At first I could handle it, the noise outside our window. A jackhammer here. A construction crash there. An occasional beep of a dump truck. After all, this was summer in Brooklyn; I could not expect life to stop just because I was 41 weeks pregnant and it was 90 degrees. Piotr rubbed my swollen feet, and I remained calm by preparing the last minute details for our home birth. Soak the menstrual pads in witch hazel and stick them in the freezer. Buy adult diapers for postpartum bleeding. Inflate the birth pool. See that pool fits into our 550-square-foot apartment.
As long as my attention was engaged, I could ignore the noise. I sipped mother-to-be tea, meditated while the workers took lunch, and steadied myself with drops of flower essences. The flowers were harvested by native women in the Amazon who themselves, I was told, had home births. Sometimes I thought I could feel the connection.
And then it really began. The 7 a.m. alarm clock of sonic booms from the empty lot next door. The eight-hour vibrations of slamming and silence and slamming and silence that send a shiver all the way up to our top floor perch. The East River fish fled. The tourists avoided our sidewalk. The corner café sold a coffee special called the Double Jet Drive in honor of the machine that had the whole block’s teeth chattering.
I paced the apartment in a panic, unable to block it out. How would I ever focus on giving birth? On breathing calmly? How was I supposed to picture my vagina opening like a flower with all this noise pollution?
Piotr offered me ear plugs and then a hug and then my flower essences, but my fretting continued, so he suggested I speak to the project manager.
I’m sure he’ll have the answers you need, he said, and I immediately headed toward the door.
Take the stairs while you’re at it! he called after me. Maybe you’ll get this thing going!
It was only when I began the descent that I realized he had been joking. About the stairs. About the project manager. It was too late now. I waddled furiously towards the work site. Don’t you worry, I muttered towards my belly. Your birth is going to be fine. It’s going to be beautiful. It’s going to be quiet and peaceful, even if it kills me.
I had plenty of concerns about having a home birth but noise pollution was not one of them. I’d considered physical risks: What if, like my sister, I hemorrhage and need instant medical care? Or what if the baby needs emergency attention? Psychological risks: What if the pain is too much to bear and I can’t tough it out? What if I ask to be transferred to a hospital for anesthesia and I suffer a loss of self-respect and have to tell everyone I quit, that I couldn’t hack it? Emotional risks: What if my family thinks I’m crazy and judges me as irresponsible?
My mom said she trusted me, but her voice on the phone had been edged with a careful brightness. You’ve wanted to be a mama for as long as I can remember, and this baby is already so precious to you. She paused, and I waited for her to drive her point home. She took a breath. I know you wouldn’t do anything to endanger him.
Thanks, I said, suddenly not so sure I believed her.
Ten years earlier, a friend of mine interned at The Farm, the Tennessee community where the midwife Ina May Gaskin had created a Mecca for the modern American home birth movement. My friend described the laboring women, how they strolled under sun-dappled trees, rested and hung out with their partners in gurgling streams, breathed and howled from the comfort of their own beds.
"Women know how to give birth, she said emphatically.
Our bodies have done this for thousands of years."
Women know how to give birth, she said emphatically. Our bodies have done this for thousands of years.
But so many women have died in childbirth, I said. Or lost babies.
You’re buying into the fear, she continued. When your time comes, just remember this: if you’re healthy and your baby is healthy, there is no reason you can’t have your baby at home.
The years passed and in the meantime, I’d been present at two of my sister’s births. In one, I watched her nearly bleed to death. It shook me to the core to see how quickly she transformed from some fierce goddess drawing upon an ancient power into a fragile creature, pale from blood loss and shaking from chills. Her eyes were wide and her teeth chattering when she handed her tiny girl to me. Hold her, she said. I’m scared I will drop her.
She had been in a birthing center connected to a hospital, so her midwife called for the on-duty OB. The doctor arrived in three minutes, reached her hand deep inside my sister, and ripped out the piece of placenta that had kept the uterus from properly contracting. Julie screamed from pain, but within minutes her energy rose, her color returned, and she held her baby to her breast as if nothing had happened. I saw how easily it could have turned out differently. I saw the delicacy of the body and its systems. How deadly the process could be with just one glitch.
I saw, too, that it was a miracle she lived, and it wasn’t the wisdom of her own body that had saved her. It was modern medicine. The skill of the doctor. The amenities of a hospital setting.
When I left the hospital at midnight, Manhattan was hushed by a blizzard. I blinked against all that whiteness. I breathed in the crisp air. A cab skidded towards me and the driver beckoned me in. Maneuvering slowly through the unplowed streets, he listened as I described to him the birth. It was incredible, I told him. It was . . .
And he said, Perfect.
Yes, I said. In its own way it was.
My prenatal appointments at St. Luke’s Birth Center began with a ride in the dank elevator. During the several minutes I sat in a sterile waiting room, I would read posters about umbilical cord banks and genetic testing and premature babies in need of kidneys and blood. An unsmiling nurse—tired or bored or both—would weigh me without saying a word before sending me to the bathroom to urinate. One of the three midwives would finally examine me, giving a listen to the baby’s heartbeat and asking a few cursory questions.
All fine, she would inevitably say.
The whole exchange took about ten minutes.
By the time I was 23 weeks pregnant, I had devoured Spiritual Midwifery, Ina May Gaskin’s first book. Most of it is a compilation of home birth stories as told by the mothers themselves. Contractions are called rushes. Pain is renamed sensation. The women don’t fight but rather surrender to their experiences. It felt beautiful to push this body out, wrote one new mother, a beautiful feeling of fullness and then relief. Another woman described how she and her husband kissed between her rushes and while she was pushing. It wasn’t hard at all, she wrote. It was fun. The baby was fat and rosy and we all got very high. The woman loved her midwife so much that she named the baby after her. In the section devoted to educating birth specialists, Gaskin instructs her midwives to make sure you are in good touch with the mother. You should feel friendly and relaxed with each other; it should feel comfortable to look in each other’s eyes.
For my six-month appointment, I arrived at the office with dread. I had been fantasizing about a home birth, but before I took that leap I wanted to confirm that I could not work with the midwives I had chosen. Maybe I hadn’t asked the right questions or connected with them in the right ways. Maybe I should have been putting more into the relationships.
Again, I was weighed. This time, however, I was met with disapproval. Frowning, the midwife told me I had gained seven pounds that month rather than the recommended four.
But I only gained two-and-a-half last time, I said. I’m sure it evens out in the end.
She ignored me and continued writing in my chart. You must not be exercising.
Have you even read my chart? I asked, insulted and shocked. I’m a runner. I teach prenatal yoga. I practice yoga five times a week.
I took a breath and tried to smile. I’m definitely exercising.
Then you’re probably eating too much macaroni and cheese, she said with the hollow laugh of a person who has made the same joke too many times.
Not once had she looked into my eyes. She was not friendly. And in her presence I was definitely not relaxed. Instead I felt the insides of my thighs trembling from frustration and anxiety. Did I trust this woman to support me through such a pinnacle life experience, such a physical and emotional feat?
I made one more attempt to connect, posing a question about labor. Since I’ll be in a birthing center, does that mean I get to choose what’s comfortable for me? Like what if I want to move around the room or squat? What if I want to be on my hands and knees?
Finally, her gaze slammed into mine. If you think for one second that I’m going to get down on the floor, on my knees, to catch your baby . . .
She paused and laughed coolly. You’ll be in the bed like everyone else.
Then she turned back to the chart, and my insides caved inward. I felt betrayed. This was not medical care. There was nothing remotely caring about this place, these people, this experience. And I felt betrayed by myself for not having had the guts to choose home birth in the first place. And now I was six months pregnant. Who would take me this late in my pregnancy?
Outside on 59th Street, the traffic roared past Columbus Circle. The spring wind pinned a plastic bag against my legs. A car alarm blared an incessant wail. I leaned against a building, bringing my water to my mouth with shaky hands, cracking the bottle clumsily against my front tooth. When a tiny piece of tooth broke away, I began to cry. Again and again, I ran my tongue against the jagged edge. I was a long way from confident and relaxed.
At that time there were less than 20 home birth midwives serving all five boroughs of New York City, and everyone I called was booked for the month of September. Feeling dejected and waiting for a call back from one last midwife, I aimed to distract myself by showing Piotr a YouTube video of a bathtub delivery. I cried when the baby emerged, slipping right into her mother’s hands like an oversized bar of soap.
This is all wrong, Piotr said, critiquing the aesthetic composition of the filming. Look at that lighting.
But look at that baby, I sniffled, and how happy that mom is!
If you want to create a beautiful birth experience, he said, then let’s move to the desert.
He described the cabin we would rent, the wooden hot tub outside, the baby born under the stars. The coyotes would howl, a big sky all around.
And who exactly will deliver the baby?
How hard can it be? He smiled. Taxi drivers do it all the time.
Perfectly timed, my phone rang, and as it turned out, The General, as her home birth mothers affectionately called her, had a last minute opening.
But I need to meet you as soon as possible, she said. I can’t work with women I don’t like.
The next day I rang the buzzer to her Brooklyn apartment and after several minutes, a small Asian woman with a no-nonsense bun opened the door. Slippers on her feet. Eyes puffy with sleep. A loose t-shirt draped over flannel pajama pants.
I had a birth this morning, she said. You woke me up.
Great, I thought. I’ve blown it already. Should we reschedule? I asked.
She waved her hand as if to clear the air. Professional risk, she said. You’re a midwife, you get woken up. Green tea?
She shuffled towards the kitchen, gesturing towards a refrigerator covered with pictures of babies. That’s my life work, she said.
Then, stepping over a stack of clay pots brimming with packets of garden seeds, she said dryly, And that’s my summer work.
Born in Malaysia to Chinese parents, she said she left home as soon as she could, scraping through Europe and barely making ends meet. She worked as a bilingual secretary in Berlin, sketched portraits of tourists outside the Uffizi in Florence, backpacked her way to London. As a single mom in Manhattan, she taught herself photography, had a few shows, sold some pieces, not until, she said, she grew up. For several years, she was a labor and delivery nurse until her righteous anger threatened to destroy her. Every night, she explained, she would come home and weep about what she called the patriarchy of America’s hospital institution, the disempowerment of laboring women, and so many backwards birth policies.
That’s when I began the good fight, she said, describing home birth midwifery as an art as well as a science, a calling, and a humanitarian service.
Please don’t get me wrong, she said, eyeing me as if she could see that I was under the influence of Ina May Gaskin’s birthing commune. This is not about some hippie, feel-good bullshit. Home birth is a revolutionary act. Are you prepared for that? Can you make a decision to claim this birth as your own?
I thought about what I wanted, of what I felt I was capable. I was healthy, the baby was healthy, and as a lifelong athlete and a serious yogi, I understood my body. I wanted the birth to be as natural and organic as possible. I wanted my labor and delivery to be the way I wanted it to be. Under my control. No unnecessary interventions or anesthesia. No pressure from robotic nurses going through the motions. No sudden shift changes in doctors or medical students gathering at my bedside to study me like I might be some kind of rare zoo animal. Thanks to The General I felt my confidence returning. I was drawn in by her battle call.
Let’s do it! I said.
Now don’t get too excited, she said, leading me to the door. You will be tested.
I nodded, still smiling but trying to appear serious.
Then she looked me right in the eyes, and for the first time since I’d arrived, she smiled back. She took me in her arms and patted me on the back. Okay then, she said. I like you.
Later I told Piotr that it was like a great first date. He nodded and said that if we’re going to have to have the baby here in Brooklyn—and not in the desert—she sounded all right.
She’s reserved and tough, I said. You’ll like her.
Her website design isn’t bad either, he said.
A month before my due date, I visited my family’s Midwest lake cottage for our annual reunion. In the mornings, I swam. In the afternoons, I napped in the hammock. At night, I sipped my half glass of wine while the others swilled gin rickys and tried to convince me to water ski.
Mom did it, my brother said, and she was, what, eight months pregnant?
Times have changed, my mom said.
In what way? My sister asked. Like not smoking while pregnant? Like doctors recommended skiing then but the current research suggests it’s not actually healthy?
Stop, my mom said. You know I was young and naïve, and Sara is not.
I could try a dock start, I suggested, feeling restless from my inactivity and tempted by my brothers’ provocation. That way I won’t take water between my legs.
Well, you are having a water birth, my sister added.
And suddenly everyone wanted to know what the heck that was and why I’d chosen it and the conversation that had felt fun-loving became an invasion of my privacy. Instantly, I wanted to protect my choices, worried I would be swayed by their judgment or confusion or simple lack of education, but my younger cousin, a construction worker in his late 20s, pressed on. I cringed as the talk turned to what I planned to do with the placenta, whether consuming it was considered a vegetarian act, and why in the world I would choose to go drug free.
That’s just masochistic, my cousin decided, popping a handful of almonds into his mouth.
How about I deliver the baby? My uncle suggested. I’ll drag you behind the boat and the baby will just float right on out.
The table roared with laughter as I forced a casual smile. That’s when my dad—a gentle, non-confrontational man—began to grill me about the practical details, and I understood suddenly that there were serious worries behind the joking. Where was the nearest hospital? He asked. What would happen if I hemorrhaged like my sister? Had babies ever died under my midwife’s care? How much did I really know about her?
His concern pounded against my certainty, and I could feel the walls of my confidence trembling. When the others left the table I was near to tears. At seven months pregnant, my emotions were barely under my control anyway, but this was deep. A real test. Was I making a stupid, romantic decision? Or trying to prove something—some kind of toughness—by having a home birth? The equivalent of water skiing in my third trimester just because it would make for a great story? Or was this about some dreamy aesthetic ideal—like Piotr’s desire to deliver the baby in the desert—just some sentimental hippie notion about natural being better?
My dad put his arm around me and squeezed my shoulder. Hey, he said quietly, You know I trust you, right?
I nodded, but his last question came like a jet driving home.
Have you really thought this through? he asked.
After everyone was in bed, I slipped outside and walked the length of our quiet lake road. The stars were thick above me. If I had been in a calmer state of mind, I might have sensed in them the centuries of women who had birthed their babies under a sky such as that, the constellations their only witness, their home the great world. As it was, I was in too much turmoil to notice the ease of nature doing what it does. I dialed The General’s number, seeking inspiration from her courage. She answered in a groggy voice.
It’s Sara, I whispered. I have an emotional emergency.
I knew it, she groaned. You’re with family, aren’t you?
Can you remind me why am I doing this?
As she paused, I could hear the frogs croaking in the nearby swamp, their insistent noise as strong as my family’s interrogation.
When she finally answered, she sounded annoyed. I warned you about telling your parents.
I know, I said, but I did and now I need support.
I can’t give you that.
What do you mean?
That’s not my job, she said. Am I having this baby? No, you are.
I swallowed hard as she explained how we had to be partners in this, that I was responsible for my choice, that if I didn’t feel sure about the home birth then she couldn’t feel sure about the delivery.
I won’t try to convince you, she concluded. You either empower yourself and take responsibility or you shouldn’t do it at all.
I stood near the edge of the water and studied the lake’s dark still surface. Calm though it seemed, I knew there was movement deep down, active springs that fed the water, keeping it constantly circulating, and therefore, fresh. Below that lay the solid ground, a foundation to hold all that shifting weight. I wanted that combination of muscle and movement, the strength that supports and flexes with change and uncertainty. What was happening deeper inside myself? Did I have the rock solid foundation to handle the shock of my own doubt and fear, let alone other people’s?
The General was right. I had to own this decision to make it a success, whatever that success looked like, and listening to her reminded me not that I should have a home birth but that I had the strength to do whatever I needed to do, be it stay at home or opt for the hospital, refuse drugs or receive pain relief. I took a breath. I pulled it deep into my belly, into the quiet core of my being. I let my voice speak from that place.
I’m in, I said.
I waited for her to say more. When she didn’t, I asked, Have I passed the test?
Yes, The General laughed. But I didn’t say there would be only one.
You can prepare as much as you want, everyone says,
but birth—like your child one day—will not bend to your will.
Forty-one weeks has come and gone and each moment delivers a test of its own. I close the windows. Turn on the box fans. Run the air conditioning on high. Still, I am haunted by the incessant pounding of the pile drivers.
Giving birth, like raising a child, is uncharted territory. When it will happen. Where. How long it will take. What it will feel like. As such, it is a process that cannot be controlled. The General warns me about this and seeks to eradicate my expectations, helping me investigate my assumptions about birth, my beliefs, my unconscious connections to my mother’s experiences, to my sister’s. Books caution me to make a plan but keep my mind loose. Friends relay their own unexpected outcomes. Hospital transfers. Car births. C-sections. You can prepare as much as you want, everyone says, but birth—like your child one day—will not bend to your will.
So, I focus on what I can control: my reactions, my mental state. I sit on my meditation cushion and imagine soft things, rose petals and morning glories, blooming open. In my mind’s eye, I gaze at gentle waves washing up onto sand. In my pretty new bathrobe—a recent gift from Piotr—I envision those first hours of nursing, lounging on pillows, the robe draped over my shoulders, my little boy sucking peacefully at my breast.
Still the booming continues. Long after the night has fallen and the machines sit silent like sleeping giraffes, I hear them, testing the ground, testing my nerve, pushing my patience, taunting my ideas about myself. The lessons from my visit home are forgotten, and my own ground seems to be sinking into a muck of irritation and fear. How will I ever build myself into a mother?
It is a Friday morning in late September, ten days after my due date, and I wake to a drizzly, gray quiet. It takes me a second to appreciate the significance. I shake Piotr.
What? he cries. Is it happening?
Listen, I say and turn my head toward the window.
I don’t hear anything.
Exactly! No pile drivers!
A few hours later, as if the baby had also longed for silence, it happens. My first contraction. No longer the shy darting of minnows, the unmistakeable sensation is the bold rolling wave of a whale's tail slapping the water, and it’s funny how suddenly the conditions of the day and our home and my body are perfect for a birth, the present moment forcing a readiness that no amount of thinking could accomplish.
Piotr jumps off the couch excitedly, pacing and circling like a dog trying to get comfortable. When I order him to a yoga class, he looks skeptical, but I’m sure my labor will take a while. Don’t call me until 4-1-1, The General had said, a reference to a midwifery rule that mothers should labor alone until their contractions have established a pattern: for at least an hour, they must occur every four minutes and last one minute in duration.
So, while Piotr breathes through his last yoga class for the next three months, I breathe through the gentle tremors that shake my body, slowly splitting open a space wide enough through which a baby can emerge. My fears have been replaced with excitement—there is nothing I cannot handle!—and in that energy burst, I become convinced that my birth team needs a hearty vegetable stew. At the corner grocery, the contractions quicken and I cling to freezer doors and checkout counters. I exhale noisily while choosing ice cream and laugh with the teenage cashiers who are amazed to see a woman in labor. They are reluctant to let me carry the food, but I refuse their help, and they call Good luck! as I drag the bags home, pausing only to labor against a mailbox. Maybe I’m crazy, I think, but I can’t help feeling proud, too, so relieved to finally do something. Anything is better than all that waiting around.
Stop working so hard, The General barks. Your breathing is harsh.
But it’s low, I say. It’s open.
Feel your face, she says, rubbing my forehead. It’s all tense.
I’m trying . . .
Well, stop trying!
And then her voice becomes quiet. Soften into it, she adds. Like a scarf tumbling through an ocean wave.
The birth team—Piotr, my sister, The General’s assistant—stand back as The General holds me, tenderly, like a dance partner. She rests her forehead against mine and as another wave slams through me, she whispers, Dive in and roll with it. That’s it. Easy. Easy. Let it move through.
Before she dances me through a few more, she informs me I have back labor, my boy turned partway, his occiput and butt—the heaviest parts of his body—pressing hard against my sacrum so that each contraction sends pile-driving shock waves through my lower spine. I’m sure my bones are being crushed to dust. Trying to create a hairline of space to ease the pressure, Piotr—six foot three and 180 pounds—presses with all of his strength against my lower back.
It feels like her skeleton is shifting, he whispers to The General.
It is shifting, she confirms. It’s making more room.
But is that okay? I mean, is she okay?
Trust this, she says, giving him a look. Trust Sara. Her body is made to open like this.
The softer breath helps, but I’m still desperate to escape. I climb in and out of the pool, I throw up, I make noise - howling, ohmming, moaning and crying. There are cool wash cloths and coconut water and hands squeezing mine, but nothing can pause the pain—going through it is the only option—and each stage of the labor offers up another doorway through which I find a new sensation. Like some kind of modern hero's journey, the closer I get to the prize—meeting my baby—the more challenging the sensation I must confront. Never have I been in such a no-way out situation. Not for this long anyway.
And so the night passes and the sun comes up and The General—at times gentle, at times fierce—finally orders me into the pool to push. I feel a surge of energy, similar to how I felt when the contractions began. How hard can this part be? I think. Again, I believe I can rest in the control of action, of doing. No more going limp. No more soft receiving. No more letting the experience wash over me. This is the time to fight, to be a warrior and an athlete. My specialties. I hang over the side of the pool on my hands and knees, gripping Piotr's arm, using every ounce of muscle I have to urge this baby down and out. But again and again nothing seems to happen. I feel no movement, no progress. Only effort.
He’s stuck! I wail.
He’s not, The General says.
I can’t do it, I whisper.
You can do it, she orders, and suddenly she stands up, rips off her pants, and jumps into the pool in her underwear. Say it, she says.
I can do it.
It’s so hard.
I can do it, she repeats and now our knees touch and she’s looking into my eyes and this intimacy—far beyond what Ina May Gaskin has advised—is perfect. It’s exactly right for this moment, and the act reveals the dynamic artistry of this partnership, the in-the-moment creativity that midwifery and laboring require.
I can do it, I say.
I can do it!
I scream as I push and then rest between contractions, breathing in the oxygen that Piotr holds beneath my nose.
I thought this would be the easy part, I pant.
The General laughs. Now, she says. It’s time to get serious.
When the next contraction comes slamming down, I start roaring and the room roars with me. Huddled around the pool, squeezed between bookshelves and plants and the couch and an air conditioning unit, my birth team responds. You can do it! They yell as if I’m back in high school and I’m sprinting the last 100 meters of the 400-meter dash, a competitor close on my tail. They yell like they can see how close I am to the finish line. They yell like they know something that I don’t. I believe them and with my eyes closed I feel their energy inspiring my own, meeting it, completing it, recovering it, raising it. I howl and ride this driving force down into the bottom of myself, into my soul, the foundation of my being, whatever has always been there and will continue to be there. What I find is solid and enduring. It is something beyond words like pain or pleasure. Mother and son. Now and then. Definitions collapse into dust when compared to the resilience of this Self, a Self that I feel I am meeting for the first time.
And that’s when my son’s head emerges. Then his shoulders. Finally his body. Out into the warm water he slides, a slippery hairy bear-cub of a boy. On my chest, with Piotr holding us from behind, he sputters and coughs and gulps like a fish. The General leans her face close and breathes into his mouth. Just once. And then he breathes, his eyes wide and astonished.
We did it, I whisper, and he watches me through puffy eyes. Wary. A little grumpy. Perfect.
The pile drivers remain silent for two weeks after the birth, and I remain inside for most of that time. When The General comes for a check-up, she pretends to faint from her adoration of our boy. Sitting cross-legged on our bed with the three of us, her fierce orderliness has melted into a cooing warmth.
I think I’m getting a contact high from all the love in this room, she says.
We share our highlights. We process moments of fear. The General asks me to describe the birth, and I list the words in no particular order of importance. Miraculous, awful, magical, grueling.
It really is everything at once, she agrees.
I don’t think I’ll ever do it again, I say.
She laughs, promising to check in with me in six months. Then she holds Freddi close and inhales. This is the best part of my job, she says. Smelling all these baby heads.
Freddi is nearly a year old, and I often think I could do it again. But no. It’s not that I could; it’s that I want to.
Are you crazy? Piotr asks.
He reminds me how the experience of giving birth does not end the moment the baby arrives. As The General said, There are no refunds in this business.
True. But I also remember how she coached me during labor, how she made me say, I can do it. It’s a simple mantra that I’ve put to use many times in these last months. Sleepless nights of seemingly endless nursing? I can do it. Bearing the fear when my son was hospitalized with fever? I can do it. Uncertainty about the rewiring of my own identity? I can do it.
The pile drivers have been back for some time, the daily shaking again a reality. Now, however, they are no longer digging into the earth to test its strength.
We found that the ground is solid, the site manager recently explained, eyeing Freddi as he peeked out from my sling. It’s ready to bear the weight.
And so the building has begun.