Delivery at sign-out

I was signing out to the night team and minutes away from going home, when suddenly a nurse called saying one of our patients was about to push. As I ran to the other side of the floor, I grumbled— knowing I wasn’t going home for a few more hours.
It was a hectic delivery— a lot of yelling, a lot of cords, a lot of hands and fluids flying— we lost fetal heart tones for a hot minute so we decided to push through.
Even with the head at the perineum I was thinking about the papers I had to fill out, the sign-out I needed to now update, and the traffic home. Here’s head! Crowning now— the ears and face— restitution! My hands pull down, my hands pull up— the body slips in front of me like sushi on a plate— A girl! I rub her dry, her limbs move, then finally, a cry.
As I was cleaning up, I peeked at mom holding baby. It was then when I knew I was gone—
When a mother’s eyes lock on to her baby for the first time, the universe expands. Then it contracts until there is no one in existence except parent and child. The doctors, the nurses, the med students— they all disappear— what matters are little hands, little feet, mother’s voice, and mother’s warmth. The whole of creation under a spotlight— from the face of the deep emerges a mom and a baby curling into the life between them.
I drove home, sleepy and dull, surrounded by the sound of summer cicadas— surrounded by a universe of fading and emerging.


  1. For interpreting fetal heart tones – A category I tracing has a normal baseline rate, moderate variability, and are absent of late or variable decelerations; Cat I tracings may have early decelerations
  2. The 7 cardinal movements of labor
  3. A vigorous baby – defined as normal respiratory effort, normal muscle tone, and heart rate >100
  4. APGAR scores – help us determine if resuscitation is needed; a 1-minute APGAR does not predict an infant’s outcome, a 5-minute APGAR of ≤5 in some studies show correlation to morbidity and adverse neurological outcome, but according to the AAP and ACOG are not precise enough to be predictive
  5. Contractions – they come and go; if cervical change is made, you are in labor; if not, you’re going home
  6. Genesis 1: 2

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