Before we begin, please know that some episodes include language that may be sensitive for some people. Thank you for joining me for another episode of the Birth Portal. My name is Connie. Today's true story is about a woman I'll call Frankie. This was her second pregnancy, but her first time with midwives. Her first pregnancy was relatively normal, except that she developed gestational diabetes and was able to control it well with diet and exercise. We routinely screen women for diabetes around 25 to 28 weeks gestational age. The screening is done by the woman consuming 50 grams of a glucose drink and then having her blood drawn an hour later. If the glucose is below the threshold, they are not diabetic. If it is above the threshold, they would do a fasting glucose and drink 75 grams of glucose, then their blood would be drawn three times in the space of three hours. For those that have elevated glucose levels, even for just one of the blood draws, they would need to monitor their glucose daily. Most people with diet changes and exercise, like walking a few times a week, can manage well without the need for insulin. Women that develop gestational diabetes are at risk for growing a big baby, a small baby, a baby with metabolic disorders, or heart and lung issues. But if managed by a diet, those risks can be reduced. Frankie screened at 24 weeks gestational age this pregnancy and had normal glucose levels. She reported that she maintained a healthy diet and walked three to four times weekly since the last pregnancy. When she was one week before her due date, Frankie wanted a stretching suite to try and go into labor sooner rather than later. We discussed the risks and benefits, and I proceeded to check her cervix. She was already five centimeters dilated and wasn't feeling any contractions or even cramping. As I continued with the exam, I felt the intact bag of water, and suddenly the baby grabs my finger through the bag of water and startles me so much I shriek and pull my fingers out quickly. The woman looks at me and says, What? What? What's wrong? And I start to laugh and say, Wow, that was so cool. Your baby's hand was in front of its head, and its tiny little hand grabbed my finger and startled me. I've never had that happen before. There's nothing to be concerned about, as you're not in labor. We stopped the exam there, as I didn't want to risk the bag of water rupturing with a hand in front of the head. Approximately three days later, Frankie went into spontaneous labor. And two hours after her labor started, we met at the hospital, and she was nine centimeters dilated. No fingers were felt this time, just the baby's head. Can I have an epidural? says Frankie. I'm sorry, Frankie, I don't think you have time to get one. I think very soon you'll start to push. I quickly set up my equipment and call for my backup midwife to come immediately. Thankfully, the backup midwife lives close to the hospital and is there within 20 minutes. I discuss with Frankie and her husband the option of breaking her water now and suspect that she'll start to push soon thereafter. Frankie says, Yes, please break it now. I want this over and done with. When I check her cervix, she's fully dilated and the head is nice and low in the pelvis. I easily break her water and the fluid is clear and the baby's heart rate is normal. Frankie, why don't you stand on the side of the bed with your arms around your husband's neck, just like you're slow dancing? They both give me a strange look. Really, Frankie, trust me. Just do it through one contraction. Go ahead, try it. We help her stand up and she puts her arms around her husband and waits. Within a couple of minutes, a contraction starts and she gives us that primal sound. Thankfully, I still had my gloves on, and at the end of the contraction, I said, Okay, Frankie, you can lay down now. As she laid down, the baby was quickly born before her head even hit the pillow. I placed the baby up on her belly and said, There you go, here's your baby. They both looked at each other in complete disbelief, and then at their beautiful child. Wow, you weren't kidding. Thank you for joining me for another episode of the Birth Portal.