Chapter 10

Noah and his mother stepped into his bedroom. Rachel way lying in bed, her head on a pillow propped against the headboard. "Rachel sweetheart," Meredith said, "I want to feel your belly." She lifted the shirt Rachel wore as a gown and probed her abdomen. "Baby feels like he's in good position."

"I'm scared," Rachel said. "Is there any way to get me to the hospital?"

"I'm afraid not," Meredith replied. "Women have been giving birth at home for thousands of years. Ninety-eight percent of the time there's no difficulty. We go to the hospital because they're equipped for the other two percent. Most of the time it's unnecessary."

"I was planning on having an epidural," Rachel said.

Meredith nodded. "You're going to have to tough your way through it. You've been to childbirth class?"

"I have."

"Then you have a general idea what to expect ... not that anything can prepare you for what you're about to endure. Noah will be with you."

"I know. That's a comfort."

"And I'm here. You'll do fine." Meredith hugged Rachel. "You haven't felt any contractions?"

She shook her head. "Nothing at all. Maybe we can wait until the roads are clear."

"Realistically, it's going to be late Sunday or Monday morning before we can get out of here. Now that your water is broken, there's a real risk of infection that could jeopardize both you and the baby. Baby needs to come out. We need to get your labor started."

"How do we do that?"

"Nature usually takes care of it, but we may need to give nature some help. I want you to try walking -- just pace up and down the hallway. Gravity and the motion sometimes can get it started. Another thing to try would be manipulating your nipples. They're connected to your uterus and that sometimes works." She glanced toward her son. "I'm sure Noah would be happy to accommodate."

"I'll try walking."

"I'm going to put some clothes on. Noah, you should, too. I've never seen a man attend a birth in his skivvies."

Meredith returned in jeans, athletic shoes and a nurse's smock. "Anything?" she asked Rachel.

She shook her head. "Not yet."

"Keep it up. Unfortunately, we don't have any pitocin here. I'm going to go downstairs and start making ready."

Rachel resumed walking. "I'm getting discouraged."

"Maybe we should try nipple stimulation," Noah suggested.

"Noah -- I would rather not." He stood behind her, placed his hands on her breasts and stroked them through fabric until her nipples began to firm. "Noah ... I'm really not in the mood."

"It's doctor's orders ... from doctor Mom." He began rolling her nipples between his thumb and forefinger.

"Noah! Stop it!" She reached to pull his hands away from her chest. "OH!" She bent over and clutched her abdomen. "I have a cramp ... and now I have a pain in my back."

"I think we got your labor started. We should've skipped the walking and gone straight for the nipples." He supported her as she headed back into the bedroom and climbed onto the bed.

"Mom," Noah said as he descended the stairs. "I think she's having contractions."

"I'll be right there. Noah -- go rouse Marcus and Sarah. We'll need all the hands we can get."

Noah pounded on his brother's bedroom door. "Marcus ... Sarah," he called.

"What?" Marcus asked with drowsy petulance.

"Rachel's having her baby. We need help."

"We'll be right out," Sarah said.

Noah's brother and sister-in-law joined them in the bedroom. Sarah knelt and took Rachel's hand. "We're here, Rachel," she said. "We'll help however we can."

"Sarah," Meredith said, "I want you to keep Rachel company. Keep track of her contractions -- the duration and the interval."

Noah pulled his Blackberry from his pocket and powered it up. "Here -- I have a stopwatch app on it." He handed it to Sarah.

"Marcus, I want you to use the snowblower to clear a path between the house and the barn. There are some things out there that we'll need."

"Okay, Mom." He headed downstairs.

"Noah -- go to the basement and look in your dad's tool boxes. He used to have me bring hemostats -- surgical clamps -- home from the hospital. See if you can find a couple. Also, look for an X-Acto knife or somesuch with a clean, sharp blade.

"Got it." Noah headed downstairs.

He climbed the stairs from the basement and found his mother in the kitchen. Outside he could hear the snowblower. "I found these," he said and handed her four clamps and a hardware store variety snap-blade knife. "I put a new blade in."

Meredith tested the clamps and chose two. She dropped them into a pan on the stove. "I don't know how well the plastic handle will withstand boiling," she said as she examined the knife. "It is a good, sharp blade. See if you can find some rubbing alcohol in the bathroom. We'll need it anyway."

Noah returned with a bottle of alcohol. "Here."

"Good. Help me move the table and chairs out of the way. We'll set up shop here."

"In the kitchen?" he asked. "Why not upstairs?"

"The linoleum I can mop. The bedroom has carpeting."

"Is it really going to be that messy?"

Meredith regarded Noah for a long moment. "Heh!" she replied. "You don't know the half of it."

Noah lifted one end of the kitchen table and pulled it to the side. He inverted the chairs on it. Marcus stomped snow off his boots and stepped inside. "Okay -- there's a path to the barn."

"Noah, you and Marcus bring in that old trestle table we used to use in the dining room. It's in the barn somewhere. Dust it off and bring it inside. We'll use that as a birthing table. It's a little higher than optimum but it'll do."

"Right, Mom," Marcus said.

"Find a couple of buckets and bring those in, too."

Noah and his brother struggled with the trestle table as they carried it to the kitchen door. "It's not going to fit through the door," Marcus said. "Go open the patio door."

Noah opened the sliding door leading from the living room to the patio. He and his brother carried the table through thigh-high snow to the patio and set it inside. Then they brushed off snow and carried it into the kitchen.

"Right here. Thank you, boys. Marcus, can you find a floor lamp that'll give us good illumination? Noah, come with me. We'll check on the patient."

Noah found Rachel lying on her side and holding Sarah's hand. "They're getting stronger," Sarah said.

"How far apart?" Meredith asked.

"A little less than ten minutes."

Rachel let out a whimper, bit her lip and grimaced. She squeezed Sarah's hand. "OH!" she groaned and then relaxed.

"Roll onto your back," his mom said. I'm going to check you between contractions." Meredith reached between her legs. "About four centimeters ... and she's thinning out, nicely. It's going well, Rachel. Lie however you're most comfortable."

She rolled onto her side.

"Noah -- she needs you with her, now. Do whatever works to alleviate her discomfort. We still have a long night ahead of us." She knelt by Rachel. "Sweetie -- the contractions are going to induce a strong urge to bear down. You must resist that urge at all costs until you're fully dilated. Otherwise you could injure yourself severely. Do you understand?"

She nodded. "I understand."

"Good. Groan, shout, scream, swear -- whatever you need but don't push. You'll get your opportunity to push later. Sarah -- I want you to go round up every towel you can get your hands on. Check the bathrooms and the linen closet. There's a trunk in the basement with some old towels. Bring those up, too." She turned to Noah. "Make sure she doesn't push."

Meredith probed between Rachel's legs. "She's up to eight centimeters."

"She spent an awful long time at five," Noah replied.

"That's not unusual. I think it's time we moved to our makeshift birthing room. Rachel -- can you walk?"

"I don't think so."

"Noah -- you'll have to carry her."

"Up we go," he said. "Hold on tight."

He carried her down to the kitchen. The trestle table was covered with towels covered with sheets. On the counter Meredith had lined up her necessities -- alcohol, hydrogen peroxide, the clamps and snap-knife, stacks of towels, a spool of butcher's twine and cotton balls. "Set her on the table. You're doing really well, Rachel -- especially for a first delivery."

Rachel clenched her teeth. Noah offered her his hand and she squeezed it in a white-knuckled grip. She began to relax.

"That was a long one. Look how the shape of her belly has changed."

"The baby is moving down," his mom said.

"Oh, I want to push so badly," Rachel gasped. "And it hurts so much."

"I think maybe another half hour and you can start pushing," Meredith said. She felt between Rachel's legs again. "You're well on your way to nine centimeters ... and I can feel a head."

Rachel grunted and flailed her hands reaching for Noah's. She grasped it and squeezed, grimacing. "Oh!" she gasped as the contraction passed. She squeezed his hand again.

"They're almost continuous, now," Noah remarked.

"Yes. She's having a good labor." Meredith reached between Rachel's legs again. "She's up to nine. It won't be a half hour -- it'll be ten minutes." She turned toward the living room. "SARAH!" she yelled.

Noah's sister-in-law stepped into the kitchen. "We're going to need another pair of hands here shortly."

Rachel groaned from another contraction. Meredith probed her cervix. "Rachel, sweetheart," she said. "On the next one, push. Use the same muscles you use to go potty, but push with everything you've got. It'll feel good after holding back for so long."

Rachel nodded in acknowledgement. She took a deep breath, held it and bore down. Her face reddened and veins in her neck began to protrude.

"That's it, push, push, push!" Rachel gasped for air. "Push with the contractions, sweetie. Rest between them."

Noah stood and watched over his mother's shoulders as Sarah held Rachel's hand. "My, God," he said. "I see hair!"

"She's about to crown," his mother replied. "Rachel, honey -- this is the most difficult part. If were your OB, I'd be giving you an episiotomy right now. I can't do it without anesthesia, and I don't have sutures to close it anyway. We're going to try something else. Have you ever been fisted?"

"WHAT?" Noah exclaimed.

"No," Rachel gasped.

"If you had been, you'd know those tissues are capable of considerable stretch. All it takes is patience and lots of lube. We're going to see if we can stretch you without tearing you." She picked up the tube of K-Y jelly and squeezed a blob on her finger. "I want you to push but not as hard. We'll take it a little slower."

Rachel pushed and Noah could see her opening bulging. His mother ran her lubricated finger around the edge of Rachel's opening, between her skin and the baby's scalp. "Should I push or not?" Rachel gasped.

"Push but don't give it your all." Meredith continued lubing and stretching Rachel's opening and more of the baby's head appeared. "We're almost there, sweetie. Once the head is out it's downhill." Meredith grasped the infant's temples and gently turned the head. "Give us one good push, Rachel ... the head's out. Another push and we'll have the shoulders..."

Noah watched as his mother hooked her fingers under its arms and gently withdrew the infant from Rachel's birth canal. "Rachel -- you're not pregnant any more!"

"Noah!" she exclaimed and reached for him. He embraced her and she gripped him and sobbed.

"It's all right, Rachel ... it's all right. We did it! We did it!"

Rachel held him and wept. "I'm sorry," she blubbered.

"It's the release," Meredith said. "Let her have her cry; but we're not done yet. Sarah -- grab a towel and clean her off."