She looked like a little kid. She was black and very, very young. I recall that she was 14 years old. She was equally very, very pregnant. And she was my very first delivery on the Obstetrics ward. As a 4th-year medical student, I had observed and participated in several vaginal deliveries and Caesarean sections. But she was to be my patient. She was assigned to me. I was to deliver her baby, with an attending or chief resident assisting. I was responsible for her.

The reason I had so much responsibility? This was a public charity hospital and she was as poor as she was young. My being assigned to her was an example of our tiered medical system. She was on the lowest tier – and she got me. I was her short straw. But I wasn’t really looking at the bigger medical-social issues. In fact, I welcomed the experience. And she was to be my only patient...for 36 straight hours.

So we came to know each other pretty well, between contractions, which had begun earlier that day. Her contractions were not Braxton-Hicks this time. She was in active labor when her Mom brought her to the hospital that day. But her Mom could only stay a few hours and had to go home to rest before going to work the next morning. Her Mom was the sole support for the family and feared being fired if she missed work to attend her granddaughter’s birth. That was really sad. So my young lady had no moral support. No family or friends were there with her. And I never met her boyfriend. So by midnight it was just her and me... and her baby trying to be born.

Her contractions became more severe and closer together. I was surprised by how she endured the agony of the contractions in silence. No screaming, like the adult women elsewhere in the delivery ward. She intermittently gritted her teeth and grimaced. I got a washcloth and repeatedly wiped the sweat from her brow. Otherwise, I was not helpful at all.

After many hours of active labor, it became clear that her delivery was not going to be easy. She was too young. Perhaps her pelvis was too narrow for her baby’s head: cephalo-pelvic disproportion. This was years ago and we practiced primitive medicine by today’s standards. We had no ultrasound, just x-rays. So the Obstetric Resident assigned me to bring her to x-ray. I wheeled her on a gurney down the hallway and into another area of the hospital, up a steep ramp, into an elevator, and over to radiology.

We measured the baby’s head and her pelvis. We applied a formula and she did not automatically qualify for a Caesarean section. But, in retrospect, that would have been easier. That night was hell. Her baby’s head had become wedged in her pelvis and was progressing slowly down the birth canal. I made other trips to x-ray with her, wheeling her through the silent dark hallways in pain.

Her baby finally made it. He cried right away and seemed ok. But he was covered with blood and slime and his head had been molded by the tough delivery. He was not a Gerber baby. I clamped and cut the umbilical cord and waited for the placenta to be delivered. Meanwhile, a maternity nurse whisked him away to cleanse and warm him in a baby blanket. The nurse brought him back looking less disgusting and pretty cute. But his mom was virtually unconscious from exhaustion. So I held her baby for a while, admiring his perfect little hands. It was morning now and his mom woke up and I handed him to her, wished her good luck, and left.