childbirth

For the past three years we've spent most of our education considering things that harm, threaten or take life. Now on my ob-gyn rotation, for the first time in med school and really in my life, I've given serious thought to the birth of life. This brings to mind something I heard somewhere (okay, from Dawson's Creek) about how people think of life as the opposite of death, but really birth is the opposite of death and life has no opposite. I still think the latter part of this is true, but I feel now that the former is not quite so straightforward. Setting birth and death apart from life assumes that they're isolated events. But as medicine has showed me that dying is a process, ob-gyn has taught me the same for birth.

The process happens in so many different ways in so many different venues, and even the same kind of labor and delivery holds unique crevices. That the joys of fostering life can be so nuanced makes me think that Tolstoy's all-happy-families-are-the-same philosophy isn't true. I haven't minded observing deliveries several times over. Each baby is different by nature of being new. Besides that inherent change, every woman experiences this process in her own way, absorbs and gives in her own form. Even the same silence, or the same cries, can't be described quite similarly. It's the eyes and the lips and the hands clenched or open that I find drawn to, that I want to use to etch the outlines of those sounds that might sound the same but travel to the ear and register in mind in singular paths.

Then there are all the other places where life is considered and formed. At the fertility clinic, I watched a sixteen year old deal with premature ovarian failure and I watched a forty year old couple contemplate their options for having a child. Having failed in vitro fertilization three times, they would like to try again, and after that? Adoption, egg donation? I clearly remember the first time egg donation ever crossed my mind as any sort of thought, sitting at the freshman dining hall and glancing at a school newspaper advertisement for egg donations from tall women with high SAT scores. I don't think I've given it any sort of thought since then, until fertility clinic, where I realized that childbirth includes all that precedes it, the carrying and laboring. And this is why women choose to place within themselves someone unconnected to them, to take this process into their own hands and foster the connection with strength and desire and commitment. Later in the antenatal testing unit, where women receive ultrasounds during pregnancy, I watched twins float within a 45 year old woman, a phenomenon made possible by egg donation. In class we watch a video about home birth, and debate its use. Regardless of anything else, home birth pays attention to the labor of childbirth, and I find this respect for the process so important. Like most things, it's not something that happens to you; it's something you go through. I can't honestly say it seems easy or pleasant to bear all that pain, but I do believe feeling fully allows for a heightened awareness of experience and why settle for less of something so substantial?

Ob-gyn brings to the forefront much of what I've enjoyed in medicine, the broad range of experience and emotion, and the role of healthcare providers to connect to patients dealing with personal, sensitive, important issues. With each component of this field as a whole and of individual patients, it challenges us to confront things as continual processes with steps, thoughts, and consequences, immediate and far in time. I've really enjoyed seeing babies born, which is a given, but I'm thankful for the surprise of how the value of this moment comes so much from the before and after.