birth day

Yesterday I showed up at the clinic to weigh babies, as I do every Wednesday. This week, the nurse on duty had a special surprise for me: she asked if I wanted to help her deliver a baby. It was a morning of firsts—Mama's first time giving birth, my first time attending a birth, the baby’s first time venturing out of the womb. The nurse laughed at how excited I was. To a Tanzanian woman, the fact that I had made it to the ripe age of 23 without having witnessed a birth was kind of ridiculous. 

Staring into the terrifying mess between the soon-to-be-Mama’s thighs, I saw oozing gooey whiteness, chunky dark redness, and, lower down, dripping out of a smaller hole, mucus-y yellow-brownness with a distinct and unpleasant smell. I know I’m supposed to use positive adjectives to describe such a miraculous event, but my first thought was: gross.

Then everything changed. Hiding shyly behind this curtain of deeply human fluids, I glimpsed the tiniest hint of curly black hair. That detail, extraordinary and dizzying, turned the scene from disgusting to indescribably beautiful.

A brand new life. A tiny, helpless, wrinkled being in the process of discovering that his cozy little home—all he’d ever known—was merely the prelude to a grand and tragic symphony. As the soft walls that had held him in a tight embrace for the entirety of his being began to contract, pushing downwards and outwards, the little dude began to hear epic chords, the music of a world he didn’t realize he’d been preparing to enter ever since the moment, about nine months ago, when, through a serendipitous mix of timing and the idiocy of the young, sperm from a commitment phobic taxi driver met with and entered the egg of a pretty village girl with very dark skin, chubby cheeks, and deep black eyes. The girl, Amina, had run away to the big city to find a new life. And so she did, through not in the sense she had hoped. Now, back in the village, the new life Amina found in the city was ready to make his debut, and I was there to cheer him on.

The first thing I noticed after the nurse gently wiped away the blood and discharge was that Amina’s vagina seemed strangely one-dimensional. I saw what looked like two holes—the top one a few centimeters larger than the bottom one. The two holes were separated by an inch-and-a-half wide, half centimeter thick membrane. There was nothing else, just the holes. The baby’s head was now pushing against the membrane, stretching it and trying to rip it in two. The nurse tried to help the little dude get past this unnatural barrier. The membrane and the slit-like appearance of the woman's genitals is the result, the nurse explained, of a severe form of female circumcision that involves removal of the clitoris, inner and outer labia, and the sewing up of the remaining tissue. This form of female circumcision is fairly uncommon in Tanzania, and definitely against the law, but it continues to happen today, always in secret and usually to girls between ages 2 and 8. I fought the urge to go to the room next door where the woman’s mother was waiting and yell at her for letting her daughter go through that awful ritual however many years ago. The nurse seemed to think it more prudent to admonish the girl herself. 

“If you hadn’t been cut, the baby would have been born by now. Instead, it’s in distress and you’ve been in pain for almost 10 hours. If this baby is a girl, remember this moment when your mother tries to talk you into cutting her,” the matronly woman said with a disapproving scowl.

There was an awkward pause broken by another wave of contractions. More black hair came into view through the widening—but still not wide enough—top section of the woman’s unnaturally segmented vagina. The head floated into view. The area between Amina’s fleshy thighs began expanding outward, pushing… pushing… pushing… and then, suddenly, the baby’s head began to recede.

“I can’t do it,” Amina whispered as she collapsed back on the hard examination table. “I give up.”

“Not an option,” the nurse replied matter-of-factly. “Shut up and push.”

Unconvinced that this was a time for tough love, I moved to take the girl’s hand and tried to think of something encouraging to say.

“Your baby has a lot of hair,” I offered.  

Amina’s short laugh set another contraction in motion. As the baby’s hair slid back into view, Amina continued to whisper over and over again, “I can’t, I can’t, I can’t.”

I watched more and more hair slide into view and the head start squeezing into a cone-shape. The hint of a forehead peeked out uncertainly.

“You can, you can, you can,” I chanted in time with Amina’s protests.

“Shut up and push!” the nurse repeated sternly. I gave her a mean look and she grinned at me, then reached in with her hand to cup the awkwardly shaped head, twisting it like she was trying to unscrew a stubborn light bulb.

The unnatural membrane—leftover from a cruel needle stitching up a place that should never be stitched—began to stretch. Beads of blood appeared, much brighter red than the dark, chunky kind still oozing out from deep inside.

And then, suddenly, a face! A scrunchy, wrinkly, angry-looking face. Before I had time to fully register the bizarre sight of a squished head poking out between its mother’s thighs, the rest of the baby’s body flopped out and into the nurse’s practiced hands. I took a quick peek and informed Amina that she had given birth to a son. She smiled weakly. Three and a half kilograms of human being had suddenly joined the world, but something wasn’t right. The baby’s skin was rapidly turning yellow, chest and belly looking sickeningly deflated. I held my own breath as I waited, waited, and waited for the baby to inhale. He didn’t.

The nurse, unfazed by the infant’s terrifyingly lifeless presentation, worked quickly and quietly, placing the baby on Amina's chest, instructing her to hold him. Amina's lungs filled up with each breath as though she was trying to breathe for both herself and her baby. The nurse sucked out some yellowish goo from the baby’s mouth and nose and pumped gently against his chest. Tears began to spring to my eyes with the horrifying realization that the baby might be dead, and the nurse started blowing on his slack, yellow face. As she did this, she used both hands to tie off and cut the umbilical cord with a single graceful motion.

Suddenly, as though he had just remembered that he was supposed to breathe in order to survive, the little guy took the tiniest gulp of air and let out a strangled gasp. Tears of relief ran down my cheeks as the nurse kept up her regimen of blowing into his face and pumping his chest.

Once the baby seemed to have figured out the basics of survival in the world outside the womb, the nurse lifted the whimpering infant, wrapped him in a clean blue khanga, and placed him on a metal scale. His face turned from yellow to pink as she recorded his weight. Leaving the baby on the scale, she turned back to the mother to help remove the placenta.

I couldn’t take my eyes off the baby. Alone on the cold scale, he seemed impossibly small and helpless. He was breathing less deeply than he had been in his mother’s arms and the pinkness in his face was fading as quickly as it had appeared. I know absolutely nothing about newborns, but something told me he needed to be held. He had yet to open his eyes.  

“Can I pick him up?” I asked the nurse, both eager and terrified at the prospect that she’d say yes.

“Yes,” she said.

Carefully cupping his head, I lifted the baby boy and held him gently against my chest. I took a few deep breaths, hoping he would learn from my example. Color rushed back into his face and his big brown eyes shot open. He looked up at me and scrunched his nose as though he was trying to figure something out. Then he let out a loud, healthy cry.

“I’m here,” he announced in the ancient language of newborns.

“Karibu nymbani,” I replied. "Welcome home."