Great Expectations: A Birth Story
“She could be here by tomorrow morning.” my wife Rachel beamed.
I was equally as excited, “I just can’t wait to meet her.” Somehow under the impression that my newborn daughter and I were going to shake hands, grab a cup of coffee, and get to know each other.
We were in the car on our way to the hospital for an induction. Our daughter was now two weeks overdue and our midwives suggested we not wait much longer. We envisioned the birth to be a candle lit affair, with a birthing tub, little to no medical intervention, as drug free as a crisp early spring morning, a young lady with dreadlocks gently strumming an acoustic guitar, perhaps some Martha Graham choreography in between contractions, and to catch our child as she spilled forth from her mother’s womb. The three of us would then be naked, perhaps in a warm cave-like setting, maintaining skin to skin contact for no less than 72 hours.
Many of these expectations came from our twelve week birth class, which focused on keeping the birth as natural as humanly possible. The class instilled confidence that a woman’s body was made to give birth and most medical intervention was due to impatience and was ultimately unnecessary. The class also encouraged the birth partner, in this case me, to keep a close eye on the nurses and doctors, they can be shifty and may try to pump Rachel full of drugs and cut her open at the drop of a hat. I needed to prepare myself to intervene and demand to know just what the hell they were trying to do to my wife. The class provided pointers for much of the doublespeak I could expect from these monsters. “You think a C-section would be best?! I bet!! So you can line your pockets before your tee time?! Why don’t you C-section yourself right out the door, bub!” I’d yell while kicking the conniving obstetrician in the ass. This was something I was fully prepared to do, I just needed to have a complete shift in personality and temperament before our daughter was born.
One of the great miracles of birth is how miraculously naive first time parents can be with their birth plans. Our induction was scheduled for eight o’clock in the evening, the day after Thanksgiving, during a pandemic. When we arrived It felt like we entered a restaurant an hour after closing and asked to see the wine list. After having our temperatures taken and answering a slew of rote COVID-19 related questions, including if we’ve recently had diarrhea which is always a coin toss, we made our way to the Labor and Delivery unit. Rachel was only permitted to have one person with her due to pandemic restrictions. I was relieved she chose me.
We were shown to our room and Rachel was told to put on her gown so they could strap two monitors around her big pregnant belly. One monitored the baby’s heart rate, the other monitored contractions, and both insured Rachel wouldn’t know a moment’s comfort while wearing them. There is a stage of active labor referred to as “loss of modesty” in which the woman no longer cares who sees or touches her body as long as the baby is on his or her way out. Rachel, in an inspired turn, reached that stage as soon as she set foot in the hospital and went naked under her gown for the duration. She had all the modesty of a nudist resort activities director.
The nurses would ask, “Are you sure you don’t want to put on some underwear?”
“Nope.” Rachel would respond with her backside proudly displayed, finding underwear to be inefficient for the task ahead. They also had her take a rapid COVID test. I asked if I should take a test but they told me since I wasn’t a patient they couldn’t give me one. They simply told me I needed to keep my mask on for the duration of my stay. By this point in the pandemic, a mask felt like a natural extension of my face and it’s best to go with the flow if you’re not the one having a baby come out of you.
I was allowed to keep our car temporarily parked in front of the hospital so we could unload our luggage and it looked as if we had packed for a long weekend in the mountains. I struggle to pack a lunch so packing for the birth of a child was almost untenable. I asked the security desk if there was perhaps a luggage rack and my inquiry was met with a definitive and singular “No.” I returned to the same security desk after getting the luggage to our room and asked where I could park the car. Like any hospital in a densely populated urban area, parking was a multi-phased operation and if each directive wasn’t followed to the letter, my car would almost certainly be towed. I was given a piece of paper to hang from my rearview mirror, a piece of paper to place from my dash, several stickers I was advised to keep safe in my wallet, a wristband that granted me access to nothing, a map with crudely scrawled directions, and I was advised to park on the final level of the underground garage which was warmed by the Earth’s core. For all this, I paid a shockingly reasonable five dollars which I was repeatedly told was nonrefundable.
Rachel began a course of medication around 10pm that would help her dilate and it would take up to twelve hours to make any meaningful progress. Due to monitors strapped around her abdomen, she had to be sitting in an upright position which made sleep or meaningful rest very difficult. The monitors would make arrhythmic beeps throughout the night and nurses would regularly come to our room to check on them while asking Rachel any number of questions. Each time before exiting, they would strongly encourage her to “really try and get some rest.” This was a recurring theme of our stay at the hospital. It would be as if you were trying to sleep and I, along with several other individuals I made no attempt to coordinate with, entered your room every fifteen minutes to gently tickle you and inquire about your bowel movements. As our parting shot, we’d wonder aloud why you weren’t sleeping.
My sleep station was a fold out barcalounger in the corner of the room. The mattress seemed to be made of pipes and sand while the sheets were purely ornamental. I remember reading that fast food restaurants made their seating purposely uncomfortable to discourage loitering and I wondered if hospitals were employing the same tactic. No one should be too comfortable for the birth of their first child and everyone loves to linger at the hospital. The nurses and doctors were also urging me to get some sleep. My right leg heeded the advice and went numb shortly after laying on the mattress.
The following morning we were bleary eyed but excited to hear just how much her cervix had dilated overnight. When the midwife came to do the examination, we were taking bets and wondering if the baby might effortlessly fall out any minute of her own accord. This was one of many vaginal examines I had the pleasure of witnessing. Turns out, I have a delicate constitution when it comes to medical professionals examining my wife’s vagina. Although Rachel could grit and bear it like she was receiving triage on a battlefield, I became lightheaded and felt faint. I kept these feelings to myself because a squeamish husband is an unwelcomed and utterly useless presence during labor. Holding myself up on the barcalounger, I did my best to gently say encouraging things like, “You’re doing great, sweetie. I’m so proud of you.” But it ended up sounding more like, “Jus…. great. Yup….. doing it.”
What quickly becomes clear to any husband or birth partner is that you are the least useful person in the room and perhaps the least useful person in the entire hospital. Everyone serves a direct and dire function while you are puttering around looking terrified. I was also perpetually in the way. Nurses and midwives would often come towards me and say, “Can I just scoot past you?” or “Mind if I just try and get around you?” or “Actually, could you just stand over there.” and more than one “And you are?” One might assume I was providing invaluable emotional support but “Just breathe, honey!” pales in comparison to medical expertise.
The results of Rachel’s vaginal exam were not as we had hoped and her cervix had dilated to what could have ambitiously been called one centimeter. At this moment, we realized that we were in for a long, arduous haul. The next suggested course of action was… the balloon. They would put an uninflated balloon inside her, fill it with saline solution, and leave it for at least twelve hours to help stimulate dilation. After it was fully explained, I prayed the midwife would crack a smile and say, “Just kidding! Can you imagine?! Yikes! A balloon?! Well, it is a birthday! But seriously, folks..” And we’d all share a hearty laugh. But this was apparently our best option if we wanted to stay on a more natural path and Rachel told them to proceed. This marked the beginning of an unpleasant shift in energy. To no one’s surprise, having a balloon full of water inside your vagina is extremely painful and Rachel had all but stopped talking, any movement brought her great discomfort. I did what any supportive husband would do, I sat sentry and watched a marathon of a television show I particularly enjoy. It wasn’t much, but it was honest work.
Hours passed, very quiet and very powerless. I would help Rachel to and from the bathroom and then she’d do her best to find any position that would provide the slightest relief. Over the nine months of pregnancy, we’d often talk about our birth plan but always acknowledged we had no idea what would happen. Our way of telling the universe, “This is how we want things to go but of course we know we don’t control the future. Now that we’ve clearly humbled ourselves unto you, dear Universe, we have every expectation it will go exactly as we planned.” And here we found ourselves, after a relatively uneventful pregnancy, minus a global pandemic, with absolutely nothing going as planned. My only solace was figuring out how to get more than one free meal at a time delivered to the room. This was accomplished through a series of very performance heavy phone calls to the cafeteria.
After fourteen hours of the balloon, the midwife came to remove it and check on dilation. It was two o’clock in the morning and Rachel and I were in varying states of consciousness but ready for some good news. I held Rachel’s hand as two nurses assisted the midwife in removing the balloon and checking Rachel’s progress. While the midwife was checking her cervix, she was able to move the baby’s head and we found out Rachel’s water had already broken and the baby’s head was blocking it’s release. When she moved the head, amniotic fluid poured out. I could hear the gush, I glanced at the source of the noise, and then I began to pass out. One of the least productive things I could have done in that moment was let my limp body collapse onto my infirmed wife, so I sat down and put my head in my hands. I was worried I had done so in too dramatic a fashion but no one noticed, which is one of the benefits of being useless in high stakes situations.
Then the midwife said, “There’s meconium in your amniotic fluid. The baby might be in distress.” Thanks to twelve weeks of birth classes, I knew that meconium was essentially the baby’s first poop but I was previously unaware that babies had the ability to defecate in the womb. Also hearing the words “baby” and “distress” in the same sentence was disconcerting to say the least. This was when real fear made its entrance onto the scene. The kind of fear that can storyboard unspeakable horrors in your imagination at a moment’s notice. No matter how hard I’d try to stay present, the worst conceivable scenarios flooded my mind. It’s also the kind of fear that puts an objectively dumb look on my face. I want to look like I should be holding a sword, ready to do battle against an unbeatable foe. Instead I look like a child with cheese dust all over my face and hands, pretending not to understand his mother’s question, “Who ate all the Doritos?”
Rachel asked, “How much more have I dilated?”
“Almost two centimeters.”
The midwife began laying out our options with an urgency we had yet to hear, making clear our situation was no longer typical. To her credit, she was being very sensitive to our birth plan and did not want us to feel obligated to stray from it. Rachel, in another inspiring turn, took on an attitude which could best be described as not-fucking-around and was ready for medical interventions well outside our plan. She requested a drug called Pitocin which induces very heavy contractions and she also requested an epidural, the big kahuna of pain relief in labor. She had sacrificed herself on the altar of natural birth for long enough and no longer wanted to be in so much pain.
Right away, Pitocin was flooding into her IV. When we first arrived at the hospital, they asked to put a hep lock into Rachel’s arm, which is like a pre-IV that’s already in the vein. This was not in our birth plan and we wanted to keep the fat cats at Big Pharma as far from this birth as possible. The nurse strongly encouraged the hep lock and we told her no dice. She went and got the midwife to speak to us and we finally acquiesced. We thought it would be a simple inconspicuous tube in her arm, but it turned out to be the three car garage of hep locks. It looked like it could not only provide safe passage for several intravenous drugs but also charge an iPhone. We rolled our eyes at what we saw as overkill and less than forty eight hours later, it would have several life saving IV drips attached to it.
Next came the anesthesiologist for the epidural, a man a few words with the efficiency of a German radiator and arms as hairy as Robin Williams’. My wife and I enjoy a brief amount of small talk before having anything injected into our spines but this anesthesiologist was having none of it. After several unsuccessful attempts at engagement while he was assembling a needle that would have looked more at home on the deck of a spaceship, he looked at me and ordered, “You don’t see this.” His way of warmly letting me know to stand somewhere else, specifically not near him. I happily obliged as he injected the needle into my wife’s lower back. His bedside manner was not cuddly but extremely capable. He wasn’t in the room to tend to our fears and insecurities, he was there to insure Rachel couldn’t feel anything from the waste down. I could’ve kissed him on the mouth for it.
We started to feel some momentum. We had gone outside of our plan, she was taking some intense drugs, it was time for big contractions and ample dilation. Instead of relying on the body’s natural functions, we were relying on modern medicine to take us home. It might not have been what we originally wanted but we felt results were now guaranteed. Then, nothing. Like most significant life events, along with the anticipation is an incredible amount of sitting around.
Rachel started getting cold and asked for one of the several flannels I had packed for our weekend getaway. She started to shiver and asked for another blanket. Nurses came into the room more frequently to take her temperature because she was developing a fever. They were worried about infection so they took a blood and urine sample, confirming that she did have an infection. This meant the baby probably had a fever as well. Not great. And to add another ray of sunshine to our already sunny day, the baby’s heart rate was significantly higher than it should be. Rachel was put on oxygen and they placed ice packs under her arms to help bring the fever down. She was too sick to speak and too weak to move which is not exactly the most conducive state for child birth. It was a moment that made me grateful for the pandemic because I was the only person there to see her in that state. Had I seen the fear that I felt in the eyes of a family member or friend, I might have broken down. A hysterical husband would have been of little benefit to the situation we found ourselves in and I’m also a very ugly crier. Blotchy faced, lip quivering, snots, you get the picture.
I studied the behavior of the nurses and midwife every time they entered the room. Reading deeply into every glance at the monitor, every nod when Rachel answered one of their questions, every exit from our room. I have no experience in the field of behavioral analysis but you would have thought I had a degree in how individuals hold back catastrophic information. By this point, the darkest sides of my imagination had free reign and I was almost dizzy with powerlessness and fear. It briefly flashed through my mind that if Rachel and the baby die and I somehow manage to not commit suicide, I’ll move back to New Jersey and become a hermit. Who could imagine a worse fate than living in New Jersey?
Hours passed and with no progress in dilation and Rachel was still running a fever. We had finally reached the get-this-fucking-baby-out-safe stage of labor. Again the midwife laid out our options, the first was a C-section and the second was some sort of amniotic flush to clean out the meconium which would buy us time for a natural birth. To me, the C-Section sounded like dinner at a fine restaurant with loved ones and the amniotic flush sounded like hanging out behind a Chik-fil-AI with militia members. I knew Rachel wanted to avoid a C-section at all costs but the whole vibe felt like we were approaching mortal consequences. I was ready to ask the midwife to leave the room and I planned on begging Rachel to consider a C-section but she beat me to it. “C-section,” Rachel interrupted the midwife, “I’m done. I just want the baby out safe.”
“Alright, I think that would be best as well.”, the midwife agreed, “I’ll get the obstetrician.”
For the first time in almost forty eight hours, Rachel and I felt something akin to relief with a suggestion of hope. Rachel joked, “Did you hear that amniotic flush bullshit? No way I was doing that.” I never loved her more.
Within moments, the obstetrician was in our room laying out our course of action. The obstetrician was a tall, radiant, red headed woman with the confidence of a samurai sword and the last thing she said to us was “I will have your baby in your arms in thirty minutes.” She may as well have put on sunglasses and climbed onto a motorcycle. I had to hold myself back from chasing her down for her autograph. Immediately things started moving very fast. First, Rachel had to sign paperwork confirming she wanted the C-section and there was something that felt so vulgar about having a woman in Rachel’s state sign paperwork. “I know you’re terrified. Life’s crazy, right?! Anyway, sign here, initial here, last four of your social there… do you happen to have the phone number of your previous employer?”
Then the nurse brought an empty cart into the room and said to me, “Put all of your and Rachel’s stuff on here in the next five minutes. You won’t be coming back to this room.” It felt like we were being evacuated before an enemy attack. Rachel is an extremely organized person and this was perhaps the most helpless she felt during our entire stay at the hospital, watching my abysmal packing skills only made worse by the rushed nature of our circumstances. Shoes on top of jackets, larger luggage on top of smaller luggage, loose toiletries, it was her nightmare. She did her best to give me frequent suggestions while the nurses were preparing her for surgery. I would have preferred a dramatic goodbye with Rachel where I held her hand, pledged my undying love, and wiped tears from her face. But my last words to her before surgery were a confused, “Wait.. ok, I’ll see you in a bit.” What it lacked in elegance, it made up for with informality.
I was asked to leave the room with my luggage cart that looked like a prop from The Grapes of Wrath and was ushered into the recovery room. I was told not to leave the room and they would come grab me when it was time. I was alone and this gave me the opportunity to pace a groove into the floor and have several crying fits. Even though I once went on a carnival ride that was operated by a drunk man with one arm, this was the most scared I had ever been in my life. From the recovery room, I was able to watch the doctors and nurses scrub in and wash their hands before the surgery. It was a comforting juxtaposition because I was embarking on the biggest event of my life and they were just heading into work. Performing a C-section is just something to tick off the to-do list. They were asking each other about their Thanksgivings and catching up on the daily trivialities of hospital life. It was like music to my ears. Only thing out of place for them was the hysterical about-to-be father ogling them as they washed their hands.
After what felt like several hours but was only about fifteen minutes, I was cordially invited into the operating room. It was a hive of activity that included a natal intensive care unit on stand by to suck the meconium out of our daughter’s lungs in case she wasn’t breathing. It would be like if you boarded a plane and the pilot handed you a parachute, it would be somewhat comforting but you kinda wish the flight just goes smoothly. They had set up a curtain that started at the base of Rachel’s sternum so we wouldn’t be able to see the profoundly invasive surgery that was about to take place. She was on her back with her arms stretched out and strapped down on either side of her. Thanks to fourteen years of catholic school, my mind made a brief and lazy comparison to childbirth being like a crucifixion that even a freshman Womens’ Studies major would have found exhausting. The man-of-few-words anesthesiologist with the hairy arms was stationed behind Rachel to monitor her anestesia levels on a computer or he was just there to hang out and check his email. He pointed to a stool right next to Rachel and warmly said, “You sit there.” Her body was shaking due to her high fever and the adrenaline of the moment. They told her that it was normal but it worried her. She assumed it would be hard to perform a C-section if her body was doing The Earthquake but they didn’t seem to mind.
Rachel and I said we loved one another and they began the operation. The feeling of uselessness left me and I held Rachel’s hand and told her how well she was doing and that I was so proud of her. She was scared and I got to be the one to tell her it was going to be okay. It was one of the only times in my life I felt like a grown up. Not because I was confident everything was going to be okay — I was shitting my pants — but because I intrinsically knew it was my duty, as a grown up, to tell her it was going to be okay. There was no mother or mother-in-law or wise old uncle to comfort her, there was just me. For a brief moment, I wasn’t useless. Then Rachel told me to get my elbow off one of her IV tubes and I was right back.
The longest part of a C-section is not getting the baby out, that part is almost freakishly quick, it’s putting the mother back together that takes a while. Before we knew it a nurse came from behind the curtain, which made me feel like we were backstage at a very experimental theatre piece, and asked me, “Would you like to see the baby’s head come out?” I didn’t want to leave Rachel’s side and I thought we should see the baby together for the first time instead of me peeking over the curtain like a nosy neighbor. The nurse asked for my phone and took pictures of our daughter’s initial entrance and then there was a big joyous commotion as the baby was all the way out. I immediately forgot about my first-look solidarity with Rachel and jumped to my feet to see over the curtain. We had been warned that the baby might come out covered in what looked like green mud. But it wouldn’t be mud, it would be her feces and we shouldn’t freak out. I thought I was about to see some kind of swamp monster grabbing at the obstetrician’s throat but instead it was a big beautiful baby that wasn’t covered in shit. All I could think was this is who’s been growing next to me on the couch for the last nine months.
The NICU team whisked our little non-swamp monster over to a table to make sure her lungs were clear but no one was all that worried because she was crying loudly which was a good sign.
Rachel put her hand on mine and said, “Go be with her, I don’t want her to be alone.”
I walked over to the table and there was my daughter kicking her legs in a stationary march that appeared very urgent to her. My heart didn’t suddenly explode and I didn’t immediately feel like a proud father, I just knew nothing was ever going to be the same and that was okay.
“Rachel, she’s good,” I yelled across the operating room, “She’s perfect!”
I asked the nurse if I could cut the cord. In a lapse of understanding basic human anatomy, I didn’t realize that since the baby was already well across the room, unless Rachel had some kind of world record umbilical cord, it had already been cut. The nurse could tell I didn’t know that but kindly said, “Of course you can, Dad.” She handed me the scissors and I cut a bit of the excess cord, completely unaware the cutting was a symbolic indulgence provided by a good hearted medical professional.
“This was in our birth plan,” I told the nurse, “At least one thing went as expected.”
Tom Sibley: Writer reluctantly living in Los Angeles, CA. Work has been featured on Gothamist and MTV.com