The Miracle of Life

I do not want to be an OB/GYN. Immaturely put, I do not want to look at vaginas for the rest of my life. I knew this before I started med school, and I knew this when I started my OB/GYN rotation. I was, however, looking sort of forward to one part of the rotation, and that was delivering a baby. It’s just one of those things that I always sort of wanted to try doing in life. Like milking a cow. I really want to try that just once. It’s probably not as awesome as I keep thinking it’ll be, but hey, you’ll never know until you try. So I was reasonably excited when I began my L&D (Labor and Delivery). Even when I got stuck on the night shift, which is several hours longer than the day shift because you have to come in before your shift for the daily lecture at 5pm. But I’m not bitter. Nope, not at all. Fuckers.

After the lecture, which ends at 7pm, you dash into the hospital café to grab a cookie or something (because doctors don’t like to see you eating on their time, hunger is for the weak), then report sadly to the unit while your lucky day shift classmates skip home. You look up at this giant whiteboard where all the expecting mothers are written on, along with their current cervix size, how far down the baby’s head is descended, and how many babies each mother has had. There’s a whole slew of additional information, like what medicines every mom is on and if the kid has weird birth defects and the gestation age, but the first three things I listed are really what matters if you want to help deliver a baby that night. See, movies are always showing the mom screaming in pain and dads fainting and the baby popping out all cute. What they don’t show are the hours and hours and hours and hours of waiting in between for the baby to get in position, and those assholes can take their sweet time. During those hours, you, as a medical student, get to pop in every half an hour or so to ask the moms how they’re doing and maybe get them some ice. Some moms are really nice about it. Others start to get irritated, especially since it is nighttime and most people are trying to sleep. Another advantage of the day shift. Again, not bitter. In between waiting for those cervices to dilate, you can chill in the ED and see if other women are showing up in labor, which has its ups and downs.

And if it’s a quiet night, you just sit in the unit and try to study. It gets old really fast, especially when you’re trying to keep your eyes open at 4am, surrounded by eagle-eyed residents ready to dock you points if you don’t look like you couldn’t imagine doing anything else but reading about yeast infections. The same residents, I should mention, order huge dinner trays around 10pm, then laugh and munch in our faces. We ignore the delicious aromas of chicken fingers and dessert brownies and resolutely study our notes on uterine cancer.

But I digress. Back to the whiteboard. After you see which moms are the farthest along and which moms are multiparous (had at least one other baby), there is a brief and frantic battle-royale fight with the other medical students to write your name next to the most desired patients’. You then put on your most chipper face and go introduce yourself to the mother and the rest of her family if they’re there, being careful NOT to mention that you, an inexperienced medical student, are dying for the chance to catch their newest family member.

The supposed advantage to night shift is that there is less staff around so you have more of a chance to get involved and deliver babies. This was how I consoled myself. Especially that first day when I showed up and a resident told me proudly, “Sally (a medical student, the name has been changed) delivered a baby on the day shift.” There was a pause. Then, “She cried.”

What exactly am I supposed to do with this information? What response are they expecting? Two thumbs up? Jumping up and down for joy? Doctors, I’ve noticed, do this a lot. They tell me about previous medical students with a certain tone in their voice and a certain look in their eyes. I’m notoriously bad at reading people’s minds, but I will tell you every time they do this, I get the distinct impression that I’m supposed to be impressed and should follow suit. In this case, I guess when I delivered the baby, I was supposed to cry. This was bad news. I did think witnessing the miracle of life would be pretty cool, but I did not think I’d be so touched as to cry.

Still, I was hopeful. Maybe delivering a baby really would be that mind-blowing. Surely I could squeeze out a few tears. Unfortunately, my first baby that night was by a first-time mother. To be clearer, her vagina had yet to be traumatically ripped open by a 7-lb mass of flesh, so even after the cervix is dilated and everything is technically ready for the baby to pop out, the whole process can take several hours. The process, specifically, is for the medical student and nurse to watch the monitors and whenever a contraction begins, you each take a leg to help the mom curl up and then yell encouraging and inane phrases like, “Little harder!” and “Push into it!” and “You’re almost there!” over and over again as the mom bears down. Once the contractions are over, you set her legs down, let her breathe, and wait for the next contraction. Occasionally, a bored doctor finds their way in and checks down there to see if the baby’s head is visible. If not, they leave, and we resume our awkward cheerleading. Again, to reiterate, this can literally take hours, especially when it’s a first-time mom because she doesn’t know exactly where to squeeze to force the baby out.

My mom was particularly confused or something because after many an hour passed, the baby was still stuck inside and she was getting worn out. At this point, it was decided instead of a simple delivery, the team would have to use forceps, a slightly more complicated procedure, which meant I would have no part in it. All that waiting, ice chips-delivering, and cheering for nothing. I deflated a little inside. Still, witnessing a live birth. It should be interesting.

Once the doctors all scrubbed and gathered around the patient, the real show began. I couldn’t see everything, having had to step out of the way for the doctors, but the first thing I did see was poop. When mothers bear down hard, well, it makes sense. Still, it was kinda gross, especially when a doctor stepped in it and then walked around the room, smearing it everywhere on the floor.

I stayed as still in my tiny corner of the room as possible. And then the amniotic fluid. Which is not particularly disgusting to behold. The smell, on the other hand, I was not too fond of. And of course, I started to see the top of the baby’s head. Every time the mom pushed, it would sort of slide forward. And then she’d stop, and it would retract back inside. After seeing the poop, I couldn’t stop thinking of it like a giant hard piece of turd.

And then, the doctor must have pulled hard on the forceps because there was this loud wet pop, and an entire head jerked out. The odor in the room also increased. I did not cry, but I almost screamed. It was just so…violently sudden. And it was all wet and smelly. And the baby looked dead. I thought it would emerge all soft and pink and crying. But no, it was covered in body slime and its skin was sort of a grayish waxy complexion and its head was squishy and slightly deformed from squeezing out and the forceps. It was not cute or touching.

The rest of the body quickly followed, as creepily dead-looking as the head. It got handed to the nurses, who checked vitals and rubbed it with a towel and the baby finally started crying and waving its little limbs and finally looking a healthy color. Much cuter after that. Alas, when it hits that starting-to-look-cute phase, the pediatricians take over to make sure it’s good and healthy. OB/GYNs, on the other hand, are focused on the mom and getting the placenta out.

This quickly became my favorite part of the delivery. Largely because the doctors were much more comfortable with letting us medical students deliver the placenta than the baby. And, if you ask me, after seeing the yanking out of the slimy corpse baby, the placenta was looking rather adorable. It’s like a giant amoeba or something.

Not to say the first time I did it I wasn’t terrified. The placenta also doesn’t come out until it’s good and ready, and if you yank too hard on the cord, you risk ripping something and causing a hemorrhage and, well, killing mom. I really didn’t want to kill mom, so I went slow. Too slow, and the doctors yelled at me, so I decided, ‘Sorry mom, I hope you don’t die’, and yanked hard, and out slid the placenta and mom didn’t die. Hurrah.

Since night shift doesn’t end until 7am-ish, you usually get the chance to be at 2-3 deliveries every night. So I did later go on to deliver a baby, and doing it as opposed to seeing it wasn’t any different, emotionally. No tears. Just terror. This time, the terror largely stemmed from how heavy and slippery the baby is when it first pops out. There’s a reason right before the delivery, every medical student is again reminded by the doctor, “Just don’t drop the baby.” Because that’s a very real possibility. Luckily, it didn’t happen to me.

Better yet, during another delivery when somehow the yanking out of the baby resulted in an eruption of amniotic fluid from the birth canal, I did not have my mouth open like the father-to-be.

I also wasn’t present during a delivery where the baby somehow managed to piss on the first-year resident’s head. That had to have been epic because at no time during the delivery is the baby in a position where it should be able to do that.