. They took a few moments to absorb this and we started moving to the case 
room to meet this baby! The case room can be overwhelming with it’s highly clinical feel, people in scrubs, extra people we hadn’t met, the aura of risk always hangs over that room. But after only 20 minutes of the hardest work of her life, at the end of the most intense 14 hours of their lives, this room became the best place these new parents had ever been. It was the place they met their son. It didn’t matter that it wasn’t the picture they had in their minds eye going in, because nothing could have prepared them for that first look and feel of the person they created with each other.
The looks on their faces tell the whole story.
