I do not fear doctors, surgery, medicine or modernity, but in the spring of 2014, this I knew: If you let them, they’d slice you open on their own time. American medical professionals were wild for the surgical removal of term fetuses. Caesarean rates spiked at twelve and four, hours when doctors were nearing the end of their shifts, sleep-heavy and eager to leave. If they couldn’t get at the baby direct, if he slid canal-ward before they could carve him out, they’d take a knife to the perineum, outspreading the point of exit so they could more quickly make their own. In every case, they’d go first for a needle to the spine. They wanted you numb. They wanted you docile.

I would give birth in a bath, awake to the pain. My reasons were scientific, my sources peer-reviewed. There would be a quiz later, and I would ace it. I chose a doula based on the selectivity of her college, met with her at a chic cafe where the tables were high and small.

‘I want to reduce my child’s chances of antibiotic resistance,’ I said, and meant, ‘Please don’t talk about my “birth journey”.’ ‘I do not want the baby to bear the risks of synthetic oxytocin,’ I said, and meant, ‘Please do not offer to preserve my placenta.’

‘That seems very . . . rational,’ Katherine said, with care. Katherine was smart. She had been to a very selective college. She slid the contract across our tiny table. There were options, extras, deluxe packages for the naturalest among us. ‘Doula Services’. Check. ‘Childbirth Education’. Check. ‘Delivery of First Placenta Smoothies’. There were second smoothies? No check. I filled in the blanks, signed on the line, slid the contract back.

My late twenties were spent among a dozen mixed martial artists, cage fighters, ‘ultimate fighters’ if you like. I was writing a book. They were living their lives. Each fight took months of studied preparation, a kind of refined writhing in an abandoned storefront. They trained in boxing, in wrestling, in ju-jitsu and judo. Sometimes they’d stand and punch one another, and other times they’d have their backs on the ground, rolling like a pack of pups. All the skill was in the hips. They trained for hour upon hour, in the heat of summer, until they were shimmering wet and sick. The men were a team. They’d never fight each other. They trained to fight other teams, conjured grudges against other men. When invited, they’d fight one on one, in ‘the cage’, which was not a cage but a fence-lined eight-sided octagon dropped in the middle of a casino, or a gym, or sometimes a strip club. They’d pound and writhe until a man gave up, a man passed out, or three five-minute rounds came to an end. It was legal, mostly.

Among the marvels of these men was how little they minded the presence of a writer in their midst. Most people change under observation, blink twice before answering, scan the treeline for words that won’t offend. The fighters, in their insistent solidity, lacked the flickering feel of people looking to run. It came across as an open-eyed kindness, a heaviness of presence that made listening possible.

The first time I met them, Rob and Lonnie were days away from a fight in Des Moines. Rob was a pint-sized, red-haired former paralegal turned, when his lawyer lost his license, dump-truck driver.

‘What does that entail?’ I asked.

‘You have a truck, you pick stuff up, you dump it,’ he said. I wrote that down.

Lonnie was a thirty-something house painter whose extreme shyness others took for a terrifying masculine reticence. Cedar Rapids feared him. We exchanged no words, ever.

The summer I met them they were training seven days a week, four hours a day. The idea was that your pre-fight training be more intense than the longest possible fight, which is to say five rounds and twenty-five minutes of pounding. I watched Rob thrust mounted men off his hips until he threw up, Lonnie whack a bag until he wept.

This was for the fight with the Tai Dam, a Southeast Asian tribe who’d traded Vietnam for the Midwest when the Americans shipped off. The problem with being resettled to the United States is that there are many of them, and one of them is Iowa. The Tai Dam endured in Des Moines, worked at Wells Fargo, raised sons who staged fights on the side. Rob was nursing a grudge against the whole tribe.

‘They called me an Asian-stealer,’ Rob said.

‘They’re Tai Dam. Your girlfriend is Japanese,’ I said. ‘It’s different.’

‘Doesn’t matter,’ he said.

‘Maybe she’s a Caucasian-stealer.’

‘I am fighting,’ Rob said, fist lifted all mock indignation, ‘for interracial relationships!’

I loved these men, their embrace of pain, their sense of significance. They treated their bodies like some exotic animal they’d found fast asleep, beings they needed to wake to truly know.

The year before I became pregnant, my husband and I abandoned Iowa for Houston. He would study story-making in a fine arts program funded by oil magnates, and I would feed us while he finished. Houston felt like a vacation I’d taken by accident, perhaps a trip I’d won on talk radio. Real life was somewhere else, a place with fewer non-native palm trees and more friends.

I spent months job-searching, alone, hungry for human contact. I watched television on a stained couch in a one-room apartment, wishing I could drive to a coffee shop but unable to afford the coffee, anxious about the cost of gas. A wealthy neighborhood abutted ours, and when I could stand it no more I walked the streets. The houses were stucco with turrets. What does one do in a Houston turret? I imagined silk-clad women leaning languorously against curved walls, shooting pricey salves onto pursed lips. Thousands of feet beneath us, quivering droplets of oil encased in rock waited to be sucked to the surface by wells dipping and lifting like giant drinking birds. If the fighters were here, I thought, I’d feel the release, the slight shake of the earth as each drop wrests itself free. In their absence, I stared at the meticulously clipped hedges of people who provided legal counsel for the people who bought and sold what others forced from the ground.

I came to believe that my failure to be happy in this city was a failure of will, and tried to maintain an air of ironic distance. As defenses go, it wasn’t much, or in any case, wasn’t enough. When I finally scored a phone interview, a heavy-breathing CEO asked me about my childhood, my feelings. ‘What do you most fear?’ he asked. ‘What breed of dog are you? Tell me about your childhood.’ I feared inauthenticity, loved pointers, I said. He cut me off as I described my parents’ gentle neglect. ‘I’m looking for a hunter,’ he said. ‘You’re not a hunter.’ For some reason, I thanked him. He hung up before I could finish.

Pregnancy was a relief, a project. It involved other people. Once a week we gathered at Katherine’s: me and my husband, other couples. A girl in yoga pants came always with a salad, munched as Katherine talked crowning, colostrum. There were the requisite lesbians. They took notes. I did not need notes, because I’d memorized the lines. If you didn’t have the baby by week forty-two, the doctor would prescribe Pitocin. If you did have the baby by week forty-two, but took more than twenty-four hours to labor, the doctor would prescribe Pitocin. If you took Pitocin, the contractions would be super-sized, and you’d need the needle to the spine. If you accepted the needle, you’d be flat on your back, too numb to push, and they’d search out the scalpel so as to be home in time for Law & Order: SVU. Your baby would emerge drugged, overfull of fluid, deprived of healthy vulvar bacteria, denied his rightful microbiome.

It was 2014, and the biome was all the rage. We’d turned against overeager soaps, against bacteria-blasting translucent goo. Meta-studies suggested we’d do better to feed our children dirt, let them chew on shoe-bottoms lest their overscrubbed homes subject them to allergies, to asthma. Hospital interventions involved antibiotics. If you let them, they’d blast away the bacteria.

Katherine enveloped us in dolls, diapers, birth-journey DVDs. Watch the pregnant Mexican woman walk naked into the crisp river. She leans on her husband, a sensitive Japanese sculptor. Sun-baked children play on the banks. Hear her moan, hear the children shriek, see her eyes roll back. A baby, born into warm Mexican microbes, protected, by its attractive and sensuous parents, against peanut allergies.

In the DVDs, women unleashed screams, caught babies in dirt huts, in baths, on suburban decks. (‘Tell the neighbors first,’ advised the deck people.) That you know something to be propaganda does not necessarily steel you against its narrative pull. I loved these videos, these women who swayed and stretched, who writhed desperately and rolled with opponents invisible. At the moment of delivery,
a change of mood: a ferocious agony slakes to celebration. I cried every time.

We watched hospital births too, women in hospital-issued slippers still and supine, leashed to machines. Katherine’s own first birth went like this. ‘Your hips are small,’ said the doctor, scheduled a C-section, numbed her up, sliced her open on a rolling bed. For ‘small hips’, she would risk blood clots, infection, a bladder accidentally snipped on the way in. The wound was such that she needed a wheelchair to get to her child, whom the hospital had placed in a translucent box. ‘Explain this to me again,’ she asked the doctor. ‘Stop obsessing,’ he snapped. Her next three were born in this living room, the siblings gathered round some spiritually significant quilt.

A spouse was a ‘nest-builder’. Contractions came as ‘tides’, and after them, your vagina would be ‘a sleeve’. Katherine was rational, skeptical, sarcastic and into metaphors. She had answers. I did not know how to change a diaper, dull my nausea or convince my nipple to withstand an infant’s will to suck. I did not know how to labor. ‘You’re not supposed to know,’ Katherine said. ‘In the past, the tribe knew. Older women in the tribe would have taught you.’

That seemed right. I had been denied a tribe. I was a tribeless victim of modernity, marooned in Houston with my husband, alone in a world excessively obedient to standard medical practice.

‘What tribe?’ asked someone else’s husband.

‘The tribe that conveys culture from one generation to the next,’ said Katherine.

‘Yes but specifically, to what tribe are you referring?’ He was Indian, accented, resistant to the rhetorical.

Katherine smiled. ‘The one you don’t have.’

The way you avoided Katherine’s situation was this: you didn’t let them make you docile. You didn’t take off your cotton clothes, let them sheathe you in paper. They would try to stick a needle in your wrist and leave it hanging there, so that the IV the epidural required would be just a snap away. You would, submerged in a pain-induced mania, have to deny those who would pull you out.

I finally fell into a job as an underpaid fashion editor at a glossy Houston magazine, where I worried over blog posts with titles like ‘Gingham Goes Glam’ and ‘Hair Chalk: What’s the Deal?’ I spent nights at runway shows held in car dealerships, wrote roundups in which fashion people were ‘mixing and mingling’, enjoying ‘light bites’. I hired models and makeup artists, borrowed 47,000 scarves from gay shopkeepers. The magazine’s editor asked that we book an eighteen-year-old fashion photographer Houston deemed a ‘boy genius’. The boy dimmed the lights, draped the models in sequins, adorned them in broken mannequin parts. I could see that the plastic arms approximated a solemnity he thought befitting of his genius, made him feel connected to something. Oil quivered beneath our feet, and neither of us could feel it. He picked up a disembodied torso.

‘No torso,’ I said, ‘stick to the limbs.’

He shook his head in disgust. ‘I’m trying to tell a story,’ he said.

When a fighter forces another man’s arm into an unbearable twist, he calls it a ‘submission’, one man conceding to another. But in years of following fighters I have come to see submission as something that happens the moment they walk into the cage, trading the angsty disquiet of self-protection for the broadening promise of great pain. Let others worry about cavities and smile lines and slowly clogging capillaries. You can fight entropy, or swim in it.

That spring, after one dark evening of mixing and mingling, I surrounded myself with happy artifacts of my past life: a motley pile of journals, bookmarked with torn tickets to strip-club fights. I wrote about the Tai Dam, about Rob trotting into the octagon, about the night he had fallen almost immediately to a rain of punches, froze, choked, ‘failed’, in fighter terms, ‘to defend’. The sound of his body hitting the mat was surprisingly slight. The fight lasted fifty-four seconds. Interracial couples would maybe need a new defender.

There were nine fights that night, and Lonnie’s was the last. The referee waved and Lonnie, slim and sculpted, laid into his opponent, kicked him in the stomach, jabbed him in the jaw. Lonnie absorbed an achingly precise blow to his orbital bone, and slammed the man to the mat. Both men landed on the ground, sweat-soaked, kick-flailing until they found a way up.

They struggled to gain purchase, lying on top of each other. Once, on television, I saw a 200-pound tuna dragged aboard a small boat. Stunned, it was still for a moment, until it opened its mouth and revealed its razor teeth. A single slim muscle thrashed and whacked, slamming sailors, snapping them into the water. It’s that fish I think of when I see two men on the ground, willing their bodies into a single sleek substance that will knock the other man flat.

By round five Lonnie was supine on the ground, the man sitting atop him. ‘Hip out!’ Rob screamed from outside the cage. ‘Hip out!’ The man punched Lonnie just below the right eye. He took blow after blow to the same soft square of skin between the lower lashes and the top of the cheekbone. It was tearing, rivering red into the corner of the eye. All Lonnie needed to do was tap the mat, offer the slightest flick of his wrist, to concede the fight and end the assault. ‘Elbow him!’ shouted Rob uselessly. He was just a foot away, but Lonnie had given himself over to a place words can’t penetrate. Again and again during those years, I watched men swim through some portal violence opened for them. They came back ecstatic and whole.

The bell rang, the mood broke, and everyone cheered. Lonnie had lost. He stood up smiling, a racing stripe of blood across the top of his shaved head.

Afterward, the team gathered around Lonnie, now flat on his back on a stretcher waiting for the fight doctor to conduct his post-fight exam. A purple egg rose from his brow, the suggestion of a split bone under the surface. He smiled, and his gums shimmered pink and wet, except where they were red with blood. Together the tribe recounted the fight, shouting ‘Warrior!’ and ‘Beast!’, words of praise for the man who made them proud. They were giddy, and he was both with them and not, absorbing their admiration while riding his own high somewhere far off.

This baby would not have a leather-bound bouncer, a stroller with Wi-Fi, none of the luxuries I saw on wish lists made public by prosperous parents of the child’s cohort. We were writers, and he would suffer for it. We lacked loving extended families, and he would suffer for that too. He’d have a mother with an unpublished manuscript on fighters, and a father in graduate school. I wanted him to have his rightful microbiome, which I imagined as a living second skin, a shield of spores to ward off future hurts. I wanted, desperately, to give that to him, to be brave enough to resist the saline lock, the numbing needle. I’d take the hit so he’d be a step ahead, submit myself to the pain and preserve what was his.

Afternoons at Katherine’s lasted three hours. We seemed always to be talking around the point. The point was: How could I be more like Lonnie? ‘Try some birth tea,’ said the books. ‘Go to yoga.’ I went to yoga. ‘Follow your blissipline,’ the yogi said. ‘Try a mantra. Say: “My body knows what to do. My body knows what to do.”’

Pregnancy is a pack activity. All across the country, my friends were with child. Four of the five had midwives, doulas, books by Ina May. ‘You will think you are going to die,’ someone advised a friend of mine in search of a midwife. ‘Find the person you want to see when you’re going to die.’ Katherine collected birth stories on her website, testimonials from mothers with whom she’d moaned. ‘I was sure that my hips were being smashed in half. I screamed and screamed,’ wrote one woman. ‘Katherine looked me dead in the eyes and said, “I know.”’

I wanted to argue with someone, so I called my mother, who thought drug refusal was madness. (‘It will hurt,’ she pointed out.) I leafed through the Lancet and lectured her about the ‘cascade of interventions’. I used the term ‘vacuum extractor’.

The hospital was a glass-and-steel building huddled with dozens of other such structures in a ‘medical complex’ the size of a city. The outdoor space between the buildings was hard dead emptiness, unused but for soft doctors spiriting between them. Inside, a series of elevators led to my own doctor, a young and plump Punjabi woman I liked, mostly because she reminded me of television’s Mindy Lahiri. ‘I think you should consider a vaginal birth,’ she said at our first visit, as if this was an experimental treatment she’d read about somewhere.

Mindy loved the magazine for which I worked, and thought me an authority on glam gingham styles. She and I regarded each other with a kind of wary adversarial respect. I said I wouldn’t be getting an epidural, and she nodded knowingly. Like hadn’t she heard that before.

‘I’d like to try a water birth.’

Her hospital promised ‘jetted tubs’, which was why I had chosen it.

‘You can labor in the tub,’ she said, meaning, not deliver in the tub, for legal reasons she claimed not to comprehend.

This was the moment when my unwritten birth plan sprung into being. It was: Resist getting out of the tub. What were they going to do? If they came at me, I would flail in a way that looked fetus-endangering. What did the lawyers have to say about assaulting a woman in labor? A lot, I imagined.

On the hospital tour, in a model birthing room, I learned that the saline lock, the plastic stick that stays poking out of your wrist, is compulsory. I did not want a sharp object piercing my wrist skin as I writhed, did not want to be one step closer to tapping out. It was, the tour guide said, ‘hospital policy’. ‘With whom can I discuss this?’ I asked, emphasizing whom on the off chance that grammatical precision might denote authority and impel this tour guide to lead me to the breathing font of hospital dicta, an actual body with blood and gums and delicate ear bones that would twitch in tune to whatever I might say about the sanctity of the microbiome. I wanted her to take me to the source.

She shrugged, I smiled and as we walked away our heels clicked on the eleventh floor of a glass-and-steel box.

I was deep in a pre-bed downward dog when my water broke. It was late, and my husband was reading The Sun Also Rises. ‘Read it aloud,’ I said. This was the nest I needed. I breathed through Jake’s manly longings, his absurd inarticulate angst. I thrilled at the first tightening, the womb gone hard, a slack bag turned firm. I liked ceding control to some process, as if lodged within a tracked car wash, sitting and waiting for the spray. My body knows what to do.

The pain nipped up my legs, my back, my hips. I would miss this particular pain for months afterward, long for its pert insistence to pull me from the drift. I had read that it was like a wave, but it was not like a wave. The takeover was not gradual. It was a dominating possession that came all at once and fell away as if I’d dreamed it.

Early morning in the hospital, I am many hours without sleep, leaning on walls, crying into Katherine’s breast, shrieking on occasion. I am in a black cotton dress, having refused the paper one. I have been told to picture a flower opening and closing with each successive contraction. It is not like a flower. It is a single slim muscle, thrashing its way through my ribs. The fish careens from side to side as if carried by waves, whacks me onto my knees. It rests. In a moment, it will come back stronger.

I curl up on the bed. Prior to this I had always imagined extreme pain as pointed, the rip of skin above Rob’s eye, the sharp crack of his nose bone. But the sensation of a blunt ballooning fury, of some rib-rending force awakening inside the cage of you? Also bad.

A young doctor, not Mindy, arrives. She is wearing the glasses of a girl who affects interest in anime. She does not care about the microbiome. She says it’s time for a saline lock, ‘just in case something happens down the line’. Her manner suggests that I would definitely want to go numb later, that she knows this, that this attempt to go without is a waste of her time. I beg to be left alone. I want to be able to move.

‘It’s hospital policy,’ she says, her smile tight. ‘In case we need it later.’

The fish wants to thrash my hips apart, split them like a wishbone. Its razor teeth seize on a back rib, the second one down.

‘No,’ I say.

‘Did you discuss this with your doctor? Do you have permission for this?’ she asks.

‘Yes,’ I lie.

She leaves for an hour, returns when I am leaning against Katherine, driving my head into her shoulder. She says that Dr Mindy denies my story. ‘It’s hospital policy,’ she says. ‘I’m ordering it.’

My husband and Katherine look at each other. The doctor stares at me in open challenge. From somewhere deep in my consciousness, a phrase rises up, words I maybe heard in a movie, words I maybe heard on SVU.

‘I do not consent,’ I say.

The phrase unlocks something. Her lips tighten; dark lines gather around her mouth. She sighs heavily, looks ostentatiously sad. Then she forces a smile. ‘This is for your own safety,’ she says, ‘because we want the best for you.’ Witnessing this are a passel of nurses, eyes on the ground.

‘I do not consent.’

I do not consent. I do not consent. I do not consent. The doctor with the glasses has stopped smiling. She shakes her head, mutters something about talking to other doctors and leaves the room. It is 6 a.m.; I have missed a night of sleep. The fish feeds on my fatigue. It chaws at some organ, ripping meat from bone. It swims in a sloppy spiral, faster and faster, pummeling ribs as it circles. It rarely rests now. I think, maybe if I open my mouth wide enough, it will propel itself outward. My body knows what to do.

The pain is gathering. I am worried about time now, worried that they will blast the biome and slice me open if I don’t hurry. Katherine has to leave to get her kids to school, but she thinks I am many hours from opening, and she will be right back. For a short period of lacerating torment, the fish rips down through my womb and swims back up to beat against my ribcage.

My husband is saying something, but I can’t make out what it is. Instead, I hear the fish. He has the voice of a man. His gums are pink and wet, his razor teeth red with my blood. He smiles a far-off smile, a smile of deep and abiding calm. It’s Lonnie’s calm, some sacred high only known through agony. If you can dwell here long enough, I am sure, there is some knowledge to be had, some grotesque erasure of the self that makes knowing possible. Only then the bloody yank from pain to pleasure, that glorious tempo shift not known among the numb. I want to come back from knowing what it is that Lonnie knows, and I can almost see my way there, like a memory I’m muscling my way toward, while the fish clubs my tailbone.

I need an epidural.

I say to my husband: I need an epidural. Katherine is gone. There is panic in his face; does he listen to the me deranged by pain? I feel sorry for him. I think: Press forward. Convince him that you are fit for self-governance. Try to form normal-sounding words. Are you sure? Are you sure? I am sure. There is no skill in my hips.

The nurse comes back in. Are you sure? I am sure. She reaches inside. In the past ten minutes, the ones where I lost my nerve, the body has opened. You are so close, she says. Perhaps you can make it just a little longer? But something has snapped shut for me. Am I sure? I am sure.

The doctor with glasses comes back, nodding, smiling, a show of magnanimity as the world arranges itself in precisely the pattern she expected. She says the words ‘saline lock’. She says the words ‘hospital gown’. I stare at the bed as the nurse stabs my wrist. I twist sideways, and a bearded anesthesiologist, sounding bored, tells me to be still. I continue to scream. He rolls his eyes. He stabs the fish dead.

Relief is sudden and total. A sense of the sacred, of the elemental, is a fragile thing. It has already slipped out of the room.

My husband and I chat happily. Katherine arrives, and doesn’t judge. My phone rings, and my husband answers it. ‘I was supposed to interview that guy,’ I say. ‘Tell him I’m in labor.’

Numb from the waist down, flat on my back, I text emoji to my mother. I progress. When it’s time, Dr Mindy arrives, chatting, smiling, with an entourage a dozen women deep. I ask my husband to turn up the music, and nurses sway their hips in time with the tune. The tribe makes itself. A single push, and the baby swims out, sleek and wet.

Back when I was deep in the writing, when a child would have been unthinkable, friends, fight fans, asked me about my book. The fighters never asked, except once, on a night when I was three vodkas in and holed up alone in a Vegas hotel. The text was from the team’s leader, a fighter for whom the fight was an opportunity to philosophize.

‘How do you see us?’

The query filled me with fear. I sat up in bed, stared at the phone, decided, because I was drunk, to tell the sober truth.

‘I want,’ I typed, ‘what you have.’

In the fighters I witnessed a liberating annihilation I envied. At Katherine’s, we watched women loose themselves from the ordinary world, rip through a wall impenetrable but for moments of extraordinary violence. ‘Microbiome,’ we said. ‘Vacuum extractor,’ we said, because we had no words for whatever lay beyond the lacerating spasms of agony to which we aspired. That you fear to name your need, that you ascribe your desire to maternal altruism rather than human curiosity, does not mean it is wrong to want what you want. I still think it noble, this experiential wanderlust, this drive to get to a place I in my weakness will never know.

I am saying that it was never about the baby. I am saying that it didn’t have to be.

Artwork © Marthe Jung, Plongeon, 2012


Poem Conveyed