Transferred from another community hospital so that she could have her preferred type of postpartum contraception, I leafed through her prenatal record for the necessary information. An abnormal one hour glucose test and borderline three hour test, after checking her belly, let me know the baby was likely bigger than her others. I let that cross my mind, and then moved on.
Not a surprise, her cervical change was slower than expected, likely due to the new setting, new providers, and all the hustle and bustle. With a little help her contractions picked back up, and were rolling along. She became very uncomfortable and I knew we were on the right path.
As the head crowned she asked for an epidural, a common theme lately. I applauded, the baby was almost with her. At the neck I suggested she take a breath, wait for the next urge, and push again. The shoulders did not come right away, nor with slight encouragement, and it seemed like all her energy disappeared. I moved one of her feet to my shoulder and pushed it back, she pushed again, and the shoulder popped loose, with a healthy baby lifted high and happy.