I remember it was my first month on the Labor and Delivery deck of a small New England Naval Hospital as a Naval Nurse Corps officer. I had never worked Labor and Delivery in my 7 years prior while in civilian service and was intentionally trying to do everything by the book. My patient was a Gravida 1 Para 0 mother who had started her labor about 90 minutes before she came in to be admitted. She was 50 percent and 4 cm. Dilated.
No sooner than I had removed my exam gloves when, the mother started screaming “it’s coming…it’s coming”. I reassured her that she was no where near delivering but her face, and uncontrolled body language told me otherwise. She pleaded with me to once again check her only 2-3 minutes after I had removed my hand. I reluctantly pulled back the sheet only to view a thick layer of dark black hair crowning. No where in my books or lectures had I remembered that it was possible for a first time mom to go from 4 cm and 50 percent effaced to complete and crowning in less than 3 minutes. That is the moment I decided that reading my patients took priority over reading my books.