It is so hot, the air is like a blanket over the house, this town, this lush green valley. The fan whirs dully and the lurid, waxy dreams cling to me like sticky cobwebs as my mind tries to surface from sleep. My limbs are heavy and damp, there are hot animal bodies pressed into me as I fight to open my eyes against the effects of the sleeping pills that blur the shift from night to day. It feels like giving up, admitting to my doctor that I can't sleep, that the sounds of fetal heartbeats, bump....bump.....bump-ing along at sixty beats per minute, half the rate it should be, that this is the soundtrack of my nightmares, playing on repeat over a looping reel of blue, slick, flopping babies pulled from bodies, silent.
She listens calmly, makes a case for therapy and hands me a prescription for Ambien, which I fill, defeated but exhausted.
* * *
She'd just gone to the bathroom and as she climbed back into bed, the anesthesiologist was on his way, she wanted an epidural for this fourth baby's labor which was speeding along and leaving her breathless in its wake.
The nurse moved the fetal monitor all over her belly, her eyes found mine and time started its elastic stretching and pulling.
Seconds that lasted hours of silence and then occasional beats heard, way, way too slow.
She's on her hands and knees now, head into the bed, the oxygen is cranking at 10L a minute, I hear the angry hiss and I feel like I'm floating as I hear my voice ask for gloves, I apologize as I fit my whole hand inside her, feeling for a cord and all I can feel is the baby, her cervix, fluid.
Call the team, page the OB, open the OR, I hear my voice saying and there are four nurses now, we're wheeling the patient down the hall, she's on her back now, I pull her gown over her belly and feel silly for caring that the construction workers don't see her exposed because it will be the last thing she cares about if her baby is dead.
Her eyes find mine and I tell her calmly that she needs to keep taking deep breaths and that she's being very cooperative and I'm so sorry that this is happening but that her baby is telling us he needs to be born this very moment and so that is what we're going to do.
I scrub for half the suggested time, the OB is here, her eyes are piercing as she checks the patient and the scrub tech dumps an operating kit onto the table with a crashing clang, someone slops half a bottle of iodine on her belly and it splashes the floor and stains dark brown. She's fully now, the OB says and makes a split second decision and I'm holding her legs back, I put my arm under her head and say, Now, you need to push like you've never pushed before.
Deep breath in, that's right, chin to your chest, push with everything you've got.
That's right, again, big breath in, no you're not contracting, we can't wait for the contractions, you've just got to push.
They're putting a vacuum on the baby's head to help you, come on, one more time, yes you can do this, I know you can.
Big breath in again, and now, GO, PUSH, NOW.
The baby takes a few tentative breaths and whimpers. I hold her hand and tell her calmly and quietly, Can you hear that? That's your baby starting to cry. The pediatrician is making sure he's okay. You need a few stitches, so the doctor is going to give you some numbing medicine first. That's right, deep breaths, it's over now, you did it. You did such a good job.
She looks up at me and the tears start in both eyes, running backwards into her ears on the operating table, she tells me with her words in a rush, I am so glad you were here.
I hug her, hard, her sister weeps into my shoulder and all I can think but would never say is, I want to be anywhere but here.
* * *
It's not entirely true, of course.
I love being a midwife. Most of the time.
But I wait, every time, for the time it doesn't end like this.
DISCLAIMER: whenever I tell work stories here, they are conglomerations of multiple patients and I change details such that the actual stories no longer resemble any one patient's individual story. Yeah, HIPAA.