Note: Mom’s provider was an OB/GYN, birthing in a hospital and without the support of a Birth Doula.

First-time mom headed into her 38 week prenatal checkup at her OB/GYN office. They were doing BPP’s (Biophysical Profiles) every 2 weeks to check on babies well being and growth rate due to suspected IUGR (intrauterine growth restriction). Each time before, baby had “passed” this ultrasound criteria with flying colors… but this time was different.

At 36 weeks moms fundal measurements were behind what they should have been. This is the measurement from the top of the uterus (the fundus) to pubic bone and should match your gestations in centimeters during the 3rd trimester. It is considered normal to be measuring 1-2 cm forward or behind. At 36 weeks mom’s fundal height was more than 2 centimeters behind and the OB/GYN decided it was best practice to perform BPP’s for the remainder of the pregnancy to make sure baby was growing and doing well. During the 36 week BPP, baby scored a 10/10.

During a Biophysical profile ultrasound, they are looking at 4 components: fetal body movement, fetal muscle tone, fetal breathing movements, and amniotic fluid volume. Should the ultrasound technician determine that there is irregularity in any of these components, it would be scored as a 0. Scoring between 8-10 is considered normal and anything under that is considered abnormal. In this case, the provider may order a non-stress test (NST) or another BPP 24-48 hours later to re-check the score. Depending how low the score is, the provider may decide to delivery the baby.

At 38 weeks, mom went in for her now-routine BPP and appointment with her provider. During the BPP, the ultrasound tech noted that baby was not doing any practice breathing this time. Upon talking with the OB/GYN afterwards, the parents were told that sometimes babies can be lazy and they would repeat the BPP the following day. So mom shows up to her appointment the next day (which happens to be her birthday!), the ultrasound was repeated by the same ultrasound technician and once again, no practice breathing. They give the baby 30-minutes to show at least one episode of continuous breathing lasting at least 30 seconds. Due to “failing” this portion of the BPP two days in a row, the patient being full term (38 weeks) and the patient having a “favorable cervix” (soft, starting to thin and dilate) the provider decided it was best to induce mom and delivery the baby.

Mom was able to run home to collect her things, grab a bite to eat and then was to head to the hospital. Once settled into the birthing room, IV fluids were started and then Pitocin (a synthetic form of oxytocin). From there it was a long evening and night of slowly progressing labor. Epidural was given pretty early on and bag of waters ruptured on their own around 4 cm. Parents were able to get a bit of overnight rest due to the epidural. Around early morning, labor was progressing well and mom had the shakes due to transition. Shortly after, the cervix was fully dilated and thin and it was time to push.

Due to the epidural being very strong, mom couldn’t feel when to push on her own and was therefore having troubles pushing correctly and effectively with each contraction. After about 2 hours of pushing and rest periods, it was determined that babies head was tilted towards one of moms hips making it difficult for the head to descend all the way down the pelvic cavity properly. The nurse then brought what is called the “peanut ball” which is a giant exercise type ball that is in the shape of a peanut. Mom was laid back and put on her side with the peanut ball between her legs for several contractions, then flipped to the other side and repeat. This did help babies head rotate into a more optimal birthing position. Mom was put onto her back to resume pushing.

Another 30 minutes later, mom was really struggling physically and mentally. The nurse offered to pull a giant mirror down in front of mom so that she could see her progress as she was pushing. This ended up being the motivation that was needed and another 15 minutes later, baby was born. Apgar of 10/10 and perfectly healthy, 6 lb. 8 oz. baby boy!

– Written by Katie