Don’t Push

“Don’t push!”

I held back a snort of laughter. This baby was coming. I could feel my uterus tighten again, involuntarily squeezing Twin A further down, her head crowning and bumping against the residents’ hands.

I surveyed the scene. The OB resident, holding Twin A’s head until her attending could arrive. The nurses, white-faced and fumbling with the IV lines, caught off guard by the sudden progression of labor. The two NICU teams, cramming into the tiny delivery room, ready for the premature imminent delivery at thirty-five weeks and five days. And the attending physician, rushing in the door and scrambling to get her sterile gloves on to assist the resident.

I should have been scared. So much could go wrong. Instead, I had a wide grin on my face. As a family medicine resident, I had rotated through pediatrics, the neonatal ICU, and OB. I knew exactly what each person would do if something went wrong. I felt safe in their hands and an odd sense of calm. But it was hilarious to watch everyone else panic.

“Twin A is clear!” the resident announced. A small cry pierced the room, followed by a collective sigh of relief, most notably from my physician-husband. He was plastered against the wall, watching anxiously. His cardiology fellowship did not train him for this bloody ordeal.

The resident deftly cut the cord and handed Twin A over to the NICU team, a collection of pediatricians donned in yellow gowns. Their plan had been to labor in this small delivery room, and then transition to the OR as I neared delivery, in case a C-section was needed. Now, instead, they huddled around the warmer, evaluating Twin A, elbow to elbow in the tiny space.

If only my nurse had believed me! A month ago she transferred from pediatrics to the labor and delivery floor. I was her first twin patient. When I felt increasing back pain despite my epidural and requested a cervical check, she replied “You were 3 cm when checked an hour ago, it’s too early for another check.” Not eager for a fight, I labored on, but twenty minutes later when the pressure shifted to my rectal area, I insisted on an early check. She reluctantly called the resident, and turned white as a sheet when the blankets were lifted to reveal Twin A crowning. “Don’t push,” the resident instructed as she placed her hand on Twin A’s head, urging the nurse to STAT page the attending and NICU teams.

Now that Twin A was safely delivered, the OB resident turned back to my vaginal canal and the foot peeking out and dangling on the bed. A rare breech delivery. If Twin A is born head first, they allow a vaginal delivery of Twin B, even if breech.

“Don’t push!” the OB resident urged again, as she focused on the maneuvers so rarely used in this hospital. The attending finally got her gloves on and tried to move the resident out of the way. “I got this,” the resident said firmly and calmly, as she stayed her ground and finished the maneuver. My uterus contracted again, and Twin B completed her successful breech delivery into the residents’ hands.

The sound of both my girls crying in that tiny chaos-filled labor and delivery room will forever fill my heart. And I still hold back a snort of laughter when I think of that laughable command: “Don’t push.”

Jessica Faraci
Falmouth, Maine