I’m 60 hours in to my 72 hour shift. I haven’t slept more than an hour at a time, so I take the opportunity to lie down in the back of the ambulance on the bench.

“Medic 1 for code 3 active labor.” The dispatcher’s voice crackles over the radio, rattling off an address. I groan and punch the numbers into my phone and see that we are a good 20 minutes away from this call. Crap.

“Medic 1 responding, go for additional,” Harley says cooly into the microphone. Sara, one of new EMT’s sits in the passenger seat next to him and I hear them chatting. “How’s that for coincidence?” he says. “Holly, did you know Sara was a student midwife before she came here?”

I had delivered babies during medic school – in a hospital surrounded by nurses and doctors and techs. Not to mention a sterile environment with enough space for everyone. We had picked up Sara as a 3rd rider on a whim. She didn’t have a medic partner that day, so she asked if she could ride along with us and run some calls. I take a deep breath. 18 minutes out. I grab the OB kit out of the cabinet and throw it on the gurney along with our pediatric emergency jump bag.

Dispatch crackles again: “Patient is 32 weeks pregnant with contractions about 2 minutes apart.”

Harley punches the gas. 32 weeks is way too early. You learn in school that the lungs are the last to develop in the womb which is why it’s so vital to be ready to provide emergency care to premature newborns. My hands start to sweat as I’m struggling to shove my hand into my glove.

Be cool, be cool… babies are born every second. Chill out, I tell myself over and over.

The fire department is on scene and I walk with a purpose (but cooly, of course) up to the fire medic. “Hey guys, how’s it going?” I ask, but my focus is immediately on the woman lying on her left side on the couch practicing Lamaze breathing and letting out a painful groan.

“Hey guys,” the fire medic says, “not too bad. This is Felicity, she’s 38 weeks pregnant. This is her 7th pregnancy. She has had 1 live birth. Her water broke before we got here. Contractions are 2 minutes apart lasting approximately 1 minute.” Okay, 38 weeks. The dispatch information was incorrect and this baby is full term. One obstacle out of the way. I see they’ve already established an IV and I’m thankful for that. Felicity let out another groan.

“I think those contractions are closer than that now,” I comment. “Are we crowning yet?” I soothingly instruct Felicity that I’m going to check to see if we can see the top of the head. She spreads her legs. No head. Okay, we’ve got a second. “Alright lets get going.”

With little to no effort the firefighters and Harley slide Felicity from the couch to the gurney, attempting to make her as comfortable as possible. Harley covers her with a blanket, and we buckle the seat belts and made a mad dash for the ambulance. We start fitting Felicity with the blood pressure cuff, pulse ox, and cardiac monitor.

“Holly are you going to want a rider-”

“Yes, please.” I say before he can finish his sentence. “I have Sara who will be back with us. She was a student midwife, but since we’re probably going to have a baby soon I’d prefer to have two medics.”

The fire medic gives me a thumbs up and climbs into the airway seat at Felicity’s head. Harley jumps in the driver’s seat and takes off down the dirt road. We’re about 25 minutes from the hospital. Everyone of us knows we’re not going to make it in time. Sara and I get to work laying down plastic sheets and coaching Felicity as she cries out. Without warning she flips on her back and let’s out a hollow wail. I hear Sara coaching her on breathing: “Don’t hold your breath, when you breathe, baby breathes. Heehee hooo, heehee hooo.” Felicity responds with another wail.

I check for crowning. Nothing yet, but we know it’s a matter of minutes. We coo at Felicity and tell her she’s doing great. “You’ve got this, girl. You’re a rock star, Felicity! Keep breathing!” When she tells us she feels another contraction we ask if she’s ready to push. Felicity cries out with tears streaming down her face.

“We’ve got crowning!” I call out, “Harley, pull over, we’re having a baby!”

The baby doesn’t want to wait until we come to a complete stop. Felicity gives an agonizing push and I guide Baby’s head. Sara and I continue to shout Felicity’s praises, “Keep pushing! You’re doing great! One more big push!”

He slides into my hands and Sara unwinds the umbilical cord. He’s covered in vernix and merconium. Sara grabs the bulb syringe and suctions Baby’s nose and mouth while I rub his back to stimulate and clean him.

The first cry of a new born is the most beautiful sound. It’s magic and elation and relief wrapped into a mini pink package.

We clamp and cut the umbilical cord and place Baby on Felicity’s bare chest for skin-to-skin contact. I cover both of them in a gray fleece blanket. I grab an oxygen mask and place it near Baby’s face for blow-by oxygen therapy.

“He’s perfect!” Felicity sobs as Harley starts to accelerate as we head toward the hospital, “Thank you! Thank you!”

As we wait for the placenta I listen to his lungs, check his reflexes, and continue to tell him how handsome he is. “What’s his name?” I ask.

Felicity smiles through tear stained cheeks. “Aurelius. It means ‘the Golden One’.”

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After turning over care to the labor and deliver team at the hospital and thoroughly washing my hands and arms, we return to the ambulance to clean and debrief. We all exchange high fives and congratulate each other on a successful and smooth delivery. My pants are stained with merconium and blood (some blood from the delivery, some from calls earlier that day). I’m exhausted and I desperately need a shower but I know it’s unlikely I’ll have time for one. I use chemical cleaning wipes to clean what I can.

From inside the truck I hear the tones drop and the radio static comes to life. “Medic 1, go available for code 3 for cardiac arrest.”

Harley punches the address into the GPS and flips on the lights and sirens. “Medic 1 responding, go for additional,” his voice is smooth as butter.

Often I find myself responding to a person who is having the worst day of their life. Sometimes, it’s the last day of their life. But it’s truly a privilege to be there on the first day. To witness the first breath, the first cry; no other feeling can compare.

62 hours into my 72 hour shift.