“Push when you feel the urge, Elizabeth, with a nice big breath in, and a long, hard exhale out.” Downbreathing, we called it, and I loved it because it saved the mama’s energy and let the contractions do most of the work. Could she breathe the baby out? Not exactly. But she didn’t have to pop a blood vessel pushing, either.
Another contraction. Another. Another. Another. Elizabeth kept her eyes closed in concentration, breathing steadily and deeply, pushing well, not saying a word.
“That’s it, honey,” Tom said. “The only muscle that needs to work now is your uterus. Let everything else relax. Ride the contraction like a leaf on a river.”
Woo-woo? Hey. It was clearly working.
The door opened, and I glanced back. Carline was standing there, a puss on her face. I had no time for her. Two more contractions, Elizabeth breathing deeply. No screaming, no cursing, nothing like the movies. Just the most intense concentration of Elizabeth’s life. Some women called it turning inward, so much so that they forgot where they were. Carline left, sighing as she did so.
The baby’s head eased down the birth canal, nice and slow. I checked the fetal heart rate—160. Perfect. I could see his dark, wet hair. “Elizabeth, the baby’s head is about to crown, so bear down, sweetheart, and give him a little help.”
She grabbed Tom’s hand with the next contraction and pushed, and the baby’s head eased toward daylight. “Okay, Elizabeth, just breathe here, and the baby’s head will come out nice and slow.” She whimpered. “I know, honey, but you’ve got this.”
“He’s right there. You’re doing great. He’s almost out,” Tom said. His eyes were full of tears.
She took a huge breath on the next contraction, exhaled through pursed lips, pushing as nature told her to do. Then she made a thin, keening sound, and the baby’s head slid right out with no tearing.
“Perfect. The hard part’s over,” I said, smiling at her. She was breathing hard and damp with sweat, but she smiled back. “Next push, and you get a baby to hold.”
She took another deep breath, exhaled long and hard, and the baby was in my gloved hands. I slid him right up onto Elizabeth’s chest, tears in my own eyes as he reached out a little hand.
“Hi!” she said, her eyes shining. “Oh, God, thank you! Hi, baby! Hello! Hi!”
This was the best part. The wonder. The awe at what her body had done. The beautiful, perfect infant. He opened his eyes and looked around, then opened his mouth and gave a hearty cry.
“You did it,” Tom breathed. “Oh, honey, I love you so much.” They stared at him, and then at each other. Elizabeth turned her head and kissed her husband, tears streaming down her face as they marveled over their miracle.
This was what I got to witness. Best job in the universe.
I covered the baby with a blanket, clamped the cord, delivered the placenta and put it aside. No stitching necessary. After we’d cut the cord and Elizabeth had held the baby for a while, Jane came in to help me check the little guy and do the necessary tasks.
“Seven pounds, ten ounces,” I said. “Apgars are ten and ten.” I burrito wrapped him, put a little striped cap on his head and gave him back to Elizabeth. “Congratulations, guys. I’m so happy for you. Does he have a name?”
“Silas John,” Tom said. “Named after my dad.”
“Oh, how lovely! Elizabeth, how do you feel, sweetheart?”
“Amazing. Oh, Lillie. Thank you. You were wonderful.”
“Eh,” I said. “You did all the work. I just caught him at the end.”
* * *
Turned out that when I went to Dr. Barton’s office later that day to lodge a complaint about Carline, I found she’d already lodged one against me.
“What?” I said, jerking back in surprise. “The baby and mother are doing great! Thirty minutes of pushing, ten on both Apgars, no stitching, no pain meds. What’s to complain about?”
Dr. Barton sighed and pushed her glasses up her nose. “She doesn’t like you, Lillie.”
“That goes both ways. She suggested the baby might have microcephaly right in front of them! Told the mama she needed Pitocin because labor was taking too long, and it wasn’t, and she didn’t.”
“Look, I know she’s . . . old school.”
“Archaic.”
Dr. Barton grimaced, not contradicting me. “She’s good in the OR and only has two more years here, and then she’s retiring. But, Lillie . . .” She looked down at the paper in front of her and read aloud. “？‘Nurse Lillie Silva spoke in a hostile and unprofessional manner. In addition, she put her hands on me and dragged me out of a patient’s room.’？”