The young mother struggled with every surge of uterine activity. "I can't do it! I am too tired!", she cried in English, then lots more in another language.
If one of us had been able to step in as proxy; to labour and give birth, or even to do some of the work, and lessen her load, we would have. Surely it's unfair that the woman has to do it all?
Each time I witness the massive effort that culminates in the unmedicated, unassisted birth of a baby - and particularly a first baby - I am in awe. The journey that can have many unpredictable and unexpected turns in the path; many forks in the road. At each decision point, only one way can be taken. Is this the best way?
As midwife, I hear many voices. The mother's body, the baby's body, my own mind, the voice of professional and scientific knowledge, and the words of others participating in the birthing journey.
When the mother's mind says "I can't do it! I'm too tired!" I can't just block my ears.
I ask, what does her body tell me?
There is power in these contractions, and I have seen progress over time.I know we can continue.
There is strength in this young body. Her pulse rate is steady and strong.
There is quietness in the moments of resting between contractions.
Is mother well? At present, yes.
I ask, what does her baby's body tell me?
The baby's heart rate is strong and steady.I know we can continue.
The contractions, although strong, do not bring any sign of distress in the baby.
The baby's station is progressing with time.
Is baby well? At present, yes.
I ask, what does my own mind tell me?
It's the middle of the night, and my mind is also weary.I will not interrupt or interfere with the amazing metamorphosis; the life-giving struggle that we are witnessing.
I hear the cries. I know that she is sleep-deprived.
I seek to guide this girl who is being transformed into a mother through this rough terrain.
I ask, what does professional and scientific knowledge tell me?
Simply this: that there is no safer or more appropriate way for this baby to be brought into the world, than for the midwife to work in harmony with natural physiological processes in labour and birth.I know we can continue.
That this woman's body is wonderfully made, that this baby's body is uniquely suited to this mother, and that the process of birth is so much more than delivery of a child from the womb to the outside world.
That the transitions which must take place shortly are best supported in strong, unmedicated birthing.
I ask, what do the others - the husband, the friend, the student - tell me?
We are working together, and I am responsible for so much. These members of the team are looking to me for encouragement and strength. They do not have the years of life experience that I have, and they are quietly learning to harmonise their actions with those of the labouring woman.I know we can continue.
We moved to the birthing pool. The pushing had been ineffective, and the voice "I can't do it, I'm too tired!" was becoming more persistent.
Then, as an expulsive urge was about to go, I saw some fine, thick black hair peep out between the labia, then disappear again.
"I can tell you what colour your baby's hair is" I said. "Black."
We all laughed. Babies from their people group all have black hair.
I don't know when the young mother realised that she actually could give birth, that she was giving birth. But I know and hold onto the look of utter amazement and satisfaction as she took her child into her arms.