The big push

Andrea started out pushing on her back sometime around 5:45am with only the attending nurse and me in the room. There were a number of things that didn't seem to be clicking for the pushing---the goal was three 10 second pushes per contraction and Andrea was on her back for this stage. She was getting very dizzy with each push and would only get one or two full pushes per contraction. Additionally, her technique was a little off so she wasn't getting the baby far down the tube (it started at -1cm pre-pushing for those in the know). At about 6:45 a couple of things changed: the nurse decided that Andrea should give pushing while on her side a try and our ob/gyn showed up (after the change of position). The nurse had called our physician a little earlier without telling us why, so I had a feeling that something was wrong as the pushing wasn't going anywhere. However, when Andrea went to her side some progress was made so that by the time our ob/gyn walked in the door it looked like the baby really was going to make its way out, easing my fears.

Not long after our physician's arrival, the head made its first appearance (a quick side note: if you would have asked me a few months ago I would have never thought that I would have anything to do with any action taking place south of Andrea's belly button. I don't have a great fondness for some medical procedures, so I figured I would spend all of my time being a cheerleader in the face region. However, not long after Andrea was up on the table, I was peeking down to the action region). The head was a hairy, strange-colored, pea-sized mass that only peaked through for a second during a contraction and then went back into hiding, and without a professional by my side I am not sure I would have identified it as a head. The excitement that the doctor and nurse showed at the appearance of what they said was a head was infectious and their encouragement that the baby would be out in a few minutes was great news. Not long afterward another nurse showed up to relieve the first nurse (somewhere around 7:15 I would guess), and as the first nurse left she told Andrea that with a few good pushes the baby would pop out.

By this time, it is worth noting, Andrea had the art of pushing much more under control. She was not getting dizzy with the pushes and would survive three and sometimes four pushes per contraction---she was really quite amazing. However, progress was very slow. The pea-sized 'head' made its way to black bean, garbanzo bean, kidney bean, and so on over a series of very painful contractions. The new nurse brought with her a very positive and encouraging demeanor and every time the head would climb the bean ladder before returning into hiding I was convinced by her words that the next push would be the last one. This was not to be the case, however, and there would be another set of pushings, another appearance, another disappearance, and another wait for the next contraction. At one point I commented to the doctor that it is kind of surprising the the body, once pushing starts, slows contractions so much from their 2-3 minute spacing during the earlier labor. She let me know that I was crazy and showed me the chart that had the contractions maintaining the same frequency, and I realized how strange this all was where you pass from one part of labor where you dread the contraction giving the feeling that they come too fast to the part where the baby is on its way and you (as observer, not as mother, perhaps) get so excited for each contraction and the possibility of the child popping out that the time between contractions feels like an eternity.

Something that I forgot to mention is that the first nurse mentioned that the baby had a bit of a cone head. That will be an important detail soon. Anyway, the visible part of the baby's head continued to get larger with each push, and though the doctor, the nurse, and I were more excited with each little bit more that showed (and encouragement that the next push was 'the one'), Andrea found it difficult to share in the joy we had as she was paying dearly in pain for each increase in appearing bit of head. Apparently Belinda, Nick, and our friend Luisa (who we didn't know had shown up at the hospital as further support) had a very different impression on the other side of a closed door of what was taking place, as there would be excited countings of ten and encouragement to "push through the pain" that would culminate with a not-so-pleasant yelling or screaming at the end of our counting. I didn't think Andrea was yelling very loudly, but from what I was seeing from my vantage point I thought that every syllable (even the profane ones) was well-deserved.

Somewhere around 8:15 or so I learned that a full term baby's head is not the size of a silver dollar. When our baby's silver dollar-sized head appeared it looked like the completed edges of a full head and when that appeared I was convinced that the one birthing term I knew, "crowning," would be declared and Andrea could rest, her work done. No, a baby's head is not the size of a silver dollar. The coned head that was mentioned earlier was all I was seeing and the blood, etc. that covered this bit of head shadowed it in a way that could convince those that think that a baby head is the size of a silver dollar that the end has been reached---especially when that someone can hear the agony that his wife is going through and wishes dearly that a baby's head is indeed that small.

Andrea continued to push with each push more painful than the last. The doctor applied copious amounts of mineral oil to the baby's head to ease its exit and real progress was being made. A change happened in the doctor at around 8:30---she had been massaging Andrea's perineum and adding oil, and without saying that things were actually really progressing (they had said it could be the "next push" for at least an hour now) she started putting on the full-protection outfit with booties, gown, plastic sheet for the bed, etc. The end of the table had a special fall-away section that I didn't know about which allowed the doctor in her space suit to get up very close to the action and she made that adjustment. She really believed that things were progressing apparently and at 8:49 the baby's full head (larger than a silver dollar) appeared, the doctor had Andrea slow her pushing, and in what I am confident was less than two seconds the entire baby was out. Our doctor held it up and said "here is what you got" knowing that we didn't know the gender and at once we could see that we had a new little boy.