Wednesday, August 06, 2008

The Sweetest Little Face

No matter how often you've seen it, the appearance of the baby's head in the birth canal is exciting. Encouraging comments ("you're doing so well," "what amazing work you're doing") take on a new level of sincerity and intensity when non-maternal skin shows up.

Many partners become emotional at seeing this first glimpse of their baby:

Oh my gosh! I can see her! You're doing it! Yes...pushpushpushpushpushpushOmigod! Sweetie, She's right there. She's coming! Again? O.K. Pushpushpushpushpush. OH! I can see her little face [sniffle]. She's beautiful! She looks just like-- O.K. YES! PUSHPUSHPUSH. She's so close now...
I've been there. I've ridden that climaxing wave of emotion. It is a big part of the payoff for us doulas, that high.

However, after a few births we learn to take a second look when someone announces they can see the face. Face presentations are rare. In fact, when they occur, the face can become so swollen, that it is mistaken for a bottom! And because it takes the brunt of the friction and force, face presentations often aren't pretty (at first).

Nor is the "face" in the canal pretty. On closer inspection, it seems rather disfigured, often with lots of dark lanugo.

What's going on?

It took me a while to realize I and all these thrilled (or horrified) parents were seeing not a wee face, but a wrinkled patch of scalp.

As the baby comes down the vaginal canal, she usually does a two-steps-forward-one-step-back progression. Overall each push moves her down, but she slides back up a little once the pressure is off. At that point, her skin is pressed tight against the vaginal wall. It doesn't slide all the way back. As the skull bones pull back and slacken the scalp skin, it folds and wrinkles. Try this with your arm: grab it a few inches below the elbow and push toward your hand. See the wrinkles near your grip?

Put those wrinkles under some mucus, down a narrow tunnel, and they could be anything. Especially when all the thoughts of love and anticipation are projected onto them. They could indeed be a face.

When the baby truly crowns, when the perineum is stretched to snapping and the head is moments away from fully exiting, the scalp is stretched taught. There are no wrinkles and no mistaking what is face and what isn't.

Unless they look upset, I don't explain to a partner what that "face" really is. When they are so happy to see it, so full of affection for it, who am I to get in the way? I try to see a face, too, as they are seeing it. Their sweet baby's face.



Blogger Alwen said...

I will never forget touching my son's black baby hair when his head crowned. So soft, good heavens.

Now he's a feisty 9-year-old!

9:56 AM  
Blogger Dorothy H. said...

I remember the first birth I attended and being quite concerned over seeing that wrinkly "face" - having no idea what was going on with that!

12:39 AM  
Blogger Rebecca said...

The scrunchy scalp looks like a walnut, doesn't it?

4:51 PM  

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