'Breathe like this, sweetheart,' David said, panting and puff-ing like a dog.
'I can't,' she screamed, her entire body convulsing. She fell back, exhausted.
'That was good,' Fletcher said calmly. 'The head's almost through, so one more time ought to do it. Wait until I tell you, then push as hard as you can.'
'I can't.'
'You will.'
The contraction came. David lifted her up and forward by the shoulders.
'Push,' Fletcher cried. 'Now!'
'He's tearing me up!' Her voice became a straining animal grunt. David cried out, 'I see its head!' His voice, ringing in her ear, sounded so full of love and wonder that she began to cry.
Dr. Fletcher gently cradled the head in her hand. 'Not yet. Stop straining. The shoulders are next. Coordinate it with the next contraction.'
While Dr. Fletcher held the unbreathing baby in her hand, Nurse Dyer battled with sponge and gauze to keep other bodily fluids away from the newborn.
The baby rotated about, cradled firmly in Fletcher's grasp. Another contraction loomed. 'Push now!' she said.
'Come on, honey,' David cried. 'Push!'
Wordlessly, Karen leaned forward with David's aid and pushed as hard as she could. This time was easier than the last. David's voice was near tears.
'There she is! It's a girl! God, Karen, she's beautiful.'
'Eleven-oh-seven A.M.,' Fletcher said, glancing at her watch. Dyer made a quick note of the time. The little purple-red, blood-smeared, vernix-coated figure rested in Dr. Fletcher's hands. She gently ran a finger through the baby's mouth to remove the mucus plug. Dyer used a tiny suction bulb to do the same to the infant's nose. Fletcher ten-derly transferred the newborn to the belly of her mother. She took her first breath. Intrigued by the change in proce-dure, she tested her new equipment with a healthy, hearty wail. Her parents wept with joy seasoned with not a little exhaus-tion. Dr. Fletcher gripped the swollen grape-purple corkscrew of umbilical, gently holding tension on it to guide the afterbirth farther out with each uterine contraction. At the same time, the baby received added blood from the placenta, topping off her circulatory system.
Nurse Dyer registered the baby's Apgar score-a nine in her first minute. That was nearly perfect, since out of superstition nurses rarely gave babies a ten. Only the newborns of pedia-tricians ever received the top mark, and only then because the doctor would worry if her own child were not pronounced perfect. Dyer put down the clipboard to mop the doctor's sweaty brow. That done, she turned her attention back to the baby, placing erythromycin drops in her eyes.
'Now, Karen,' Fletcher said calmly, 'in births such as yours, the placenta doesn't all come out, so I'm going to go in to get the last of it after you've expelled the main part.' They heard none of what she said. The couple watched the pulsations of the umbilical cord, mesmerized. They gazed at the squalling child on Karen's stomach. It turned from purple to a radiant shade of ruddy pink.
A series of contractions expelled the afterbirth into a shal-low tray held in place by Fletcher. The cord collapsed, lost its candy-swirled shape and shiny gloss. Taking her cue, Fletcher used a yellow plastic clip to seal off the umbilical as close to the baby's navel as possible. Nurse Dyer handed the husband a pair of scissors.
'Would you like to do the honors?'
Crying, he took the scissors and allowed her to guide his hand within an inch of the clip. A quick snip severed the cord. Blood pulsed out, dark red, further collapsing the cord into something that resembled a limp crimson noodle. Fletcher put the tray aside.
Nurse Dyer gently snatched the infant away from Karen, tak-ing it to a scale for weighing. She measured the circumfer-ence of the baby's head, her length, and fastened an ID tag on her wrist.
'Six pounds, eight point four ounces,' Dyer called out. 'Nine-teen point five inches.' Karen wept happily at the news, taking her baby back to hold her.
'Doctor?' David asked, remembering something from his classes. 'Shouldn't you count the veins?' Dr. Fletcher smiled and reached over for the tray. David watched with curiosity, splitting his attention between the doc-tor, his wife, and his new daughter. She picked up the end of the umbilical, nipped it between two fingers, and spread the edges back to examine the interior.
