Where on earth is the head?

When I was 37 weeks pregnant with my second child, we moved one block up the street. The day we moved, my husband flew to London on business. This, my friends, is the formula for induction of labour.

I spent the next few days hauling boxes around and arranging furniture. After a particularly vigorous session wrangling the couch, contractions began. When they persisted for six hours, I called Pete and he arranged a hasty return flight.

Once he was back on Canadian soil, the contractions ceased. I was embarrassed and hoped desperately that the baby would arrive in the next day or two so that I might redeem myself. I didn’t want Pete showing up at his office on Monday without something to show for cutting short a business trip.

I was relieved when labour began in earnest two days later. We headed off to bring our three-year-old to our friends' place, but I was so uncomfortable in the car that I asked Pete to swing by the hospital and drop me off first. I brushed off his offers to assist me inside and made my way up from the parking garage alone, stopping every two minutes to lean against the wall and breathe.

Now, I’m a polite and reserved person, even in labour. I don’t scream, I don’t curse and I take pains not to let anyone else feel awkward witnessing my discomfort.

As I made my way into the maternity ward, I ran into my obstetrician, with whom I had an appointment that day.

“I don’t think I’ll be able to come in to see you this morning,” I told him apologetically.

“You have a woman in labour to attend to? No problem, we’ll rebook your appointment,” he replied pleasantly.

“I’m in labour!” I corrected him.

As he looked at me skeptically, a contraction began and I excused myself and turned towards the wall.

He gave me a keen look, murmured, “The leaning-against-the-wall sign,” and directed a nurse to show me into the assessment room.

I lay on the exam table, in the standard light yellow gown, waiting for the resident, with the contractions steadily becoming more painful. When a junior and senior resident stepped into the room, I asked politely for analgesia.

They were busy manoeuvring a portable ultrasound. “First the ultrasound, then the exam, then we talk about pain control,” the senior replied briskly.

“Ultrasound?” I asked.

“We had two undiagnosed breeches recently,” she explained. “So we’re doing an ultrasound on every patient to establish presentation.”

She ran the probe over my belly. With supreme effort, I kept from writhing in agony with each contraction.

She began a detailed teaching session with the junior resident, reviewing the operation of the machine and the findings on the screen. “There’s the back,” she explained, gliding the probe down my abdomen and over my pelvis. Then, muttering to herself, “But where’s the head?”

The nurse, who was clearly annoyed by the residents on my behalf, noted that my face had turned white and announced that she was going to fetch the obstetrician.

“Could I please have something for pain?” I asked the resident again, more urgently.

“Ultrasound, exam, analgesia,” she repeated, irritated. Then, swooping the probe over my belly once more, “Spine . . . where on earth is the head? That is just the strangest thing.” The residents were puzzled.

I knew exactly where the head was. Crowning. I had no choice but to be rude. “I have to push,” I announced. At that moment the obstetrician walked into the room.

“How dilated is she?” he asked the resident.

“I haven’t examined her yet,” she replied. “We can’t find the head on ultrasound.”

He berated the resident for not doing the exam first, and she defended herself, “But I had no idea she was so far along!”

“I’m going to push,” I warned.

As I was rushed down the hall on a gurney to a labour room, I was so focused on refraining from pushing, that it only briefly registered that Pete was not among the mass of people swirling around me. Frankly, that was the least of my concerns at the moment. In Room 11, the nurse fumbled with the nitrous oxide, only to announce that the mask was missing.

Then, with not even a Tylenol on board, with my husband missing in action, I pushed out my son with two pushes.

Ten minutes later, as I lay with a bundled 6-pound 5-ounce Leif Jacob nestled in my arms, blissfully happy that baby and I were well, Pete tentatively entered the room. If he hadn’t said anything, I would have assumed he had had trouble with traffic. But he felt compelled to admit that he had thought he had time to spare, and had popped into Starbucks for a latte and a chocolate croissant as his son entered the world.

(Cross-posted at www.freshmd.com)