I had a woman by the name of E come in for her postpartum visit recently and we were re-visiting her birth story. She graciously has allowed me to share her birth story here!
E had her first child a little premature at 36 weeks. This pregnancy was hanging on a bit more! She had been experiencing lots of bouts of contractions since about 35 weeks with some cervical change. She came into the hospital triage at 38 weeks contracting very regularly at every 2-2 and half minutes. She was 4/90/-1 (the first number is how many centimeters dilated with the ultimate goal being 10cms/the second number is effacement which is how thin the cervix is and ultimate goal being 100%/the third number is where the baby's head is in relation to certain landmarks in mom's pelvis - +3 is crowning). She walked for a bit with no change in her cervical exam...just these persistent contractions that were causing her some discomfort but not really changing anything.
I know that E was ready to be done with the pregnancy and offered her the option of AROM (artificial rupture of membranes). I explained the risks (infection, fetal distress, need for pitocin) and benefits (onset of labor!) to her as well as letting her know she had the option of therapuetic rest (little trick where morphine is given to someone in prodromal labor - will allow the woman to rest and she will either wake in full-blown labor or it will knock the prodromal stuff out) or just going home.
She and her husband discussed the choices and opted for the AROM. Her first baby had come very quickly after ROM but she was 8cms at the time. She had natural childbirth with her child and planned to do the same with this one. Once she was settled in her room, the plan was to break her water and then send her out walking, then into the tub. The ROM worked very well as E became increasingly uncomfy while walking so we moved her to the tub. She was coping very well with her contractions and working hard. She had not been in the tub long when she felt she needed to push.
She moved to the bed and I checked her cervix - she was 10/100/+1. She pushed beautifully, very well controlled and delivered her baby over an intact perineum (bottom).
I looked at the clock...total time elapsed from ROM at 4 cms to birth was 1 hour and 51 minutes. WOW!