With Great Power Comes Great Responsibility

I am often amazed that there are so SO many things that can go wrong during the birth of a baby, and yet, most deliveries happen without anything bad ever happening.  I would love to take credit for all the wonderful outcomes that occur in the delivery room....but the truth is, the birth process usually happens so perfectly, so automatically, that it is not really BECAUSE of what we do, but in SPITE of what we do that these babies are born so "normally".  Of course, we learn all the "what if's"....what to do if the patient does not go into labor by her due date?  What to do if the fluid is not clear when the water breaks?  What to do if there are contractions, but they are not strong enough to cause the delivery to happen?  We "manage" a patient's labor, but the REAL manager is the baby----the baby responds a certain way, or doesn't......the baby passes through the birth canal in a specified period of time........or not.  The baby knows how to take its first breath and "convert" its circulation over to "non-umbilical" circulation....or it can't.....and all we can do is help the process along.  There is so much we don't know.  People are always asking "What can I do to get myself to go into labor?"  but there is nothing, after studies and research, and testing...we still do not know what is the "trigger" that will make someone go in to labor.  (not in humans, anyway.)  We know how to INDUCE labor, how to AUGMENT labor---but not exactly what INITIATES labor.  Why can one woman's pelvis accommodate the passage of a 9 pound baby, but another woman cannot successfully give birth to a 6 pounder?  We are really not sure.  Why do some babies present with feet or butt first, but most try to enter the world head-down?  AND WHY ARE THERE SO MANY C SECTIONS??????  We have talk--we have speculation---we have discussion---but we really do not know.....we watch what the baby does---and we work around it.  I DO know that I have a lot of "sneaking suspicions"...that babies seem to mostly want to be born between the hours of 12 midnight and 6 am!  That when the moon is full, the delivery room is too.  And the biggest thing I have learned, after all these years is this------the baby is the boss.....and the sooner the parents and the doctor/birth attendant accept this, the better off we all will be.