Beautiful. Her mother-in-law, Irena, and 6-year-old son Safi are there for support. If you’re in a public place, consider watching it later. This is called hard labor or transition. Midwife: The intensity of the contractions is increasing, and just a certain force is now really behind that baby coming. Video note: Contains medical situations and nudity. I mean, women, we were designed to do this. Find other parents like you. She is 38 weeks pregnant with her second child. Applying pressure is a common practice used by caregivers to help expel excess blood. Birth centers offer a more relaxed and intimate alternative to hospitals for women expecting uncomplicated births. Narrator: Her midwife uses her fingers to pull back her cervical opening as Samiyyah pushes. Birth centers offer a more relaxed and intimate alternative to hospitals for women expecting uncomplicated births. Samiyyah tore along her previous episiotomy line, and her midwife repairs it with stitches, which takes 15 minutes to complete. Narrator: Though most mothers dilate nearly 8 to 10 centimeters before transitioning, Samiyyah is only 5 centimeters dilated and is having trouble resisting the urge to push. Pushing before being fully dilated is uncommon. The muscles your body uses to contract are transitioning from dilating the cervix to pushing the baby down and out. The #1 app for tracking pregnancy and baby growth. The midwife made the right decision, listening to her body. Samiyyah is 3 centimeters dilated, 100 percent effaced, and her water hasn't broken yet, which is common in the first stage of labor. At the birth center in Bryn Mawr, Pennsylvania, Julia Rasch, a licensed nurse/midwife, performs an internal exam and starts an IV line to give Samiyyah a dose of antibiotics, since she's positive for Group B strep. Samiyyah: I thought it would be painful, but it wasn't at all. Samiyyah's natural birth is a success, and she's ready to try it again. Prepare for labor and delivery with our free childbirth class. Samiyyah: With the first pregnancy, I delivered in a hospital, and it was very restricting, you know, being confined to the bed, not being able to, you know, move when I felt my body wanted me to do certain things. Samiyyah finds some relief by trying a combination of slow steady breathing, constant deep massaging and counterpressure, spending lots of time in a heated Jacuzzi, and trying different labor positions. Narrator: Her midwife agrees her body is ready to deliver. Midwife Julia Rasch: Large amount of clear fluid. Midwife: Okay now, take a breath and do it again. With just 11 minutes of pushing, Arvan and Samiyyah's baby emerges. Narrator: Her midwife feels it's time to break her water with an amni hook, since she can feel the amniotic sac bulging. It's healthier for the baby; it's healthier for me. Narrator: As her contractions pick up, she starts experiencing painful back labor, typically caused by the baby's head pressing against the lower spine. Watch one mom give birth without pain medication, with help from her midwife and husband. This is why each caregiver has to manage her patient's labor on an individual basis. Samiyyah: We've talked about, you know, what he's gonna see, we've shown him pictures, and I think he'll be okay. Narrator: Everyone played a supportive part on the birth team… Even big brother Safi got to announce the news that his brother was born. Samiyyah: My goal is to remain calm and try to stay level-headed. It's important to choose a birth center with nearby hospital privileges in case of an emergency. Helping her through her first natural birth is her husband, Arvan. We're going to try for a girl. The midwife helps deliver the placenta, and a nurse presses on the fundus -- the upper part of the uterus -- to check how much the uterus has contracted. It was a fast delivery, with just four hours and 11 minutes of labor. Incredibly, in an hour, she is showered up and savoring some well-deserved fettucini Alfredo. (laughs). So why not? Narrator: Dad cuts the umbilical cord, and the midwife collects some of the cord blood for routine testing. Narrator: Samiyyah is the owner of a day spa in Philadelphia. Samiyyah: One more. Narrator: As Samiyyah's labor progresses, her baby's heart rate is monitored every 15 minutes. Narrator: For her son Safi's birth, she was given pitocin to speed up labor, an epidural for pain management, and an episiotomy (a surgical cut to widen the vaginal opening). Narrator: Transition can be the most painful part of labor -- but usually the shortest phase. It's not over yet. Narrator: Sami Sarrajj, a healthy boy, is placed immediately on his mother's chest. Planning a natural birth? Arvan: Sam, do not push. She's doing great. Positions your baby might be in during birth, How an upright position can make delivery easier, 7 ways your breasts change during pregnancy, How to sleep like a baby when you’re expecting one, the most helpful and trustworthy pregnancy and parenting information. Fight it. Samiyyah: Yes, I've been told that I am completely crazy for being, you know, for not having the drugs, but I've been there and I didn't like it, so I figured I would try this. This is a common procedure and usually helps speed up the labor process. It's important to choose a birth center with nearby hospital privileges in case of an emergency. Narrator: Seven days after her due date, Samiyyah's labor kicks into gear. Fight it. Her mother-in-law, Irena, and 6-year-old son Safi are there for support. Arvan: She's doing great. Actually it was like a relief of pressure. Helping her through her first natural birth is her husband, Arvan. She's really pushing through. This time, she's planning a natural delivery -- without pain medication and other medical interventions -- at a birth center. Narrator: Samiyyah is now breastfeeding and bonding with her baby. Narrator: Her contractions now intensify as she starts to feel the urge to push.