On our way through Silver Spring, up Georgia Avenue and to the beltway, I timed the contractions. They were coming quickly, lasting over a minute, and were intense. This was not, repeat, not a drill. We arrived at the Maternity Center.
It was 10:30 p.m.
The Maternity Center was a midwives practice, in Bethesda, for low-risk pregnancies. The mom gives birth in a regular bed; in a regular bed room. Parents typically spend the night together with the new baby. Not only do Dad's and partners get to spend the entire time with the mom, they are active participants in the various birthing methods taught and supported through the center.
Anne Seifert, our midwife, greeted us and showed us to our room. Amy was having steady, very strong contractions. She didn't want to be touched or moved during a contraction which was now most of the time. Amy was in a good deal of pain. It took a couple minutes to get Amy to the bed. Once in bed, Anne checked Amy's vitals and listened to the baby's heart beat with an external monitor. All were normal.
"You're eight centimeters dilated, Amy,” Anne announced, “this baby is coming soon."
She turned to me.
"I paged the on-call assistant but she won't get here in time. You,” she declared with her figure pointing at my chest, “are going to be my assistant."
I don't remember being nervous. But I also don't remember not being nervous.
"Um, should I wash my hands?"
"It's your germs, your baby and your choice," replied Anne.
Lacking any better ideas, I went to the bathroom to wash my hands.
As I finished, Amy let out a rather forceful groan. Her water broke.
It was 10:45 p.m.
There was meconium in the amniotic fluid. Not much but enough that Anne announced we'd have to suction out the baby's lungs for any fluids. Meconium is a combination of the baby's stool and the amniotic fluid. The first stool usually passes after birth, but sometimes before. But what this means for me, Anne explained, is as the assistant I get to work the suction pump. We'll suction the lungs after the head emerges, but before he is completely birthed, before he takes his first breath. She'd feed the tube down his little nose and tell me when to apply suction. She told me all this as she demonstrated the process. Simple enough.
Events unfolded rapidly. With each contraction Amy would push and plant her right foot on my left thigh. Anne, now playing catcher and coaxing us along, kneeled with her right knee up so Amy could plant her other leg on Anne’s thigh. Playing umpire I was able to position myself above and behind Anne, reach over, and let Amy grab my hands. The real pushing started.
With each contraction Amy would bear down; we'd plant ourselves and Anne would guide us. Between contractions, as Amy would try catching her breath, Anne monitored the baby's heart rate with the portable ultrasound heart monitor. Anne would hold the probe end while I'd turn it on and off. Then another contraction; then we'd do it again.
I don't remember how many times Amy pushed. Four, maybe five times? With each successive push a little more of the baby's head would appear. And between each push we’d monitor the baby’s heart rate. The baby's heart rate had dropped from 150 beats per minute down to the 70-80. As stressful as all this is on us, the stress on the baby passing through the birth canal is tremendous. This is critical time.
A baby gets all nutrients, and oxygen, from the placenta through the umbilical cord. During a contraction, oxygen from the mother to the placenta is temporarily cut off. The baby is essentially holding its breath. The baby is designed for this and between contractions the oxygen flow is restored. With long contractions the first indication that the baby is not getting enough oxygen is a drop in heart rate.
"Amy you are doing great and you need to push that baby out now," Anne firmly but calmly directed. I don't know if the heart rate was getting too low at 70 beats per minute, but clearly no one was interested in prolonging this.
The next contraction came. We were in position. Amy bore down hard and groaned loudly with the push. This was going to have to be it. Bryan's head, coaxed by Anne, slipped through. Now we had to pause quickly to suction the lungs before the next contraction. Had this been my first child, I imagine I'd have been quite distressed. When the baby's head comes out, he isn't breathing yet and the skin color isn't pink. It's gray. It doesn't look so good. But the placenta is still running the show, so no need to panic, but events are moving quickly. I turned on the pump and Anne fed the thin hose through each nostril and instructed me when to apply suction. It all went as Anne described. Then with one final push, Bryan Joseph Robinette was born.
As miraculous and awesome as Adam's birth was, our first child, in some ways Bryan's was more so. I had already seen how Adam had grown in the three years prior and the total joy he brought to our lives. Having this precognition for Bryan's birth elevated the experience to a profound level. In the moment I was overcome. Amy and I held each other, now with a new little creature on her belly, and wept. What an incredible experience.
The time was 11:12 p.m.