By Lisa M. Belisle, MD, From the Department of Family Medicine, Maine Medical Center, Portland, Me.
Originally published March 2000, Family Physician, Vol. 32, No. 3

I meet her in the throes of labor. Her eyes are closed tightly against the outer world. Her fingers clutch the hand of a weak-kneed partner and the cool rail of an impartial bed. Her belly is locked in battle with a familiar yet foreign creature. A family practice resident covering for an absent attending, I meet her when she is deep within herself, oblivious to those along for the ride. 

She greets me with a forced smile, sweat beading on her brow. I am one of many who have entered her room. With my blue pj’s, white coat, and plastic “Maine Medical Center” nametag, I am wellmeaning but to her an unknown. 

Her partner acknowledges my presence with a nervous smile. Nate is a first-time father, with decades of gray hair and worry lines ahead of him. His hand is rough, his fingernails clean. A Pennzoil cap is perched on his dark hair. I sense his concern. I know that his life is contained within the muted pink walls of the delivery room. Here is his blue-eyed wife, his high-school sweetheart with his unborn child lurking within. His mind wrestles with thoughts of what could go wrong. The prospect of new life is tightly coupled with the possibility of sudden death. 

Her belly, a tight water balloon perched beneath a flowered cotton sheath, bucks with another contraction. All eyes seek the monitor for comfort. 

“It’s going away. Hang in there, Jen. It’s almost over.” Jennifer breaths frantically, just this side of losing control. Her toes curl as she fights the strange urge to empty her body of everything it holds—baby, bowels, urine. She feels as if she can’t hold back. The contraction eases. 

The nurse hands me a glove, swathed in an overabundance of packaging. She waits patiently as I fumble with the limp fingers, a struggle for dominance over latex, no small contest at 4:27 am. I am grateful for the nurse’s understanding smile. When I am ready, she squeezes sterile petroleum on the glove. I ask, “Should we check?” 

Thirty-eight weeks, three days, and nine hours — a rim of cervix remains, a visor of flesh tightly gripping the small, irregular noggin buried deep inside. Jen involuntarily recoils from my touch as her belly grows hard with another contraction. I page the attending physician to update her on the progress. 

“How much longer?” Nate asks, placing his hand on his wife’s flushed cheek. “It’s so hard to see her this way.” Neil Young sings softly in the background. “Born to live on Sugar Mountain....” Forgotten music. Soon, we tell them, soon. 

In the hall, another nurse walks by. “Room 6 has delivered.” The smell of burned toast sneaks under the door, a consolation breakfast for the working night owl. Sounds of celebration erupt from nearby. 

Several more contractions. Neil Young finishes his serenade. Jen’s ragged breaths cut the silence. She moans and grabs for Nate. “Hold on,” he whispers, “not long now.” 

The attending calls back. She is in another delivery and will be done soon. Then Jen says, “I have to push.” 

We are at the point of no return. Nothing in all of life is as strong as this feeling. Attending or not, this baby is coming. 

The nurse, Cynthia, and I get the room ready. Nate looks pale. Jen lets forth a guttural growl and pulls her legs back. I stand at the sterile altar, an acolyte serving a miraculous god. Cynthia buttons my gown and arranges the flannel blankets in the infant warmer. Behind us, the sun sneaks over the mountains, setting fire to the Portland sky. The autumn leaves glow with light. 

Nate bends near his wife, one arm around her, the other grasping her moist shoulder. He whispers encouragement. She bends forward, her body curled into this massive task. She grabs every contraction, harnessing its energy as she pushes her baby toward the dawn. 

In an instant, a dark knob emerges from the depths of this woman before me. It rapidly becomes a head, then shoulders, and finally a tiny person. A perfect being trailed by a pulsating lifeline. I release him to his mother’s nowsoft belly. His soft snuffling sounds are in harmony with the joyous sobs of his parents, smiling through tears. 

I am congratulating Jen and Nate on baby Benjamin as the attending bursts through the door. She stops short and smiles at the scene before her. Everything is fine. She thanks Cynthia and me for a job well done. 

As I am turning to leave, the window beckons. Sunlight reflects off the windshields of the cars far below. I look out, drinking in the beautiful fall morning. Touching the infant whose birth has pulled me from my slumber, I silently wish him well. I offer him my gratitude for a wonderful ride.