She came in 3cm dilated, at 5am. By 8am, her cervix had dilated to 8cm. She was progressing quickly. This was her second baby. Imelda broke her bag of waters. Upon doing so, there was thick, dark meconium that flooded the plastic sheeting on the bed. The darkest I have ever seen. This showed us that, perhaps, though she was progressing quickly, her labor had probably started a while before she came in in the early morning. We checked the heart beat of the baby, it was around 120bpm. It seemed slow to me… even more evidence that this little guy needed to move down, and the quicker the better. About an hour later she was complete, 10cm dilated, and ready to push. But witnessing her arrive at 10cm was different. There was something subtler about this labor, her contractions we not that strong, nor were her pains.
She began to push. Her body knew this work, but her pushing was, as her contractions were, subtle. She was tired. Her contractions were showing it. In about five contractions, the head was born. It was big. It was squished. It was a dark purple. This baby had experienced some of meconium… Although we were relieved that the head was born, this is when the birth began to get a bit scary. The contraction that pushed the head out, was the last contraction that this mother had. Her uterus simply stopped. She had no more urge to push, no more pain signaling her to bare down, grit down, to birth the rest of his little purple body.
Her baby was stuck.
The fetal ejection reflex, flooding her with adrenaline, did not kick in. Though she tried to push, she didn’t have the actual physical clamping-down contraction of the uterus that helped to finish the birthing process. A moment of seriousness entered the room. This little purple-headed baby, was stuck, and needed to be born, now.
I watched Imelda perform something I’d never seen before. She began to mimic the contractions, using a raking motion with the pinky-side edge of her hand. As she did this, she told the woman to push. She was manually performing the action of a contraction that the tired uterus that was no longer having. This didn’t seem to work. Anna-Maria lifted the mother’s hips, as Imelda manually worked to expel the rest of the baby’s body, with her hand still simulating the contractions. Anna Maria lifted the mother’s hips, up and down.
After what seemed like a lot of action, and far too long of these unnatural (but necessary) movements, the rest of the baby’s body was born. He was big, and purple, and worst of all, he was completely quiet. We gently picked him up and looked at him, and his purple 7.5 pound body. Using a bulb syringe we began to suction strings and strings of meconium mucus from his throat and nose. Still, he was silent. I remember distinctly, his little left arm, as it hung there, more limp and lifeless than any newborn Id seen before. It hung straight, swinging droopily from his shoulder joint. We began to rub his chest, stimulating his sternum. We performed two-finger compressions on his tiny chest.
It was in this moment that I noticed the profound stillness in the room. Surely, a dropped pin would reverberate like a drum. Everyone, three midwives, myself, the new mother, and the new grandmother, all held our breaths. Fixated on this tiny purple being, watching, not daring to blink, as a pair of blue-gloved hands gently compressed his little chest. Turning him over to pat his back. The silence was broken while three different languages—Mam, Spanish, and English—began to speak to the baby. I heard myself—in English, for in this moment of feat, I had forgotten all of my Spanish—whispering to him, “come on baby, come on baby. Come on baby, breathe for us, come on baby.” These three languages spoke to this new life. We were simply not going to let him go.
After what felt like an eternity of us waiting on our toes, absolutely fixated upon only the moment at hand, this little being began to gurgle. The most exquisite sound of tiny little wet and gurgly inhales filled the room, and filled our hearts. Finally, a cry! This beautiful purple little babe was crying, and his purple color began to shift and fade, very quickly. I have never heard more beautiful music. A sigh of relief calmed my whole being, and exploded over the whole room. Shoulders fell away from ears, jaws were unclenched into wide smiles, and air began to circulate all of our lungs, including the new little pair of lungs that we had just welcomed into the room.
I learned a lot in this birth. It sounds obvious, but I learned, truly and deeply, the importance of contractions and how they move through the body. They are the most important movement to bring the baby into the world. That nothing can help to move the baby like a contraction will. And if they stop because of an exhausted uterus and mother, they must be simulated, as best as possible. I learned the dreadful silence in a room full of women waiting, praying for a new life to hang on. I learned the total bodily and cellular relief that can come with a single sound. I learned the strength of a new, tiny life, being called to stay, even in three different languages.