I’m in the bathroom of a hospital room that overlooks the Atlantic. My belly is a full moon under a gown that ties halfheartedly at the back in two places, as if to say, Here is your allotment of dignity. Otherwise I’m bare. Well, I have on a pair of polyester-spandex-blend underwear crafted by Nurses Choice. They have a high waist and would repel even the horniest of fraternity brothers. Even a young man who has paid forty-seven dollars for Kamikaze shots, who finally has the girl back to his place, who has dimmed the damn lights — even that young man, if I stripped down to my Nurses Choice, would glance at his cellphone and say, Oh, man, I gotta go. This is underwear made for old women who were never young, who live in hillside towns like the one my mother was from in northern Italy, where there is a woman they call La Befana who wears all black and has looked seventy-five for all of my thirty-five years.

But the underwear is not the point here. It contributes to my misery, but the main point is the pain. Holy hell, I’m in pain, and the pain is Third World. I’m standing and pawing at the cool tile wall above the toilet, fluid leaking in warm rivulets down my legs, while the pain radiates across my lower back and around my pelvis to my guts. My entire southern hemisphere is in revolt. The only way to get through it is to think about how many other women have felt this, or worse.

Outside the safe house of the bathroom are my husband, Jackson, a nurse named Lily, and a doula — a kind of birthing assistant — named Lila. The last two have been coaching me to make low, cow sounds: Uuuhhh. But when you’re in labor, it’s hard to take the advice of someone who isn’t in the same boat as you. Or maybe they are in the boat, but they’re coxswains on the dry end of my sinking ship. They want me to get on my hands and knees in the chocolate-brown medical tub they’ve wheeled into the outer room. There it waits, lit by the sun. They want me to strip off my gown and my Nurses Choice, get inside, and moo.

Childbirth is about letting go and being a capital-W Woman — no, a capital-all-of-it WOMAN, with frizzed hair and frequent flab and strong scents and low sounds to be emitted in a doggy-style position, not unlike the doggy-style that may have gotten me here in the first place. Labor is swollen and moist, and the best women for the job are the ones with massive pubic jungles who don’t cover anything up in gym locker rooms. Me, I wrap a towel from chest to thigh in the sauna. At spas I keep my robe on the whole time.

And here I am hiding in the bathroom, pretending to have to use it so I don’t have to get naked in front of a couple of women. I want to stay in here and make high, bird sounds. I want to be alone with my pain, like a cat slunk off to die in the woods. I’m not good at being pregnant. It’s worse than that — I’m not good at being a WOMAN. I thought I might be, once my labor began, but for me the hospital, any hospital, is inexorably linked to the hospital deaths of my parents. Losing them both when I was younger — my father to a car accident and my mother to cancer — broke me. Years later I put myself back together with books and yoga performed on surfboards and Eastern principles polished with Western oil. I became whole again, but I’m not the same person I once was. Like Frankenstein’s monster, I’m made up of incongruent parts. I live in fear of death, of cancer and wrecks but also of car bombs and airplane crashes and air conditioners tumbling from tenth-floor windows; of earthquakes and volcanoes and twisters and drunks on the street in New Orleans with pearl-handled knives; of house fires and frozen ponds. Oh, Jesus, ice ponds. I am so goddamn afraid someone I love will fall through the sodden middle of a thawing winter pond.

The point is, I am not like the rest of you, who don’t spend every moment fearing the worst. I think you are ostriches with your heads in the sand, and I envy you for it. You wake in the morning and don’t imagine all the ways in which the people you love might die. Or perhaps you do. If so, call me, but not before 8 AM, or else I will think someone I love has died.

I wonder if this hospital gown is for maternity patients only or if it is shared with oncology. Are these faded old bloodstains marks of sorrow, or of joy? The last time I felt safe in a hospital was when my father, a doctor, was alive, and I was his waist-high little girl. I would like to meet that child. I would like to tell her she is both lucky and stupid. I would like to tell her to hold on to her father’s mighty hand as he walks her down those halls and never let it go — especially not on a bright September morning when he goes to work wearing the tie with teddy bears that she bought him.

Right now I feel closer to death than to giving birth — on account of the hospital, and of the pain. The expectant-mother message boards did not prepare me for this. Other women did not prepare me. I don’t feel I can do it. The idea that some women do this two, three, four times — that there are Catholic women in Kansas who do this seven times — seems impossible to me. Those are real WOMEN. They’re gladiators with titanium uteruses. But maybe, like the little girl in the hospital, they are also stupid.


“Are you OK in there?” asks Lily the nurse through the closed door.

Lily is young and blond and has an Irish boyfriend and a finicky rescue dog. The other day she pushed a couple of fingers up inside me and waggled them from side to side as if she were ringing a dinner bell. I was ten days past my due date and had been scheduled for an induction, despite having followed all the advice for how to stimulate labor: tinctures of blue cohosh and black cohosh; slices of eggplant and chunks of pineapple; sex and acupuncture; evening-primrose capsules both swallowed and deposited inside me, like gum balls sent back up the tube. But none of it had worked the way Lily’s blue-gloved, mildly lubricated hand did.

I also have a midwife: steady, brown-haired Nancy, who, upon hearing what Lily had done, said, “Bad girl, Lily.”

Lily smirked.

In a hospital you get to know the nurses well. Your relationship to them is at once hallowed, without boundaries, and also at a starched remove: they have no idea how your heart swells for them.

Another contraction sallies through my wrecked body like a video-game fireball. I’m having back labor because my baby’s head is pushing down on my spine. This is sometimes called “sunny side up.” The resulting pain is both dull and sharp and hot and cold in ways that defy explanation. It has a vivid crescendo with the sort of peak that does not allow you to see relief in the distance. Lila the doula says her sister described the feeling as like trying to shit out a knife. Lily the nurse says she has heard it likened to shoving a Coke can up your butt. The pain feels wrong somehow: not lovely, not spiritual, not like a gift, the way the books described contractions. It feels like my own body is raping me.

It’s my fault that my labor hurts so much. I am not breathing through it like a champion, or even like the most intermediate of weekend yogis. I am not making low, cow sounds; I am yipping through it. My heart isn’t in it. On certain days you push yourself, at the gym or in a hot-yoga class; you rise up like a phoenix from your own sizzling toenails; you grit through cruelty and pain. But on other days it’s been raining, your neck is wet, you don’t feel like a warrior, you feel like the bad guy in a movie who deserves his ignominious end. This is one of those days. I am soft. I am letting my husband down. He thought he married a woman who practiced yoga on surfboards, but I am a wet red bug with zero spine. I am a dachshund puppy with its belly drooping down past its knees, down past its Nurses Choice.


This hospital is on Martha’s Vineyard. We came here because a friend had her baby here and said it was a dream. We came here because it scares me the least of all the hospitals in the world. We came here to try to be ostriches.

It’s March, but the air still smacks of February, and nobody is vacationing on the island. Here in the winter, restaurants that are packed in summer are dead quiet and sell their wares at reduced prices to the duck-booted locals. The other day I ate forty-eight shrimp for ten dollars. And nobody here wears duck boots ironically. They wear them when it rains. We are the only couple giving birth on the maternity ward. We have all the nurses to ourselves, plus one midwife and one doctor. Our room is large and private. There is a necklace of multicolored beads around one of the lamps, and battery-operated candles give off a moony glow. The cabinets look like real wood. It’s as lovely as a hospital room can be. I don’t smell death anywhere. Maybe just a little bit here in the bathroom, where my blood and amniotic fluids are dribbling down the sides of the toilet. Here I have to remind myself that I am not dying — that I am, in fact, giving birth, which is the opposite of dying. But try getting that through my Frankenstein brain.

I’ve labored for ten hours, raw and unmedicated. I’m holding off on pain medication because I have a doula, and because we are on an island where WOMEN in labor sit in tubs at home, where they drink red-raspberry-leaf tea and put their trust not in doctors or in God but in their swollen pink bodies. But I have seen bodies fail more than I have seen them rise in triumph. I have said goodbye to my parents because of the body’s betrayal. This is my heritage: bodies with no zeal.

Nancy the midwife has repeatedly told me that I’ll want to do this again, to have another baby. I’ve tried to explain to her that one is enough. I can’t handle the pain, the fear, the hospital. I tell her this is the only one for me.

In the months leading up to today Jackson said, “You won’t need an epidural. Not you,” and I smiled and agreed.

But things change. I’ve undergone ten hours of the kind of pain that makes dying seem OK. I understood going in that it hurts to produce a child. The problem is that, for me, pain does not produce gifts. In my experience pain is invariably followed by death.

I think now of my mother’s final hours. The lung cancer that had metastasized into her brain. The insensate jabbering, on account of the morphine. Her pale head on a plasticky hospital pillow. Her chapped blue lips barely passing air.

I think of my father’s final hours, after the car accident had broken him inside and out. He lay there for eight days, chemically sedated. The doctors said that if he were to wake up, he would die of shock, because the pain would be too much. I remember thinking, No, not my father.

No epidural. Not me. A WOMAN does not selfishly seek to end her pain. She does whatever is best for the baby. She doesn’t need drugs. She screams for hours in a tub and does not die.

Lily pokes her head in to check on me. Clearly I am not OK. Listen. I am not a WOMAN.

“What would you do?” I ask.

Her smile dissolves. “I would not want to be in pain,” she says.

I nod. She gets it. She calls for the epidural.


Now that I’ve given in to being weak, the relief can’t come soon enough. But this is a rural island hospital, and the anesthesiologist on call is busy with a surgery. The price I pay for being the only patient on the maternity ward is twenty more unmedicated contractions.

Forty minutes later Dr. D. walks in with his tools. His accent is Irish. At first I don’t trust him, but in the middle of a wild contraction, I don’t care. He has me lie on my side, goes around to my back, tells me to stay still, and swabs the area where he will insert the long, thick needle. The right place to stick the needle is perilously close to the wrong place to stick it, so it’s possible that he’ll miss, hit my spine, and paralyze a part of me. But I don’t care, as long as the pain stops. I imagine this is what my mother felt in the final throes of her cancer: the desire to evanesce, to go and meet my father in heaven.

And then the relief flushes my system. The break is blue and cool and parades down the avenues and streams of my body like a white-water rapid with glacial peaks and warm, puddling swells. It feels like love, honestly. At moments like these I want to become a heroin addict and live in a bathtub. Even my fear is washed away. I imagine this is how you normals live, you divine ostriches. You drive down the Pacific Coast Highway and look across the water, and you think what a beautiful day it is. You turn to your sunny passenger and say, Should we stop for oysters? I have dreamed of living this life. I have dreamed it, and now it’s mine.

For all of five minutes.

Lily, who is monitoring my vitals and the baby’s heart rate, goes white. She picks up a phone and says something low and unperky into it. I am about to be punished for being unafraid.


But first let me tell you about my baby.

It’s a girl. A girl is what I was hoping for, because I want to feel closer to my mother and father by having a girl of my own. I want to feel what they felt for me.

We have chosen a name for her that is special and small and also large: Fox. I am worried about her health already. At her thirty-week ultrasound the blurry image made it look as if she had no mouth. So we had a more expensive 3-D ultrasound image made in which her mouth was gorgeous.

I love the way she moves inside me. There have been times when I didn’t feel her moving for an hour or two, and I was afraid, but she always moved again.

Now Nancy is running into the room, her rubber clogs thumping the floor softly. I hear Lily tell someone to prep an operating room.

My baby’s heart rate has dropped because her mother is weak; because her mother wanted an epidural; because her mother could not live for another moment with the sort of pain her own parents had suffered.

Later I’ll be told that it wasn’t because of the epidural, but I won’t believe it. What I do believe is that I have the power to save — or kill — everyone I love with my actions. My mother died because I didn’t seek out the right therapies. My father died because I didn’t answer the phone when he called. I was busy at work, at a job that meant absolutely nothing, so I let it ring, thinking I would call him back in five minutes. Five minutes later his car flipped and landed in the median. I think of how alone he was as it turned over and over in the air. I imagine him calling my name.

If I had picked up the phone when my father called, he would not have left his office at the exact time he did. Instead he left me a voice mail, twelve seconds long: “Hey, little girl. It’s your daddy. I’m just calling to say I love you. Talk to you later.”

The recording is on a cassette tape. I had to buy a cassette player so I could listen to my father’s voice. Not just his voice, but the last words he ever spoke to me. I have played back that voice mail more times than I have pledged allegiance to the flag. Every time I hear it, you wouldn’t believe how I hate myself.

While we are waiting for a gurney to arrive to take me to the operating room, Nancy tells me to roll onto my other side. There’s controlled fear in her voice, and the fact that she is trying to control it only frightens me more. I’m nearly paralyzed from the waist down, but with Nancy’s help I heave myself from my left side to my right. I think of my father’s voice mail. I think of my mother in her cancer cocoon. My stupid choices.

Moving to the right adjusts the baby in some necessary, holy way, and her heart rate begins to climb. Everyone in the room watches the monitor to be sure. She is safe.


The rest of the night passes without incident. Jackson sleeps uncomfortably on the couch. I lie awake in the bed. Lila the doula, who has less to do now that I’m on a heavy dose of pain medication, goes to her pickup truck and eats fruits and nuts and comes back and cleans up the room. If my mother were here, she’d be tidying up, too. She would not tell me how to breathe or suggest I get into the tub. She would want to keep things in order. I wish I could explain to people that the best way anyone can help me is by throwing out my used tissues, lining up my juice boxes.

I’m waiting for my cervix to be dilated to ten centimeters. It’s stuck at nine, my daughter’s head wedged at the entrance to my pelvic bone. Nancy comes in periodically to check, and every time it’s still a nine.

I suck down organic fruit juice and watch The Bachelor’s season finale. I watch Sex and the City, the whole first season. Someday I will tell my daughter: This is the show I watched while I was waiting for you. You will never worry about what a man is thinking the way these women do. You will never cry about a man the way your own mother did. I almost killed you once because I needed relief, but now I promise you, I will never let you down again.

My husband and the doula are both sleeping, so I’m the only one awake except for the night nurses coming in. There’s something scary but also homey about their presence. I remember the nurses coming into my mother’s last hospital room, the one they moved her into after everyone realized it was the end: a pretty room on the oncology ward, where people spoke in low voices and everywhere there were pink and yellow flowers. There were also nicer complimentary toiletries. My mother loved travel-size shampoos and soaps. Having grown up poor, she would take the little bottles and bars from hotels in Rome, Los Angeles, or Nevada and bring them home, where they’d languish in bathroom closets. The penultimate time she was in the hospital, she gathered a few with less than her usual thieving gusto, tucking them into one of the hats we’d bought to cover up her head, with its patchwork of matted, radiated hair. In that final room, the one with the better toiletries, if she hadn’t been on morphine, if she hadn’t been dying, she’d have gotten a kick out of the high-end shampoos. She’d have hustled them into her pocketbook. When she finally died, after seven hours of breaths so far apart I never knew which would be the last, I thought about taking them on her behalf, but instead I left them there. I left them all.


Three years ago, when Jackson was just my boyfriend, he and I were driving across the country in a conversion van. We’d known each other four months. In Whitefish, Montana, I realized I was more than a week late. It was the first time in a long while that I had been too happy to worry about my period. I bought a pregnancy test in a pharmacy. In the phone-booth-size bathroom of the van I peed on a strip and handed it to Jackson. “Holy shit,” he said. He handed me the strip, and I passed out.

I’d never been pregnant — I didn’t think I had the mommy gene — but now here I was, with child in rural Montana. The father was a man I loved but had known only a short time. I was scared. “Look,” he said, “you — I mean, we — are not getting any younger. And I love you. Let’s do this.”

And for several months we did it. We looked at baby clothes. We bought baby oil. We made a dedicated “baby shelf” in the van.

Back in New York City, at a medical office uptown, a doctor showed us a dot on a video screen. The doctor did not seem excited about the dot. Jackson, who’d been reading What to Expect When You’re Expecting, said, “That’s not the size of a blueberry.”

The doctor nodded.

Three weeks later the baby, who I imagined was a girl, passed out of me. For seven hours I bled until finally a small embryo, translucent and beautiful, a seahorse gleaming inside a bubble, plunked into the toilet, and I wept for days.

Now, after twenty-six hours of labor, sixteen of which I’ve spent in a dreamy epidural wonderland, I am still dilated only nine centimeters. My daughter is having trouble making it into the birth canal. We are failing together, she and I. I feel a cozy affinity with her in our shared deficiency.

Nancy spreads me open and shakes her head. She says she has to call in the doctor. We need to do a C-section.

When you are being prepped for surgery, the maternity ward becomes a hospital again. There is Dr. P., who looks like an MD on television, and Dr. D., who gave me the epidural and will now monitor my anesthesia. As they wheel me to the operating room, I’m afraid. Jackson is scared, too. I have turned him into a disciple of my fear. I try to take comfort in the capable people with metal implements and kind faces. A young nurse with a pixie cut and a surgical mask tells me, “You’re going to do great.” In the elevator she slips off my necklace and earrings. The speed with which they are moving is frightening.

“You’re actually going to do amazing,” she says.

“I like your eyebrows,” I respond.

When we reach the operating room, I ask Dr. P., “Do people die during these surgeries?”

“Sure,” he says. “Sometimes.”

They strap my arms down crucifixion-style, the punishment I deserve for seeking relief last night. Jackson is waiting in another room until I am fully prepped. Lying there like that, with extra anesthesia surging through my system, I feel as though I might puke. I say as much, and Dr. D. brings a coiled vomit bag, like a tropical purple snake, to my face. The surgical mask covers his mouth, but I can tell by his eyes he is smiling, and this comforts me. I don’t puke. He tells me about his daughter, who was delivered by C-section. She’s now seventeen. He says this as though he can’t believe it. I certainly can’t. People you love living for seventeen whole years. This seems exotic.

Dr. P. leans his head around the curtain that conceals my lower half from view, and he, too, smiles with his eyes.

Jackson comes in wearing a mask and holds my hand. Then it begins.

Oh, my God. I’m dead down below, but I feel my insides being lifted and stretched like taffy, my uterus held in a man’s hands. Jackson takes one glance behind the curtain, then quickly looks back at me.

There is a powerful tug, as if my soul were being jimmied up from under my intestines, and I realize that Dr. P. has just pulled my daughter from my womb, like a rabbit from a hat.

The baby is taken to another table, where several people examine her. I do not hear her cry. My husband continues holding my hand. The doctors begin removing the placenta and stitching my flesh together like an African drum.

“Go to her,” I say to Jackson.

He leaves my side. I still don’t hear our daughter cry. I think of the ultrasound in which she appeared to have no mouth. I can’t see her, but I know she is being suctioned. She has not yet taken a breath. I know this because I have not heard her cry.

Then, suddenly, there it is: the cry not of a baby, but of my baby.

I wanted a little girl — to feel closer to my parents, to know how they felt having me — and now I’ve got one, or I’m about to get one. Please, God, just let her live long enough that I can kiss her feet.

You read about the love, how big it will be.


She is brought to me. Her mouth, her smell, her new skin — everything is perfect. She has dark hair and cobalt eyes that belong to some distant planet. She is not human, I keep thinking, but she is inhuman in the most ideal way. She looks into my eyes. “Hello, Fox,” I say.

I put her feet to my mouth. She is the part of me that didn’t die.


After the surgery the doctors disappear, and it is just the nurses again.

There is Missy, a WOMAN who comes to the recovery room to ask if they gave me my daughter right away; if, after the evil and probably unnecessary surgery, they placed her on my breast immediately. This hospital is big on skin-to-skin contact: my daughter’s naked chest on my naked chest. I suddenly have these hulking breasts full of food, and the nurses teach me how to breast-feed in a way that borders on obsession. They teach me tricks that the doctors either don’t know or don’t believe in. They whisper these tricks to me, so that only I can hear.

There is Carla, who looks like a cartoon character from the fifties, with slick curlicues of dark hair. She has two grown kids and doesn’t believe in nursing round the clock. And there is Joyce, with a kind and lovely face and an energy like candles burning, who recommends constant nursing. Their opposing theories miraculously work in tandem.

Fox is a bit jaundiced, and they say I have to feed her a lot so that she will pass the bilirubin out with her urine. I begin to call my daughter “Bilirubin.” On my phone alarm every hour it says, “Feed Bilirubin.” Carla shows me how to hand-express my milk, using her thumb and forefinger to press down toward the areola, then away from it, until pale-white fluid like diluted paint emanates from four distinct spots on my nipple.

Joyce is like the mother I no longer have, but I don’t tell her this, because it might make her uncomfortable. Instead I try to convey the love I feel for her wordlessly, with a smile, an expression. Perhaps she won’t know how much I love her, but the sense of it will be with her on a lonely night when she needs it.

On the second day of my daughter’s life I’m in the shower — my first shower in days — and my husband is in the room with Fox when she goes red-faced and begins to choke on mucus. He runs into the hall and finds Joyce, who saves our daughter’s life. Of course, Joyce will not say she has saved Fox’s life. Joyce is just doing her job. For her this is merely a standard of care.

Joyce will die one day, and I won’t know about it. My daughter will be twenty-eight and living somewhere with a man she loves but who doesn’t love her enough in return, and this woman who saved her from mucus will die quietly in a split-level house in Redondo Beach. A scented candle will be burning near a teapot. The whole room will smell of apples. This makes me cry torrentially — on account of the hormones, but mostly on account of life.


The three of us are home now, with no more Joyce or Carla or Missy, and my husband and I are a bit anxious. There is nobody else to save our daughter from the many dangers out there. It is up to us.

I know now why people do this seven times. I know that the whole clammy history of pain, including the pain of losing my first pregnancy, is worth it.

Today my daughter is lying on my lap, her tiny fingers hooked around the gold fox necklace I wear. Her eyes are still from another planet that I can never actually visit.

Jackson and I look down at her, and she seems to laugh. She is only three weeks old and doesn’t yet register her surroundings, but she is smiling at the walls, at the ceiling, at the area just beyond my head.

“I think your parents are with her,” Jackson says, though he does not believe in God — at least, not the way I do.

I did not believe in God before. I didn’t believe on the day I brought my mother, whittled by cancer, to my nephew’s christening, and she tried to kneel when the priest bade us kneel but her irradiated legs gave out, and she fell, crushingly, to the ground. But I believe in God now because I need to see my parents again. I need to believe in something that will enable that to happen.

“Do you think they talk to her?” I ask Jackson.

He nods. He nods in a way that I never could — with complete certainty. He nods like someone who doesn’t believe in God, but who believes in something that won’t give way in the face of accident or disease.

“Yes,” he says soberly. “That’s why she laughs.”

My daughter suckles at my breast. My milk is feeding her. My African drum of a stomach doesn’t hurt. I miss my parents as much as ever, but there is proof of life in places I forgot it could exist, in places inside of me. For now everything is OK. In the bathroom, when I shower, I look at the shelf where I have nestled the baby shampoos from the hospital: six of them, two for each day we were there, lined up neatly. Small, cherished bottles I will likely, like my mother, never use.