Preparing for Home Birth

Our baby would be in good hands with his mother. The weak link was me. 
An adult holds a newborn's hand moments after birth.
Photograph by Alice Proujansky

I was not prepared to be a father—this much I knew. I was thirty-nine years old, didn’t have a job, and lived in one of the most expensive cities on the planet. I had always assumed that I’d have kids, but I had spent zero minutes thinking about them. In short, though not young, I was stupid.

Emily told me she was pregnant when we were walking down 34th Street, in Manhattan, on the way to Macy’s to shop for wedding rings. Our wedding was a few weeks away and, true to form, I had put off shopping for it to the last minute. I had a fellowship at the time at the New York Public Library, in midtown, and I must have Googled “wedding rings near me.” Macy’s it was. All around us on 34th Street people were shopping and hurrying and driving and honking. Emily told me, and I thought, O.K. Here we go. We are going to have a kid.

Then I thought: We need to get some very cheap wedding rings at Macy’s.

I was born in Moscow and came to the U.S. with my parents and older sibling when I was six. I grew up in a suburb outside of Boston and dreamed of leaving to become a writer. After college, I moved to New York and worked odd jobs and wrote short stories, which I sent to literary magazines, which never wrote me back. To see my name in print, I started doing journalism. I also started translating things—stories, an oral history, poems—from Russian. Eventually, I started a left-wing literary magazine with some friends, published a novel, and travelled as much as possible to Russia to write about it. This was a decent literary career, truly more than I could ever have hoped for, but it did not bring in a lot of income; when Emily and I met, I was living with two roommates in a grand but cockroach-infested apartment on Eastern Parkway in Brooklyn.

At the time, Emily was a writer for Gawker, a media-gossip Web site. She was brilliant, beautiful, and very funny; she could also be very mean. She had grown up in an upper-middle-class household in suburban Maryland, but she had a chip on her shoulder. We dated for a while, broke up—she dumped me at a Starbucks, in Cobble Hill, that later closed during the pandemic—and then started dating again. Eventually, we moved in together, to a 1.5-bedroom apartment above a bar in Bedford-Stuyvesant. Emily had quit working for Gawker and, with her best friend, started a small feminist publishing house. The year she got pregnant, she had published her first novel, “Friendship,” about two best friends whose relationship is disrupted when one of them gets . . . pregnant. I was working on my second novel, about Russia. The library fellowship was the bulk of our income that year. Strictly speaking, we still didn’t have much money, but that was O.K., because we also didn’t have any kids.

I suppose it isn’t exactly true that I hadn’t thought about kids. I hadn’t thought about actual birth, or what sort of clothes a baby wears, or about the practicalities of early infancy. “As a child, from the moment I gained some understanding of what it entailed, I worried about childbirth,” Rachel Cusk writes in “A Life’s Work,” her dark, brilliant memoir of motherhood. She feared its pain and its violence and what would happen on the other side. To this, truly, I had given zero thought.

But I see, in retrospect, that I had spent years imbibing the heroic male literature of family neglect. There was Henry James, champion of Art over life (“One has no business to have any children,” one of his writer characters says, “I mean of course if one wants to do anything good”); Philip Roth, who refused to have children; Tolstoy, who had many children and a long marriage but still managed, at the very end of his life, to walk out on them. “The intellect of man is forced to choose / Perfection of the life, or of the work,” William Butler Yeats wrote. I would choose the work. I had been married once before, while still in college, and at the time I was adamant that the relationship not interfere with my writing. My time must be my own; I must have adequate amounts of it; if my writing does not get done, then all is lost. My insistence on this eventually doomed the relationship. The lesson I took from this was not that I should keep things in perspective, but that I should arrange my life such that it revolved wholly around literature.

One time, not long after Emily and I had started dating, I hosted the Russian writer Ludmilla Petrushevskaya in New York. Anna Summers (my ex-wife) and I had translated a book of her scary fairy tales, and Petrushevskaya, by then in her seventies, flew over to do some readings, shop for clothes for her kids at Century 21, and eat Thai food. She was, and is, in my opinion, the greatest living Russian writer, the final chronicler of that country’s life at the end of its most terrible century, and one evening toward the end of her stay, while we were eating Thai food, she suddenly looked at me and said, apropos of nothing, “You know, Kostya, I started writing when I was a little girl. But I didn’t become a real writer until I had my first child.”

I don’t know why she decided to say this to me. Maybe she was just talking. But, at the time, I thought it was because she saw in me a person leading a superfluous existence. I had thought that I had devoted my life to literature. That wasn’t what Petrushevskaya saw.

Now here I was, five years later, about to be a father. This was serious business, involving doctors, nurses, life and death. Immediately, I was worried about the baby. Was he comfortable? Was he safe? Was he getting the proper nutrients? At the same time, I started trying to figure out, almost despite myself, how I was going to make sure none of this interfered with my work. I had a vague foreboding that it would.

I had one friend, Eric, from graduate school, with whom I’d kept in touch after the birth of his child. I asked him out for a beer and told him that Emily was pregnant. I asked, “What do I need to know?”

“It’s tough,” Eric said. “It’s not easy. You need a lot of stuff.”

Stuff?

“Yeah, a lot of stuff.”

Of course! I was delighted. Stuff was something I could handle. I bought a kids’ dresser—with a little nook up top for a changing pad—from some Russians in Sheepshead Bay. One of Emily’s friends gave us her daughter’s old crib; another gave us her old bassinet. Emily’s parents bought us a car seat and a stroller. My father bought us the mattress for the crib. My friend A.J., who’d just had a baby, mailed us what looked like a large pillow with a little depression in it, which she called a “dog bed,” for putting our future baby down onto. We bought some onesies and some diapers and a changing pad. One day, Eric’s wife, Rachael, came by our place with a baby carrier. Her daughter was asleep in the car downstairs; technically, I think, this was illegal. Rachael threw the carrier on our bed. “Here,” she said. Someone had sent a stuffed bunny for the future baby, and Rachael grabbed him by the throat and put him atop the carrier. She secured one strap around her waist, then bent down over the bunny and threaded her arms through the shoulder straps. “Like that,” she said. We nodded, uncomprehending. “O.K., bye,” Rachael said, and ran back down the stairs to her daughter. We now had a baby carrier.

The stuff kept the fear at bay. If the baby showed up tomorrow, we’d have a place to lay him down while he slept, a surface on which to change his diapers, methods for transporting him by street or car. But still we were scared.

Or maybe I should stop saying “we.”

Before the baby, Emily and I were very similar. We both liked to drink coffee and read books and work on our laptops, sometimes together, at the café on the corner; before going to bed we liked to watch an HBO show and eat a chocolate bar. If we were on the beach, we liked to go swimming. Emily was on her high school’s swim team and remained an excellent swimmer.

The pregnancy both brought us closer and pushed us apart. For a while, including at our wedding, we were the only ones who knew. Then, later on, we were the ones to whom every little thing mattered: at the sonograms, we studied the expression of the lab tech, or examined little photos to see if we could make out the face and character of our baby.

But there was also no denying that this was all happening to Emily, inside of Emily, and not inside of me. It was like we’d discovered that Emily had a superpower—a partly debilitating superpower that would lead to incredible physical pain, but a superpower still. We were scared of different things, then, and in different ways. I was scared of my ignorance. Emily was scared of the pain. But Emily was also prepared: she had read the literature and she knew lots of moms. Once she was pregnant, she downloaded an app that told her all about the baby. “Our baby is the size of a pea,” she would tell me. Then: “Our baby is the size of a plum.” Eventually, our baby was the size of an eggplant. He was in good hands with Emily. The weak link was me.

Emily wanted a home birth. I thought this was crazy, but she said that she didn’t want to take a cab to the hospital and possibly give birth in it. I imagined looking up at the taxi meter as my child was born and seeing, like, a hundred and ninety-eight dollars. I agreed to explore the option of home birth.

We watched an unconvincing documentary called “The Business of Being Born,” in which the former daytime talk-show host Ricki Lake, pregnant with her second child, sings the praises of home birth and denounces an American hospital system that pumps women full of drugs and then pressures them to have C-sections they don’t need. Toward the end of the film, Lake gives beautiful birth at home, no drugs needed. The director of the film is also pregnant, but ends up giving birth at the hospital, because her baby is coming out the wrong way (legs or butt first, known as “breech,” as in breeches). The film is pretty compelling as an indictment of a profit-seeking medical establishment. In proposing home birth as a sort of opt-out movement, it is less effective. There are a lot of people who cannot or should not give birth at home. When the director has to “transfer” to the hospital to get a C-section, the news ought to be that her baby has survived. But, in the context of the home-birthing paradigm, the director is made to seem like a failure.

Still, we remained open to the idea. We interviewed a midwife named A. She was young and seemed nice enough, but, as we were wrapping up, she said a very strange thing. “I have a question for you,” she said. “If something goes wrong, will you still remain advocates of home birth?”

It took us a moment to process the question. If something goes wrong? With our baby? Will we be what? Of what? “Sure,” we managed, but what we were thinking was: Why would someone ask that of two terrified people who had never given birth before? It felt like the midwife had an ideological commitment to home birth that went beyond her commitment to our unborn baby. It did not feel right.

We continued to do research and talk to people. One friend warned me that his daughter’s shoulders had gotten stuck on her way out of the womb and that the doctors, who were about to break her collarbone, finally managed to get her out with some large forceps. Can’t do that at home, he said. (Actually, you can—shoulder dystocia, as I later learned this was called, can sometimes be handled, or better yet prevented, at home by an experienced midwife.) Another friend, whose husband was a doctor, said that she couldn’t believe people gave birth at home in bathtubs. “The baby can’t breathe underwater!” she said. This also was not quite right—though there are rare cases when newborns accidentally drink some bath water, most wait to take their first breath until they’ve been brought into the air. But these bits of advice stuck with me. I was becoming concerned about home birth.

Then we met Karen and Martine, two midwives, in their fifties, who ran a joint practice. Karen and Martine did not regale us with stories about the magic of home birth. Instead, they unfurled a list of all the things that could go wrong, the possibilities that would trigger the dreaded “transfer” to the hospital. A baby in breech position, like in the Ricki Lake film, to be sure. Also a baby showing signs of fetal distress, with a heart rate outside the normal range. A baby turned the wrong way laterally rather than vertically, i.e., with his back perpendicular to the mother’s back, is tricky. (You can, at least theoretically, turn the baby around through the mother’s abdomen.) They seemed to be saying that if our commitment to home birth was stronger than our commitment to the health of our unborn baby, or of his mother, then they did not want to work with us.

I thought that it would be a great honor to have our baby delivered by Karen or Martine. Emily agreed. We decided to have the birth at home.

Karen and Martine recommended a birth class specifically devoted to home births. Our teacher was a lovely artist named Ellen. Every Tuesday for seven weeks we sat on cushions in her living room, alongside six other couples, and discussed the birth process. We learned about the events leading up to delivery: Braxton Hicks contractions, which are deceptive contractions that don’t actually indicate that labor has begun; early labor, where the contractions start for real but are relatively mild, compared with what happens next; and then active labor, which is sometimes inaugurated by the rupturing of the amniotic sack (“the water breaking”). During early labor, Ellen said, you could hang out and do a project or watch TV; during active labor, you would no longer feel like doing those things, because active labor was painful and prolonged. Once it became bad enough, you called the midwife. After the midwife arrived, the mother would start pushing to get the baby out.

It was a great class. I had absorbed from popular culture that birth classes taught women some kind of elaborate breathing technique for their contractions, but this had gone out of style. Rather than breathing in some specific way during active labor, Ellen advised mothers to do what comes naturally when you are in pain: to scream.

I was becoming more prepared, but I still wasn’t prepared. We bought and borrowed and accepted stuff; hired our midwives; wrote a letter to our insurance carrier asking them to pay for a home birth. We even came up with a sort-of name for the baby, so we wouldn’t always have to call him “the baby.” It was a Russian name, in honor of my Russian heritage, but also the most implausible Russian name that we could think of—“Yuri.” It was implausible because, as Emily pointed out, mean kids would just call our baby “Urine.”

Two weeks out from the due date, with our baby now the size of a small watermelon, we had our first real scare. Karen came over for a checkup and, while listening to the baby’s heartbeat, noticed a skipping beat. Thump-thump-thump-thump-silence, the handheld heart-rate monitor said. Karen, normally unflappable, seemed worried. She got on the phone and, after checking to see if they took our insurance, made an appointment with a pediatric cardiologist in Manhattan. Then she dropped us off at the subway. Even though it was just the G to the L to Union Square, it was the longest subway ride of our lives. The subway platform was dingy; all the people on the train were strange. When I tried to call the baby by his joke-name, Yuri, Emily snapped at me. “A name seemed so important all of a sudden,” she later wrote, “like it could tether our baby to us and to life.” We felt like two very small and helpless people, in a giant city, with a little unborn baby whose heart was not working quite right.

Eventually, we reached the cardiologist. After running all the scans, he told us, to our great relief, not to worry. Our baby was beginning his long journey out of the womb. Sometimes things like this happened during this period. Most of the time they worked themselves out in the process of birth.

Six days later, I came home from a beer-league hockey game at around midnight. Emily was still up, watching a show in what was still the TV room, though the child dresser and crib were hinting that its time was running out. “My contractions have started,” she said. These could be Braxton Hicks contractions or the contractions of early labor. Luckily, Martine was coming the next morning for the final pre-birth checkup. We went to sleep.

In the morning, Martine was happy to hear about the contractions. She checked the baby’s heartbeat. Thump-thump-thump-thump-silence. As Martine was doing the rest of the checkup, a large wet spot appeared on Emily’s sweatpants.

“Uh,” she said.

“Ah,” Martine said.

It was her water breaking. Martine, as always, was calm. “Call me when the contractions are stronger and more frequent,” she said. Then she left! She had other stuff to do. We were a little bit surprised. It was eleven a.m.

For the next four hours, we hung out, watched a bunch of TV, and waited. “The one thing you must not do,” my friend George had told me, “is buy a bag of Milano cookies and eat them all while Emily is giving birth.” Apparently, George, waiting in the hospital during his wife’s labor, had become a little peckish, gone out to a deli, and bought some Milano cookies. Then while she gave birth he sort of stood there and mindlessly ate them all. They really are very delicious. Four years later, she still had not forgiven him.

I managed not to eat a bunch of cookies, but I did make a mistake. We were watching a TV show that I thought was very funny, and I was delightedly laughing at it, and so was Emily. But I failed to notice the moment that she stopped laughing. She had been sitting next to me, on a yoga blanket, occasionally getting on all fours during a contraction, but now her contractions had increased in magnitude. “What are you doing?!” Emily said, as I laughed again at our show. She was on all fours again, but grimacing. I turned off the TV.

I was the timekeeper, and I was convinced that I would fuck it up by calling Martine too early. She would show up, say that I was exaggerating the severity of the contractions, and leave. Then Emily would give birth, with just me there, and it would be a catastrophe. But the contractions were very clear. The formula was 5-1-1: they were to be less than five minutes apart, and last for longer than one minute, for one hour. I couldn’t really understand how a contraction could last longer than a minute, but then I saw Emily visibly in pain, moaning, groaning, wincing, for an entire minute, and was convinced. At four p.m., I called the doula, and told her she should come. Then I read to her from the piece of paper in which I was recording the contraction statistics. “Should I call the midwife?” I asked.

“Yes!” she said.

Martine and her assistant arrived at six p.m. By then, the contractions were even stronger. Emily threw up. She was in unbelievable pain. She started pushing at around seven o’clock. She pushed in our living room, then on the floor of our bedroom, and finally on our bed. At one point, when Emily was on the bed, just before the baby’s head started coming out, a geyser of blood shot out from her vagina. On the advice of our midwives, we had placed a plastic shower curtain under our bedding, so that blood wouldn’t get on the mattress, but the bloody geyser was not something we’d anticipated. It was high and strong enough that it got on our window shades. I made a mental note to get some new window shades at Home Depot.

And then, about half an hour later, the baby was out. For a brief, terrifying moment, he didn’t say anything, but right after that he started screaming. He was fine; the baby was fine. Emily and I looked at each other and laughed. We couldn’t believe we had managed to do it—that Emily had managed to do it. At home, in our bed from Ikea, in our apartment above a bar. The assistant listened to the baby’s heartbeat again: thump-thump-thump-thump-thump. Just like that, the missing beat was gone.

We decided to call him Raphael—after my grandmother, Ruzya, who had died just a few months earlier; and after Emily’s beloved cat Raffles, who had also recently died; and because in Hebrew Raphael was rafa (healed)-el (God)—“healed by God.” He had been healed of his heart condition in the moment of his birth. For a while, we argued over whether “Raffi” or “Raphy” was the proper spelling of his diminutive—Emily thought Raffi, I thought Raphy—but eventually I gave in. Raffi it was.

In the months and years ahead, I received some answers to my questions about babies and writing, and about parenting more generally. The answer about writing was that the baby did, eventually, sometimes, fall asleep; then, if you had not been up all night breast-feeding him (that is to say, if you were me, and not Emily), you could get some work done. And you did need to get it done, or rather I needed to get it done, because babies, in America, were expensive—they required diapers and wipes and health insurance and day care. I finished my second novel when Raffi was still a baby, because I had no choice but to do so. When, that same year, a university teaching job opened up, I jumped at the opportunity.

But if you worked you were not with your child, and if you were with your child you were not working. There was no getting around it. Even the partial and temporary solution that I came up with—to start writing about Raffi and his antics and our life with him—was shot through with compromise. In order to write about raising Raffi, I first had to get him off my hands for a few hours, or better still a few days. Maybe this is what Petrushevskaya had meant about being a real writer: You didn’t know what writing was until you had dropped off your little boy at day care, or baseball camp, then walked away as he cried because you needed to do your work.

As for parenting, I learned that it was not a single event but a long, slow slog through time. I learned that it was better to sympathize and “mirror” than to yell; better to live close to your day care than far from it; better (most of the time) to just give your kid the snack he wants instead of having a two-hour standoff over whether the snack would ruin his appetite for dinner. I learned that despite Emily’s vast over-all superiority as a parent, there were things I could do with our kids (we eventually had another) that she could not. Raffi would one day begin to catalogue, out loud, the things Mama was better at versus the things Dada was better at. The list of things I was better at—wrestling, driving, picking him up and throwing him on the couch—was shorter, but, still, there was a list.

But all this would take a long time, and many of these things that I figured out, I figured out too late. Meanwhile, back in our apartment on Franklin Avenue, we learned the true meaning of home birth. At the hospital, I’ve been told, you remain in the care of experts, who give you a day or two to acclimate before sending you out into the world. That was not the case when you gave birth at home. While Emily and I lay in the bedroom with Raffi, Martine, her assistant, and the doula cleaned up all the blood and gore and other stuff that got messed up in the excitement. Emily gave birth at 11:18 p.m., and by three a.m. they were gone. Our apartment was clean and empty. It was a Tuesday night; the whole neighborhood was asleep. They had left us with a little baby, and we had no idea what to do.

This is drawn from “Raising Raffi: The First Five Years.