My one hope is that they don’t just focus on birth in the developed world (although, granted, we’re desperately in need of a birth revolution here in the developed world), but also tackle some of the ongoing issues in the developing world, too.  I can’t wait to see what comes next out of this! Viva la revolucion!

One of the women from this group was also willing to share her birth story here on Belly Tales, so with her permission I am going to post it. Her name is Katie, and she gave birth to a beautiful son, Sebastian, at home in a birthtub.  This is their birth story, written by Katie:

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I had a lot of nervousness going into my third birth. Mostly I was nervous about the length of labor, tearing, shoulder dystocia and some other things. My second birth was my first home birth, and it was great; however, there were a few complications, all of which were handled marvelously by my midwives. At a blessingway that my friends threw for me, I was asked to tell about my ideal birth, so I did. I was nervous to say things like” it was short,” or “I didn’t tear.” I did, though, and I just hoped it would turn out that way.

Both of my boys were born after their due dates, so I was sure I had 40 weeks before I would have my baby. I worked hard to get all of my writing done so that I could relax for a week before the baby came.

On Monday morning, May 9, when my husband Michael’s alarm clock went off, I told him I’d been having some regular contractions for a bit, and since I’d been having contractions on and off for a couple of weeks now, he reminded me that they were probably just Braxton Hicks warm-up contractions. I agreed. After a while, I got up and went to the bathroom. I noticed, though, that I had lost my mucus plus, so I knew that these contractions were different.

I kept about with my morning plans, though. I went to eat breakfast with a friend, and on the way, I called my midwife to let her know that I thought maybe I was in early labor. After breakfast, I was going to go to the YMCA to walk to the track and help move things along, but since my midwife was in the area, she decided to come over and see how things were progressing. She checked me around 11 a.m. and said that I was almost four centimeters dilated. I was shocked. My contractions were about four minutes apart, and they weren’t even that painful. She told me to try to take a nap that afternoon. She also told me that she had another mom in labor, which made my heart sink. That mom was also about four centimeters dilated as well.

After she left, I decided to take Atticus to lunch on his way to preschool. He enjoyed that, and when I dropped him off, I told his classroom assistant that I would likely have the baby later tonight, as I was four centimeters. She looked at me in complete shock, like, “Why are you driving and walking around right now?” It cracked me up.

When I got home, I did lie down, and I tried to sleep, but my excitement was too overwhelming. I knew I needed to conserve energy at that point, so I just grabbed my laptop and watched some TV shows on Hulu to keep me distracted. I watched the most recent episodes of “The Office,” “30 Rock” and “Parks and Recreation,” in that order. By the time I got to the last TV show, I had to pause the show during a contraction, get on all fours and rock through the contraction. It was becoming more intense. Atticus came home from school, and he watched me labor for a bit. He asked a lot of questions.

I called my midwife and told her she needed to come again. She got there around 5 p.m., and checked me again. I was only at a 4 ½! I was sure I was further along as the contractions at this point felt more intense. I was discouraged and thought that I was in for a repeat of August’s slow labor. Plus, her other mom in labor was at six centimeters, and I felt so nervous that I wouldn’t get to have my midwife at my birth.

My midwife’s assistant arrived around 5:30 or 6, and she and Robyn, my midwife, went outside to discuss what they would do. When they came back, she said that she was going to stay with me and send her assistant to the other mom. She also called my friend and midwife, Mary, to stay with us and be with me when and if Robyn needed to go to the other mom.

During this time, Michael started filling the birth pool, so when that was done I got in it. The water was definitely not hot enough for me, so he started boiling pans on the stove to fill it with hotter water.

During this time, my contractions stayed three to four minutes apart, but I needed a lot of help getting through them. I had to hold someone’s hand through each one. I would either blow my lips out like a horse through the entire contraction, chant things like, “I am strong,” “I am bigger than this” or “it’s ok” over and over again. I tried some of the same visualizations I used for August’s birth, but they didn’t work for this one, so I made new ones. I also told myself that I could do anything for a minute. I stayed in the pool for a couple of hours, just working through the contractions like this and thinking I had a very long way to go.

At one point, my midwife told me that she thought I was a lot further on. So, when Mary arrived around 8:30ish, she wanted to check me again, because she thought the baby would be born very soon. I was shocked to hear that. When Mary arrived, she checked me, and I was dilated to an 8 or 9 with a bulging bag of water. I could not believe it. I was sure I was going to be laboring all night. How in the world could I be that far along? I felt like even though my contractions were very painful, they weren’t even that close together yet.

We decided to break my water, and as soon as that happened, I felt tons of pressure, and knew that it was very close. My midwife helped stretch my cervix through two or three contractions, which, of course, was painful, but I knew it meant the end. That was about 8:45. Atticus and my mom joined the rest of us in the bedroom. I liked that Atticus was there. He just stood next to Michael and watched everything.

I couldn’t believe how quickly I felt the need to push. He was right there, and I could tell. During my next contraction, I started pushing his head out, and it really hurt. I kept saying that it hurt. I said I couldn’t push anymore. So, the midwives said it was ok to just breathe and pant a bit, which I did. It still hurt, but at that point, that felt better than pushing. I still could feel him moving down, though.

It was intense, and at one point, I saw Atticus run away, and that made me sad, but I knew it was probably best at that point. While he was crowing, the midwives remarked on his black hair, so I put my hand down and felt it. I could not believe that that was my baby’s head and that I would meet him soon. That made me want to push harder.

Throughout my pregnancy, I had expressed to my midwife how I didn’t want to tear as much as I did last time. While I was pushing, she was using oils to help me stretch and putting a lot of pressure on my perineum. While it was happening, though, I was sure I was tearing, because it was so intense and painful.

After his head was out, the midwife checked for cord, and then I start pushing the rest out. It felt like it took a while to come out, but now, when I look at the pictures, I see that it was less than a minute. As soon as he was out, I grabbed and just loved on him. I was so relieved it was over, but I was also so happy to be holding him. And I just couldn’t stop staring at his hair! There was so much of it! He also looked so small, as August was almost nine pounds, and this baby looked teeny-tiny compared to that. I kept hugging him, and the other people in the room reminded me to check to see is he was a boy or girl.

I knew he was a boy as soon as I saw him, and my suspicions were confirmed as soon as I looked. I had wanted a girl, admittedly, but when I saw him, I didn’t care one bit that he was a boy, and I thought about how great it would be to have three little boys, and how cute they all would be together.

I got to stay in the tub for a few minutes. I was still crampy, and I tried to push the placenta out, but it wasn’t coming yet, so I decided to get out of the pool. I didn’t want to cut the cord yet, so Michael helped me stand up, and my midwife held the baby close to me so that he could stay attached for a bit longer.

I tried to nurse him to help the placenta detach, but he was so quiet and just not really interested. I gave a few good pushes, though, and it finally came out. After some inspection, my midwife said she didn’t think that I would need stitches. I was in complete and utter shock. I was also thrilled.

My midwife had been in contact with her assistant who was with the other laboring mom, so she had to leave to be with her, which was fine with me. I was just so thrilled that she had been able to be at my birth. After she left, Mary helped me get cleaned up and settled in bed.

The next day we named our boy Sebastian Michael. He weighed 8 lbs, one ounce and was 20 ¼ inches long.

I still can’t believe that everything I wanted for my birth came true: no tearing, no shoulder dystocia/easy passage and relatively short(er) labor. I feel quiet lucky.

It’s funny to be writing this.  I have heard and listened to so many women share their birth stories with me, posted birth stories here on my blog, attended births and helped women write their birth stories, but now I come to a first for me: the writing of my own birth story.  I think there’s something really important about writing your birth story down, for so many reasons.  First, it helps you process something which is almost too big to process, too mysterious and transformational and ephemeral; writing it down helps capture it in a way that can be recalled.  It turns it into a story, something which can be retold and remembered, something which can be shared with others, something which can take on mythic qualities the more you share it.  It can offer guidance or inspiration (if it’s a positive story) or confirm fears and doubts (if it’s a negative story); it becomes part of the framework that women use to understand birth, and I believe that the sharing and retelling of these stories if vital for women, and a very important part of the postpartum healing process.

So, without further adieu…

Labor for me started on Saturday May 14th.  I was 39 weeks and 2 days pregnant, and was very ready to give birth.  I had stopped working at 38 weeks, and had spent the last week finishing up the few small things on my to-do list, but mostly I spent it resting and reading my novel, getting a last pre-birth pedicure, catching up with friends, and waiting, waiting, waiting.  Wondering when it was going to start, when I would go into labor, what labor would be like, how long or short or awful or ecstatic it would be…

Even so, 25 weeks is extremely premature, right on the cusp of viability.  She was moved to L&D this morning because she had begun to contract regularly again, and was feeling increased pressure.  We were able to hold her off for most of the day, but one of the doctors did a sterile speculum exam towards evening in order to visually assess the cervix (vaginal exams are avoided as much as possible when a woman has broken her water, since they tend to increase the risk of infection), and all the doctor saw was a head of hair, without any cervix covering it at all.  A vaginal exam afterwards quickly confirmed what she had suspected: the patient was nearly fully dilated, and the first twin had moved far down into the pelvis, to nearly +1 station.  Initially we thought she might need a cesarean, but a sonogram quickly confirmed the first twin was vertex (obviously…this was the twin that was presenting) and that the second twin was very nearly vertex (more transverse, but with the head still sloping downward).  After consulting with the MFM and attending pediatricians, the decision was made to attempt a vaginal delivery, since one of the risks of extreme prematurity is cerebral hemorrhage in the fetus, and pushing a tiny, head-first twin back up through the bony pelvis in order to deliver through the abdomen was sure to cause more damage, rather than less.  Nevertheless, she was taken to the OR for the delivery just in case a cesarean was needed after all.

All hands were on deck, and the OR was packed.  The attending OB physician was there, the back-up attending was also there, and I was there. We were the delivery team.  Two attending pediatricians, 3 pediatrician residents, and 2 neonatal nurses were also there, divided into two groups–one for each tiny twin.  We had two warmers ready for the twins, two isolettes, two laryngoscopes, two sets of everything.  The anesthesiologist was present and on standby in case we needed to put the patient under general anesthesia for an emergency cesarean.  There were also 3 L&D nurses on hand; one scrubbed and ready to assist in a stat cesarean, and the other two as runners/ circulating nurses.  And a medical student, who was observing (with the patient’s permission)–and holding her hand, and feeding her ice chips.

She was nervous, naturally.  This was her first pregnancy, she’d never pushed before, and she still wasn’t feeling the contractions very strongly (one of the hallmarks of preterm contractions is that they tend to be painless).  We set the sonogram machine next to the patient, and the back-up attending used it throughout the birth to help assess the position of the second twin (twin B), as well as the fetal hearts of both twins throughout the pushing.  We gave her reassurance, helped hold her legs, got her into a good position, and then asked her to push.  Amazingly (well, not really, given how small these babies are, and how low in the pelvis the first twin already was), it took only a few strong pushes before the tiny little head was starting to crown in the vagina.  Before we knew it, the first tiny twin was out, a red little girl weighing only 1 lb 6 oz.  I helped deliver the head and quickly clamped and cut the cord; the attending OB handed the tiny baby to the waiting peds team, and they instantly got to work, intubating and ventilating her tiny little lungs.  She never cried, but she was nice and pink, and waving her little arms and legs around.  Within minutes she was intubated and stabilized, and the team quickly moved her to the NICU.  Meanwhile, we were concentrating on twin B.

The back-up physician was applying steady fundal pressure on the uterus, helping to hold twin B in a vertex position and guide her into the pelvis.  After a few more contractions, the uterus began to close around twin B and push her down into the pelvis.  Once she was engaged, the OB attending broke the second amniotic sac, and we asked the mom to begin to push again, which she did with renewed energy (having gotten a brief rest after the delivery of twin A).  About 10 minutes later, twin B was also crowning, and again, we quickly delivered the baby, clamped and cut the cord, and handed the twin to the second peds team.  She as another tiny little girl, this time 1 lb 8 oz, and again, doing as well as could possibly be hoped for at only 25 weeks gestation.  Once she as stable, she too was moved to the NICU, and the OR began to clear out a bit.

It’s quite an amazing sight, to see two umbilical cords presenting.  We waited for awhile, and slowly the cords began to lengthen as the placenta separated from the uterus.  About 15 minutes after the delivery of Twin B the placenta came out–much larger than a singleton placenta, with two cords and two separate amniotic sacs (di-chorionic/ di-amniotic).  Once the placenta was out, we all breathed a sigh of relief.  A quick exam showed that the woman was intact (not surprising, given how tiny the babies were).  We cleaned her up, took out the foley catheter we had put in just in case she needed a cesarean, and transferred her to the recovery room, where her family was waiting. And there you have it: a remarkably straightforward vaginal twin delivery at 25 weeks gestation.  Not exactly something your average midwife gets to see everyday, but certainly something I felt very lucky to have been able to experience.

This is from Brownstoner, via NewYorkShitty.  Found in McCarren Park, Williamsburg, NY.  Totally cracks me up!

There were two deliveries. One was a grand multip (G6P5005) who came in 9 centimeters dilated with a bulging bag of waters. The other midwife ruptured her membranes at 3:40 am and she delivered at 3:41 am. I love deliveries like that! It’s always amazing to me how QUICKLY a baby can actually exit the human body, when all the conditions are right. It’s as if they’re on a greased slide, and they just whizz on out. If only all births were so quick and easy.

The woman I delivered was 16 years old, having her first baby. She was newly immigrated, and the father of the baby was back in Santo Domingo. She had her mother and grandmother with her, though, and they were a tremendous support team for her as the contractions were picking up, fanning her face and feeding her ice chips. She progressed remarkably fast for a first baby. We forget, sometimes, that teenager’s bodies are meant to give birth, and probably more so at this age than at any other time in their lives. Even though they might not be emotionally ready, their bodies are, and they often open up through labor as if it were the easiest and most natural thing in the world. This girl was having a labor like that.

When I came on at the start of the night she was 4 centimeters dilated and in a lot of pain. We discussed her pain options, but she didn’t think she needed anything just yet, and carried on with the support from her family. Two hours later, she was ready for something for the pain, and was thinking that she wanted an epidural. However, when I checked her, she was a whopping 8 centimeters dilated, and the head had moved down to zero station. I told her she was a superstar, she was doing amazing work and the birth would be really, really soon. I told her that she could have an epidural if she really wanted one, but that by the time she got it she would probably be fully dilated and ready to push, and that an epidural would just slow down the birth in the long run. She didn’t believe me (I can’t really blame her….the contractions were pretty intense at this point), but her mother and grandmother exchanged a look, and both of them rolled up their sleeves. We coaxed her into a sitting position, and her grandmother went behind her, rubbing her back, while her mother continued to fan her face. Less than half an hour later, she was fully dilated (there is a Russian doctor at our hospital who likes to call this moment “fully delighted”), and was pushing beautifully.

The baby came down quickly and was delivered 11 minutes after she was fully: a beautiful little girl with a really tight nuchal cord which had to ultimately be clamped and cut in order to allow for the birth, and a compound right hand that extended as the baby delivered and unfortunately tore the girl’s left labia, leaving a tender, open gash. The pediatricians were there to check on the baby due to the moderate meconium which had been in her amniotic fluid, but the tracing had been overall reassuring (we’re calling this Category II now…has anyone else moved onto the new NICHD guidelines? Our hospital has finally made the switch officially, despite the fact that these guidelines have been around and endorsed by nearly everyone [ACOG, AMA, ACNM etc. etc.] since 1997, but I must admit, I’m still finding it a bit strange) and the baby came out vigorous and screaming, waving her little pink arms around. An altogether beautiful and uneventful labor and birth, which took less than 5 hours in total. You couldn’t have asked for a nicer first birth than that.

The eventful part came next, unfortunately. Everything was looking good. I was checking her perineum (intact! the only tear was the labial laceration) and waiting for the placenta when there was suddenly a pretty forceful gush of blood. I figured it was a sign that the placenta was starting to seperate, so I gave a gentle tug on the cord, and the placenta quickly began to descend. Instead of coming out with the shiny, fetal-side showing first (Shultz presentation) it came out maternal-side first (Duncan presentation) and I immediately noticed that the membranes had been completely sheared off on one side. There was a thick tendril of trailing membranes which were still firmly attached somewhere up in the uterus, and were taut and unmoving when I tried to gently tease them out by spinning the placenta a bit. Rather than tearing the membranes and losing them, I cut the placenta away and put a ring forceps on the trailing end of the membranes, so that at least we had them. I quickly inspected the placenta and saw that there were hardly any membranes present, only the cotelydons of the placenta, and the cord. Which meant that most of her membranes were still inside, either retained or trailing, I wasn’t sure which yet. And all the while she was gushing blood.

We moved pretty quickly. I called the attending doctor, we asked the family to step out a moment, and started the IV pitocin running. I gave fundal massage and felt absolutely no fundus! I couldn’t find it anywhere (later on, the attending pointed out that that is exactly what an atonic uterus feels like…as if there’s nothing there). The attending began to remove the rest of the membranes by traction, gently teasing and working them down. We administered methergine, then hemabate, and finally 1000 mcg of cytotec rectally. We started a second IV line and used a catheter to help quickly drain her bladder. I was doing firm fundal massage all this time, and finally, after what seemed like quite some time, but was really about 8 minutes, I began to feel a hard, firm fundus balling up under my hand, and the bleeding had slowed down to a trickle. The doctor had managed to extract what looked like the rest of the membranes, and his sonogram later confirmed that the uterus was empty. And then, just as quickly as it had started, the bleeding stopped. The total loss was estimated to be between 800 – 1000 cc. But once the trailing membranes were finally out, and the fundus was finally firm, she was absolutely fine. I repaired the labial laceration, cleaned her up, and helped her breastfeed her beautiful girl.

Her hemoglobin and hematocrit dropped pretty precitously when we checked her CBC four hours later, but it was still in the range of normal (10.0/ 30%), so in the end she didn’t need any kind of blood transfusion. In fact, I’m still kind of astounded by the entire thing. It’s as if a huge emergency had been averted, and yet, at the same time, it felt really routine. We drill our hemorrhage protocol pretty regularly on our unit. It was really nice to see that when push came to shove, we were able to go down the steps of the protocol one by one, and amazingly (or perhaps not), they worked just the way they were supposed to, and lo and behold, the bleeding stopped! Nobody panicked, the nurses were prepared, the doctor was calm. Everyone knew what they were supposed to do, and we just did it.

Afterwards I was waiting for the shaky post-adrenaline terror feeling that often comes after emergencies, but it never came. It made me think about how far I’ve come in my first year as a new midwife. A year ago, this would have probably left me crying or near tears, shaking in the chart room, totally freaked out. Instead, I finished the paperwork, checked her bleeding again (it was fine) and carried on with the rest of the non-stop night. I guess this is what midwives do. They don’t panick, and they stop the bleeding, and that’s that. It was just a hemorrhage kind of night.

We were all expecting a big baby. Her estimated fetal weight from Leopold’s palpation was judged to be approximately 4500 gms. The baby felt huge: fat and happy, and we were all duly nervous, because her first baby was only 7.5 pounds. She wasn’t a large woman, either, but her pelvis felt incredibly roomy, so we were proceeding very carefully, watching closely, wondering if things would progress.

She had an epidural, but even with the epidural, everything was hurting her: her back, her legs, her vagina. With the assistance of her partner, we kept turning her side to side, sitting her up and lying her back down, trying to alleviate some of the pain through what limited position change is available when someone has an epidural. She had cold packs on her forehead and sacral massage. Even so, it wasn’t helping much. She began to feel a lot of rectal pressure and wanted to start to push, but she still had a small lip of cervix in front of the baby’s head, so we breathed with her through her contractions and tried to keep her from pushing. She was really unhappy with us at this point; who wants to breathe when they feel like pushing?? It’s the hardest thing in the world, and she really struggled with it.

The thing is, even though her cervix felt nice and soft, and we could possibly reduce the small lip of cervix in front of the baby’s head, we didn’t want to. With large babies, there’s a lot of danger involved in reducing an anterior lip and bringing someone to fully dilated when maybe they’re not supposed to be. Sometimes there’s a reason for a woman with a large baby not making it to fully dilated. Sometimes it’s a message to you that the baby is actually too large, and it’s a warning that should be heeded. So we let her body work on its own, without forcing it, and eventually, after over an hour of being at anterior lip, the last remaining, stubborn piece of her cervix finally disappeared.

Our concern, of course, was shoulder dystocia, which is without a doubt one of the most dangerous of all obstetric emergencies. With shoulder dystocia the head is delivered but the shoulders get stuck, and you have only minutes to get the baby out before he or she begins to rapidly decompensate on account of the severe cord compression that occurs. There’s a whole list of maneuvers that you’re supposed to work your way through: first you pull the legs back, which helps to widen the pelvic outlet, and then you apply suprapubic pressure, which helps to pop the baby’s shoulder under the pubic arch and get the baby out. If that doesn’t work, you move on to other maneuvers, like Wood’s Screw or the Gaskin Maneuver (named after our favorite midwife, Ina May). You reach your hand in and try to delivery the posterior arm. Even though it’s not the perineum that’s the problem, but actually the bones of the pelvis, an episiotomy is often cut in order to ensure that there’s enough room to get your hands in to maneuver (and in our sick society, if a lawsuit is ever being brought to court on account of a shoulder dystocia, apparently if you haven’t cut an episiotmy, it’s a huge strike against you, since cutting is part of the “standard of care”. I’m not sure that I agree with that, but on the other hand, in such emergencies, you do what you have to do). You empty the woman’s bladder. You pray. You try the maneuvers again if they didn’t work the first time. The clock ticks so slowly, so that miliseconds seem like eons and all you can do is stare at this stuck baby with a face that’s slowly turning more and more purple. Sometimes nothing works. Sometimes you need to break the baby’s collarbone or humerus in order to get the shoulder out. I’ve never had a true shoulder dystocia yet in my short career as a midiwife, but I’ve seen a terrible shoulder dystocia in my work as a nurse, and I’ve heard the stories. It’s no joke. It’s one of the scariest things you’ll ever have to deal with in this profession.

So we were nervous, and rightly so. But she was making slow progress, on her own. She began to push once she was fully dilated, but she was tired, and her effort wasn’t great. She lost her fighting spirit, and began to cry, asking for a cesarean, telling us that she couldn’t push any more, telling us she wanted to die. This is all pretty normal stuff for the pushing phase, at least among the women we take care of at our hospital, but it only served to make us even more nervous. The four P’s of labor are the Powers (contractions), the Pelvis, the Passenger (baby) and the Psyche. If any one of those P’s are missing, you’re in trouble, and staring at this huge baby waiting to be born with a mother who’s psyche wasn’t in the best place was very, very worry-making. There comes a point in the labor as the baby’s head is just beginning to peek into view when you can really get a sense of just how big the baby is. You can put a finger on the baby’s crown and then palpate the baby’s rump through the woman’s uterus, and get a true measure with your hands for the first time, and let me tell you….this baby was HUGE.

But she was making progress. Slow progress, but progress. The baby’s head began to come into view during pushes, then would tuck back in again in between contractions. This is called Turtling, and it’s a sign of impending shoulder dystocia, and when we saw this, we really began to wonder what in the world we were doing by encouraging this woman to push. Slowly, though, it became clear that the baby was moving down, and was starting to stay down, even in between contractions. We could still get our fingers in, and could still feel lots of room in the sides and the back of her pelvis, and little by little, she kept pushing the baby down. Soon enough (well, after over an hour of pushing), she began to crown.

I was catching the baby, and was gowned and gloved and ready, running through the shoulder dystocia maneuvers in my mind. The doctor was standing next to me, also gowned and gloved. We had the pediatricians in the room, waiting. The back up doctor was also in the room, plus another midwife and 3 nurses. We had a stool ready, in case someone needed to stand on it to apply suprapubic pressure. We had broken the bed so there was plenty of room to get in close to her perineum, if need be (of all my births so far, I’ve broken the bed on only two deliveries, just to give you an idea). And there we all were, waiting, sweating, watching and waiting.

The head emerged, and it was huge and fat, with these chubby cheeks and tons of hair. I didn’t cut, but instead gave perineal support and pulled the perineum down around the baby’s face as he crowned. And there he was, in all his glory. It looked like she had the head of a young toddler between her legs, that’s how big he was. I don’t know about the rest of the staff, but my heart dropped into my feet when I saw that head. Surely this was going to be a shoulder dystocia. Surely we were all in a lot of trouble.

I let the head restitute on its own without rushing it. The baby slowly turned into ROT, and I thought: well, might at least try to deliver the shoulders, just to see what happens. So I gently applied downward traction, little more, little more…and then, all of a sudden, there was the anterior shoulder!! Just like that. Just like a totally normal delivery. As soon as I saw the top of the anterior shoulder, I applied upward traction to delivery the posterior shoulder, and the shoulders were out. Getting the actual baby out required hooking a finger under each armpit and actually gently tugging the baby free, because this definitely wasn’t one of those births where the baby was just going to slide out. But the baby came quickly and easily, with hardly a pause between the delivery of the head and the delivery of the rest of the baby. He began to howl, wiggling both his arms and fingers (a good sign, indicating that there was no erb’s palsy going on), and we put the baby onto the mother’s stomach, and everyone just sort of stared in amazement.

He was enormous!! Guess how big….just guess. Much bigger than 4500 gms. He was actually 5150 gms. 11 pounds 5 ounces. The biggest baby I have ever delivered, and one of the biggest babies I have ever seen.

Delivered in a hospital, by a midwife, without the slightest whiff of shoulder dystocia. Oh, and one of the best parts: she didn’t tear, at all. Her perineum was intact. There was one nick which was bleeding, which required one stitch, and that was it. That was it!! Such a miraculous, miraculous birth.