I was covering Labor and Delivery one day during the second year of residency. We had the usual bustle of women arriving for labor checks, antenatal testing going on and had a few babies whose new cries punctuated the yadda-yadda of nurses, patients, and my own blithering.
Suddenly I heard my name being called to room 206. "Dr. Chan, we're having a baby in here!"
As I ran down the hall, I heard a woman bellowing over the soothing voices of the nurses. The patient was on her hands and knees, butt up in the air, and pushing as if her life depended on it. She was a big woman with a sonorous voice and she vocalized loudly and deeply with each push.
One of the RNs was bent at the waist, her face close to the patient's. I couldn't hear what she was saying, but I imagined it had something to do with getting focused and controlling the pace of the baby's birth. She might have been speaking to a brick wall for the attention the patient was paying her. The patient had her eyes squeezed shut and her jaw locked into a grimce.
A second nurse was supporting the patient's perineum and a third was waiting at the baby warmer. The nurse supporting the perineum gave me a pithy report: "Gravida three, showed up an hour ago and was four centimeters. I think she's complete now."
I was inclined to agree. I pulled gloves on and took over supporting the perineum. From this awkward vantage point, I introduced myself to the laboring woman.
"Hi, I'm Dr. Chan," I said in what I remember as a perky tone of voice. "Looks like you're going to have your baby pretty soon."
She was still on her hands and knees so she had to look over her left shoulder to meet my eye. "Help me!" she shouted.
"I think you're doing plenty well on your own," I said in the same perky voice. I don't know why my voice turns perky like that. Something to do with trying to normalize extraordinary circumstances, I suppose.
"Dammit, help me!" the patient yelled.
The nurse standing by her tried to get her attention again, and I imagine she was trying to get the patient to focus on the next push, but the woman was too strong of body and voice to pay any of us any mind. "HELP me," she bellowed emphatically. "Come ON!"
Her next contraction came on strong and she started hollering again. I watched in amazement as her perineum bulged and her labia began to splay open. A peek of dark, damp, wavy hair showed the baby was on its way.
"No yelling," I said loudly. "Put that energy into your push!"
"Just grab it," the woman ordered.
"What?"
"GRAB IT!"
I looked at the two other nurses standing by. They looked back at me, and their expressions said: You are on your own, sister.
I took a deep breath, and--in a calmer tone of voice, not perky but not stern--I said "My friend, there's nothing to grab. Push."
I can't remember what she said in response, but I think the F-word played into the sentiment. The next contraction came on and, with a truly Wagnerian bellow, she pushed the baby's head out.
I was eye to eye with the baby's face. The whole scene seemed so unreal, all I could do was blink at the baby for a moment. The woman panted for a while, then realized the baby wasn't fully born yet.
"Isn't it out yet?" she shouted.
"Not quite," I said. "Your next push--"
"Then pull it out," she yelled. "PULL IT OUT!"
I was about to explain there was nothing I could do to pull the baby out when she decided to take matters into her own hands. Emitting an enormous bellow, she pushed the baby's body out onto the bed.
With help from the nurses, she rolled over and panted with exhaustion as I untangled the baby's umbilical cord from around her ankle.
"Congratulations," I said, but the word didn't quite capture the moment.
"Oh thank god that's over," she said fervently. "Thank GOD."
Sometimes birth is like the changing of the tides. Other times, it's like the eye of a perfect storm.
Oh man, I remember feeling like that at the very end of my labor - the "damn it, just GET. IT. OUT!" feeling.
You write these stories so well!
Posted by: Emily | September 18, 2008 at 10:41 AM