Birth

When my now-grown children were babies sleeping, my husband and I quipped as drunken smiles spread across their faces, “Womb.” When their sleepy smiles faded and they whimpered and pouted we commented, “Birth canal.”

As a family physician who has “delivered” hundreds of babies (medical speak for attending a birth), I consider myself well appraised of the uterus and vagina of a person in labor. I have wiped away blood, amniotic fluid, meconium, vomitus, stool and urine. I have touched tissues and instrumented bodily orifices.

My memories of the Lamaze-esque childbirth preparation classes my husband and I took are sketchy—not surprising, given that the baby I delivered is 30 years old. Yet even as I hoarded every potentially useful snippet of obstetric information with the frenetic energy of a squirrel facing a harsh winter, a lot of the tidbits the instructor dispensed slipped by me for one simple reason: I was incapable of staying awake for the duration of a class.

This became apparent when I was in labor. Coaching me through the contractions, my husband kept urging me to imagine turning red lights to green. “What the hell are you babbling about,” I asked in confusion and annoyance.

“You know, the red and green lights,” he repeated. “Remember? From the classes?”

The body knows what it knows.

I was about to be a first-time mom, in a hospital bed for a few weeks on bed rest for preeclampsia. I tried to catch a nurse’s attention without actually pressing the call bell. When someone brought my lunch, I told them – I think I’m having contractions. They pushed the call bell.

The nurse was surprised. Baby wasn’t due for two weeks.

“It’s just a little Braxton Hicks,” she said with a smile. “Try to relax.”

Birth can be hard work—even brutal terror—for new mothers and fathers. I’d like to point out that sometimes it’s no fun for doctors and nurses either. Sadly, we very occasionally see mothers or babies die or be grievously injured.

When the heartbeat of Sharlene’s baby kept slowing down, everyone agreed she needed an emergency Caesarean. She desperately wanted to hear her baby’s first cry, however.

My first child was born in a U.S. Naval hospital. There were no childbirth classes to attend in those days, so my sister lent me her nursing school text book on labor and delivery. I read it every night but still was not prepared for what was to come.

The birth was nothing she had imagined. Her baby fourteen weeks premature, grossly disfigured from a sacral teratoma and pelvic mass, and now her body revolting from housing this baby any longer. Her blood pressure shot up, her liver became enraged and her platelets malfunctioned as she developed HELLP syndrome. The severity of her symptoms along with the shape of her malformed baby that wouldn’t fit through the birth canal necessitated that I perform a c-section. Her baby lived thirty minutes.

During my second pregnancy, I was terrified I’d experience a postpartum hemorrhage, as with my firstborn, twenty-two months before. That bleeding was so serious the team had used every intervention short of a hysterectomy; they saved my life. As a family physician who attended births, my trauma from the hemorrhage interfered with my ability to attend births. I eventually gave up my maternity practice.

“Don’t push!”

I held back a snort of laughter. This baby was coming. I could feel my uterus tighten again, involuntarily squeezing Twin A further down, her head crowning and bumping against the residents’ hands.

An arranged marriage followed by childbirth within the next year was the lot of many Indian women for centuries.

Moving to the USA provided some reproductive freedom. With little support from extended family in a foreign land, I wanted to complete fellowship before having children, but the dreaded biological clock was ticking louder. I remember feeling conflicted: wanting to wait, but acutely aware of aging eggs. We decided there would never be a perfect time.

Soon after I started my orientation as a labor and delivery nurse, an obstetrician called to say he was sending in a patient whose labor needed to be induced since he was no longer able to hear the fetus’s heartbeat. An ultrasound had showed the baby to be anencephalic, so it was expected to be a stillbirth.

When the mother arrived, we didn’t do the usual check of the fetal heart rate—just started the intravenous line and the drug to stimulate contractions.

December has always been a month of birth for me: fifty-one years ago, on December 11, I gave birth to my first child—my wonderful son. I try not to let the complications following his arrival (the doctor’s failure to deliver the afterbirth, massive hemorrhaging, a D and C, and loss of my breast milk) taint this miraculous event. My husband and I had transformed from being a couple into becoming a family—and I had so many dreams for that six-pound, eleven-ounce bundle of joy. When my daughter was born two years later in November, life felt complete to me.

Dear readers,

My wife’s labor with our first child did not go as planned. We took childbirth classes, and like every other couple, we hoped for a birth experience worthy of a Hallmark card: manageable pain, minimal drugs and a supportive partner–in this case me, a family-medicine resident, whose comforting presence and able coaching would smooth over any rough patches.

Fast forward a few weeks: It’s D-Day. Diane is exhausted, having endured forty-eight hours of labor, the last twenty hours of which have been unbearably painful.