The Stadol has kicked in and given Kristin a chance to renew her strength and refocus her energy. Cara checks Kristin's cervix, which has finally fully dilated to 10 centimeters. At last, it's time to start pushing. "I can do this," she says confidently as she lies in bed on her back, with Glenn supporting her from behind. Again, Cara checks the baby's heart rate, and it's still stable.
Cara's trusted colleague, Miriam Schwarzschild, arrives to assist and provide a new perspective. Miriam, also a certified nurse-midwife, does another internal exam.
"Good pushing," she says to Kristin. "Put all of your effort right on top of the baby." Debra tells Kristin to relax, breathe deeply, and try to visualize her body opening and her baby coming down. Kristin closes her eyes and concentrates.
It's dark outside. Glenn shines a flashlight on Kristin to avoid turning on an overhead light. Kristin has been pushing now for two hours. During one rigorous push, the midwives get a quick glimpse of the top of the baby's head. "Not a lot of hair on that child," one says.
Kristin has certainly made progress. Still, Miriam suggests transferring to the hospital. She believes the baby is in a posterior position and reluctant to budge. But because both Mom and Baby are in good condition, Kristin and Glenn decide to press on.
Finally, the home stretch. As Miriam supports the perineum (the area between the vagina and the rectum), Kristin bears down, while Glenn supports her knees from behind. To avoid any tearing of Kristin's perineum, Cara applies warm compresses, and Miriam swabs on olive oil retrieved from the kitchen. As the baby crowns, there's a trickle of blood. But an episiotomy isn't necessary.
After more than 16 hours of rigorous labor, Kristin gives one final push and a boy is born. Cara and Miriam immediately plop the chubby infant—who is named Griffin the moment he emerges—on Kristin's tummy. "He's got such big feet," the new mother says, tears in her eyes. Griffin lets out a tiny cry, and the room erupts into shouts of joy. "What a victory," Cara says. Glenn beams.
Griffin is comfortably latched on to Kristin's breast. When his umbilical cord stops pulsating, Glenn cuts it with a surgical knife. Shortly afterward, Cara does a standard neonatal baby exam, the same one he'd get if he were born in a hospital.