The first birth experience
Try to get involved, but step away from the patient if you feel like fainting. Check in with the patient often, but give them some space to rest. Review the stages of labour, but remember that each labour process will look different.
These were amongst the many pieces of seemingly paradoxical advice that I received as a medical learner heading to my first day on labour and delivery. I had never seen someone go through labour, nor had I ever witnessed a delivery. I had so many questions, and yet somehow, there seemed to be even more answers from family members and clinical teachers, who had gone through this process themselves, helped patients through labour, or in many cases, both.
I remember meeting our patient when I first arrived for my shift. She had been having contractions for the last eight hours, and this was her first pregnancy. When I introduced myself, I could see nervousness and excitement in her eyes; I wondered if she could see a reflection of those emotions in mine.
She asked, “Any advice as someone who sees this all the time?” I paused, thinking through the plethora of advice that I’d received and the studying that I had done before answering honestly. “This is my first delivery actually.” She laughed and replied, “Me too.” We bonded over this shared first experience, sharing we had heard of loved ones’ birth stories. She told me that in her prenatal class, they had explained techniques for pushing—curling the body, bearing down, and controlling the breath. She said she was worried about not doing this correctly, and I reassured her that we would be there throughout the process coaching her. I felt grateful to be able to dispel some common misconceptions and provide reassurance during this daunting and novel experience.
We continued to check in every few hours. She grew increasingly weary, and I could understand the advice that I had received about encouraging rest where possible. When her cervix was fully dilated, we coached her through pushing. Her nurse started to talk to her about some of the advice she’d received in her prenatal class, and I felt the patient look at me appreciatively. Her pain was so clearly conveyed in her expression, posture and voice, and yet, she continued to push every time prompted. I joined the counting as she pushed, “1… 2… 3…” The obstetrician was a fountain of comforting words and constructive feedback, “You’re doing so well. Yes, that’s the push!” The patient adapted pushing based on the feedback, and I remember thinking that I had never witnessed such physical and emotional resilience.
When the baby’s head started to emerge, we guided the patient’s hand to feel the top of her baby’s head. This seemed to renew the patient’s strength, and her next push brought the baby’s head out of her body. My mind jumped between academic learning about cardinal movements in labour to the simple realization that a new human being was about to enter the world. Hand-over-hand, the obstetrician and I delivered the child. The baby was small, wrinkly, and covered in fluid. Tears began to roll down the new parents’ faces, and I could feel them welling up in mine as well. The nurse dried him off with a towel, “Congratulations!” The baby’s cry filled the room, and I let out a breath that I did not know I was holding. The atmosphere in the room shifted from focussed and intense to relief and joy.
The doctor clamped the umbilical cord, and the father brought a shaky hand with scissors to it. There was something moving about watching the physical connection between mother and baby be cut, while at the same time, a strong emotional connection was formed. The doctor smiled at me under her mask. As the parents admired their child, the doctor and I delivered the placenta and repaired her tear.
The parents couldn’t seem to take their eyes off their newborn, and the joy in the room was palpable. The mother said softly to her child, “I can’t believe you’re finally here!” I felt overwhelmingly grateful to be a part of this milestone moment as they started their lives as a family of three. Everyone in the room felt connected, and I knew I would remember this shared first birth experience for the rest of my career.