Photo courtesy of Sara Nolan

Getting Permission To Push My Baby Out

They expected the baby in maybe 10 minutes, and definitely before midnight — this baby’s coming today, they said — but when it wasn't out two hours later, and the clock arms had weaseled past 12, they called in the patriarchy.

You know, the doctor. The Guy.

Other than my husband, Fred Flintstone was the only other dude in the delivery room, his larger than life head winking at me from a framed poster on the opposite wall. Who had chosen the decor? Who thought THE FLINTSTONES would hearten laboring patients? I slowed my breathing between contractions, focusing on, of all things, him.

Fred whizzed along in a primitive vehicle — exactly what I felt like! — with his wife Wilma and baby Pebbles, going nowhere fast. I suppose they were chicken soup for the cultural soul: America’s longstanding TV family. Still. Was Wilma there to encourage me a la: I did it too sister… sorta. Hardly solidarity, right? The animator dudes just penciled my baby — no pushing, no C-section. How ya like my pinched-in, ain’t-ever-going-to-be-postpartum waist? Childbirth is whack, dangerous and too messy for cartoons. But YOU got this!

Did I? The trouble was they — my midwife-led birth team — thought the pushing stage would be pretty short;, even though I was a VBAC, an expulsion virgin. They predicted this based on my steady, textbook labor progress thus far. And they were wrong.

The women’s eyes flickered back and forth between my own cave opening, where the baby’s tuft of hair waited patiently like a car at a toll booth.

It is hard not to turn whatever circumstance into a referendum on your own shortcomings. Ask anyone who has, say, grown a child inside them and then labored. No stranger to birth, and its unpredictable nature, I still saw the ticker-tape of self-condemnation as the sweat rolled down my temples: Why can't I get the baby out? What am I doing wrong?

The women’s eyes flickered back and forth between my own cave opening, where the baby’s tuft of hair waited patiently like a car at a toll booth, and the fetal monitor, methodically doodling the contraction pattern.

Your perineum is long, the midwife said. Well, thank you, though she meant it as a cause of delay. Another OB-GYN once told me I had nice boobs. That doctor was female so I took it as a compliment, having never once considered my boobs particularly nice or not. If she was a man, I would have reported her right away.

And we need to get the baby out, the midwife said evenly. We're going to have to do an episiotomy.

Not the snip! Something in me flipped. My husband was a fencer — he could fight off their scalpel, or was it scissors? Right?

No, I said, no, don't.

What, you want your baby to DIE in there? That’s the unspoken implication, the shroud. Ask any pregnant person who’s considered refusing a recommendation.

Fred and Wilma, if legit cavepeople, had probably seen more than their share of babies perish. Pebbles, for surviving, was the anomaly. (And, of course, fiction). Maybe that was why the Flintstones were here, reminding us that our tools, if sometimes overused, are sometimes good.

After hours pushing in semi-squat, pulling on my doula and husband, ready to breathe my baby down, I was exactly where I did not want to be: on my back in the hospital bed in the classic TV-show vagina-pointed-at-the-camera-but-hidden-from-it-by-a-very-clean-sheet position. The only thing empowering about it is that you fart and poop in people’s faces with impunity. And I still couldn’t push her out.

My doula shaman had helped hundreds of women recover from childbirth in her practice; "ALL my patients who tear heal better than those who get cut," she assured me quietly. "I had a fourth-degree tear. Tear if you can."

“Out in one more push,” The midwife said. "Or we’ll do an episiotomy." That word might be enough to eject the babe, but no. Her mohawk had been testing the air for hours.

My doula said loudly, "Can she have one more push?"

My L&D room was full of and controlled by women, as advertised. But the doctor’s word was always the backdrop, from which his overriding authority could spring fully formed at any moment. Anyway, in “your” hospital room, the door is always open. The finance guy wandered in between contractions to let me know something financial. The maintenance guy came in to change an unused trash bag. When you feel like you have a wrecking ball between your sitz bones, you're not really into chatting. But each dude turned to me for a little breeze-shooting flint.

The doctor came in as summoned, long white coat, glasses, small frown, a cloud of darkness around his head. This was the moment I dreaded most, when he would turn the tide of what had, until then, been going beautifully. The Patriarchy would finish this up.

My doula said loudly, "Can she have one more push?"

The doctor, bless his heart, just stood there. He did not disrupt the bedside gathering of women. He did not brandish his tools and turn my body into steak tartare. He stayed back. Paused. He is the exception.

Patriarchy is not known for its pauses. Fred winked at me. Wilma winked hard. Someone with authority was giving me just enough thumbs up and autonomy to finish my journey on willpower fumes alone.

Each strenuous push had tapered too soon. Far from fear during the labor, I had felt a hole open up in my confidence, with the speed of wet toilet paper coming apart. This is where it all goes wrong.

Of course it's ALWAYS the end when things go wrong, because in birth, they don't let things take their own course once the course is unfavorable. I flashed back to my son's birth, when my care providers kept asking me if I needed to push, but no, I didn’t. Instead, everything was slowing down, going backwards as if to the cave ages, and I was deposited into a hot hell.

And at the end was when my first baby’s cord prolapsed, and the frontman for the patriarchy — Surgeon F — saved him in under 60 seconds with a perfectly timed stroke of his knife. I did not argue with that. And here again I saw his white coat, waiting.

"She can have just one more push," He said, clinically, to the room as a whole. "I think she can do it in one more push, but that's all." His blessing seemed to reinvigorate the midwife and nurse.

I can still see his face, willing to be a side character in this drama, believing it possible. He watched the fetal decels, but didn’t see only the ghosts of lawsuits past flitting in their midst. He preferred I do this myself.

With the next contraction, I bore down into the lava pit and shot her out of me. Her whole body at once, head to toes. I did not even feel her leave. I wondered if death would be similarly traceless. She (I did not know the sex yet) was on my chest for only a minute before they cut her cord and brought her to the far corner to be checked. I did not see the doctor, who had exited quietly and with grace, taking no credit. My midwife leaned over me with a spelunking headlamp to inspect the damage, encouraging me to get the placenta out, because, no, you're not done pushing.

I forgot that part, I said. Do I have to? Yabba dabba do?

I remembered the baby had actually, like, come out. Is the baby okay? I asked. And would it be my fault if it wasn’t — yours? “Okay” never had so many strings attached as in those moments after a baby is born. It’s the only question that seems to matter.

Yes, the midwife said.

My doula squeezed my hand. My husband kissed me as I winced. You have a daughter, he said. Our house would no longer be the testosterone palace (save for two female parrots, and me). Now that my daughter had dismantled my perineum, the patriarchy could be next.

What do we know and when do we know it? Did my body know it had the reserves and wherewithal to get her out? How could I know in advance of doing? After all, tearing didn’t sound so great either — think about, say, picking something up at the risk it would rip your bicep down the middle. Doubt had clubbed me: What if I can’t do this? And what if this is where I lose the thread of my strength and everything unravels?

The truth is I have no idea how I pushed her out.

Who can give your strength back to you but you? Did the patriarchy? Did my daughter? Or did I actually find it somewhere beyond any structure or concept, beyond anyone’s ultimatum?

The truth is I have no idea how I pushed her out. The doctor could have gone into commando mode and used his authority to evict her from my body with any tool at all, including the tool of his gender. But he stayed out of the spotlight. Hands in his coat pockets. Willing to wait. Thank you, Big P, for not disqualifying me from my own inner power source. I would have fought you, but maybe not hard enough.

Often, this extra time, this eleventh hour, is all we need to find the thing in ourselves that is inexplicably potent and godly. For our midwives to guide our babies out. But we have to be allowed the chance, then trusted into using it. A room of women with faith in women’s bodies is supposed to foster this. Yet the care providers were deriving their confidence and conviction from a man. They let me push one last time because HE let me push again.

Had he waltzed in and declared it too dangerous, it would have been show over, slice away. Luckily, the dude saw this birth for what it was; urgent but not critical — he was not needed. And I saw myself for who I could be, someone whose body and spirit could do the thing that seemed as impossible as Fred and Wilma leaping off the wall to eat my placenta. I’m grateful the doctor remained in the shadowy fringe, where the cartoons were, so I could dig deep in my visceral resources before his tool could beat me there.