It All Leads Up To This...

Yesterday morning I was on my way to my second call shift of the semester. The man got up to take me at 6:45am. I got in the car and put my head back to take a two minute nap. I was so, so tired because I had stayed up most of the night trying to prepare for clinical (making sure I had what I thought I needed, reading up, filling out my brain book, and making some cheat sheet flashcards) I wish I had've remembered to look in the guide they gave us which told us what to bring because I stilll didn't have everything. As we pulled off from the house, Brittany's tribute song came on the radio. It's been 20 days.

I was given report by the student midwife who had worked the 7pm-7am shift, and then went to meet the laboring woman. When I walked into the room I recognized her, and I was so grateful because I really hate how we work with women in labor and birth without ever having met them, but this woman had worked a shift with me on my pediatric rotation. When I got to the room she was 7cms and working hard. The father of the baby and her sister were there, but the sister was youngish (16?) and very pregnant and just there to "see how it is." But her guy, he was present and supportive.

S.A. is 27, and has 2 baby girls at home. She had epidurals and lacerations & tears requiring stitches with her first two babies. She had went from 3cm to 7cms dilated in less than two hours, and this was 30minutes later and she was grunting. So, when she asked about an epidural we explained the possibility of it not taking affect quick enough for how fast she was moving "You're about to have the baby," we were saying.

She looked at me and said "I've never done it this way - never without an epidural."

Me: "I know, but you can."

Her: How do you know?

Me: Because I believe you're strong.

Her: But I...I...I

Me: You got this. We're here. We're all here for you.

Her: No, you don't understand, I can't do this! (transition kicked in with...trembling...crying...hot flashes)

Me: You're doing it! You're at the end, this is it, you're so amazing!

This is about where my friend who was 2nd call came in to help with labor support, which was awesome because she was needing all the encouragement she could get, plus a little shocked that she was going to have the baby without pain meds! And I was needing to refocus down below since I really had very little clue what I was doing LMAO. When you're learning it's hard to do both the eye to eye personal attention and the physical work.

Then her body began involuntary pushing and she grunted "it's coming." When women who have had children already say this, it's usually true! And their babies can come out pretty fast. So that was my cue to gown up (gown, gloves, mask). She had an anterior lip of the cervix left, so we got her to lay on her side with her leg up (held by the nurse) and she ended up loving that position and wanting to stay that way for the remainder of the time. The only concern I had was her hemorrhoids...the worst case I had ever, ever seen before. Even my preceptor was a little worried at the size of them. She tried to apply counterpressure while she pushed, but she said that didn't help at all, so my preceptor abandoned the attempt and we just kept an eye on them.

Then the screaming began.

Crowning.

A forehead, a nose, fat cheeks, lips, and a chin - very slowly as to prevent tearing. The anterior shoulder, posterior shoulder, and the rest of baby's body.

A cord wrapped once around the neck and then once around a foot. Baby straight to mama's belly, UNpulsating cord cut by the daddy.

Yesterday, on February 9, 2008, I caught my first baby.

I welcomed a person, a girlchild, into the world with my own two hands. I saw a person open their eyes for the first time on earth....take their first breath.

And one more thing...four little words: over an intact perineum.

I'm still a little dazed.