Primary Facility

L*'s birth yesterday was great for wetting my feet again and getting used to the Birthing Unit.
L* was in labour with her second baby. On visiting her at home she was found by B* to be 3 cm dilated with a very soft cervix and contractions were regular and lasting for more than 60 seconds. I hadn't met L* previously, but she was happy for me to be there.

We drove into the hospital and set things up for when L* arrived. I have quite a learning curve ahead in getting oriented to the processes of a different unit to where I am used to working.

On a subsequent examination baby was still high, and B* did an artificial rupture of membranes. When she said the head was still high I offered to apply fundal pressure. A small amount of clear fluid leaked.

The intensity of contractions slightly increased and L* was wanting to try entonox. This provided some relief. L* was upright and walking throughout first stage.

B* determined second stage commencing from L*'s uncontrollable urge to push. Her pushing was not as effective as it could have been. L* was standing, leaning into the raised bed. So a change of location to the toilet was suggested. Pushing in this position was very effective and after about 4 contractions the baby's head started to stretch the perineum.

It was certainly awkward having the birth in the confined space of the toilet, but cleaning up afterwards was much easier.