I wouldn't second guess your decision at all. You could try the other interventions while pushing....oxygen on, IV fluid open, and even have her push on her left side, but ultimately it is your job to make sure mom and baby are safe, regardless if the doc is in the house or not. I definitely wouldn't sign that paper and would sit down with the nurse manager and explain your reasoning! Good job!!! I'm sure the mom and baby thank you for their health!