Chapter Text
*
The pain is very subjective, very personal, very much about the context. There has been a false news circulating for years now, claiming tthat a birth it's the equivalent of having 20 bones breaking in your body, and there are people who say they felt like they were being torn in half.
I worked for ten years with the Russian and US armies, and you'd be shocked by how much they need an obstetrician. The number of abortions performed is too brutal to qualify as humane.
I have never been pregnant and have no plans for it. What I know for sure is that every childbirth is different, and the pain depends on the circumstances and the preparation before delivery, especially if there is no adequate analgesia and anesthesia.
So, when I arrive for my shift and someone tells me that a woman has been in labor for 14 hours, my first question is: why was the pain prolonged for so long? Is she one of those mothers who insist on a natural birth at all costs? Is it a complicated case?
The attending obstetrician was in the hallway when I arrived.
"Yelena, thank goodness you're here. This woman will die if we don't do something," he said anxiously.
It's not common for us to show our emotions in front of patients, but among doctors, it is common, widely accepted, and even healthy to be a little desperate.
"What happened?" I said, leading us to the preparation room. As I washed up, he explained the situation to me.
A silent mother , clearly in agony, but she wasn't complaining about the pain. She didn't ask for an epidural, morphine, or vodka. She wasn't cursing the fifth generation of everyone involved in the delivery.
She arrived alone, walking, informed us that her water had broken, waited patiently, and her baby simply refuses to come out.
Maybe it's a case of the mother not pushing hard enough.
"How are the breathing techniques and pushing exercises to encourage dilation going?" I asked, reviewing the patient's medical record.
"She's a silent warrior, doing everything we ask, but clearly in agony," he said, passing me the patient's blood pressure and the baby's vital signs.
"Did she have proper prenatal care?" I asked, putting on my gown and lab coat. I slipped into my dinosaur crocs and was ready for the fight.
"Yes, she's an important name. She had complete prenatal care here," he explained as we walked through the corridors.
What the hell is wrong?
Maybe it's one of those unusual births. Births tend to be very straightforward events. Feel the contractions, see the water break, and come in for us to deliver the baby. Simple. Very rarely are there crazy stories of dirty taxis and hours of pain. The science of childbirth is advancing every day.
"How is she doing now?" I said, stopping at the door of the room.
"She's resting a bit, but it's time for her to wake up," he said, opening the door for me.
She looked like an expressionist painting as soon as I entered the room. The first rays of morning sun were illuminating her pain-stricken face.
I entered and was alone with her.
I observed her for a moment. She was a young 25-year-old woman, wealthy, beautiful, very beautiful, with long dark hair, and when she turned to look at me, perfect blue eyes. I froze in the middle of the room. We locked eyes for a minute.
"Hello..." she said with a fragile voice.
"Good morning, I'm Dr. Yelena Belova... I will be your obstetrician from now on..." I said, approaching the bed.
"Oh, finally someone will be able to convince my baby that it's time to come out?" she said, weakly laughing.
"I would like to be that person. What's her name?" I said, smiling.
"Anya..." she said happily, rubbing her belly.
She smiled, and her smile was beautiful too. I shook my head, approaching to place her medical record at the foot of the bed.
"Beautiful name... you know, that's a very common name where I come from…" I said, gently touching her swollen feet.
"Yes? And where do you come from?" she asked, grimacing with a specific twinge in her right leg.
"I'm Russian, it's a common name, a variation of Ana..."
"Bearer of good" she said, looking at her own belly with a smile. I observed the entire scene attentively… she had definitely planned the pregnancy.
"So, would you like to tell me what's the thing with the silence?" I asked, sitting at the edge of the bed.
"I just don't think I need to make a fuss about my pain..." she said curiously.
"You know, before we get paid to deliver babies, in our salary there's an extra hazardous pay for insults and absurd requests for anesthesia, right?" I said, trying to make a joke, and she laughed, but the whole act was interrupted by a wave of pain that made her writhe. She didn't make a sound.
I quickly approached her.
"Look, while I think you might already be considered my favorite patient for not being a screaming diva, I really want you to be honest with me about your level of pain," I said, already lifting her gown and listening to her heart.
Racing. Racing too fast.
I touched her wrist, feeling her pulse, and stepped back to grab a meter. Blood pressure is high.
"Do you have a headache?" I asked softly.
"No..." she said, and I looked closely at her face. She's lying.
"Listen, I'll be very clear, you might find me tough... even harsh. It's not like they taught me to be compassionate back in my days at medical school in Russia, but here it goes... if you don't tell me how you're feeling... You and your baby will die," I said, looking at her calmly.
"Wow, that's really tough. I just... I don't know how to make it better... They tell me to push, I push, they tell me to breathe, I breathe... And yes, I have a headache, and I feel like there's tremendous pressure in my belly. Here," she said quietly, pointing to her right side.
Alright, first point covered. She trusts me.
"This could mean you're at risk of eclampsia... When your blood pressure is too high... It can be complicated," I approached to examine her medication. Maybe all this suppression of pain is an effect of shock. Eclampsia tends to affect the psychological aspect in some cases.
"What has been discussed with you about a c-section?" I asked, checking her eyes, there was no swelling. I pointed to her hands, asking if I could touch her, and she nodded. Her hands were soft and seemed to be in the process of swelling. Her feet already looked like fluffy buns. She definitely needs to be checked.
"They asked if I would like it, and I said I wouldn't object, but one of the attending physicians... damn it..." She shifted uncomfortably. "One of them said I didn't meet the requirements yet..." She composed herself a bit in the bed.
I looked at her body. I need to perform a pelvic examination to understand the dilation and know at what stage we're at here.
"Sorry, what's your name?" I said, pausing to observe her. I know her name, but I need to engage in small talk here to distract her.
"I'm Kate, Katherine Bishop..." she said with a smile. And then more grimaces of pain. Apparently, contractions are still happening.
"Alright, Kate Bishop, introductions made. Now, I would like to perform a pelvic examination. I need to know the dilation and what's happening down there. Normally, I would do this on a third date... But..." I said, trying to make a joke, and she laughed out loud again, and there was definitely more pain. She never uttered a sound.
This is not the time for flirting, it's unethical.
She was blushing. I think I'm blushing too. Be professional, Yelena. I positioned myself to adjust the angle of the bed, placed the leg supports for her while always observing her reactions to pain stimuli.
"Well, after you witness my vagina expelling a 4.5-kilogram child, maybe I can buy you a coffee to make up for it..." she joked when I was about to lift her gown. I stopped and clinically observed her entire face. Did she just throw my move back at me? That's cool.
"I'll hold you to that..." I said, leaning in to investigate why my new client refuses to come out.
"Katherine, you know those spikes of pain that have been happening since I arrived here, they've been occurring every 5 minutes, they're contractions. For me to perform this examination, they need to be happening. I need you to let me know when they're close, it should be now... But if you keep suppressing your pain, I'll miss the opportunity... You can be honest with me, I'm here to help..." I asked, looking at her.
Her eyes were calm and serene. She nodded slowly.
"It's starting," she said, letting her head fall onto the pillow.
I had my cue to begin the examination. The cervix is in a perfect position for delivery. Adequate thickness, but there's still room for two fingers. The baby is in position, but not fully engaged. It needs to descend further. She need to have more contractions for that to happen.
I finished the examination, took off my gloves, and went to wash my hands. This situation is not a big deal. The mother and the baby are holding on. I need to encourage this delivery. I already know how. I prepared some analgesics for her, anticipating my plan.
"Look, today I'll be here with you all day. I already know what can help us here. I need you to rest for an hour, and then I'll come back for my next 'examination'."
****
The workday was stressful. How could I think that working until nine months of pregnancy would do me any good?
I'm a woman with enough money not to need to work, but I'm a workaholic who doesn't know when to stop, dealing with a multimillion-dollar company that recently got involved in scandals because of a greedy and unscrupulous mother whom I had to report and make sure she was arrested.
Did I want to be a mother for the rest of my life? No, I didn't. But last year, I started researching my options. I could adopt, I could have a random hookup, I could have a surrogate, yes, I could buy a child. None of that caught my attention as much as in vitro fertilization options. It was safe, I would have choices, I could do it how and when I wanted. I had all the means.
She would be solely mine.
I researched the donors, I wanted healthy guys with a good medical history. I needed it to be smooth, and honestly, I had a lot of fun throughout the process. It was quick and easy. My good medical records, my previous healthy life as a semi-professional athlete.
My girl... Anya...
Everything was perfect. My prenatal care was incredible. I had support from my friends, and I had the means to do it all, both psychologically and financially. What could go wrong?
My friends were at a wedding party in Vegas because, frankly, I didn't want to go, and it's not like I could take a flight there.
I was alone in my penthouse, checking my bag for the thousandth time to take to the hospital when the time came. They say that ten days before and ten days after the nine-month mark is when the best time for delivery occurs.
I read everything about it. I really wanted to have a good experience, and I would. All the ease only lasted until my water broke in the middle of my living room, on top of a $30,000 carpet. This is not simple. I can't even take care of it right now.
Alright. I need to freshen up, change clothes, grab my packed and organized bag. I need to take a deep breath and call a taxi.
Everything went smoothly. I arrived at the hospital, got out of the taxi by myself, walked to the reception, and explained my situation. My doctor is here. He's a relatively young guy, a bit absent-minded, but all doctors are a bit cold and distant, right?
I started feeling the first contractions. They were getting worse, but I kept myself calm and composed. There's no point in screaming and thrashing around. I couldn't sleep in the past 14 hours due to the pain, with people coming in and out of my room periodically. I just wanted to make sure everything would turn out fine. There's no reason for anything to go wrong.
We discussed the options, but nothing seemed to work. I was getting frustrated, not even a cesarean section was an option yet. My body wasn't cooperating with the skilled doctors and nurses. I remained kind, following all the instructions, but nothing.
When I saw her for the first time, petite, long hair tied up in a pretty braided ponytail. Ugly blue hospital attire, a pristine white lab coat, and... dinosaur crocs. Right. She's beautiful. Dr. Yelena Belova is beautiful... attractive... fascinating. Her presence made me even calmer, even when she said I would die if I remained so calm. I still didn't see any reason to get worked up.
She would be the attending, she was honest about my situation, seemed concerned, well-prepared, very kind, she flirted with me. I'm sure she just wanted to be kind. No one flirts with a woman in pain for 14 hours, but yes, I trust her.
Alright, she saw my once-good vagina, which probably doesn't look so good right now, but she examined the poor lady and decided she had some crazy idea to help. I didn't argue, I didn't complain all night, and I won't start now. I'll do whatever she wants.
She gave me a medication that helped me rest. I couldn't really sleep, but the pain eased. I stayed lying down and remained calm. She said my blood pressure is high, maybe if I don't get worked up, the pain will improve, and the delivery will happen faster.
I was looking out the window, thinking about how the baby's room is ready to welcome her and how I need to inform my friends. In the rush, I didn't want to interrupt them in the middle of a wedding. Will they be angry? Probably, but I'll already be home with my daughter, waiting for them.
Dr. Belova walked through the door with a box in her hands, accompanied by another redhead woman with some decorations, and a short-haired brunette bringing... wigs? What on earth does she think she's doing?
I stood up as best as I could without causing myself more pain. I watched as they took out a speaker and quickly connected her phone to it. Cardi B started singing. The sound was low, but the three women were putting on the wigs, approaching me.
"So... since we don't have that coffee yet... I really need to take you dancing..." She said, adjusting a pink wig on my head. All the women helped me get off the bed.
The pain returned, but I held on. She looked at me attentively.
"You don't need to hold back... I'm here now..." She said, doing a few dance moves like squats. "Can you repeat this movement, please?" She said, holding my hands. I looked at her as if she were crazy.
"I'm Dr. Natasha Romanoff from Gynecology... this is Dr. Sonya Thomas from Pediatrics... together with Dr. Yelena here, we're the nightmare of the hospital director, but don't worry, she's our mother..." The beautiful redhead said.
I tried to squat as best as I could. Dr Belova had her eyes on me.
"Focus on me... go... do everything I do..." She said softly, moving to the beat of the lively music.
I moved slowly, smiling at all the women in the room. Dr. Romanoff was circling the room, singing and smiling, and the other Dr. Thomas was repeating the same movements as me.
The music increased in intensity, and I was laughing at the funny faces Dr. Belova was making at me.
"Isn't this going to get you into trouble?" I asked after the sixth squat.
The music changed to some fun cumbia.
"No, my mother loves my unorthodox methods..." She said, pointing at my waist. I looked at her confused. She smiled at me and placed one of her hands on my back, bringing my hand to her shoulder.
"Let's do some more elaborate moves now... sway your hips to the rhythm of the music." She said, making some incredible moves with her own hips, and I watched everything, perhaps more attentively than I should have.
I've always enjoyed dancing, been to many parties, had a blast throughout my college years. I've never been shy, and I may or may not have been an almost Olympic gymnast, but this is not how I expected my childbirth to be. I was letting myself be carried away by the music, feeling excited, calm, the whole atmosphere created by the petite woman in front of me was making me feel perfect, even though I'm the size of a refrigerator and my feet feel like small buns.
I approached her a little closer and then made a motion to push her away for a spin while holding her waist. She laughed out loud, happy, and I loved everything about it. The other two women joined us, one clinging to my back and the other to Dr. Belova's back, and then the four of us moved together in a motion of swaying and bending our knees. We were all laughing now. And I only had eyes for the petite woman with sparkling eyes.
Dr. Romanoff felt something in her pocket and let go of Dr. Belova. And we all stopped. I took a deep breath. All the laughter and movements had taken a bit of my breath away.
"Girls, I have to go, I have a patient... Sonya, I need your help, 18 years old. It's a T742..." She said, serious.
"Yes, I can still attend to her, let's go." Dr. Thomas said, excited.
"It was a pleasure meeting you, Mrs. Bishop, send my regards to your husband." Dr. Romanoff said, smiling. She seemed to hold all the secrets of the universe in that little sideways smile. I didn't really understand the whole exchange.
Dr. Belova, who was still holding onto me, sighed.
"I'm not... not married... fertilization..." I explained. I didn't know if the response was meant for Dr. Romanoff or for Dr. Belova, but the shy smile that the latter was wearing now assured me that the response applied to both.
"We'll come back later to dance with you again, Mrs. Bishop..." Dr. Thomas said.
"Thank you... you can call me Kate... all of you..." I said awkwardly, still smiling.
The two hurried out the door, and I remained there being held by the flushed and smiling person. I want to continue what we're doing; it's distracting me and making me feel really good.
"Can we continue?" I said, starting to move slowly again. She nodded, still encouraging me in the hip movements and now holding onto them to descend together with me.
"Dr. Belova... this has to be the best time I've ever had in a hospital..." I said, laughing.
"You can call me Yelena when we're alone... save the 'Dr.' for when there are other people around. We doctors are arrogant and like to have our titles said indiscriminately... you know, and I'm still short and petty... I make up for it in that..." She said with a mischievous smile. I laughed even louder. It didn't last long, though, because I felt a much stronger pain, and I screamed.
She immediately sat me back on the bed, touching my belly, grabbed the stethoscope, and listened to my abdomen. She felt the little movements of my little kicker and smiled. She pulled up a chair and sat in front of me, asking me to open my legs a bit more.
"Hello, baby..." I felt a weak kick. Yelena smiled. "Do you like music?" My daughter kicked twice.
I smiled at the whole scene.
"Oh yes... you like to chat..." She said with the sweetest voice in the world. No, my daughter didn't respond to conversations. She just randomly kicked me all day long, but she had never responded to a voice like she did now.
"She doesn't move when we call her, she only moves when she wants to..." I said, touching the side where I feel she is.
"Hello, baby Anya... I'm Yelena..." She said, placing her hands there. Nothing for a few seconds. Then two taps.
She celebrated with a fist pump. She seemed happy as if she had won the day.
She laughed, looking at me, and we had more kicks. Her eyebrows raised in her pink-haired wig. She looked adorable.
I watched her whole face smiling, asking without words.
"What? We doctors who deal with mothers and babies like to make the mother feel like a liar... she clearly likes me and is completely responding to my charm... right, baby Anya?" She said, speaking softly closer to my belly. The so-called baby Anya seemed to have done a double somersault in my belly, causing me a lot of pain. I slumped back onto the bed on my elbows.
Yelena placed both hands on my belly.
"What did you feel just now?" She asked, listening to my abdomen again.
"Like she just did a somersault in my belly." I said calmly.
"Shit. No. No. No... damn it." My daughter squirmed inside.
"I think you just taught my daughter her first curse words. What's wrong?" I said, looking at her.
"Alright, I might have messed up... it's not a medical error or anything... but basically, I won your daughter over, she got excited, and probably shifted out of the birthing position... most likely the pains will stop... probably you'll have to stay a few more hours here... and I need to take you for an ultrasound immediately." She said seriously, she didn't seem scared. She didn't seem worried. She seemed upset.
"From what you're saying, it's nothing that puts us at risk, so why are you angry?" I said, trying to understand.
"Because she was already being a little shit, making you wait, and now she'll have two of us eager to see her." She said, and both Anya and I reacted. I laughed out loud and my daughter squirmed inside, her whole foot leaving a mark on my belly.
Yelena groaned with excitement, cooing cute words and encouragements, telling my daughter how cute her little foot was and how she would bite it as soon as possible. She was at it for a good 15 minutes. An old song started playing, and Anya moved even more.
"Oh... you like this one? Wait..." She brought the speaker closer. Then she lowered the volume and started singing softly.
Anya seemed to calm down and then pushed her foot against my belly again, as she often did when she was probably asleep.
"Yelena... I think she's going to sleep..." I was interrupted... she asked me to be quiet, still singing.
" Talking 'bout my girl ..." She said, pointing to my belly and then she got even closer to my belly.
" I guess you'd say... What can make me feel this way...? My girl... my girl... " She sang with an even sweeter voice. She gave a little kiss right where the little foot was, and then I felt Anya's whole body relax, and the foot slowly eased out of my belly.
Did this woman just put my daughter to sleep, inside my belly?
She pressed her ear against my belly and continued whispering another song. I felt the urge to touch her head, and I did. I pulled off her wig and tucked a stubborn strand of hair behind her ear. I lightly touched her eyebrow and her ear with the tips of my fingers, and she closed her eyes, leaning even more against me. She seemed tired. I started softly singing another song. My favorite one. Ever since I was just a girl and my father was teaching me how to play the piano. He loved rock but taught me everything on the piano. I looked at the woman who was relaxed on top of my belly.
"Every little thing she does is magic… " I whispered, touching the tip of her nose.
She relaxed even more. I moved carefully, lifting my legs onto the bed, and arranged the woman with her arms on the bed. She shifted to make herself comfortable, resting her face on her arms. I lay down with my belly facing her and allowed myself to rest to the soft, low sounds of some calming acoustic playlist.
Everything felt perfect here.
Everything felt like magic.
*