Rupture Katherine Rand They say that when the baby comes, you have entirely given up and/or you think you are going to die. I pushed for nearly seven hours. That last “push” felt completely impossible and, it may only be because I had three women on one side of me, two women at the opening to my vagina—one of whom was holding onto the crown of my baby’s head, and two women on the other side of me, all telling me that I could not stop, that I must continue, that it didn’t matter that the contraction had ended, that I had to get the baby out now, that I finally pushed him all the way out. It was as if all of the other pushes that came before had meant nothing. Like, perhaps, it took that long to figure it out. Behind us was a virtual theater of hospital staff, maybe 15 strong in the room, and the baby was whisked off before I could hold him or see him. They feared he had aspirated meconium, of which there had been copious amounts, for hours, during his journey through the birth canal. None of this is what I had imagined or hoped for in his first moments with us, and yet, what I did do was experience birth in all its fullness, aware and awake from beginning to end. Had I chosen to birth in the hospital in the first place, my providers would certainly not have allowed me to push for so long. I would probably not have labored for over 24 hours with little rest for two days before embarking on that immense work, and I may have had a number of interventions that were far, far, far from my birth plan. As it was, my midwife was actively involved in a way she isn’t often, pulling back a cervical lip when I was otherwise completely effaced, performing an amniotomy—otherwise known as breaking my water, catheterizing me (when my bladder gave me unbearable pain in the latter part of the baby’s descent in the birth canal), and even giving me an IV. All of these were choices presented to me with loving guidance, and which I made for myself with complete trust in my midwife. Before any of these interventions occurred, she had gently suggested going to the hospital so I could have an epidural and get some rest. I declined. Ten hours later, and as things got to the point where I would no longer be given a choice on the matter—this was obvious to me, it didn’t even need discussion beyond the basic logistics of how it was going to happen—my midwife said, “I’m going to give you four more pushes,” so that I could give it everything I had before having to transfer. These were essential touch points which empowered me in the labor and delivery process. It’s hard to remember exactly what was happening in those last hours before going to the hospital and finally birthing my son. The focus that is required—the physical exertion while being so exhausted—well, there’s little space for anything else. I had imagined birthing my son in a squat, more actively involved in creating the best position for his descent in the birth canal. But, I ended up lying on my left side for hours because there was nothing else I could do. When I lay on my right side [End Page E1] or on my back, the baby’s heart was distressed. I was far too tired to stand, kneel, or squat. My hip and my whole body ached from being in that position so long. Occasionally I would have to move, but then everything got tense as they listened to his little heartbeat. On every contraction it disappeared, and I had a simultaneous sense of terror while knowing that women have been birthing forever and that everything would be fine. I could touch my baby’s head for quite some time before we transferred to the hospital. It is because he was so far down and because I didn’t have...