You’re doing great, Molly,” I murmured in the darkened birthing suite at the hospital. My client was lying in the birthing pool, floating on her back, eyes closed, her glorious stomach rolling with the contraction. She didn’t answer, completely focused inward on the power of her body, humming as her muscles clenched. “Relax and breathe, nice and slow.” Another low hum, and the contraction ended. “You look utterly gorgeous,” I said honestly. “You’re doing this so well.”
She reached up and grabbed my hand, and I stroked her hair back from her head. Molly was single, having gone the sperm donor route at the age of thirty, not wanting to wait for a decline in fertility to have her first baby. Smart. Funny, to think that when she first told me that, I’d been a smug married, imagining how much harder she’d have it. Now, I sort of envied her. I would’ve saved myself a lot of money and heartache if I’d divorced Brad immediately after Dylan was born. Sure, he’d been a good enough dad, but these days, I wasn’t in the mood to credit him with anything.
Molly’s sister was en route, but traffic was wretched today, a Friday. Hopefully, she’d make it in time to see her niece being born. If not, well, nature didn’t take well to direction, and babies waited for no one. Last week, a woman had given birth in the hospital parking lot. Sadly, I had not been the midwife on duty that day. Precipitous births could be wicked exciting.
The door opened, and the lights flickered on. Molly put her hand over her eyes.
“Lights off, please!” I snapped.
“Fine, fine.” The lights went out again, and the dreaded Dr. Schneider poked her head in. “Still laboring? Damn. I thought she’d be done now. Is she pushing yet?” She had a loud voice that could be heard all the way to the nurses’ station.
“She’s progressing beautifully, Doctor,” I said calmly.
“Are you in a lot of pain, poor baby?” she called over to Molly. I gritted my teeth. Dr. Schneider did not understand what it meant to empower the mother. “Poor maternal effort?” she said, lowering her voice so it could only be heard in half the hallway.
“The exact opposite,” I said, keeping my tone firm and mild, though my eye twitched. “Amazing maternal effort.”
“She’s been here for four hours,” the doctor said, as if that was a problem. “Did you break her water to get things moving along? How about a little Pitocin?”
Carline Schneider, MD, obstetrician and gynecologist, was a nemesis to CNMs everywhere. She was the kind of doctor who would order Pitocin to hurry things up or use the vacuum so she could be home by dinnertime. The kind who’d leave a patient when her shift ended, passing her off to someone else, rather than stay the extra half hour till the baby was born. Childless by choice, with the highest percentage of medical interventions at a place that prided itself on natural childbirth and healthy babies and mothers. How she had kept her job here was a mystery.
All the nurses and midwives (and other doctors, for that matter) hated her. She was the worst of the old-school obstetricians, lover of cesareans, the only one who still used forceps and used terms like “failure to progress” and “inhospitable womb” in front of patients. In her sixties, full of impatience for “you witches,” completely dismissing the fact that every midwife at Hyannis Hospital had a bachelor’s of science in nursing, neonatal intensive care nursing certification, master’s in nursing with a specialization in midwifery, and certification as a nurse-midwife.
Every other doctor at the hospital, most especially Wanda, viewed CNMs as equals, respected our opinions and essentially turned labor over to us and the L&D nurses. They only came in to check on difficult labors or when medical intervention was absolutely necessary, or just because they had a special bond with the patient. Otherwise, they let us do our jobs. In addition to helping my own patients deliver here, I did a weekly twelve-hour shift at the hospital (or two, when money was tight).
I’d be doing a lot of extra shifts this fall, that was for sure, so I’d be seeing Carline more than ever. She lumped CNMs into a group of unnecessary healthcare providers, told patients that it would take longer with a midwife, “confused” us with lay midwives, who had dubious training, and doulas, some of whom had none. She micromanaged, interrupted, told women in the third stage of labor it wasn’t too late for an epidural and clucked over women who took more than two hours to push a human out. Of course some women wanted or needed epidurals or nitrous oxide for pain control . . . but most came in hoping for a completely natural experience.
There are times when a medical intervention is absolutely necessary, of course. Multiples, breech presentation that we couldn’t change, mother or baby in grave danger—all were situations that needed cesareans or a vacuum-assisted birth. But most times, women were completely capable of natural childbirth. Carline’s patients had a 41 percent chance of C-sections, much higher than the national average. She generally viewed childbirth as Old Testament suffering, and herself as the scalpel-wielding savior.
“You’re doing everything beautifully,” I told Molly, pressing the waterproof fetal heart rate monitor against her belly. The ethereal, rushing sound of the baby’s heart made Molly smile without opening her eyes. “Baby’s heart rate is fantastic. I’ll just chat with Dr. Schneider and be right back.”
“Okay,” she said.
I hated to leave her side, especially since she didn’t have a partner, but she was calm. Her first baby, too. I was so proud of her. Another superwoman, letting her incredible body do its job.
“What is it, Carline?” I asked, knowing she preferred to be called Dr. Schneider.
“What’s the problem here?” she asked, glancing at her watch.
“Nothing. There are absolutely no problems at the moment.”
“If she’s worn out, it might be time to section her.”
“She’s doing perfectly.”
Dr. Schneider sighed. “I’d just rather do this now than have to come back in two hours. It’s Friday, and my husband and I have plans.”
“I need to get back to my patient,” I said tightly, and closed the door in her face.
“Am I doing okay?” Molly asked, wincing as another contraction started.
“Are you kidding? You’re the poster child for this. Deep breath, nice and slow.” The contraction made her belly stiffen and list to the right. She rolled over in the pool and leaned her forearms against the side. I pressed down on her sacrum to relieve her back pain through the contraction. She took a deep breath and exhaled with a low note. “There you go,” I said. “You’re doing so well, Molly. Beautiful. Just beautiful.”
God, I loved my job. For thousands of years, women had helped each other give birth. Some of the oldest practices in the world were still used—delivering on your hands and knees, not cutting the cord right away, letting the baby rest on the mama’s chest before doing an assessment. We didn’t need to yank babies away and weigh them or put in eye drops before the moms had a chance to look in wonder upon what they had done.
A healthy labor and delivery was nothing short of miraculous, every single time. I hated that some doctors (like Carline) still used the term “unremarkable vaginal delivery.” It was a miracle, thank you very much.
“I’m here!” said a voice, and there was Bridget, her sister.
“Yay,” said Molly, then took another huge breath.
“Hooray!” I said. “Wash up and come see your superhero sister.” The water in the pool had some blood in it. Wouldn’t be long now.
“Bed,” Molly said, her voice urgent. “Now.”
Ah, the one-word sentences. A sign that pushing was near. “You got it, queen,” I said.
Bridget finished drying her hands and pulled on a gown, then rushed to her sister’s side. “God, this is exciting,” she said. “You’re incredible, Molly.”
Jane, one of my favorite nurses on the floor, came in—she had a sixth sense about when she was needed. We helped Molly out of the pool and onto the bed, which Bridget raised to a forty-five- degree angle. Molly closed her eyes and held her stomach, breathing deeply.
“Look at you,” Jane said. “Won’t be long now, honey.” She leaned down to murmur in my ear. “Need me? We’ve got a footling breech down the hall, but Wanda’s on it.”
Oh, thank God. Babies coming feetfirst was tricky, and Wanda was the best OB here. “No, you go,” I said to Jane. “Molly’s got this.”