That's more like it...

I almost cried during a birth today - which I haven't done in a long time. It wasn't actually during the birth itself, but during the labor.

The patient was a young woman, in labor with her first baby, and accompanied by her boyfriend and her boyfriends family (mom, and two sisters). Her family was - well, we didn't know - the mom-in-almost-law gave the universal sign for "I have no idea - and don't ask..." with a shrug of her shoulders, a shake of her head, and a gentle roll of her eyes. She had dilated rather quickly, but things had slowed way down while pushing. She had been pushing for almost three hours - which- by any standards, especially my new medical institution, is a rather long time. We didn't think the baby was very big, the position seemed fine, and she was pushing with strength. Her family-in-almost-law was lovely and doting, and things should have been moving more quickly than they were. The docs were knocking on the door - both literally and figuratively - wanting to know what was going on - and starting to use the evil c-word when talking about the plan.

I was at a loss for what to do - we had changed positions, and used all the tricks up my fledgling sleeves. However, the midwife whom I'm shadowing today was almost eerily tuned into the woman's feelings. After a long hard push, the patient started weeping. Not a frantic 'this hurts like hell' feeling - but a deep, mournful cry or sadness. The midwife put her face close to the patients and stroked her hair. "I know this is hard," she said. "You want your own mom to be here with you. His family is wonderful - but you want your own mama now." The laboring woman's tears increased, and we encouraged her to cry as she needed to. She held her boyfriend's head, and cried, and grabbed the hand of her future mother-in-law - and cried. And they cried. And that's when I almost cried.

Voila. In about 30 minutes, she pushed out a screaming baby boy. It wasn't a shoulder or a body part dystocia. It was emotional dystocia. And she let it out. And it worked.