It was literally a matter of life or death, the decision rested solely in my hands — and it needed to be made quickly. I glanced up at Patricia for a fraction of a second, but it was just long enough to see the desperate pleading in her eyes. Everything that mattered to them, the future of their family, hinged on my decisions and actions for the next thirty seconds. My eyes dropped back down to the surface of the water, then below, where I could see the shape of the baby’s head which moments — yet, seemingly years — before, had emerged triumphantly and stopped. Patricia’s best efforts to push the rest of him out were futile, and when she reached and felt around the baby’s neck, all of our worst fears were confirmed. The cord was wrapped tightly around his neck, and he needed help. Fast.

If you’re wondering right now how I found myself in this position, in a semi-finished basement in a suburb of Chicago with the toes of my freshly washed Chuck Taylors pressed firmly against a rented birthing tub and my heart in my mouth, let me assure you… you’re not alone.

After an extremely traumatic birth experience with my first child, I promised myself that the next one would be different. I would have more control. I’d be better prepared. I’d have the support I needed to have the birth I’d wanted and assumed I’d have the first time around. I interviewed hospital midwives and found a Bradley class which would prepare my husband to be my labor and birth coach. I researched water births and read and read and read. When I did finally go into labor, I felt prepared. When my second child was born in water into the hands of my husband, and under the supervision of our midwife, I felt empowered. I could do anything! I couldn’t wait to do it again. A year later, we did just that. Then again three years later. And then it was over. My husband was done having babies and had a vasectomy, and I. Was. Devastated. I loved being pregnant. I loved having babies. The birthing process came naturally to me. And now it was over.

I couldn’t shake the feeling that everything I had learned was “lost” after the birth of that fourth baby. I wasn’t really sure what the resolution to this feeling was, but after three months, the answer came to me. I decided to become a Bradley instructor to help other families have the birth experiences we had had. It was the right choice. It felt right. During training, it was mentioned that the class would qualify as part of the certification to become a doula — a mother’s helper during labor — and my mind began to spin. To be at another woman’s side as she labors, to be her strength when hers was depleted, to coach and encourage the dad to be her support system during her most vulnerable moments, to witness a birth — YES!! This was a dream. This was where I’d been led, and I was totally down for this.

I taught a few Bradley classes and began my doula training. It flowed so easily from me. Shortly after my training was over, I attended my first birth, a 51-hour labor that included some swearing (hers), some tears (mine), and a brief nap on the hospital floor. After the baby was born, I felt… like I was going to burst right open. It was a magnificent experience, and one I will never forget! But none will ever top what was to come soon after.

Patricia and Glen contacted me in the summer of 2005, and we met in a coffee shop in the north suburbs. They had a toddler with them, and as they tended to him and she absentmindedly rubbed her swollen belly, we chatted about my birth experiences and what had led me to become a doula. Perhaps it was something I’d said, or how I made them feel, but in a twist of fate that would forever burn the memory of one another on all of us, they hired me on the spot. She was due in a matter of weeks, so while we’d scheduled a prenantal meeting to go over her birth plan and talk about their expectations of me on the baby’s birthday, baby had other plans. A week later my phone rang, and the tone of Patricia’s voice told me that I needed to get on the road.

I arrived at the address they’d given me, and Glen met me at the door. The calm, confident man I’d met just days before was anything but. He looked panicked, and it wasn’t long before I found out why. He led me down the metal-trimmed linoleum stairs to a basement that was part family room, part… game room? I remember the linoleum floor very clearly because I spent the next 15 minutes intermittently staring at it as I fervently prayed for all of us. As I turned the corner to the room where Patricia was laboring, I made two crucial observations.

One. There is a birthing tub set up already, filled with water, and containing one red-faced, deeply focused woman minutes from giving birth.

Two. There is no midwife.

Patricia’s trance was broken by my arrival, and she looked up, her face streaked with a panic which mirrored that of her husband’s (who was suddenly  in swim trunks and climbing into the birthing pool behind her) — and now mine. “The midwife didn’t show up. I don’t think she’s coming. We have been calling for an hour…” (pause as she has a contraction) “please don’t leave us. You don’t have to do anything. We just need you here to tell us what’s normal and not normal. Please don’t leave us. We have everything we need. There are scissors and clamps for the umbilical cord on that shelf over there —“ I looked to my right and my eyes fell on a 1975-issue wicker bookshelf which was deftly holding up a pair of gleaming surgical steel scissors, which are forever in my mind, rusty, for reasons I’ll explain at another time “— and we are really hoping the midwife shows up any minute, and —“ (pause for another contraction) “— and I don’t think there’s time to even call an ambulance. Please don’t leave us.”

It was at that moment that her water broke, completely interrupting my hair-on-fire full-on-panicked decision-making process. I was now in this mess. In good conscience, I couldn’t leave. I couldn’t. It wasn’t in me to abandon this family when perhaps I could help until someone with more medical training arrived. I called 911, counted backwards from 10, and when the call connected, recited the address. That was the extent of my conversation with them because it became glaringly obvious that this baby was on his way out. Now.

Patricia pushed three times and each time I held my breath along with her. Glen chanted through his count to ten, mostly masking the tremble in his voice. I was staring intently at the water, shouting my encouragement while silently praying, praying, praying. And suddenly, he was out — his head was anyway. And everyone who’s given birth knows that’s the hardest part, right? Not today.

So here we are. Patricia’s eyes were again pleading with me. She is stuck in that position in the birthing tub, and Glen is stuck behind her. She began to beg me to help her. She promised that no matter what happened, I won’t be held liable. She apologized over and over and begged me to help. I had a half second to make a decision that would either save or end this baby’s life. I had a half second to make a decision that would follow this family around for the rest of their days. I had a half second.

My mind flashed quickly to the scissors. They were a step away. I pictured myself taking that step and grabbing the scissors and cutting the — no, I can’t see anything under the water and how would I clamp the cord first, no. The scissors are out. What else? My time to think this through without all of the information was over, and I plunged my bare hands into the water and quickly felt around the baby’s neck. The cord was so tight. impossibly tight. Too tight. “Please, God, help me.”

In this moment, I can still recall every sensory detail. I can see the back of the baby’s head, his light brown hair swaying in the underwater current I’d created when I’d acted on my decision and thrust my hands into the pool. I can smell the amniotic fluid that’s mixed with the water just inches from my face. I can feel my toes bent up and pressed firmly inline just below my knees against the side of the pool. I can hear the blood rushing through my ears. I can taste a whisper of the coffee I’d drank on the way to their house mere moments before… time stood still.

I felt the cord. Too tight. I could barely get my finger underneath it, and the tension was so great that I feared it would snap if I applied any more. I scrolled through my list of choices and came up empty. I said one more prayer, or perhaps I’d never stopped, and began to gently roll the umbilical cord over the baby’s left ear and lower jaw. I rolled it up the side of the baby’s head. I rolled it until it reached the very top of his pointy little head, and with the slightest nudge, it was over. I grabbed the slack I’d created on the right, pulled it back over and unlooped the rest of the cord from under his chin… and with one final push he turned face up, and into my hands he was born, staring straight into my eyes.

I looked down at this new life for just a moment before I reached forward and placed him into his mother’s arms. I can’t describe the feeling I had. “Relief” doesn’t seem to touch it. Thankful? Blessed? Overjoyed? I honestly don’t think a word exists to describe it, and that’s ok.

The next few brief moments are quiet and sacred, and I think I’ll leave them there, in that space between the four of us, but I will tell you this — I was led there that night. I feel it in my bones all these years later. It was the first and last time my hands would ever be the first to touch a child that wasn’t my own, and it is a powerful and profound experience that I will take with me to eternity, along with everything I smelled, tasted, heard, and saw.

I was led there, and it changed my life.