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.