Progress Notes


Emily Podany, MS2

There is a small, white heart drawn on the sign outside the labor and delivery room. It is an inconspicuous sign, powder blue and simple.

“What does that sign mean?” I ask my attending as we stand at the nurses’ station together, reviewing charts.

“It means comfort care,” she answers softly, glancing over the top of her pink-rimmed glasses at the door. “The baby born in that room will not receive any fetal monitoring because he or she has a disease that is incompatible with life. We put the sign there so no one goes in without knowing.”

Incompatible with life. I imagine the clinical phrase accidentally spilling from a doctor’s mouth in front of the family. The words hanging in the air, cold and impersonal, becoming permanently inked in the mother’s brain. Once said, they cannot be taken back. Your baby’s disease is incompatible with life. All of those future birthday candles blown out in one cold breath.


Ten minutes later, I stand at the back of the room as a different woman tries to push a healthy baby into the world. “Deep breaths!” the OB says, patting her on the arm. “You’re doing great!”

Someone pulls out an ultrasound and the sound of the fetal heartbeat fills the room with a rapid but steady lub dub lub dub. They carefully monitor the fetus for any signs of distress.

There is a moment of chaos, of movement, and then suddenly, as though from nothing, there is a baby in the doctor’s arms.

The baby takes its first breath, and congratulations ring out around the room. One nurse plays “Happy Birthday” on a little speaker built into the bed, the tinny notes echoing in the delivery suite. The baby is placed on his mother’s chest, then whisked away.

“I don’t like your color,” the neonatologist murmurs to the newborn, placing the baby under a heating lamp and beginning to massage its limbs. “There we go, come on now,” she says as she suctions out the baby’s nose and mouth. The baby begins to cry in earnest, and its limbs turn a beautiful, healthy shade of pink. “Perfect,” she whispers, smiling down. The baby’s father hangs back, tears in his eyes.

“Come on, Dad! You can get closer!” one of the OBs shouts from the other end of the room, grinning. “You don’t have to be scared — that baby is yours!”

The excitement is contagious, but my mind is wandering to the other side of the labor and delivery floor, where another mother is laboring. She is laboring to bring a baby into this world to die. She is doing this hard work to hold her baby for a few moments before the baby drifts away from her.

No heartbeats will fill her room, no songs will play at her baby’s birth. But she will have a moment when that baby is hers and hers alone, together in a momentary bubble of time before it bursts.

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