This young woman was having her second baby and showed up to the hospital almost in transition! She had natural childbirth with her first and wanted to do the same with this one.
When I arrived, she was just getting out of the tub. She wasn't feeling too comfortable in there, with her back hurting. She stood in the bathroom for a while with her boyfriend to lean on. Eventually she came out and stood by the bedside, with her mother on one side and her boyfriend on the other. I asked her what she wanted to do and made some suggestions, as she wasn't really sure what or where she wanted to be! She didn't like the idea of hands and knees, and really just wanted to lay down. She requested to be checked as well. She was 9cms with a very stretchy, soft cervix. That's the kinda cervix that tends to slip away if momma starts to do some grunty pushes. I figured it wouldn't be long.
She didn't want to be touched and I think her boyfriend's feelings were a little hurt. I explained to him this was a normal part of birth and some women were a little irritable at the end - nothing he should take personally!
After about a half hour had gone by, she told me she felt like she needed to push. I said go ahead but she seemed really nervous about doing that without me checking her. I waited a bit and she spontaneously started bearing down...she couldn't help herself. She asked me to check her. Of course, she was 10cms and the baby was at a +2 station. The bag of waters was still intact. I told her she could have the baby whenever she was ready. She wanted me to put my gloves on. I told her I would when she showed me the baby :)
Which she did, in about 2 more contractions. I could see the bag, with clear fluid in it and the baby with lots of hair! I threw my gloves on and got ready to catch. I did rupture the membranes once the head was crowning - just made a tiny little hole. She pushed the baby out with great control over an intact perineum. The baby went up onto her chest, while we waited for the cord to stop pulsating.