You got it, he texted back.
Seven hours later, Elizabeth still hadn’t progressed much . . . she was at four centimeters but handling the pain well, breathing through the contractions, which were strong and steady at five minutes apart. She was currently in the birthing pool. I checked the water temperature and occasionally put a cold facecloth on her forehead or neck, but tried not to intrude, either. They were doing great . . . Tom murmuring the phrases from the hypnobirthing meditation. It was a lot like yoga—breathing deeply, consciously relaxing your muscles, picturing lovely things, telling yourself your body was strong and capable.
Elizabeth seemed completely in the zone, eyes closed, breathing fine.
“I’m going to step out a minute,” I whispered to Tom. “Can I bring you something to eat from the cafeteria?”
“That’d be great,” he whispered back. “A sandwich?”
“You got it. I’ll only be ten minutes, and Nurse Jane is right outside if you need anything.”
I filled Jane in and waved to another midwife who had her own patient in labor. Women in labor didn’t usually want to eat, and in the olden days, they weren’t allowed to, on the off chance that they’d need a C-section under general anesthesia. But statistics showed that the chances of aspiration were minuscule, and a lot of us in the business actually wanted our mamas to eat a little snack to boost their energy. In the cafeteria, I waved to Isabel, one of my favorite OBs.
“How’s your mama doing?” she asked.
“Doing great. Beautiful labor so far. Are you on duty?” I hoped so, because the thought of having Carline interfere made my jaw clench.
“Afraid not. My wife and I are having dinner. It’s our third anniversary. I just needed a snack. It was a long night.”
“Congratulations! Have a great time.” I put two slices of bread in the toaster, then spread on some strawberry jam. Some carbs and a little sugar to give Elizabeth some energy. For Tom, I got an egg and cheese sandwich with sprouts on whole wheat bread and an apple. For myself, just a smoothie.
When I got back to the birthing suite, I could hear raised voices. My patient’s, in fact.
There was Carline, standing in her white coat over Elizabeth. “I’m sorry, but these contractions are awful,” Carline said, “and you’re failing to progress. You need Pitocin or you’re putting your baby at risk.”
“Carline!” I said sharply. We did not use those terms anymore. “Elizabeth is doing amazingly well. She’s in no pain, and the fetal heart rate is strong and steady. She doesn’t need Pitocin, and it’s inappropriate of you to swoop in here and order her around.”
“Thank you, Lillie,” said Tom, glaring at Carline. “We’ve never even met this woman.”
“Poor maternal effort,” Carline snapped, “indicates the need for Pitocin to get this baby moving. Do you want her to suffer all day?”
“She’s not suffering,” I said. “Or she wasn’t until you came in.”
“Can you get her out of here?” Elizabeth said.
“I’m a medical doctor,” Carline said, “thank you very much, and an obstetrician, but if you want to stick with your woo-woo, go ahead. I’ll be here for the emergency C-section.”
“Out you go,” I said, setting the tray on a table. I took her by the elbow and led her out of the room. “That was extremely unprofessional,” I hissed once we were outside. “Do not come into this room unless you’re asked to.”
“You can’t talk to me that way,” Carline said.
“I just did.” I closed the door in her face, took a cleansing breath myself, and went to my couple. “I’m so sorry about that,” I said.
“Was she right?” Elizabeth asked, looking scared for the first time.
“No. Not at all,” I said. “Listen.” I put the doppler on her belly, and we listened to the baby’s heart: 146 beats per minute. A contraction gripped Elizabeth’s stomach, and the heart rate raised to 153, then dropped back to 145. “See? Perfect. There’s absolutely no sign of fetal distress. You’re doing beautifully with labor.”
“You are, honey,” Tom said. “You’re amazing.”
“Can you check me again?” Elizabeth asked. “See if I’ve progressed.”
“Sure thing.” I washed my hands, pulled on some gloves and did a cervix check. “Six centimeters. You’re doing great.”
I’d be talking to the head of obstetrics about Carline Schneider, that was for sure. Elizabeth announced she was getting pruney in the birthing tub, so she got out, pulled on a johnny coat and sat on the labor ball, Tom behind her on a stool, arms wrapped around his wife.
It was a slow labor, yes. She’d come in a bit early, but that had been her choice. She had a little one at home, and wasn’t thrilled at the idea of Willow (and Tom’s mother) watching her labor. But there was nothing wrong here.
Time trudged by. At 2:00 p.m., she was at eight centimeters and had been in labor for fifteen hours. I refilled the pool with warm water, and she climbed back in, naked (another thing Carline disapproved of). Tom resumed the affirmations in a low, quiet voice as gentle music played in the background . . . the umpteenth time through the playlist, but hey. Babies don’t follow orders.
Around four, the contractions became more intense, and Elizabeth breathed through them, exhaling in a low groan. Tom pressed against her back. I added more warm water and stayed on the periphery. They were such a lovely couple.
“Why is this taking so long?” Elizabeth asked, her voice wobbling. “Willow was born in four hours.”
“I guess this little guy wants to make an impression,” I said. “You’re doing so well, Elizabeth. You’re mighty.”
Tom grinned. “You are. You’re mighty and strong. An oak tree.” His voice dropped back to the soothing, repetitive phrases he’d been saying all night. “You’re safe, calm and relaxed. Our baby is safe. Breathe in relaxation, exhale tension. In . . . two . . . three . . . four, out two . . . three . . . four . . . five . . . six. That’s it. Your body knows just what to do.”
The mind was a powerful tool.
An hour later, she gestured toward the bed. We helped her out and onto the bed, raising the back so she was sitting. Tom sat behind her so he could support her weight (and put his arms around her). Elizabeth put her feet against the birthing bar attached to the bed. I checked her, and yep, she was fully dilated. She closed her eyes and rested for a minute, breathing through the next contraction.
“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.”