What to Expect When You’re Not Expecting

"I have, as yet, never seen a birth that even remotely resembled mine."

Carlos Garcia Rawlins/Reuters

I didn't know what to expect while I was expecting, mostly because I didn't expect to ever be expecting. Yet here I was, in my ninth month, just beginning to learn about pain­ relief options (there were options?) and that you could actually have someone other than a doctor deliver your baby.

In order to understand how I ended up this way, we need to reel the story all the way back to when I was nine and inherited an old typewriter from an elder brother. This event allowed me to type up one of my numerous horse stories, three­-hole­-punch it, and sell it to my parents for a nickel. I decided on the spot, a 9-­year-­old in rural Minnesota, that this was what I wanted to do: become a writer, which meant I would 1) move to New York, 2) live in a garret apartment, and 3) have a cat and books for company. Because I’d be so busy pursuing my career, inherent in this list was the proviso: Never have children.

Thus, while my childhood friends played with their Baby Alives, eventually graduating to babysitting actual babies, I kept aloof, aided and abetted by the fact that my parents were Korean War refugees, plunked in the middle of Midwestern nowhere due to circumstance and history. Ergo, we had zero relatives: no cousins, aunts, or uncles, no grandparents, no regular exposure to the cycle of life. I was often dispatched to play the piano for guests, but never to change a diaper or amuse a baby cousin. This made it so much easier to concentrate on pursuing the artist's life, one without any familial responsibility.

A high school English teacher noted my focus, monomaniacal even then, and allowed me to skip her class in favor of writing in the library. My senior year in high school was marked by publishing an essay in Seventeen, as well as by the first of my friends becoming pregnant.

After college I proceeded to New York to make a go of it. I acquired a stray cat, Arthur, both of us supported by my "day job" at Goldman Sachs. This was the age of Yuppies, and soon my Yup­pie friends began having children in broods and packs. I was still partnered with my college boyfriend, Karl, who wanted and planned to have kids. I presumed at some point he’d agree with me on the advantages of the kid-­free life—no college tuitions to save for and, that most precious resource: time. Or, he’d move on to find someone more reproduction-friendly. But big life choices can be pushed to the periphery by the small urgencies of the day­-to­-day and our 20s flew by, my fertility ignored thanks to birth control pills.

By 30, I had the cat, the apartment (nicer than a garret, thanks to Goldman Sachs), and I was finally hitting my stride. I'd also won a fellowship funding a yearlong research trip to Korea for my novel. Then, within the fissure of my leaving New York for Seoul, Karl’s mother became ill with pancreatic cancer.

To make a long story short, the smugness I felt about being a young person, a Fulbright fellow happily writing into my future, was cut short when Karl's mother, only 63, succumbed during one of my visits back home. The closeness I felt with Karl and his family in this time of crisis made me wonder if my usual modus operandi might be one I would grow out of, if being tucked cozily within the cell of a family might actually be something I'd want.

When I softened my stance on children, we married. After I came back from Korea, we stopped using birth control. I became pregnant right away, and we presumed everything else about creating a family would be just as easy. But I miscarried three months later. It was the miscarriage, or maybe the failure it represented, that made me want to try again, with gusto. After all, I'd achieved my childhood dream of becoming a writer despite everyone telling me it couldn't be done. And now that we'd moved to a much more financially sane situation, both returning to teach at our alma mater in a small, livable city, what better conditions could there be for having a child?

I redoubled my efforts, stopped drinking coffee, watched what I ate, and I was pregnant again. Then, seemingly days—and a shocking 40 pounds—later, I was on the cusp of giving birth.

Again, since I'd presumed I'd never have children, I'd observed my friends' pregnancies with the same kind of removed curiosity I have about my brother­-in-law's job as an air-­traffic controller: That is so cool but I can relax, knowing I'll never be called upon to do that.

So when asked about my thoughts on pain relief, I was clueless. To get up to speed, I turned to interviewing my sundry friends and various medical experts. I heard everything from "I felt like I was going to split in two!" to "I had a patient who felt some pressure and thought she was having a bowel movement. She delivered her own kid with no pain."

People espoused breathing techniques, epidurals, the Bradley Method, the narcotic Stadol, doulas, a morphine drip. Each person’s feedback took on the fervency and faith of a Moonie wedding; it was thus hard to know what was "normal." ("You have to get an epidural." "Don't get an epidural; they cause C-sections.")

As my last trimester dwindled, my confusion only grew. I'd switched to a midwife largely because I felt my male OB was inattentive and dismissive. Laura, my midwife, took the time to answer all our questions, no matter how paranoid or basic. When it came to pain relief, she was pretty catholic. The practice's only restriction was that if I should entertain even the slightest possibility of wanting an epidural, I couldn’t use the hospital's cozy Alternative Birthing Center, which resembled a bedroom rather than the tiny dorm-­like hospital labor room.

So in order to have a birth that didn’t use an institutional rubber-­sheeted bed with a zillion beeping monitors, I'd have to have a National Geographic-type natural birth with very little medical equipment beside me—at best, a handheld Doppler device to check the baby’s heartbeat from time to time, and maybe I'd be allowed a shot of narcotics if I became desperate. It was a pretty big either/or.

In my third trimester, I also found myself hanging out with Deepak Chopra. (Who doesn’t like to say that? Actually, we were both just taking part in the same lecture series.) When I broached the topic of labor pain management over dinner, he gave me a long, pitying look. He declared that if I would just not "Westernize" (that is, fear) labor, I wouldn't feel any pain.

It wasn't epidural versus no epidural; it was all in my West­ernized mind, he insisted. If I didn’t fear the pain, I wouldn't feel it. When I broached this with my friends who'd given birth, they all keeled over laughing. Only a man could say that, they said.

I thus arrived at the big questions of my labor ass-­backward. Even after nine months, I still felt like the observer, never like I was quite in it. But as my child’s yet­-unknown birthday drew inexorably closer and our midwife and doula (why not have more people on our side?) made us sit down and write out an actual birth plan, I realized that choosing one thing over another would be, basically, my earliest documented statement on parenting. Earth mother or high-­tech urban mommy? Breast or bottle? Rooming in or nursery? Drugs or just say no?

When our prenatal class was given a tour of the local women's hospital, the last places we visited, almost like an afterthought, were the measly two rooms of the Alternative Birthing Center. While both were appointed with homey touches, like a Jacuzzi and a real bed, they were still situated in the hospital's windowless basement. The regular delivery floor, it was stressed repeatedly, was by far the "safer" option. If something went wrong, our guide warned us, we'd have to depend on a balky elevator to get upstairs … and then who knew what could happen?

After that PSA, the only one of our group brave enough to declare her allegiance to the Alternative Birthing Center was the woman I referred to as "Yoga Lady": a part­-time yoga instructor, a white woman with an acquired Hindi name. Even though she was a first­-timer like the rest of us, she was sure she would never come within a mile of formula, pacifiers, cribs, or "toxic" birth drugs. During our last few meetings, she calmly breathed through Braxton­-Hicks practice contractions, while the rest of us doubled over and said, "Ugh!" when they happened.

As a doctor's daughter, I had started my pregnancy on the opposite shore. I’d thus happily begun with the gray­-haired male OB, had every clinical test and procedure and more, including a zil­lion ultrasounds, rubella titers, the newest "quad" blood tests, and a flu shot.

My father was not just a doctor but a famous anesthesiologist—one of the first in the world who could administer anesthesia medications during open­-heart surgery. So, when my mother gave birth, she received what he proudly termed the "Cadillac of anesthesia drugs": saddle blocks (an epidural precursor), twilight anesthetics, major, major narcotics.

But now, what had been amusing family stories—my older brother’s head dented and bruised by the forceps needed to drag his unresponsive body from my mother’s womb; an overzealous helping of drugs that kept my sister from gaining consciousness for two hours postpartum—took on a very different cast. I ended up joining Yoga Lady in signing up for the ABC.

On the cusp of my due date, I was at a friend’s house. We'd gone through pregnancy together, only her child was now on the outside. While balancing her newborn on my enormous dromedary hump, I contemplated how he looked impossibly tiny but also ridiculously large compared to my vagina, which contorted in spasms when I tried to insert even a junior tampon.

I asked my friend how her labor had gone. She replied she’d gotten through one set of the hoo-hoo hee-hee breathing we’d been taught in the prenatal class and then gave up and asked for an epidural, which, she said, was the best thing ev-er: She watched TV and joked with her husband for the rest of the labor, popping out her son with only a small tear a few hours later.

The 14th of January broke clear and cold, one of the coldest days in Rhode Island history. The three-­foot snowbanks outside our house suddenly solidified into ice sculptures. I remember thinking, Oh God, I hope I don’t go into labor today. Two minutes later, I emerged from the bathroom, wondering why I’d just peed a bowlful of blood. I started having contractions right away.

As we were taught, we had a bag packed: snacks, slippers, a tennis ball for back labor, two copies of the birth plan. We somehow got the car up the icy driveway and headed to the hospital, where we were to find Ginny, a midwife we hadn’t met before. She greeted us grimly, her hair piled in a messy bun. She already had three other patients in labor, and seemed a little annoyed to see us.

She flew off, presumably to the ABC, and when she returned, she confirmed something I was keenly aware of: I was in labor. To punctuate the point, my water broke, dripping all over the sterile hospital floor. But Ginny insisted we go home, saying first labors are slow. We learned later that while first labors often are slow, it was hospital policy to keep you in the hospital if your water broke there, because funny things could happen.

By the time we got home 10 minutes later I was racked with unbearable pain. It took forever to hurl my bulk back up the iced­-over steps to the house. Once there, all I wanted to do was roll like a weevil on the floor and howl. A hot shower, despite being sold to us as a miraculous analgesic, did absolutely squat. Karl, not knowing what else to do, made pancakes, which I couldn’t fathom eating. Despite the edict not to call Ginny unless there was an emergency, it was clear I was about to lose it, so Karl called. It took forever for her to call us back. And when she did, she told us to come back in.

It was all I could do not to start screaming at the check-­in desk, where the woman made us wait, and then, in the world’s slowest Rhode Island drawl, took many minutes to insist that we resubmit all our insurance information, even though we’d just been at the hospital that morning. Ginny was “busy,” and also, both the Alternative Birthing Center rooms were in use, so instead I’d be taken up to the regular labor floor. My contractions by then were insane, so unlike anything I’d ever seen in movies—including the movie they played in our prenatal class to show us what labor was supposed to be like.

In a normal labor, a contraction comes on like a wave, then subsides. My contractions were piling up one on top of one another into a single tsunami of pain. I tried to find some space between suppressing my screams to ask the nurse for a birthing ball—as if that would have helped.

The nurse took one look at me (later she said it was the way I was grunting that made her realize) and said I needed to start pushing. I was having a “precipitous” birth, one that was too fast for me and possibly the baby. My gray rag socks had turned pink from the blood that was gushing out.

The rest was a jumble. I was hustled to a tiny delivery room, the halogen lights flipped on, people in what looked like blue hazmat suits with face shields wandering about. I remember hearing the male anesthesiologist coming in and telling not me, but Ginny, with some pity that I was too far gone for an epidural. Ginny had come in with her hair even more disheveled, that grim, annoyed look on her face, concurring with the nurse that indeed I had to get ready to push.

I thought we would do one of the baby­-friendly positions, maybe a squat to enlist gravity’s aid, but she had me in the old OB’s lithotomy position, flat on my back, while she attached a fetal monitor, stuck a hand up my vagina, and scratched the poor baby’s head to see if it elicited a pain reaction.

My pain was unreal, unrelenting; it literally blinded me. I could hear only snatches of conversation. Karl said that in the excitement over my precipitous birth, the room became filled with personnel.

I did hear, "That's a lot of blood." And, "Uh­-oh, the FH is dropping."

FH? FH? Fetal heart rate. FETAL HEART RATE!

I heard but didn’t see Ginny say it was very, very important for them to get the baby out now. Someone stuck an IV of Pito­cin (ironically, to speed up the labor, as if it weren’t already going at crazy warp speed) in my arm without asking. I pushed, and pushed again. Someone brought out the vacuum extractor. So much for the two­-hour transition period that eases the labor to the pushing stage—I’d gone straight to the roughest and most painful work of pushing within minutes.

The midwives had talked to us about using warm oil compresses to help the perineum stretch to let the baby out. Karl said Ginny emerged with a huge scalpel and, declaring more than asking, gave me a gigantic episiotomy (an incision on the perineum: No-no Number 3 on the birth plan), mumbling that there was no time for an anesthetic. I was in so much pain, I barely felt it.

J., a baby boy, propulsively shot out exactly at 3:00 p.m., a little more than an hour after we’d checked in. I had been pushing for 10 minutes. I caught a glimpse of a purpled baby, intensely screeching, but Ginny, instead of putting him on my chest, as I expected, handed him off, and he was taken away. Midwives will routinely put a not-­so-­pink baby on the mother’s chest (most of the time, they pink up right away), but, as it was later explained to us, being in the high-­tech area, everyone was overly tense about brain damage from hypoxia and wanted to test J. six ways to Sunday.

I was dazed, feeling paralyzed. Karl and I were both crying from the trauma. We had just been through a war—and we had nothing to hold.

There was a clonk. Someone was trying to enter the already full­-to-­capacity room. It was our doula, finally. "What happened?" she said when she saw the mess from every kind of medical intervention short of a C-­section and an appendectomy. And, at that time, even though I’d directed them not to (No-no Number 5 on the birth plan), in some room somewhere, the staff was putting antibiotic eyedrops in J.’s eyes.

J. was returned to us, pinked up, blinking furiously through the drops, clearly making a mighty attempt to see me. I stared back at him, his tiny face, his corneas submerged in the viscous drops as if they were tears. For a minute, I was hit by a wave of anxiety: Could I do it? I’d already messed up his birth plan. But then in the next, I gathered him up and held on. He latched onto my breast like a pro. In the photo I have, his face is a picture of utter determination, and I was this beautiful creature’s mother.

Labor is a metaphor for life. You can have your beliefs, your expectations, your plans, but when it comes, it just comes and does what it wants. Yoga Lady, it turned out, had had an interesting birth, as well: After 36 hours of "nonproductive" labor despite her preparatory inner toning exercises, she not only agreed to a mor­phine drip but also opted to stay in the hospital, despite originally wanting her labor to be as close to a home birth as possible. Instead, she recounted at our reunion, she maxed out her hospital stay, thoroughly availing herself of the call button and various postpartum pain meds.

Thirteen years later, I still am trying to make sense of J.’s birth story. I joke that it was the most painful day of my life—and it definitely was. Nothing since has come close, both in terms of pain and emotional intensity. And the context in which J.’s birth should be seen is also still shrouded in a sense of ambiguity. Was this a case where crack medical personnel got him out before any real damage could occur? (He is also severely developmentally disabled, which may be, but likely isn't, related.) Or was all the to-­do an overreaction, the panic only intensifying my pain, our precious first minutes as a family squandered on useless tests and unnecessary eyedrops?

I can’t help wondering, had I been with a midwife I knew and trusted or had the doula gotten there on time, whether I would have been able to be a more direct agent of my own labor. Maybe I could have refused to go back home after my water broke. As the years go by, the intensity of parenting a special­-needs child has made me a lot more patient—as well as quicker to speak up when necessary. To an often judgmental outside world, I must speak for my child, who cannot communicate. Would this new confidence have helped me be more than just a passive, scared patient having things done to her? 

I’m currently writing a novel about an OB and the birthing industry. I have spent the last eight years steeped in that world and watched countless births, looking for an answer. I have, as yet, never seen a birth that even remotely resembled mine.

But what I do know for certain: That day I labored was itself an ending to a story. I stopped being a pregnant woman at three o’clock that afternoon. Right then, my son, J., started his own story, one that he adds to every day. By doing this he made me a mother, a role I long thought I would never take on, and so we are continuing this story together.

This post was adapted from the anthology Labor Day: True Birth Stories by Today's Best Women Writers.