A BIRTH is a breathtaking, momentous event that changes the lives of those closest to it forever. Yet it is also quite an ordinary event that occurs thousands of times a day. And it can be a very messy miracle, especially nowadays.
Time was when you went to your doctor and he (rarely a she) put you in the hospital and put you to sleep, and you woke up and saw your baby wrapped in a bundle. It was almost automatic. These days it's messier, not only in the sense of blood and screaming and feces and hemorrhoids, but also in making choices.
For us and many of our contemporaries, there are two parts to giving birth: the birth itself, and the decision of where and how to do it. Creatures of the '60s that we are, we want to do it the best way for us, not necessarily the way we're told is best -- which calls into question the years of experience and training of respected professionals who have been running the show for some time. It's lot to sort out.
It wasn't easy for us to decide to go to the hospital for our birth. We knew all the arguments in favor of home birth. We had taken classes from an extremely competent and articulate midwife who delivers only at home. Our friends had home births.
But there was this overwhelming and very simple question that we couldn't get past: Could we live with ourselves if anything happened to the baby that could have been avoided in a hospital?
In some ways home birth is safer than in a hospital, because it doesn't introduce foreign germs and doesn't involve drugs and fetal monitors that can cause more problems than they solve. But if something goes seriously wrong at the last minute, a hospital is where you want to be.
We had been through three years of emotional hee and two operations, including major surgery on Martha's tubes, to get pregnant. Tubal adhesions grow back, Martha was 37 and I have a low sperm count. Could we risk such a precious pregnancy for the kind of birth we wanted? Our rational minds concluded: no.
Our families, including two practicing obstetricians, were relieved. They stopped sharing their fears and anxieties with us. We felt relieved to have made the decision. Everything was set.
Not that we were very happy with our choice of hospitals. One was very well equipped and well staffed, and would not allow our older children (age 11 and 13) to be present, which we very much wanted. The other hospital was small and folksy, involved a family practitioner, and would allow our children to be there. we chose the latter, not sure whether this compromise between home comfort and hospital expertise would give us, instead of the best of both worlds, too little of either to make the choice worthwhile. o
From their position of superior knowledge, many doctors argue that it is only selfishness for parents to risk their child's health, even its life, for a setting that makes them feel good. This argument is based on the idea that those with the most information about life-and-death matters should be in the most control over them.
But technical information isn't everything. A birth is not simply the medical feat of getting a baby out of a mother and keeping both alive. It's a supremely important emotional event, the highlight of many people's lives, and the role that parents and siblings play in it can color family relationships forever.
The central issue is control. Doctors and hospitals control a birth setting in a very different way than parents do; they have to consider their liability and the economics of how much time they spend on each patient, as well as the welfare of mother and child. Doctors and nurses have their own families go get home to, while parents are creating theirs. The question is what is taking place: Are parents giving birth to their child, or is the doctor delivering the baby? Is childbirth treated as a natural function or a sickness? Do the professional helpers keep respectfully in the background as much as possible, or do they occupy center stage, calling the shots from the start?
The resolution of the issue, we found, finally comes down to a matter of faith. Do you choose your faith in medicine and technology. Backed up by all the training of doctors and by their mystique? Or do you choose a faith in birth as a natural process that has been going on more or less unaided for many millenniums?
Since mattes of faith are based party on knowledge, we set out to educate ourselves. We read, we learned, we talked to both sides, listened to friends and tried to sort out our responsibilities, to ourselves, to the baby and to each other. How much, for example, should I express my own fears about home birth? If I didn't and something terrible happened, I'd be partly responsible. But if I pushed my fears too much and Martha had faith in a natural home birth, that would undermine her.
One thing we settled on definitely was using the Bradley method, and approach to natural childbrith taught in our classes that emphasizes relaxation during contractions. Dr. Robert Bradley's book, "Husband Coached Childbirth," won us over with his emphasis on the central role of husband and wife working together for a healthy baby.
We visited the hospital, inspected the birthing room, talked to the nurses and sent a letter listing 30 requests of how we wanted to handle the details of our birth. We discussed the letter with our doctor and with the head nurse, who was initially quite offended by our requests.
We had decided to do early labor at home with our midwife, and then go to the nearby hospital for the birth. Barely admitting it to ourselves and not mentioning it to our doctor or our families, we left open the slim possibility that if everything were going well, we might stay home for the birth.
Everything was going very well. The pregnancy had been normal. Martha had followed Dr. Tom Brewer's diet for a healthy baby ("What Every Pregnant Woman Should Know: The Truth about Diet and Drugs in Pregnancy," by Gail and Tom Brewer). She had to get up early in the morning to start eating, so she could get down all the nutrition in the diet by the end of the day. Her pear-shaped body was a marvel of elasticity. The baby was well positioned, big and apparently healthy.
Our house was set for the arrival. Our children and special friends gathered. Martha swore she wouldn't let the baby out until her daughter Heather had come home from Germany where she was visiting her father. My son Seth came from Washington, and Martha's close friend Judy came from out of town at the first sign of labor. Our nearby friends Larry and Mary were ready to come when called. My own fears about the birth and parenthood had shifted to the background, eclipsed by my excitement. When labor began at 9 in the evening, I still wanted to put it off; I wanted just one more night's sleep. But the baby had waited long enough.
Our weeks of practice, though boring at the time, paid off. Our system of getting Martha comfortable and helping her relax during contractions by talking to her and messaging her was reassuringly familiar to both of us. Like Olympic athletes after a long training period, we were ready for the big event.
By 1 a.m., with a clear pattern of contractions, we summoned our certified and very experienced midwife, Kay Matthews. By 3:30, Kay said it was time to go to the hospital. When I called, the nurse said the birthing room was in use and we would have to use the delivery room and then go into a labor room which we would have to share with another patient. Had the birthing room been free, we probably would have awakened our children, disrupted our situation where everything was going so smoothly, and reluctantly gone to the hospital. But the nurse's report made the decision for us. It seemed right to stay home, which was where we'd really wanted to be all along.
We continued on our journey through this very special moment in our lives. Though there were other people there, Martha and I inhabited a world of our own. I was constantly with her, getting her comfortable for contractions, supporting her when they came, rubbing her back, sometimes walking slowily through the house with her to stimulate contractions. We had worried that this time would be so mementous and private that anyone's presence would be an instrusion. But the connection between us was only enhanced by the circle of loving friends around us.
From the moment he walked in the door, Larry was a great comfort to me. Somehow having another man there, amid three women tending to Martha, was very important for me. It was Martha's moment, but much was asked of me too, and Larry, having been through it, knew what that meant.
Martha was progressing and doing extremely well. She kept relaxed during contractions, calm and confident, never losing her poise under pain. Each time I would remind her that the contraction would pass like a wave and never return. Sometimes I would describe one of Martha's favorite places where she feels whole and at peace. Occasionally she would cry out a little, and I would more insistently urge her to relax and watch the contraction pass. I was very proud of her. At this moment of supreme effort, one of the most difficult tasks of her life, she summoned her courage and strength, and they were there.
By 5 a.m., she was in transition, approaching the last stage of labor. With two centimeters of dilation to go before she could begin pushing the baby out, Martha's progress stopped. The contractions kept coming, we continued the relaxation routine, our children woke up, our friends made breakfast, the day broke -- a crisp October day with thick clouds and spotty sunshine -- and still Martha made no progress.
Having long since thumbed through every magazine in the house, Kay sat busying herself with knitting, determined not to interfere with the natural course of labor until it was absolutely necessary. The baby's heartbeat remained strong and steady. Finally, as the ordeal wore us down and aroused our concern, Kay said that we'd go to the hospital in another hour if Martha wasn't fully dialted.
But with the final check at 11 a.m., she was fully dilated, and the last phase of pushing the baby out began. I didn't think Martha had the strength to do it, but her body called on deeper resources than I could see. Between contractions she relaxed so totally, involuntarily slumbering for five or ten miniutes, that she awoke with renewed energy for each contraction. She would murmur, "Here we go, guys," we would brace her and encourage her, and she would push.
It was a baby that took a lot of pushing to be born, two and a half hours of it. Toward the end Martha had been through so much that she didn't want to push anymore. She didn't care anymore. She just wanted to get this thing out. She was operating on instinct and our urging.
Everyone was in the room now; Heather and Seth held their breath and pushed with Martha. The moment approached; the tone of the room grew hushed. We spoke in excited whispers, urging Martha through her final pushes.
Suddenly Seth and Heather, at the foot of the bed, exclaimed, "There it is! I see the head! Look at the hair!" I looked, and was amazed and relieved: After all this effort, there really was a person, a human baby, in there coming out. Then the head was out, up to the forehead first, then the whole head, then one more push and the baby came flopping, gushing out. Kay moved it right away up on Martha's chest, and two large brown eyes opened wide, peered into our teary faces for half a minute, then softly closed. We rubbed the baby and covered it with soft blankets, its long limbs totally limp, flopping wet all over Martha's chest.
For some time we didn't know or care what sex the baby was. I was too busy worrying, too concerned about its initial purple color. We were too busy nurturing the baby, too enchanted by this new being before us. "Is it all right? Is it breathing? Is the color OK?" I kept whispering, and Kay would reassure me. Then someone said it was a boy, which was very much unexpected, given family patterns.
I'd forgotten about cutting the cord. When Kay handed me the scissors, the symbolism of the act hit me: I was making this child a separate being, no longer physically part of Martha's body, and she and I were once again the couple we had been before the pregnancy. Such connections are one of the major reasons for natural, family-centered childbirth. With simple medical acts of such supreme and everlasting emotional importance, how preposterous it seems that a nurse, whose name I would forget in a week, should perform such a task.
We had a family huddle with Jacob. He was alert and very calm. We waited for the placenta, and the others cleaned up. Then we had some birthday cake and champagne, and toasted Jacob, and Martha, and me, an everyone. The sun streamed into our bedroom, and Larry and Mary and Kay left, like angels who came to lift us over a rocky path and then departed. We relaxed, deliciously exhausted, and rehashed it all with Judy, while the kids went horseback riding.
We had dinner that night in our own house by candlelight, and Martha got up the next morning and leisurely made pancakes. Jacob never left the house except for a brief visit to the pediatrician. There was no disruptive transition for him in coming home since he'd been born there. Martha's mother came to help out and was amazed at how calm Jacob was. The specialness of the birth transformed us all, including Jake, wrapping us in a glow of warmth and love.
There was something so innocent and gentle and simple about the birth. It has heightened my reverence for the two great elementary mysteries of birth and death that define our lives. Jake's birth has made me want never raise my voice in anger again, and to be gentle toward life forever. I haven't always succeeded, of course, but the impulse is still there and remains strong. The little bundle of sweet, joyful life that toddles around my house reminds me of it every day.