The unfamiliar mini-bus taxi dropped me three long blocks past the hospital entrance. I turn tail and walk briskly towards the white towers with red crosses dotting the tops of them. There’s a disinterested secretary sitting behind a pane of glass.
“I’m an apprentice midwife,” the words catch on my tongue. Words Ciska told me to say to get up to the labor and delivery floor. They feel strange and exciting in my mouth, a half truth.
“4th floor, love,” the secretary replies, clearly disinterested in my newfound excitement at calling myself an apprentice midwife.
I burst loudly into the room and curse the heavy door. Rhoda is squatting on the bathroom floor, eyes wild, she meets my gaze and grunts in acknowledgement of my arrival. She closes her eyes and seconds later a deep moan bellows from the back of her throat. I am surprised and a little upset by the noise. I had seen a couple videos of births before, but had never been present at one. Rhoda was here, but not here. In between contractions she sunk to the floor, limbs completely slack. The only way we would know another one was coming was a flicker of eyelids before the gutteral groaning began again. Ciska nudged me down behind Rhoda’s back, instructed me to press on her hips during the height of the contraction.
The next one was different. A deep, “hughgggg” that came at the end of the moaning. Ciska immediately caught the change and she started bustling towards a small cart. My novice ears didn’t hear much difference so I was unsure why Ciska had suddenly left her post.
Rhoda reached back and grabbed me around my neck. “I’m not doing this anymore. I can’t,” she panted. I looked to Ciska to intervene. She was busy grabbing gloves and counting sterile towels with incredible calm. My brain ran in circles. What if I said the wrong thing? What if what I say is weird? “I know you can do it. You can do it.” was all I could squeak out before the next round of groans. I sigh. Ok, that wasn’t so bad.
I’m still caught up in the fact that I have no idea what I’m doing or seeing, really, when Rhoda hollers at me to push on her hips NOW. I’m snapped out of my self-conscious thoughts and return to to the physically demanding task of squatting with Rhoda and pressing with all my might against her hips for a full minute, every three minutes.
I look up and Ciska has near elbow-length gloves on. She’s smiling and holding her hands together in her lap. She sits on the cold tile and just watches. The next contraction involves screaming as well as moaning. I almost miss wiry dark hair pushing its way forward as my heart starts to race. I see an ear emerge as I peek over Rhoda’s shoulder. Suddenly there is a whole head floating between Rhoda’s legs. She reaches down in the pause between worlds.
“She’s almost here,” Ciska says calmly. She sits with her hands folded a minute more. “Ready?” she asks gently.
A smaller groan, a little wimper, and a great, “ahhhhhhhh” follow. Pink, squirmy limbs engulf Rhoda’s petite abdomen. I feel hot tears rise behind my eyes and one escapes before I can whisk it away.
“Birth time?” Ciska looks up at me. Shit. That was my job.
“Uh,” I glance up at the clock, stunned. “18:34.”
The dawn creeps in around the dark curtains and I check my phone. I see the text from my co-midwife from midnight the night before, “Admitting Sasha now, she’s 5 cm/90/-1, hopefully by morning I won’t need you!”
I text back, hopeful for that outcome, but expecting to hear otherwise. My phone buzzes a minute later.
“I haven’t gotten to sit down all night. She was 7 when I checked at 5, getting an epidural soon I think. It was a long night. I’ll need relief. Sorry.”
I lay in bed for a minute longer before breaking the news to my partner. I knew it was a possibility that I could get called in on an “off” day, but my heart feels heavy knowing I will soon be dashing our plans for a very needed escape to the woods. I glance at my watch: 0549. I burrow my way further into warm blankets and warm arms and get pulled in closer, an unconscious reflex. Just a couple more minutes, I tell myself. I want to enjoy this small moment of sweetness before jumping to action.
Quick coffee prep and a clif bar lands me on the road to the hospital. I meet my co-midwife by our lockers. She gives me report and I write, like I always have, everything I need to know on a quartered piece of printer paper. Every labor. Every birth. Every baby, written out on a pocket-sized card.
My co-midwife hands off care, we do quick hellos and goodbyes in Sasha’s room, and I settle in. She’s just gotten an epidural after a long night of a slowly moving labor. My job now is to get everyone to rest. I turn the lights down, turn the music down and slowly retreat out of the room.
We’re making progress after a good long nap, and by mid-afternoon begin pushing. I can feel that this baby just isn’t in a great position. We try side lying, we try the squat bar, we roll to one side then the other. I look up at Sasha’s eyes. She’s there but not there. I see how tired she’s getting. How much farther we have to go. I know we need a change of energy in the room so I step out to take care of myself. For the first time in hours I pee and grab half a stale donut from the nurses’ station. Chug some lukewarm coffee. Update one partner, then the other, “We’re getting there, going to be a while still.” Gentle, warm encouragement is returned to me by both, and I’m buoyed in that hard moment by unseen love and support.
I take several deep breaths and close my eyes while standing in the middle of the break room. I straighten by spine bit by bit, imagining a ribbon pulling it taught at either end. More deep breaths into my diaphragm. Humming as I breathe out each long breath. I bring myself back into the moment and open my eyes slowly. I smile because I realize how much my co-midwife has rubbed off on me with the perfect amount of woo.
I return to the room and pea soup green meconium-stained fluid is now trickling out onto the chux pad under Sasha’s bottom. Both the doula and I are excited, “One big push this contraction, Sasha, I think this baby has rotated,” I say as I turn one small light on. A deep grunt accompanies the end of this push and I can see a quarter inch of head staying visible between contractions. “Yes, yes, that’s it, that’s the push!” I start to pull my table around and reach for gloves.
“You give me three more like that next contraction and we’re going to have a baby,” I glance up at the clock. 17:30. We’ve almost hit the four hour mark of pushing. I feel such relief knowing that we’re truly almost at the end.
I reach for warm compresses and gather my instruments. I’ve done this hundreds, maybe almost a thousand times, but this time is a first. My first catch with the practice I have built from the ground up.
“You can reach down and feel her, she’s right there,” I encourage as we head into our last few contractions.
We have just another moment before more wrinkled scalp pushes its way through. I see a nose pop out followed by a chin. I pause, thinking of the moment, between two worlds, two realities. Being and not-being, mothering and not yet mothering.
My gloved hands grasp little shoulders and bring a fresh babe to waiting arms. There’s gurgled cries, and a quick release to nursery staff.
As I’m leaving, I give Sasha, her husband, and then her doula quick hugs. I have so missed hugging people I have cared for.
“Thank you so much,” Sasha says as I grab my fleece hanging on the coat hook.
“I did the easy part,” I chuckle, my favorite line since I was a student, “but you’re very welcome.”
I walk out to my car, sun still high in the almost-summer sky. I peel the red fleece I wear over my scrubs off, realizing it’s a bit too warm and my endorphins are a bit too high to be wearing several layers. My car starts with a grumble, music picking up exactly where I left it nearly twelve hours ago.
Ten years stands between these births. Ten years of transition from tender, tentative apprentice to confident, calm midwife.
I’m orienting a new grad to our practice now and see the excited glint in her eyes each morning. She’s taking in our world like a sponge, sopping up each little bit, no matter how onerous. I hear each day the new word: “midwife” fresh on her tongue; bright like summer berries.