Doctor Thompson pulled his long surgical gloves further up his arms to his elbows. He watched his patient with a small grin. She was going to fight every step of the way. He leant forward as the contraction peaked. He watched the elevating readings on the various screens. The fetal heart rate was strong but the maternal vitals were shaking. He didn't need the mother to go into distress before the active pushing had commence. He waited for the extreme contraction pattern to slow for a brief period. He parted the vaginal lips and pushed hard into the birth canal. He pushed until his entire hand was deep inside. The head was birthing well through the cervix. It just needed some more help and the patient would be fully dilated. The experienced doctor applied firm pressure. With the next contraction, the head slammed forward with manual assistance. The head filled the entire birth canal. It was enormous. The pushing stage now could commence with full force.