An Early Arrival

“Baby, I think my waterphoto just broke.”  Brooke spoke the words like they were foreign, like words she had learned in a textbook, like a phrase that didn’t really fit.  My first (three-quarters asleep) reaction was to distrust her.

“What?  Are you …”  I wanted to say “sure?” but I was in such a fog that I was almost unable to make my voice say what I was almost thinking, and pretty far from ready to acknowledge the reality of the situation, much less act upon it.  I was just asleep enough that it made perfect sense to roll over, go back under the covers, and just let the situation resolve itself.  But then, of course, I am an actual grown adult, and so on second thought, I realized, I needed to sit up and begin preparations in case she was right.  The first task was getting myself to a level of conscious awareness needed to make other decisions.

Brooke called the midwives hotline.  Whoever answered told her it sure sounded like that’s what it was – her water had broken.  Since there were no contractions, she told us, just get back in bed, do your best to get some rest, there was a long road ahead of us.

Obviously that was impossible advice to follow.  But before I continue the narrative, I want to discuss this seemingly simple advice we received – :go back to bed and come in in a few hours.”  How to respond to water breaking is one of the real hinge-points in the divergent choices our medical system encourages and discourages.

Some people have been told by their doctors, in no uncertain terms: if your water breaks, go as quickly as possible to the hospital, and bring your luggage, since you will not be leaving until the baby is born.

Some other people have been told that once their water breaks, you need to go to the hospital within 24 hours.

Still others have been told to stay at home, go on living your life, and wait for contractions to start.  It might be a few hours and it might be a few weeks, and your body will let you know.

[Begin political excursus that you might want to skip but I don’t think you should.

Underlying all of these choices is the risk of bacterial infection for baby and mother.  The thing is, running to the hospital is quite likely to result in a diagnosis of “failure to progress,” and henceforth onwards to induction via Pitocin, an epidural, and then if that all fails, quite possibly a C-section.  Water breaking is not necessarily related to delivery.  Water can break anywhere up to 6 weeks before birth.  And, as a recent opinion piece in the Times argued, letting babies stay in the womb seems to benefit them in the long-term in pretty serious ways.  The piece concludes on a paradoxical-sounding not: “for a long time, we have fooled ourselves into thinking that more health care meant better health.  The truth may actually be more reassuring.”

Karl Ove Knausgaard’s memoir, My Struggle, set in Sweden and Norway, has made some literary headlines recently for its success.  The memoir, for the most part, is about nothing out of the ordinary, and focuses obsessively on the everyday, the unexceptional.  Its second volume, published in English as A Man in Love, narrates part of the story of the birth of his first child.

Knausgaard includes the story of his wife’s water breaking, and then several days later going to the hospital and having their baby.  This is a totally urban, not particularly radical, upper-middle-class couple who is well educated and well provided for by their doctors and midwives (yes, they, along with almost everyone else in Sweden, use a midwife).  No urgency, not a word about infection.  What’s remarkable about this narrative is how utterly unremarkable it is in his telling – and how utterly unthinkable this would be among large swathes of the American public.

Many Americans would say this was insane behavior.  If there’s a risk of infection, then, obviously, you have to move heaven and earth to avoid it.  Never mind (as always) that moving heaven and earth risks other complications.  But those all become these self-fulfilling prophecies for why all the interventions were necessary in the first place.  It becomes a case of “thank god the hospital was here to fix all the problems the hospital caused” – but we forget that the hospital causes some of them, instead thinking it’s just “thank god of for the hospital, there was no infection.”

Now I don’t think any of the following are just coincidences.  (1) Sweden has a public health care system, not private insurance and not private hospitals, (2) Swedes tends to  use nurse-midwives, not ob-gyn doctors, except for really seriously complicated situations, or in the case of emergency, (3) everyone in Sweden has health coverage, (4) people in Sweden report being happier in their lives than people in America.  These facts are all interrelated.  And don’t give me that business about how much “oil wealth” Sweden has.  The US has plenty too, but instead of using it to better our common fate, we let a few corporations and their investors control it so they can create corporate and family dynasties.  Please also spare me the “Sweden is smaller and more homogenous than the United States.”  Neither of those say anything about the feasibility of such a health care system within the United States.  They just speak to why the forces of cynicism and distrust are always able to keep one from being created.  If we had one, we’d be on a much better footing, and probably almost right away.

The point is – “if your water breaks proceed immediately to the hospital” is just another access-point for seeing how royally messed up most of the American health care system in general, and the birth industry in particular, are.

End political excursus that you might want to skip but I don’t think you should.]

We had been coached to advocate for as much time as possible before we got to the hospital.  But in the weeks before Brooke gave birth, it turned out, she tested positive for something called Group B strep.  This changed a lot of the risk calculations, and any time “infection” was mentioned, rather than an option, antibiotics and rushed treatment became a certainty.  For some reason, though, when Brooke called, the midwife with whom she spoke was okay with letting us stay at home a few more hours, to “get some sleep.”

We did not “get some sleep.”

At first this was something that seemed reasonable.  “Well, we’ll just take care of a few things and then lie down and get some rest.”  We had been warned in our classes that the mother-to-be might experience something everyone jokingly referred to as “the nesting instinct.”  All the joking and the self-consciousness about it, you might think, would mean it wouldn’t happen.  You also might think it would only happen to the mother.  Wrong on both counts.

After we decided this was probably real, somehow seemingly seconds later, we were in the baby’s room-to-be.  I say “to be” because it was now 19 days prior to the due date.  In our heads this meant we had an infinity of time remaining.  Dosteosvky wrote a letter about the day he thought he was going to die by government firing squad.  What he says about time there is relevant here: even, he writes, when he thought he was just 5 minutes away from his death, he felt an infinite expanse of time present and available to him.  He found supreme serenity in measuring out that final time: he measured a third to think on himself, a third to think on his family, and a third for his God.  19 days now seems like just an ordinary 19 days; to us then, it was forever.  Because part of us (or part of me anyway) was worried I was going to die a kind of death on that day.  My life would move decisively from one phase to another, and whatever independence I had, I thought anyway, would be disappearing then.  I turned out to be so, so wrong it’s hard to even remember the feeling now.

But then, there was a lengthy to-do list about which we had procrastinated.  There were piles of clothes only provisionally sorted, as we had no idea which clothes would be the right size when.  We knew how to dress ourselves; this was something we’d more or less mastered over our first thirty-something years.  To dress our child that wasn’t here yet, we didn’t know how to do that.  Conceptually understood perhaps, but didn’t have the kind of knowledge we actually needed.  There was a dresser to be re-stained (as of this blog post, still to be re-stained).  But then they were bigger.  There were piles of diapers, piles of piles.  Piles of stuff I didn’t know the purpose or function of.  Unopened over-packaged shower gifts.  Furniture from the room’s previous incarnation as guest room.

On that night, around 2:45, we began both frantically sorting it out.  We had (thankfully) packed a suitcase a couple of weeks beforehand, when my spring break was ending.  I insisted – Brooke was sure we didn’t need to yet, that first children were usually late.  I didn’t doubt that, but I did doubt that I’d be level-headed enough to pack that bag after I started working again.  And I knew Brooke wouldn’t do it.  She’s got a lot of strengths but packing isn’t one of them.  Otherwise, though, there seemed to be an infinite number of things to do.  I don’t remember any of them now.

What I do remember is that midway through work on these seemingly important tasks, I dropped a glass bottle, and it shattered into pieces on the unknown-object-strewn carpet.  This meant a frantic vacuuming session.  Sometime around then is when I called my school’s substitute hotline and told them my paternity leave, so far as I could tell, was starting presently.  I was going to take 2 weeks off.  (For context, in the Scandinavian countries some women get upt to 2 years off, and men 1.  Yes 1 YEAR).  Me getting 2 weeks is even a bit long for men in the US.  I’ve heard someone say he gets  “technically 4 weeks but no one takes that.”  And during that time, he’s got to check his email so much that he might as well be working.  I know this seems normal to Americans; it is not.  It is fundamentally insane.  We just do it all as a group, and so our collective delusions seem to have the quality of normalcy.

Sometime after that I think I did get back into the bed, probably even slept for 2-3 hours.  I woke up around 6 and sent an email to my classes.  Thankfully I had set up functioning Google+ communities in 4 of 5 of them, and also had created a day-by-day schedule through the end of the year.  So far as I can tell things went pretty well in my absence.  I was told a long time ago that that was the mark of a good teacher, how your students act when you’re not there.  I wasn’t there to see it, but I’ve got a couple of video snippets.  The IB class especially – they did well.  We talked about the schedule, practiced putting someone in charge of the agenda, etc. etc.  It really worked.

After a few minutes, Brooke being awake and me checking on her, I took a shower. I take a shower every day, but this one was different.  I remember shaking in nervous anticipation, looking around at myself and saying over and over again things like “holy shit, this is real, I’m really an adult now, are you ready for this?  of course you’re ready for this” – this was probably one of my shorter showers ever.

Soon I found myself catapulted out onto the street, rushing to CVS to buy seemingly important things like replacement trash bags (we had just run out).  We are actually still working our way through those trash bags 6 months later (I bought the wrong kind, being more or less scared out of my wits, so every time I replace one I remember this).  We like to joke that when we run out of them, that’s how we’ll know Sam (oops, spoiler alert) isn’t a baby any more, but a toddler.

I bought those trash bags and a few other things at the CVS blocks from my house.  I remember the streets that day: there had been some unusual mid-April snow, and it was warm enough that is was busy melting, but cold enough that a lot of it was still there.  Water ran through the streets and across the sidewalks.  It was early in the morning, but later than when I usually get up for work.  It was sunny, brisk, and there were a lot of people walking around, since we live in a pretty central downtown neighborhood.  More people than I’m used to encountering on my walk to the train a couple of hours earlier.

As I walked down State and onto Harrison on my way back home (I was also headed to Starbucks) I called my mom and then dad.  I think it’s at the moment of that second call that I admitted to myself this was really happening.  Here I was calling my father and telling him I was on my way to becoming a father.  He handled it like he’d handle anything else: he asked me how we were getting there. Then told me to call or text when we had more information.  The call was probably less than a minute.  I could tell he was excited though.  This was to be his second grandchild, but it felt brand new to me.

We wasted some more time doing things that felt really really important at the time, at home, until around 10:30am.  Brooke was having contractions during this time, and they had narrowed to around every 10 minutes.  That’s what it seemed like anyway. I was doing my best to time them and note it on my phone – this had been a big part of the classes, timing the contractions.  I remember in class wondering how I’d know.  It turns out I was wrong to wonder about this.  You know.  Anyone in the room knows.  Every time.  They know when it starts, when it stops, how bad it is, everything.  Whether they want to or not.  It’s not just that Brooke did a great job communicating it; it’s that a deep-seated human instinct, one that is obviously far better honed than the ones that make us to more ordinary things like speak, or walk, lets you know.  It occupies a peremptory mental and physical space in your consciousness, or better, in your being.  I didn’t know that then.  Had you told me, just as with the nesting instinct, I would have laughed, expressed skepticism about instincts of that sort.  But no.

We decided it was time to go.  We called the midwife hotline again to let them know we were coming.  We tried to use a hastily-downloaded app to call a cab.  I don’t think it ever came.  About 3 minutes later we went downstairs and hailed one.  It didn’t take long.  We didn’t tell the driver anything in particular, or anything at all.  I would have thought carrying an empty baby seat and a suitcase would have tipped him off, but it didn’t.  As we turned onto Lake Shore at Jackson, he answered a cell phone call.

“Excuse sir, my wife is in labor, can you please not make cell phone calls?”

“She’s in labor?  What?  You no say anything.  You have to say something.  We’re crazy, cab drivers, we’re crazy.  You have to say.”  He said this with a smile, sweetly even.  This is the first time I remember feeling something else that was new to me: an overwhelming positive regard for every stranger I encountered.  I found myself profusely thanking people for everything.  A couple of days later I hastily compiled and then for a time obsessively maintained a list on my phone, of all the people working at the hospital who had done anything for us.  Doctors, nurses, yes, but also food-delivery people, the public records officer, the janitor.

While we were in the cab, the contractions slowed down.  This is apparently common.  It’s a nervous and tense experience, getting into a car, heading to the hospital.  It’s almost like, oh, I don’t know, we didn’t evolve to do things like this?  Sorry that was too obvious a political interjection to make.

The cab driver (it was a small SUV cab, that’s all I remember, I have no idea what he looked like.  If I had to guess, he was Pakistani) excited Lake Shore Drive at Fullerton, meandered through the last bit of Lincoln Park and then made a left on Diversey.  We shared some small talk about foolish drunk people blocking intersections (it was 10:30am on a Tuesday, which makes that a little surprising, but it’s Lincoln Park we’re talking about here).  When we arrived at the Emergency Room, he wished us good luck.  I tipped him $10 on a $14 fare.  I wanted everyone to be happy, and get what they wanted.  If you  were a cult leader who wanted to take over my life and have me at your beck and call, now would have been the time to meet me.  I think there’s a deep significance to that.

People (conservative people anyway) have told me that I would turn more inward as I got older, care less about my fellow human beings as I developed a family, built a home and “paid my dues.”  Thus far, my experience has been exactly the opposite: I have felt far more obligated to our fellow human beings than I ever had before, as much devotion as I’ve always felt to liberal causes, if not more.

When we walked in the hospital and presented ourselves at the Emergency Room desk, they looked more afraid than us.  There was a 25-ish physicians’ assistant in blue scrubs, who, upon being told that Brooke was in labor, sprung to action:

“Are you feeling the urge to push?”

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