“Her heart is beating at 172 per minutes. Do you have fever?”

That question from the obstetrician threw chills in our bones in otherwise a routine visit. My wife quickly turned and looked at me but I wasn’t able to reassure her; I was afraid.

No she didn’t have fever. We kept our routine of freshly squeezed juice for her and a cup of black coffee for me and rushed to make it on time for the 8:30 appointment. There was nothing alarming; the baby was moving as usual. She was overdue so we had prepared everything ready from hospital gowns to baby clothes, snacks, toothbrush and paste.

“Well, your baby’s heart rate is high so I don’t think we can wait any longer. I will send you to the labor ward. Will start induction.”

The labor ward at the Memorial Hospital was only a short walk from the obstetrician’s office. By the time we arrived there, the midwives had all the information. They were nice to us, easing our fears. So that was how it all started. Slipping in to a hospital gown, intravenous lines, monitors for the baby’s heart rate and my wife’s contractions which began about an hour after the oxytocin was initiated. Baby’s heart rate settled in the 160s, which was not alarmingly high. We waited for the labor to progress anticipating a normal deliver but knowing that we were in good hands if she needed surgery.

A loud bang on the front door. Again and again.

“Doctor, wake up. Doctor, wake up. There is a pregnant mother in labor.”

I was the only intern in the compound at the time. This is back in the early 90s, in Asendabo Health Center, a small town in the outskirts of Jimma, a major city in western Ethiopia. I was completing medical school then but part of the requirement for graduation was to do internship in local health centers. There was no electric light at the time. I quickly lit the candle and checked my watch. It was about 3 in the morning. A tall and muscular man in his 50s was standing at the door, profusely sweating.

“Hurry up, hurry up, she is in labor. You are the only one I could locate. The mid-wife and physician are out of town. The health center’s only car is broken. Please hurry up.”

It was the security guard.

Fortunately the outside was lit by a full moon. We rushed to the health center. There I was, a young ambitious intern, with just a pen light at hand, at about 3 or 4 in the morning, in front of a young mother, perhaps 15 or 16, exhausted from hours of horse ride and in labor pain. Her husband, extended family, neighbors were all crammed up in a small dark room.

My wife’s contractions started to peak up as the dose of oxytocin was escalated. Our baby’s heart rate remained stable. About 2 hours in to labor, my wife finally requested epidural to ease the pain. It helped. She was able to take some rest, caught a nap.

I drifted back to Asendabo.

I soon realized I had no time to waste. Everything happened very fast. We explained to the family to stay outside. I made a quick evaluation. The mother’s vitals were stable. I picked an old pinard horn fetoscope and tried to listen and count the baby’s heart rate. It was fast, perhaps around 170. That made me nervous. The closest hospital for surgery or any major complication if needed was hours away and to make matters worse the multi-purpose car that also substituted as an ambulance was broken. Fortunately, the head was down and the cervix was fully dilated. All what she needed was a push. I got myself well situated holding the pen light in between my teeth, ready to deliver, with no other help.

Take a deep breath and when I count down to three start to push down.
One, two, three…

They both pushed, taking few breaks in between, separated by time and location but united by the same being.

Celebratory gunfire erupted outside the health center in Asendabo the moment the baby cried. Word was out that I was able to successfully deliver her, both mother and baby doing well except that I was socked in the amniotic fluid and blood, unbeknown to me, until sunrise.

Two decades later, across the Atlantic Ocean, I stood mesmerized …as my own baby was delivered at around midnight. I was frightened when I first saw the cord around the baby’s neck but it was loose … she cried… relief and joy and tears of happiness.

I didn’t realize until now what that moment in Asendabo meant for her parents. Until I had my own.