Monique Rainford

I AM often asked why I chose the speciality of obstetrics and gynaecology and my answer is always the same - delivering babies.

Few experiences compare to the excitement and exhilaration that I feel when I have the honour of assisting the birth of a child. I find it most touching when I see a mother or father cry tears of joy at the birth of their baby. Therefore, let me describe a labour and delivery room experience.

I was first introduced to this area many years ago as a student in medical school and thankfully, many years later, it is still a joy.

So what do I get to see? Sometimes in the course of a 24-hour day, the phone will ring and a woman will inform me that she is in labour. More often than not, she is able to recognise it even if it is her very first experience. She may try to weather the onslaught at home, but then, as it intensifies, she will instruct her spouse or that most important friend or family member to take her to the hospital.

She arrives at the hospital and is greeted by her nurse who becomes a special friend in this experience. She gets to listen to the baby's heart rate and then she gets her first exam to check her dilation. The cervix (or neck of the womb) opens or dilates to 10 centimetres to allow the birth of baby. If she is four or more centimetres dilated on her first exam, she is in active labour and is well on her way. With the first baby, a dilation or opening rate of about one centimetre per hour is normal. However, even with the first baby the dilation can wiz along.

Then she gets another exam and she is told that she is eight to nine centimetres dilated. By then, the pain is intense enough that she may have to receive more than one injection to ease it. Sometimes, she may even get an epidural to numb the pain. She has a wheelchair ride to the delivery room. She is completely dilated and it is time to push.

The coaching starts. She is told to take a deep breath, hold it and push like she is having a bowel movement. She is tentative at first then she gets the hang of it. After a few pushes, I begin to see the baby's head. She pushes some more. After about 30 minutes, the baby's head is out. (It may even take up to two or three hours with the first baby).

I quickly check to make sure that the umbilical cord is not around the baby's neck. If it is, I can often gently remove it or cut it, if necessary. Then I deliver the baby's shoulders and quickly the baby is out. I cut the cord and hold him or her up for mummy and daddy to see. I see her crying and I see him crying. They are full of love for this person that they are seeing for the very first time.

Nurse then takes baby and does the initial checks to ensure that baby appears normal. I then examine her and do the necessary repairs. My job is over, but hers has just begun. Then she may say thank you doctor and I think, thank you too - I just had another chance to do something that I really love.

Dr. Monique Rainford is a consulting obstetrician and gynaecologist; email: yourhealth@gleanerjm.com.