Another birth story

Back in my first year of practice, when I had to take emergency call and carry the dreaded beeper, I did several c-sections. Whenever a patient would try to have its litter but stall out, I'd give oxytocin injections to try to jump start that uterus but it never worked. By the time I saw them, surgery was inevitable, with one exception.

Once I saw a little white rat terrier, bloated with pregnancy. She'd been trying to push out the first puppy for several hours, but he was stuck. I gave her oxytocin, lubed her up, and helped pull the big puppy out. It was too late; he was already dead.

I chatted with the owners while we waited to see how her labor might progress. She was a young dog, and her owners were very sad about the dead puppy. I could feel that she had one large puppy still inside her. Nothing seemed to be happening, even after a second oxytocin shot. I feared her uterus was spent and that we'd have to do a c-section to get the last pup out. I decided to examine her one more time.

This time I could just feel the puppy's head. Female dogs have a contraction reflex: if you stroke the dorsal vaginal wall in an outwards direction with a crooked finger, they will have a contraction. It is appropriately called "beckoning." The young mother responded - she still had a little bit of push left in her! So, using more lubrication, I coaxed more contractions out of her and moved the puppy into the birth canal. The owners became very excited. Soon we could see the head in the sac starting to emerge. Using one hand to pull the puppy's head and the other hand's finger to beckon more contractions, she slowly made more and more progress until - BAM! - the puppy slid out. I pulled open the sac and rubbed her down. Mom got interested and began licking the puppy.

The dog owners were overjoyed to have a healthy, alive puppy without surgery. "We'll name her after you!" they said.