I stared at the ceiling, my hands twisting the drawstring of my scrubs. It was midnight, and I was occupying one of the on-call rooms of the delivery ward. I was going to be observing my first infant delivery, a milestone in my education that had terrified me since beginning medical school. I had been advised to get some sleep, but I was too anxious. I closed my eyes reviewing all that had happened that day, trying to calm myself.

Earlier that morning, I was in the doctors’ lounge studying with another third-year medical student when one of the obstetricians walked over to us.  He nodded a greeting to my classmate and then looked at me.

“I’ve met your counterpart here. She’s interested in OB, are you?” He was very energetic and spoke quickly. “I’m inducing a woman this afternoon and expect her to deliver this evening. You are welcome to join if you would like.”

I didn’t want to tell him that of all the procedures in medicine, delivering a baby terrified me the most. I didn’t want to tell him that I had no interest in pursuing a career in obstetrics. Instead, I mustered up a confident smile and said, “I will need to clear my time with my attending, but I will do my best to be there.”

He nodded. “Good, meet me on the delivery ward after you are done with clinic.”

As he walked away, my stomach twisted into a knot.

That evening, in anticipation for the delivery, I rushed from clinic to the delivery ward. I scrambled to familiarize myself with the mother’s medical, surgical, and obstetric histories and any details I could find regarding this pregnancy. While we waited for the mother’s labor to progress, the doctor questioned me about her medical background, medications used for induction of delivery, stages of delivery, and fetal cardinal movements. We walked through hand placement and important steps for a provider to take during delivery. Despite all the preparation, I was still anxious.

A knock on the door startled me. Apparently, I had managed to fall asleep for a little bit. I looked at my watch: 1:15 am. I opened the door, and the physician stood there holding a paper bouffant and shoe covers for me.

“Ready?” He had a big grin on his face.

I squared my shoulders, lifted my chin, and nodded. After all, I was simply observing.

We walked into the room. I quickly found a corner and tried to stay out of the way. I watched as the nurses broke down the bed and prepared instruments for the delivery. As the doctor gowned, he looked at me. Without deviating his gaze, he asked one of the nurses to help me gown and put on gloves. My heart raced, and I thought I might pass out.

“You are doing the delivery.” He said, watching my face for a reaction.

“OK,” I said, voice squeaking.

He motioned to the stool between the patient’s legs. Moving carefully so as to not contaminate the sterile field, I sat down. I tried to recall the steps he and I had reviewed, but my mind was blank, and my hands were shaking. Then I heard him. He was standing as close to me as he could without breaking sterile field.

“Take a deep breath. You can do this. I won’t let you make a mistake.” He spoke softly and calmly. “Focus Leia. There is a woman in front of you who needs your help.”

I looked up and made eye contact with the patient. She was shaking and covered in sweat, but had an incredibly focused and determined look in her eyes. Instantly, everything I studied and reviewed rushed back into my mind. My hands quit shaking, and my mind was clear. The determination of this mother gave me the strength to overcome my fear. I was ready to deliver her baby. I talked her through the delivery, coached her on breathing and pushing, all while the doctor guided my hands.

It happened so fast. Suddenly, I was holding a baby boy in my lap. He opened his eyes and wiggled his arms and legs. As I clamped his cord, he opened his mouth and took a huge breath. He screamed. I smiled and stared in amazement at his face, his blue eyes surveying the room.

The rest of the delivery was a blur as I tried to process what I witnessed while continuing to learn new information. The doctor showed me how to provide enough tension on the umbilical cord so as to not tear it from the placenta. We discussed the importance of noting the number of blood vessels in the umbilical cord, checking the placenta for any missing pieces, estimating any blood loss, and repairing any tears the mom endured. In a daze, I documented the delivery in the electronic record as he stood behind me correcting or adding information.

In the early morning hours, I walked into my apartment. My classmate greeted me sleepily.

“How was it?” She asked.

“It was the most terrifying and amazing thing I have ever seen or done,” I replied. “There is a beautiful new baby boy in the world.”

As I crawled into bed, I thought about the mother, focused and intent on bringing her child into the world without any sign of fear on her face. I looked at the clock, 3:00 am. I had to be up in a couple hours to prepare for clinic. I closed my eyes and thought of the baby, his eyes open, screaming as his heart and lungs adjusted to life outside the womb. I had just welcomed a child into the world, was the first person to hold him, witnessed his first breath, and watched as he surveyed the world for the first time. What an honor.

Leia Franchini is a medical student.

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