I remember my first birth. The mother lay on her side with ease. One, two, and three, the babies were born. They were kittens, and I was 7 years old.
I remember my first human birth. The woman lay on her back covered in a sea of blue cloth surrounded by a flock of masked faces. The baby’s head appeared but the shoulders didn’t. Moments passed. Voices became raised and anxious. A specific doctor was urgently requested. I felt faint in my surgical gown and backed up against the wall for support.
I don’t remember what happened. But I remember how it made me feel: queasy, lightheaded, hot. I needed to breathe cool air and get out of my sticky clothes. It felt the opposite of my first birth when I kneeled outside, watching the wonder of life come to me, small and wet.
I was deathly afraid of getting an epidural when my own belly was round and full with life. I didn’t want to be numbed but I knew the risks of “natural birth.” Having seen women bullied into choices they didn’t want or weren’t sure they wanted, I was also afraid of hospital births, period. I preferred to labor at home as long as possible and even hoped for a home birth. But for reasons beyond my control, I couldn’t.
Birth turned into both receiving a baby — the physical action of a baby crowning and then exiting into a new space, the space thereby giving way to something new — and the baby’s movement to light. The baby moved through me and received the light of the world: our world, this world of wonder and horror, this world of beauty and brokenness. The baby received the light, the warmth, the embrace. Through a good birth, I gave light to my baby.
dar a luz (verb phrase, Spanish): give to light, used to describe childbirth
I gave light to my first child on my hands and knees one cold and rainy winter night. The day had morphed into night between contractions while I stood with one foot on a stool or bathed myself in a hot shower, my birth doula and partner close at hand. It was a marathon of sorts — a long steady climb with an exhausted finish. The nurses whisked my child off to the NICU.
I gave light to my second child on my hands and knees one warm and dry summer evening. If there had been traffic, they would have been born in the car. I froze during contractions as I signed in at the hospital. The team wheeled me into a room and asked me to push. I did, and the nurse placed my child on my chest. My partner and doula sat beside me.
This was not my grandmother’s experience in the 1940s and 1950s. She didn’t remember giving birth. Something about being asleep. It didn’t make sense to me at the time. Years later, I learned she had been given medication by her doctor, inducing a so-called twilight sleep. I also learned that these births were violent for the mothers, with thrashing and screaming, but amnesia erased the experience for most women.
But mothers died before that, in droves. The mortality rate dropped by 99% from 1900 to 1997. Aseptic technique was introduced. Antibiotics were discovered. The Children’s Bureau was developed (today part of HHS) and introduced prenatal, natal, and postnatal care. Obstetrics — derived from the Latin word for midwife — became a medical specialty, instead of a shunned profession.
Still, we lag behind other high-income countries in infant and maternal mortality. Women in the U.S. are 10 times more likely to die from pregnancy-related issues than women in New Zealand. Black and Indigenous women are 2–3 times more likely to die from pregnancy-related issues than other women in the U.S. To help more mothers and babies, could it be that our systems need to change? That our perspectives need to shift to something new?
Dr. Lyerly, a professor of ob/gyn, talks in her book about “good births” instead of “natural births.” Maybe that can be a shift. It’s not about being at the hospital or at home, receiving interventions or not, vaginal or C-section delivery. It’s about agency, personal security, connectedness, respect, and knowledge. How do we create safety during birth for all women, no matter the color of their skin?
For my first birth, I chose a nurse midwife group known for their expertise both at home and in the hospital. They had me leave the comfort of my home to get hospital care, for which I’m grateful. I am also grateful for their presence with me at home, their kindness, and their knowledge. For my second birth, I chose to give birth in a hospital and had the same birth doula as my first birth. The birth doula helped me before birth, during birth, and after birth. It is a journey after all, not simply an event. The question of safer births might be answered, in part, by more support — more clinicians trained in obstetrics, more midwives, and routine partnering with doulas.
Regardless, women deserve good births. In NYT Parenting, they also shun the term “natural,” in lieu of “good” birth. I do, too. One article ends with asking people to pick two words to describe their birth story. For the birth of my children, I would say “doula support.” For the first time I saw life come into the world through the shape of a kitten, I would say “wet” and “wonder.” And shouldn’t all births be full of wonder? After all, what is birth? Is it the act of someone being born? Is it giving light to a new being? What if there is no natural birth, only a good birth?
Share the two words that describe your birth story, or a memorable birth you’ve experienced.
Joy Eberhardt De Master works as a pediatrician in Portland, OR. She considers herself to be an American-Mexican and is a highly sensitive person who values beauty and equity. She believes that all people deserve quality health care and that the stories of indigenous people need to be sung loudly. She is a 2020–2021 Doximity Op-Med Fellow.
Illustration by April Brust