Her water broke at three o'clock in the morning.
I'd been born two weeks early myself so I expected this. I put on yesterday's clothes and picked up the suitcase that was waiting in the corner. We had to be prepared since Japanese mothers are usually expected to provide for themselves (toiletries, towels, pajamas, etc.) during their often week-long hospital stay after birth.
The hospital doesn't provide any amenities, but a week long recovery in the hospital is something a lot of the world's mommies could only dream of. At the end of my wife's visit, the hospital even gave her a special three star meal to celebrate. Prenatal services are also top-notch in Japan, with many cities offering expecting mothers free childcare and delivery classes. I remember my wife leafing through a special baby handbook city hall gave us, which thoughtfully included color photos of healthy baby poop. We're well prepared.
I email the in-laws and tell them it's time. I do this on my iPhone because the Japanese keypad is easier to use than a Japanese keyboard for me. Japanese mom and dad speak absolutely no English and I'll be counting on Apple's built-in dictionary for translating those especially difficult kanji.
My wife swears she's not in any pain. She spends the ride to the hospital sitting on her knees because she doesn't want to leak on the seat. I can't believe she's not in pain.
"My mother was the same way," she explains. "She didn't go into labor for hours after her water broke."
At the hospital we're told labor would start in 10 to 16 hours. We're a bit sore about being woken up at three o'clock just to have to wait around till night, but I suppose that's how it is. I make it a point to ask if I can be there during the delivery, since some Japanese hospitals don't allow fathers in either the delivery or labor room. Even in the Japanese medical profession there are some surprisingly old-fashioned beliefs, and daddies not having much to do with baby stuff is one. Fortunately, our hospital says it's okay for me to be there when my wife starts screaming.
By the early morning the nervous excitement's worn off and we both would rather her start labor sooner than later because waiting for it's driving us crazy.
Waiting
Since the baby won't be arriving anytime soon we both decide I should go back to the apartment to rest for the delivery. Just as I nod off, my alarm clock tells me it's time to get ready for work. That reminds me that I hadn't told them I won't be coming in, so I shoot them an email. When that's finished my wife mails asking if I'm awake yet. Shouldn't have left in the first place, I realize. I eat lunch on my way back to the hospital.
She's been put in a shared room. Hospitals often put mothers-to-be in shared rooms with nothing but curtains sectioning off beds. Private rooms are more expensive, and while the cost of labor is partially reimbursed by the Japanese national healthcare system, it's a standard lump sum of 420,000 yen. (When all was said and done we paid about 60,000 yen out-of-pocket, which is about 500 US dollars.)
Anyway, my thrifty wife didn't want to spend the extra cash and opted for the shared room. Behind the privacy of our curtain, I keep her mind off things the best I can, mostly by drawing funny pictures on my iPad. I wish I could have thought of something better, but funny pictures is the best I can manage. But you know what? That's okay. I kept a smile on her face between nurse visits–visits that are making me worry I don't have enough Japanese for this.
Pain
The pain starts. At first it's not so bad. Then it is. And it only gets worse because less than three percent of Japanese women get an epidural or any sort of pain relief during birth. Part of it is a lack of obstetricians and anesthesiologists. Childbirth is a risky field with unexpected working hours, and a lot of medical students are opting for easier lines of work like cosmetic surgery. Several years ago things were so bad that some women, called "birthing refugees," had to roam the hospitals looking for a doctor to deliver their babies. Epidurals also require an anesthesiologist, which there just aren't enough of on hand to administer a shot to a woman in labor while a heart surgery might be going on down the hall.
They move my wife to the labor room on the opposite side of the hospital so her screams won't terrify the other women. I think of it as Purgatory, and the doctor or nurse or whoever she is starts checking in more often. She keeps giving my wife what I think is advice but I can't tell. My Japanese medical vocabulary is sadly lacking. At one point she points between her eyebrows and says something about "wrinkle" and "scream." Days later, my wife told me she was saying that screaming gives you wrinkles.
I see her massaging my wife's lower back. Once she's gone I keep it up, but am informed I'm doing it wrong. "Do it like she did, in circles." She's speaking in all Japanese now. This I expected, but now I'm worried I won't be able to understand the next thing she says. Fortunately for me she isn't saying much between screams.
All this pain, though, is supposedly a good thing. The other reason most hospitals don't offer epidurals is that the pain of childbirth is thought to be a virtue that creates good mothers. Beliefs like embracing suffering are slowly going the way of the samurai in the face of modernity, but like fathers not needing to be there for their wives during childbirth, some old habits die hard in Japan. My wife had chosen this hospital because it looked attendant to her needs, but that service still didn't include pain relief.
A lot is going through my mind, like what I can say to make her feel better. I quickly give up on that idea though. There's not a word in English or Japanese that will make this easier. Mostly, I just think that I won't ever, ever stop massaging her back.
Labor
The nurse/doctor comes back again once the sound of a good mommy-in-the-making gets too shrill. She says more things I can't understand and I'm starting to feel really bad that I don't study Japanese as much as I should. Conversational Japanese is fine, but I'm turning out to be woefully unprepared for how much medical-speak this is involving. I do understand that she is counting the time between contractions and telling my wife to go "huuuuu" instead of scream.
So I'm massaging and she's huuing and the nurse/doctor is telling her something else I don't understand but it's okay because I want this woman to deliver my baby. She has professional written all over her, carved in steel with a diamond-tipped ice pick. At this point I'm sure she's a doctor. (I was wrong about that, actually. She was a midwife.)
My wife is huuing like a panicked barn owl vacuumed through a pipe organ and after a few hours the contractions are close enough that Purgatory ends. The midwife collects my wife and throws me a smock.
"Put it on," she says. Finally some Japanese I understand.
I do, and she looks annoyed when I try to help her carry my wife to the delivery room. That's her job, not mine.
She points to the side of the delivery chair. "Stand here and don't move."
My wife is happy to be in this room. In Japanese: "We're here. In this room. It's almost over!"
I lie and tell her she's right, not saying that I think the bad stuff is just getting started. My own mother had said they'd put me behind her so I wouldn't be able to see what's going on. In Japan, if they let you into the delivery room at all, they put you beside her. Some hospitals even drape a cloth around the delivery chair so only the doctor can see what's going on. The woman, meanwhile, is stuck behind it not being able to see anything, not even how many people are in the room.
I can't massage her back anymore so I settle for her neck. I want to be useful, so I'm massaging anything I can.
"There's a needle in my arm, Nathan. Stop touching it," says my wife in Japanese. The midwife had put an IV in her arm.
"Yes….there's a needle," repeats the midwife. "Stop touching it."
Idiot! They put an IV in her arm! Why are you massaging the needle? So, frantically determined not to be dead weight, I massage her neck instead.
Suddenly the midwife looks concerned and calls down the hall for a nurse who isn't there. Just as suddenly this hospital feels oddly empty.
"Push that button," she orders me.
There's a button hanging above the delivery seat. Pressing it brings a nurse that looks far too casual for my taste. The midwife tells her to "go get doctor so-and-so."
"Itai!" My wife screams, it hurts. "Itai…"
I get real quiet and let the midwife work. I wish I could understand what was happening and I promise myself I'll study Japanese harder when all this is over. Mostly, now that things are bad enough to need doctor so-and-so, I'm just hoping my life isn't turning into some bad soap opera. I remind myself that Japan has one of the lowest maternal death rates in the world, coming in at 11th in 2010, with western countries like the US coming in at 39th and the UK 23rd respectively. Still, 11th place was 6.8 deaths per 100,000 women, which feels very high when it's your wife who needs a doctor who isn't there.
Fatherhood
Baby's head turns into a head and shoulders and I remember hearing that the shoulders are the hardest part. He comes out with limbs covered with a yellowish membrane attached to his skin. I think it might even be his skin. I remember watching a documentary about how some babies are born inside-out. I don't want an inside-out baby. The midwife doesn't look concerned, but this ice-woman-cometh wouldn't have flinched if the baby came out with two heads screaming "banzai!" so that doesn't mean anything.
While the nurse is cleaning him off the midwife asks my wife if she wants to see something. I get the feeling that something is the afterbirth. She says "yes" and I can't look away as the pan of gore is couriered over. The midwife explains how the boundary between her and the baby was like a liver. My lovely wife is fascinated.
Baby comes back without that yellow film on him just as doctor so-and-so finally shows up. They ask me to wait outside. As I leave I see doctor so-and-so sewing my wife up and realize what happened. Once I do, a thought flutters through my head about that whole afterbirth scene. It reads: why did you go on about the ins and outs of afterbirth instead of stopping the blood from pouring out of my wife's body? Later, I learn it's because of legal red tape. Japanese midwives can only perform medical interventions in the case of dire emergencies. Apparently that wasn't one. It makes me wonder why a doctor wasn't there in the first place.
So there I am, waiting in the lobby for some cosmic shift inside of my soul strata–something to turn on or even something to turn off, but so far there's no plate tectonics. I had a child, but I didn't feel like a father. I'd seen on TV there was supposed to be some magical moment when an angel waves an invisible wand over your head and everything falls into place inside you. But in real life becoming a father mentally and spiritually isn't as easy as falling into a hole. It's climbing a mountain.
Doctor so-and-so comes out and offers a smiley "Congratulations."
"Is my wife okay?"
He nods and explains what happened. I don't understand because he's communicating in the High Speech, medical Japanese, but frankly I'm just glad he's polite enough to do so.
As we've mentioned before at Tofugu, medicine is not a service industry in Japan. Japan has a strong social hierarchy and doctors are near the top of the totem pole. Unfortunately, that means some doctors think they're Doctor House. I've had a particularly nasty one even call me an idiot before. While most doctors here are great and old farts like the one I saw are rare, even now we're switching doctors about a foot problem my son has because our current one refuses to tell us what's wrong. In his mind, he's the doctor and that's his domain, not ours.
After the doctor finishes his explanation I just tell him "thank you" because I already know what happened anyway. That's one thing about communicating in Japan. Even if you don't understand half of what someone's saying, common sense can make up for a lot of what's missing. The midwife pokes her head out and says I can come back in now. My wife is holding the baby.
"You okay?"
"Tsukareta." She's tired. "Here, hold him."
And there, as I hold my son, the father inside me flickers to life.