Birth stories from the other side: An OB’s experience

We asked the contributors to our article “Words of wisdom” to share with us some of the most memorable births they’ve attended.

Today, Dawn Mandeville, MD, FACOG, obstetrician/gynecologist at Atlanta Gynecology and Obstetrics talks about one of her most interesting experiences. Dr. Mandeville has attended over 1,500 births.
First of all, I am of the opinion that every delivery is an amazing experience. To help bring life into the world, to watch to excitement and emotions of a mother, a couple or their families as a child is born still gives me goosebumps every time.
In terms of birth stories, I would have to say one of the most memorable was the one in which the mother requested to deliver while standing up. I am sure many women did this way back when, especially when women birthed “in the fields” or at home. But never have I gotten this request, especially when we have fancy hospitals with fancy beds and fancy epidurals that take away your pain and well trained nurses and doctors to guide you during you delivery process.
On this day, my patient came to the hospital in early labor. She stated that was her intention not to have any pain medication and that she wanted to deliver while standing up. She said “Dr. Mandeville, I know you will let me do this right?” The first part of her request was reasonable, but I had to think about the second part. Logistically this would be difficult as I would be crouching on the floor next her in an effort to realize her “plan.” I was in a particularly good mood that day, so I did not put up a fight and said that we would see how things went and that if the baby was doing totally fine we would see if this was possible.
Oh I forgot to mention, she also wanted to labor in the birthing tub.
I told her that this was fine as our facility did have birthing tubs. I did tell her however that I was not getting in the tub with her for any exams or delivery … I did not bring my bathing suit to the hospital that day.
Her labor progressed well that morning. At one point I was called by the nurse who was giving me an update on her progress. As the nurse was talking to me, it became clear by the loud Lucifer-like noises in the back ground that I should probably proceed to the room—and quickly.
Once in the room, I was met with nurse looking wide-eyed (as the patient refused to get into the bed), the husband looking ashen (as this experience was clearly taking a toll on him), and the patient standing up, legs in a wide stance, hands clutching the rail of the bed with white knuckles clearly visible in the dimly lit room. Oh yes, the doula was also there rubbing her back telling her that she was “almost there.” (Not a chaotic scene at all!)
My goal is to try to remain calm in any chaotic birthing situation, so as not to scare anyone in the room if something is not going well. This was a difficult task in this case as so much was going on at once and I was out of my element as this patient was standing and was NOT going to lie down. So I had no choice but to go with the flow. After a quick assessment of the situation, I did get gloves on “just in case.” As I told the patient that I needed to check her to see where the baby’s head was, she said in a forceful, deep, guttural tone … “The head is right there!”
Sure enough, when I placed my gloved hands between her legs the head was indeed there. I told her to bear down and push. With one strong push the rest of the baby came out in my hands with an umbilical cord long enough to show the patient her new baby boy.
It was only at that point that she decided to lay down … not on the bed, but on the floor. I clamped and cut the cord and handed her baby to her.
It was at this point that I too sat down (mentally exhausted) on the floor with mommy, daddy, doula and baby to enjoy this most amazing yet unconventional modern delivery.
The nurse was only one left standing in the room.