Ann's water broke at 4am on 7/8/2006, and contractions started at around 2am on 7/9. We were pretty excited, as they were under 5 minutes apart when they started, and over 45 seconds. But over the next 60 hours, the contractions alternated between slowing way down and speeding back up, and Ann only got a couple hours of sleep.  We tried a whole number of options for encouraging labor, stopping short of castor oil.  We were becoming concerned that Ann may get too exhausted to push the baby out if the labor didn't progress more quickly, and of the greater potential for infection with the water breaking over 72 hours earlier (or perceived dangers and hospital protocol if we had to transport later).

On the afternoon of 7/11, we decided to leave home to go with our Plan B, to give birth at St. Luke's Hospital in San Francisco with their Homestyle Midwifery group.  The main decision point to do so was to get pitocin to encourage Ann's contractions.  And indeed they did.   Ann went from 4 cm to 10 cm in about six hours, and then pushed for 2 hours and 13 minutes.  To everyone's surprise (there was no good way to tell before the birth), Madeleine came out in "posterior brow asynclitic" presentation, forehead first, facing up and tilted to the left. That only happens in 1/1000 births and means the head is coming through in the widest possible angle. We found out later that obstetrical textbooks say it is almost impossible to give birth vaginally in such cases and it usually means an automatic C-section. (Only 3 in 10,000 are born that way vaginally.) Well, Ann pushed her out without pain meds, but ended up with 70+ stitches because of the fourth degree tear it created.  The birth was apparently the talk of the Labor & Delivery floor the next day as none of those who worked there had ever seen such an occurrence. 

Ann did an amazing job through the labor and birth.  Her sense of humor came through, and the midwives wrote down some of her choice quotes on her charts ("I am woman, here me roar!").  She startled everyone an hour after the birth when she jumped up to start pushing out the placenta... she must have had some good hormones going! 

While we obviously would have preferred a home birth, we were happy with our decision to go to the hospital, and felt that the "home-style" experience at St. Luke's was the closest we could have come to our desired birth at a hospital (despite some minor annoyances with hospital protocol).  There was a great midwife there and a very helpful midwife in training who capture much of the later labor and birth on camera and videotape.  Our midwives were able to pretty much do what they would have with us at home, and one of them caught Madeleine as she came out.  (In the end, we went through the entire pregnancy and birth without ever having to see a doctor.)

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