Lea's labor was quiet and light when I arrived at her house. The rice sock was her friend and Lea was pacing the room, stoppping and breaathing quietly every so often. Her mother was sensitively keeping out of the room but nearby. I watched as I unpacked supplies. Soon things were progressing beautifully, and as often happens, Lea and Jim retreated to the tight little bathroom space. The power geared up a notch. Her water broke and Lea retreated still further, onto the toilet. "Can I push?" she asked (as if she needed permission). She didn't look or sound like she was pushing, so I said "Only if you have to" and remained mostly just outside the bathroom. But it wasn't much later that the "He's coming" told me that Lea was another mom who had fooled me, a no noise and apparently no effort pusher, her baby was right there. Lea squated in front of the toilet, I squatted to one side and Jim to the other, and sweet Evan slid into our hands. Magic. The joy was complete, perfect.

But the work was not over. Evan breastfed almost immediaately. Jim, Lea and her mom werre high and happy. So was I. But the work is not done till that weird and wonderful organ, the placenta plops safely out, the uterus tightens up to prevent bleeding and the midwife breathes normally. After an hour, no bleeding but we decided squatting would be good, or walking to the toilet, or sitting on the toilet, or perhaps in the shower. What about on the bed on all fours? No purple blob. Luckily no bleeding either and Lea doing fine. Eventually, a shot of pitocin.... no blob. Then another.... still no blob. Mmmmmm. At this point there's a bubble of membrane (amniotic sack) with purplish.... blood in it, right there, but still no blob. Pulse over a hundred. Had to say, "Sorry Lea, if no blob in ten minutes (which will be two hours since birth), we'lll have to go the hospital". That would be sedation, manual extraction ( a hand inside..) but there were beginning to be signs that it was time.

It was 3:30am. Jim put his phone on speaker and dialed. The pastor picked up. Jim explained. The pastor commanded in his powerful pastor voice: "Placenta, DROP".

And the placenta dropped.