It was nearly midnight.  I’d been working at the hospital since 7 a.m., which meant I was heading into my 18th hour on call. At 10 p.m. I’d gone to the doctor’s lounge to lay down on the futon and catch a few hours of sleep, but I got a call about a sick patient, so I returned to the ward to check on him, and ended up checking on a few more sick patients while I was there.

After I took care of everyone, I walked back to the maternity ward to see if there were any cute babies to hold.

Instead, there was a woman who had been in labor all day.  She was 9 centimeters dilated, and was expected to deliver within the hour.

“Do you want to do the delivery?” the OB/GYN asked me.

I delivered a few babies in grad school when I was on my OB/GYN rotation, but I hadn’t delivered any since.

“Sure,” I said.

I went with him to check on the woman.  She was now 10 centimeters dilated, but the head hadn’t descended far enough for her to start pushing yet.

She was laboring like most women in Togo do — without any IV medications, and without an epidural.

Even in the height of the worst contractions, they lay on the bed completely still, completely silent, except for a soft moan or whimper that occasionally escapes their lips.  I’ve never seen anything like it.

After a few more contractions, we had her try pushing, but she didn’t make any progress.  So we used gravity to help things along.

The nurses had her walk around in between contractions.  When that got to be too uncomfortable, we had her labor while she was sitting on the birthing stool — which looks exactly like the ones they had thousands of years ago — a short stool with a hole in the middle for the baby to drop through.

When a few more contractions, with the help of gravity, had helped move the baby farther down, she got back in bed, and with the next contraction, we had her push again.

“Close your mouth, drop your chin to your chest, and push,” I told her in French.

She pushed for half a contraction, and then with a cry of anguish, lay back and refused to push any more.

“Push!” I encouraged her.

She shook her head at me.  “No, no, no,” she insisted.

"Did she really just tell me no?" I asked the nurse incredulously.  I was used to the caricature of American women in labor, desperate to get the delivery over with, yelling, Get this baby out of me!!!

The nurse smiled and said, "This is nothing.  We had a woman in labor a few months ago who literally crossed her legs because she didn't want to push the baby out."

Oh boy.

I looked at the woman again and said, "Push!  It's time to push!"

She shook her head again and insisted,  “NO. NO PUSHING."

"Why?" I asked her. "You're so close!"

She shook her head.  "It feels bad," she said.

I almost laughed out loud.

“It feels bad,” says a woman in unmedicated labor who’s 10 centimeters dilated.  That’s got to be the biggest understatement of all time.

"I know," I said.  "I know it feels bad, but I need you to do it anyway."

Eventually, she agreed to try again.   Twenty minutes later, with a final cry of agony, she pushed a beautiful, healthy 8-pound baby girl into the world.

I suctioned the baby’s mouth and nose, cut the cord and dried her off, then wrapped her in a blanket and handed her to her mom.

As I watched the mom’s tired face relax into a smile as she held her baby for the first time, I thought about the times in my life where God is making something beautiful in me, but in order for it to be completed, I have to go through times that are uncomfortable, stressful, scary, painful and hard.

I wonder how many times God has been calling me forward while I’ve dragged my heels and shaken my head.  “No, no, no.  It feels bad.”

As I left the maternity ward that night, I prayed for the courage to persevere when God's gentle voice calls to me in my pain,  "I know it hurts, but I need you to trust me anyway."

It seems that the key to living the life God has for us lies in that last, simple, powerful word: anyway.  (As Christian Wiman says, "in a grain of grammar, a world of hope.")

When you can't see the finish line, keep running anyway.

When you feel discouraged, keep trying anyway.

When you don't see God answering your prayers, keep believing anyway.

When you're in pain, keep pushing through it anyway.

Because contractions are strongest just before new life emerges,

....and rescue comes at the precise moment all hope seems to have been lost,

....and dawn emerges from the depth of night,

....and life comes when we keep breathing....

....anyway.