Michele has been my best friend for about 14 years. Yesterday morning, August 3rd, at 1:34 a.m., she gave birth to her son, Aubyn. He is BIG and healthy and everyone is doing well. I am so proud of her that I could just BURST.

But clearly Michele’s delivery was a portent of things to come.

This morning I was working in Outpatient when a very, very pregnant woman walked down our hallway with her mother, looking confused and concerned. “Can we help you?” we asked.

“She’s in labor,” said her mother.

Within about ten minutes she was in the emergency room, and ten minutes after that the pages started echoing through the halls. “Lorraine, please come to the emergency room.” “Bertha, please come to the emergency room.” “Kathy, please come to the emergency room.” “Security to the emergency room.”

Mom was having the baby HERE. All the RNs were being paged to the ER. Kayenta is not set up to deliver babies — Moms go to Tuba City or Chinle to have their children. But we do have a room in the ER set up to deliver babies who aren’t going to wait. I waited a few seconds, and then asked Bob, the big and intimidating ER nurse, if I could come watch — as long as Mom said OK and I wouldn’t be in the way. He nodded, and I was gowned, gloved, with little booties on my feet, and talking with Dr. Newland about how babies are cared for once they’re delivered. Mom was hollering in labor. I got impatient again and stuck my head around the curtain. There was Mom, holding her mother’s hand, all alone.

So of course I went in to stand beside her. I introduced myself, asked if it was OK (it was). And then as her labor progressed, her mother and I helped support her while she pushed, and then her mother and I rubbed her back a LOT — she was in pretty awful pain. I just felt like there needed to be someone from the nursing staff who was there and concerned about HER, not about her fetal monitor or her BP or what station the baby was at — HER. Her back pain, when she wanted ice, how she needed support. And no one was doing that.

Unfortunately, the baby started having decelerations with each contraction, which was concerning Dr. Bouchard. Mom wasn’t progressing, so he made the decision to send her to Tuba City, and try to get her there before the baby was delivered. By now Mom was in agony and crying with each contraction, but between contractions we managed to get her onto a gurney. Then her grandmother came in.

Her grandmother performed a blessing that I had read about briefly, but had never seen. She spoke as she stood next to Mom, who was having a huge contraction, and she held a thin rope in her hand. As she spoke, she tied the string into loose knots, and then held the knotted string against Mom’s stomach, and swiftly pulled the knots out. She repeated this a few times. Then she watched her granddaughter for a few moments, and quietly left the room.

The knotted rope, and the removal of the knots, is supposed to ease the labor pains and speed the delivery of the baby, if I remember correctly.

Everything happened very fast then.

We wheeled Mom out, and put her in the ambulance. She screamed with another contraction. The two doctors climbed into the ambulance with her. We were waiting on the RN who was going with her, when suddenly Mom screamed, “THERE’S SOMETHING COMING OUT!”

The RN jumped into the ambulance, and 30 seconds later jumped out again with the baby wrapped up in a blanket. She ran into the ER and put the baby under the baby-warmer and started warming him up. His Apgar score was outstanding — good muscle tone, good color, good breathing and sound. A few moments later the MDs wheeled Mom BACK into the ER, to the delivery room, and we started fundal massage while waiting for the placenta to deliver. Mom was badly torn — the baby had (obviously!) come out very fast — and she was bleeding quite a bit. We started Oxytocin wide open, and within 30 minutes she delivered her placenta, which was placed in a plastic container and gave to the family (traditional Navajo families have a ceremony for the placenta as well — I believe they bury it in an auspicious place, but I’m not sure).

Baby Boy was 8 lbs and 11 oz. He was big and HEAVY. I got to hold him for a few moments until the grandmother came back in the room, and I gave him back to the family. He was beautiful — despite being swollen and mashed and with a pointy head and unbelievably long toes and fingers.

And he was born in the ambulance. In the parking lot.

A long time later, with all the paperwork filled out, Mom and Baby were transported to Tuba City, which is standard procedure after we deliver the baby emergently. As she was heading out, I said, “Thank you for letting me be here.”

She smiled and said, “You’re welcome. You helped a lot.”