The Miracle of Life

9:51pm. It all started with a high-five. I would have preferred the classic 8 mile Eminem opening scene: I can hear the crowd in the other room as I retch over the bathroom sink; I look up at myself in the dirty mirror, breathing heavy and wiping the vomitus off my chapped lips. Lose yourself in the moment, you own it... However, beggars can't be choosers, and this is my first baby. Well, not mine, obviously. This is my first delivery. Legs spread across stirrups; baby crowning in front of my eyes. I had practiced over and over on the "fake baby, fake pelvis" at the rounding table. Left hand, perineal support. Right hand, two fingers on baby's occiput. Control the head. Pushing slows. Use both hands to guide the head, fingers point in the direction of the baby's mouth. Check for a nuchal. Birth the anterior shoulder. Grab the neck with superior hand and control. Pull up and out to deliver posterior shoulder, supporting the arms from arbitrary extension. Deliver the lower extremities. CATCH and HOLD. Untangle the cord. Turn. Present to mother. Clamp the cord. I knew the progression; I just hoped the birth would be easy and slow. These multiparous women can pop out an infant quick. Perineal support. Two fingers on occiput. Control the... "Robert! Let's go birth a baby. You can do this (insert noise of proverbial high-five slap here); I'll coach you through." We enter 391 quickly, disinfecting our hands in stride, pushing through the wide swinging door. This will all go just fine, as long as I don't drop the baby...

9:52pm. Knock, knock. "Robert, go ahead and gown up. What's your glove size?" I put on the face shield first, careful to make sure the clear plastic is miles from my face. Can't birth a baby if you diaphorese (is that a word?), or sweat all over your view. Gown next, then gloves. This is where I put on a show for everyone in the room. Ever seen a med student try to put on a pair of latex in the usual sterile fashion? It's like watching your seven year old kid try to ride a bike for the first time. Do you just let her fall over and over again? It's like putting socks over your hands and then trying to put on a pair of mittens in minus 40 degree weather, barefoot. Cut me some slack. It doesn't help that I have a mother screaming on the other side of the room as I continue my awkward display of incompetence. The little one waited 38 weeks; it can wait another minute and a half. I say a little prayer. Please God, whatever happens, don't let me drop this baby. That's what happened to me, and see how I turned out?

9:53pm. I'm still fumbling with these damn gloves. Where's the scrub tech when you need him?! "Robert! Hurry up!" Just a minute dammit. I'm going to need my gloves on if I'm going to keep from dropping this baby!

9:54pm. By now I'm standing in front of the mom. She's got her legs in the stirrups, and her pelvis is at my knee level. Ergonomically, at 6'5", this is a problem, but I'm used to it. The med student doesn't make the rules, nor does he or she set the table height. So if I D.F.O. ("done fall out"), then I get to blame it on back spasms. I lean over the introitus and begin the progression. Left hand gives perineal support, right index and middle finger control the baby's head. My coach "J" is on my right; Chief stands approvingly at stage left. It's my first birth; anything and everything can go wrong. We already know that the baby is head down via ultrasound, but the rest is completely unpredictable. Who knows, maybe the baby is reaching for the light and a hand will pop out first. Maybe the baby was doing crunches to work on its abs in utero, and the feet will present next after the head. What if the umbilical cord is wrapped five times around the baby's neck? What if there are twins? Or triplets?? And what if I drop this damn baby on its head?!

9:55pm. This is when all hell breaks loose and the shit hits the fan (NB: although defecation is a common occurrence during delivery, no "shit" hit the fan during this delivery). I have my two fingers controlling the head, and then out of nowhere the baby starts shooting out of the mom's vagina. Doesn't it know this is my first time?! Four hands come flying in. I try to get my hands in place to grab the neck, but I had forgotten to check for a nuchal. My coach gets her fingers in first. The umbilical cord isn't wrapped around the baby's neck, but I have no time to switch my hands to deliver the anterior shoulder. "STOP PUSHING!" Any more pushing and this baby is going by using my chest as a backboard. Bank shot! At least thirty fingers are now controlling its progression. I finally get my right hand firmly around the nape of its neck, my left arm rigid beneath this miracle of life. Okay, so this delivery has not been perfect so far, but I WILL NOT DROP THIS BABY. In any case, there are now two pairs of mitts lurking underneath mine, spotting expectantly. All are ready to catch if the med student turns into Mr. Butterfingers. Abdomen, thighs, knees, toes: the entire lower half of this kid slips out in half a second. And there I am in my moment of glory, the moment of truth. The baby has left its warm, comfortable habitat, and entered the real world in majestic fashion: through the vagina and into the arms of a novice, as nature intended. My eyes narrow because I realize now is the time for utmost concentration. If this baby gets dropped, now is when that would happen.

9:56pm. The cord is untangled, and I'm ready to present the infant to its mother. "NOO! HOLD ON!!" I am a little over-exuberant I guess. The cord isn't long enough yet, so my coach leans in to gently lengthen it in order to prevent avulsion from its owner. "Now, you're ready. Go ahead." I spin the baby carefully in my arms and rest its body on mom. Smiles and grins all around. "It was worth all that work, huh?" Internally, I think this question should be directed to mom and me both, but I realize attention has shifted to the new addition to the room. The cord is clamped and cut; the baby cries as fluid is sunctioned from its newly opened lungs. All is right in the world. I rest in my moment of satisfaction. Mainly because I didn't drop the baby!

9:57pm. I stand and watch. At least one minute is dedicated to joy of birth instead of the science of delivery.

9:58pm. "Alright, Robert. Go ahead and deliver the placenta." My reflection is cut short as I realize that after the birth is the afterbirth. I start at the beginning with a gentle fundal massage. A familiar thought creeps into my consciousness... whatever you do, Robert. Don't drop the placenta.