A/N: A BIG thanks to JBethH & toridw317 for their awesome reviews. I'm am ever grateful for your continued support.
This chapter is a little graphic with the birth. I actually work in healthcare and I've tried to make things as realistic as possible. I hope you enjoy!
Also, I again encourage you to check out my newest fic, fulfilling the prophecy, even though Jo isn't in it.
Please leave me your thoughts on this chapter, I rewrote it a couple of times!

HELLO AND GOODBYE

"Okay, push!" Eliza said and Jo squeezed so hard on Dean's hand that he thought she broke a few bones. "Ten, nine, eight…" Eliza started counting backwards and Jo's face contorted to a very painful expression. "Four, three, two, one. Good, you're doing great Jo," Eliza instructed. Dean wiped the sweat off of her forehead again, and brushed her hair back.

"I can't do this anymore. I'm too tired, I'm done Dean," Jo panted.

"You're almost there Jo, come on keep going," Dean said. She looked up at him with tears streaking down her face. He could only imagine how painful it was. Before Jo could even attempt to reply to his statement, Eliza instructed to push again and began to count. Dean rested his free hand on her shoulders and she hunched forward to push.

"Alright Jo, keep going, we're almost there! I can see it!" Eliza exclaimed in happiness from her position. Dean looked down at Jo and saw how worn out she truly was. He could see the dark circles under her eyes, her pale complexion, and the constant sweat that plagued her. During the push she started to sob as she screamed. The older Winchester had never heard someone scream so loud before in his life, and he'd hunted hundreds of different creatures. "Here we go!" Eliza said as a loud cry sounded throughout the room. Jo smiled slightly at the noise as the tears continued to run down her face. "It's a boy!" Eliza said cheerfully. She looked at Dean and said, "Hurry up, I need you to cut the cord." She said it in an authoritative order, and Dean complied.

It was the first time he had left Jo's immediate side in over an hour. Grabbing the scissors from the tray, he quickly cut the cord that connected Jo to his son. 'I have a son,' Dean thought, and a huge smile crept onto his face. Eliza moved to clean off the baby and Dean returned to Jo's side to make sure she was alright.

"A boy. We have a boy," she whispered through her panting. The color was quickly fading from her face.

"Jo, we've got to push the placenta out now, you're almost done. I promise," Eliza said as the baby was crying in the nearby crib that had a warming light on.

"What?" Jo said painfully.

"Come on, push!" Eliza said and the placenta was quickly expelled. Dean saw Eliza stand up straight and noticed how much blood was over the front of the nurse. However, Dean stole a glance at his son to make sure he was okay and let out a relieved sign to see a pink, crying newborn.

"Jo?" Dean said in question as he turned around to see what she wanted to name him. His heart nearly stopped when he saw that her eyes were closed and she was breathing very shallow. "Eliza!" Dean shouted at the sight of Jo. The blood-covered nurse was already bustling around.

"SAM!" she called over her shoulder and the youngest Winchester strolled in with Balthazar trailing behind. Once they saw Jo, Sam's jaw dropped and Balthazar grimaced. "She needs blood. Fast," was all Eliza said. Dean had never seen her so serious before.

"Balthazar, do some angel thingy and fix it!" Dean screamed at him.

"I cannot. I can't heal her, I'm sorry Dean," Balthazar said sadly.

"Sam I need you to rub the baby with this blanket and make sure he's breathing and warm," Eliza instructed as she set out a white palate with circles in it.

"What the fuck do you mean you can't fix it! You're an angel for Christ's sake!" Dean boomed. As he yelled, he continued to look between Jo and Balthazar.

"God is gone, with what's happening in Heaven we simply don't have the power anymore. I'm sorry."

"At his tone, Dean's heart rate increased to a dangerous speed as adrenaline raced through his veins.

"Sam, come here," Eliza ordered and took Sam's hand in her own. Pricking his finger, she let his blood drop onto the palate. Moving next to Jo, she did the same.

"What are you doing?" Dean asked frantically.

"Trying to cross match blood. She needs blood soon or she will die," Eliza said as she concentrated on mixing the two palates with a separate liquid. "Sam is not a match. Dean give me your hand." Dean all but flew into her arms to give her a finger to prick. A minute later she nodded. "Dean you're a match. Sam watch the baby. Dean, come over here," Eliza said as they both heard Jo's heat rate decrease on the small, portable monitor. Dean obliged and felt sweat drip down his neck. Sticking an intravenous catheter into Dean's left forearm, crimson liquid began to fill a clear bag.

"Jo. Jo!" Dean continued to shout but she remained unconscious. A single tear fell from his left eye as he watched the woman he loved lay still on the table she just gave birth on.

"We weren't prepared enough," Eliza said, cursing under her breath. Dean didn't hear anything she said; his gaze remained focused on Jo as his blood poured into the bag.

Sam stood over his new nephew, and he continued to rub him with the blanket. Not sure what to do, he just stood there watching the baby cry and silently prayed that Jo would make it. Balthazar stood off to the side, and watched the scene before him unfold.

"Okay," Eliza said quickly as she removed the tubing from the bag and ran to Jo's IV. Hanging the fresh blood from Dean, she paired it with the normal saline and prayed that Jo's body would accept it. Dean removed the tube from his forearm and watched as a few drops splattered onto the floor. Quickly grabbing a used towel, he pressed it to his arm to cease his own bleeding. Knowing all there was to do while the blood infused was wait, Eliza moved in between Jo's legs and saw the clotted, bloody mess. "Dean I need you to grab me that small green box," she said as she sat down at got closer to Jo's entrance. Dean grabbed it and handed it to her quickly. "Open it for me," she added as she donned sterile gloves again. He did as she asked and she removed a sterile stitch kit.

Standing down by Jo's entrance, Dean saw what the birth had really done to her as Eliza started to stitch up her cervix. Stealing a glace towards Sam and his crying son, Dean wondered how he was supposed to name him without Jo.

"I need some wet towels and a dry one so I can clean her up after these stitches," Eliza said, tearing Dean away from his burdening thoughts.
"Okay," he responded and Balthazar helped him grab the towels. Once Eliza had all that she needed, Dean stood next to Jo and took her small hand in his. She continued to have a heartbeat but her breathing was shallow. As she stayed unconscious while his blood infused into her veins, Dean kissed her forehead. "I love you. You have to come back to me. Please. Come back to me," he whispered into her ear.