Meet Dr. Lamaze

As the third and last trimester broke, with Dawn's belly rising like the sun in the east, our thoughts turned to lofty ideals, to transcendent ruminations, to a higher plane--a higher plane filled from one end to the other with paper. It was time to fill out forms.
  Of all the pregnancy exercises recommended by physicians, midwives, healers and gurus of all stripes, to my knowledge none are targeted specifically for the wrist. The wrist is shamefully neglected, especially in light of just how much writing a pregnant woman must do. There are forms and reams and surveys and piles and boxes and forests that must be filled out, scribbled in, written on, and otherwise inked, and every last bit of it is absolutely required if you are to have this baby. Apparently a certain amount of ink and graphite is necessary to induce labor.
  No one gave us more interesting and varied paperwork than the hospital. We went in in mid-February for what is called ``pre-registration''. (And though what exactly this is ``pre'' is fairly obvious, to me the term is silly. It should really be ``pre-birth registration''.) The purpose of pre-registration is simple: When you arrive at the hospital, there are approximately 1,001 forms that need to be filled out. Rather than have the pregnant woman arrive in labor with her husband and then have him fill out the forms while she delivers the baby, raises them alone, sends them off to college, attends their wedding, eventually retires and then is confused by the appearance of her long-lost husband asking for the middle two digits of her Social Security number, the hospital simply has the couple come in a few months before the mother's due date and fill the forms out then.
  So in mid-February we went to the hospital and settled down in their admissions office and filled out paperwork. Our hospital had clearly gone to great lengths to conceal the fact that it was, in fact, a hospital--at least from the inside. From the outside it still looked just like a hospital, but on the inside, in the admissions office, it looked like an old social club, with leather wing-back chairs and a thick rug and walnut coffee tables and subdued lighting. This was a little weird, because I wanted my baby delivered in a hospital, not by the headwaiter at the Supper Club.
  Once we settled comfortably into a pair of puffy chairs we began going over the forms. They were mostly the sort of things we expected: Our address, phone number, dates of birth, and so on. And also some peculiar things, like race. Well, a form asking for race is not so odd, but what made this odd was the fact that under race there was a note which read, ``Under NO circumstances is Hispanic considered a race.'' But ``Guamian'' was listed as a choice. Guamian? Where have I been? Guam's got a whole race? Guam barely has real estate. I tried to talk Dawn into checking off Guamian--I make it a point always to put down something strange in the race column of any form, such as Eskimo, Mongolian, or Hillbilly--but she stubbornly checked off ``white''. How pedestrian. Other people get countries, lands, flags, history--we get a color.
  Under the page headed, ``Rywalt, Dawn'' was a truly mind-blowing page: the one headed, ``Rywalt, Baby''. This was a sudden and sharp reminder that we were not just sitting in a plush room filling out form after form; we were starting the paper trail of a new life who would one day have forms of their own to fill out. In a strange way, I found that seeing the tentacles of the relentless bureaucracy of America reach out for our baby was more stunningly solid proof of what we were getting into than feeling the baby move. It was almost as if this baby wouldn't be a person until the government said they were, and here we were filling out the forms to ensure that recognition in the form of the baby's birth certificate. And now I recognized the baby's personhood, too.
  My favorite part of the forms, though, was the fact that they were all addressed to ``mother/informant''. I told Dawn she should be an informant, since almost anybody can be a mother but hardly anyone gets to be an informant for the CIA.
  We reached a part of one of the forms asking for information about the mother, then about the mother's spouse, then about the father, if different from the spouse and acknowledging paternity.
  ``Could you look the other way while I fill this out?'' the informant asked me meekly.

Just after we finished the paperwork we had our first Lamaze class. And, just as our Bradley class had not matched our expectations, our Lamaze class didn't either. There was one small difference, though: Where Bradley class exceeded our expectations, Lamaze fell short--far, far short. I don't mean to imply that Lamaze classes are all basically bad; but the one we attended was pretty awful. I don't know if the Bradley classes had changed our expectations entirely or what, but much of what I felt was wrong with our Lamaze class was colored by what I felt was right with our Bradley class.
  We started by once more wandering aimlessly around the hospital. It seemed they had again misplaced themselves. Eventually we found the right room, which appeared to me to be a cross between a lecture hall and a storeroom. The entire back of the room was piled high with chairs and boxes and back issues of Lamaze Baby magazine. The right wall was actually three sets of elevator doors, behind which I could hear the elevators loudly clanking and roaring and rushing. At the front of the room was a blackboard and a tiny television bolted to the wall.
  The center of the room was empty and several couples had arrived and arrayed their chairs around the walls and elevator doors facing inward. I counted eight other couples. Dawn and I chose seats off in the corner and she sat on the floor Indian-style--what some people call tailor sitting, which is the recommended way for pregnant women to sit as often as possible, as it stretches the birthing muscles and takes the weight of the large uterus off of the overworked back muscles--and I squeezed into an uncomfortable metal-frame chair. After a few moments it was clear that de Sade would have found this chair too cruel.
  From where I sat I surveyed the other couples. They seemed mostly foreign, some Hispanic--which was not a race, I remembered--and some Filipino or Thai or Vietnamese or Indian or Pakistani. We all sat around uneasily. The pregnant women, some of whom were enormous, all sat in exactly the position Dr. Bradley cautions women against using: slumped back in a chair. This only seems comfortable at first, but eventually makes the woman more uncomfortable from the pressure the baby puts on various blood vessels and muscles and ligaments in that position.
  The instructor, a registered nurse, stood at the front of the room. She was a slim, stylishly dressed older woman with a mass of blond hair with dark roots. Her eyes were large with eyeliner. After enough of us had arrived, she began class. As she spoke, another 3 couples arrived, making our class twelve couples large.
  ``There's nothing like a little personal attention,'' I whispered to Dawn, ``And this is nothing like it.''
  The instructor's voice was an amazing thing in its Long Islandness. If this doesn't immediately conjure up a sound for you, imagine Fran Drescher crossed with Joan Rivers. That was this woman's voice. It is impossible for me to convey this adequately in text form, so you'll just have to use your mind's ear to hear this.
  She introduced herself and had everyone in the room introduce themselves, along with announcing their due date and whether they knew if they were having a boy or a girl. Not long after that, she jumped in.
  ``Natural childbirth,'' she grated, ``is not a phrase you'll hear me use often. In fact, this is the last time you'll hear me say it. Why?'' She answered her own question: ``Because I feel that puts too much pressure on the mother. When you hear `natural childbirth', suddenly you've got to worry about everything and you'll be afraid to take drugs if you need them.''
  I was afraid I'd need drugs to get through this class.
  ``Now,'' she continued, ``the word `pain'--there's a word I like. `Pain' is a word I use very often: every day, every week, every minute. You will have pain. Childbirth is painful. You will have a lot of pain. You will not be in discomfort, you will be in pain. Pain, pain, pain. It will hurt a lot. Any of you ever break any bones? Big bones, like leg bones? Any skiers here?''
  Tentatively, one guy raised his hand.
  ``That pain is similar. It's a kind of dull, deep pain, but very painful. Anyone ever pass a gallstone, have gallbladder trouble?''
  My body went and raised my hand without asking me.
  ``That's the kind of pain I'm talking about. But unfortunately, that's how we get babies out. So I'm gonna teach you some relaxation for the pain. Now, you might say to me, `If this pain is gonna be so bad, I'll just take the drugs. Give me drugs. So I won't need the relaxation.' But I have to warn you: Sometimes, for whatever medical reason, we can't give you drugs. And then you'll need the techniques. So learn them just in case.''
  ``Natural childbirth is a fallback position for when you can't have drugs? Did I hear that correctly?'' I asked Dawn. She shrugged and rolled her eyes at me, clearly as stupefied as I was.
  The instructor went on in this vein for some time, extolling the virtues of medicated childbirth but stressing the need to have some alternate method of handling the enormous, intense, deep, powerful and incredible pain a mother feels during the delivery. By the time the break in the middle of the class came, I was feeling like maybe this was too painful even for me. Dawn was getting perturbed, so we took a few moments to talk to the nurse on our own.
  ``Are they going to make me take drugs?'' Dawn wanted to know, because it was sure beginning to sound like it.
  ``Oh, no,'' the instructor assured us. ``If you want to go natural, that's great. The doctors will love you for that--they love it when a mother gives birth naturally, it's one more good statistic for them. Tell them you want to go natural and they'll be thrilled. I went natural for all three of my babies. My attitude was, I wanted control. I wanted to be in control of the pain, you know? That way, in between contractions, I could be there and control the pain, instead of being on drugs and being all confused and stupid and in pain where I couldn't control it. You understand?''
  I understood perfectly: Here she had just admitted that the drugs don't even help with the pain, they just make you goofy. But she seemed very clearly an advocate of the medicated approach to childbirth--just not for her.
  This class did not improve over the six weeks of its run. Luckily we missed the one day of ``mat exercises'' where we would be taught undoubtedly important and interesting information about relaxation and how it wouldn't help with the monumental, earth-shattering, all-encompassing pain of childbirth for which drugs are the only known remedy. Two of the remaining classes consisted of my being by turns annoyed, irritated, and aggravated, in between which I silently cursed my chair, its designer, the elevators, fluorescent lighting, and the IRS (this last because, well, why not?). During these classes the instructor taught us the stereotypical Lamaze breathing method, which starts with breathing in your nose and out your mouth. She walked around the room, breathing at all of us so we'd get the idea. Then she moved on to the next type of breathing, which is through the mouth in short gasps. Again she stalked the room, breathing on all of us, because we all were, after all, not bright enough to grasp the concept of breathing. Then came the next level of breathing, where you blow air out instead of just breathing it out. We got a demonstration of this as well. And finally we went through various permutations of this, such as two breaths and one blow, three breaths and one blow, and finally one big breath and a blow to the head with a bat. Sadly, wishfully hoping someone would hit me in the head with a bat didn't bring it to pass, and I was forced to settle for more breathing.
  One of the classes we spent touring the hospital's birthing center again. It hadn't changed much, but what we were looking for had: The Bradley course had taught us to look for certain things, like dim lighting and adjustable beds and so on and so forth. With our new keen eyesight tuned to details, we surveyed the birthing center anew, and found it still to be acceptable.
  This time, though, there were a few more babies in the nursery--what Dr. Bradley calls ``baby concentration camp''. (Dr. Bradley likes to go wildly overboard with his metaphors sometimes.) On our side of the windows was a man, who quietly announced that he was the father. This news spread back through our class in a ripple followed by the requisite ``oohs'' and ``ahhs'', except all I wanted to know was, What the hell are you doing out here when your newborn baby is behind a window in a plastic bucket on wheels wailing her fool head off? I said nothing, of course, because my mother--or perhaps one of those nurses behind the window--brought me up to be polite.
  While we were standing there, we watched as a nurse came to change the bedding of one baby, no more than a few hours old, who was lying under a heat lamp like a day-old order of french fries. She whipped the baby up, their head waggling, tossed it from one arm to the other, flipped the mattress, and returned the screaming child to the bed. A few moments later she came and measured the baby, rather roughly wrapping their various body parts with plastic tape. Now I'm sure none of this was remotely harmful to the baby, but I found myself wondering: How long does one have to work around babies all day long before they start to look like noisy slabs of meat? Luckily, the hospital allows rooming in, where the baby stays with the mother at all times; strangely, some people had not chosen to take advantage of this. I can't imagine why not.
  The final Lamaze class consisted of the instructor talking informally for a while about the drugs used in childbirth followed by a question-and-answer session with one of the hospital's pediatricians. During the talk about the drugs the nurse noted most of the nastiness associated with them, including side-effects, like sluggish babies, since any anesthetic used on the mother will also affect the baby.
  The talk about epidurals was enough to make me ask for surgery without anesthesia entirely.
  ``For an epidural,'' the instructor explained, ``they will roll you over on your side. Then they'll inject you with a spinal needle''--here she held her hands a long way apart--``in your back, between the bones. This will insert a catheter into your back into which they'll drip the anesthetic. They'll start off with a little bit and during this whole procedure they'll be saying, `Talk to me! How are you doing? Are you okay? Talk to me!' They do this because nerves, they twist and turn and wrap up around each other and so we don't always know where they go. And sometimes the epidural will go up instead of down. So what the anesthesiologist is looking for is signs of respiratory distress--if you seem short of breath at all, he'll shut it off, and no epidural for you. Then you'll need the breathing and relaxation we talked about.''
  After this uplifting talk came the question-and-answer session. The house pediatrician was on the young side and nattily dressed. I'm sure he was a knowledgeable gentleman. Unfortunately, he was stuck with a crowd of dim bulbs.
  He began the session by stating, ``There's no such thing as a stupid question.'' He was wrong. There are many, many stupid questions. And this bunch asked all of them.
  ``Why do babies get the hiccups?''
  ``For the same reason you get the hiccups.''
  ``Can we put the baby in the sun?''
  ``Uh, you shouldn't. Babies burn easily.''
  ``What about sunblock, can we use sunblock?''
  ``Well, it says on the back of the sunblock containers, `Not for use on children under two.' So, no.''
  ``How about sunglasses, can we get baby sunglasses?''
  ``Um, you can, but they won't stay on long.''
  ``What about a big floppy hat?''
  ``How soon can we pierce a little girl's ears?''
  ``Should we give the baby water?''
  ``Do we need special soap to wash the baby?''
  ``Should the baby wear long sleeves or short sleeves?''
  ``What temperature is most comfortable for a baby?''
  One guy had an impenetrable accent. ``Ah, if we--how you say--congut the labnit wit tha ledergosh, wha lem nop put a cua nalho babee?''
  Nearing the end of the session I became like Rain Man, rocking back and forth in my seat mumbling, ``Two minutes to Emeril, two minutes to Emeril, wanna go home, no more stupid questions, no more stupid questions, two minutes to Emeril.''
  Eventually we were allowed to escape. In the elevator going up into the parking garage to get to our car, we were accosted by a small dark-skinned older man and his smaller darker-skinned younger wife.
  ``How to get to Jersey City?'' the man asked us.
  Dawn thought for a moment, then said, ``You go left, then right, then left, then get on 17 south, follow the signs to 3 east, then follow the signs to Kennedy Boulevard.''
  ``Kennedy Boulevard, yes, Kennedy Boulevard,'' they both said, clearly pleased. The man continued, ``So, left, then right, then left. Traffic lights at these?''
  ``The first left is out of the parking lot,'' Dawn explained, ``then the next two are at lights, yes.'' The elevator doors opened and all four of us exited. The man and his wife walked off to their car, waving at us with excited friendliness.
  ``Thank you, bless you,'' the man said, as they moved away. Then he stopped and pointed at Dawn. ``You will have a boy--I swear!'' he said exultantly, beaming from ear to ear.
  ``Thanks! Good-bye!'' Dawn called, and we went to our car.
  A few moments later we were turning right out of the parking garage and we realized: We had given them entirely the wrong directions. I hope this doesn't mean we're having a girl now.

Besides Lamaze, there were a couple of other classes we took given by our hospital. Since they came with the delivery--buy one baby get three classes free!--Dawn and I figured we might as well waste a few Saturday mornings taking them. After all, we had nothing else to do, except clean the house, do the laundry, buy things for during labor and after the baby is born, get the car's oil changed, buy gifts for our friends' bridal and baby showers, buy gifts for our relatives' bridal and baby showers, visit our immediate families, perform the pregnancy exercises, and, naturally, spend quality time with each other. So we went back to the hospital a few more times.
  The first class besides Lamaze we attended was the Parenting and Nurturing Class. We arrived on time and found the class to be enormous--maybe thirty people. Since this wasn't a class that required a husband, as Lamaze sort of does, there were several women there without escort.
  Apparently parenting and nurturing doesn't come naturally to humans, as I thought it did. I rather expected this class to be a little unnecessary, and so it was--for us. But the people here were only slightly smarter than the people who pestered the pediatrician at our last Lamaze class. To give you an idea, one man--a grown man, I tell you--wanted to know if the amniotic fluid would contain food eaten by the mother. I'd really like to see him draw what he thinks the innards of your average woman look like. ``This here is the stomach, where food is processed and babies grow.''
  Not only were these people almost as dumb as wallpaper, they were ugly as wallpaper from the early 70s. Some of the people in this class were the ugliest people I've ever seen. One woman sitting across from us looked like she was there to learn how to nurture this one properly, since the last three kids she ate were hardly filling. I mean, I'm not beautiful--my wife is, of course, the most beautiful woman in the world and getting better looking all the time--but this bunch was ridiculous. There were people I've seen that I could look at and say, I can see how she'd be pregnant. And then there were these people, and all I could wonder was, Who would get close enough?
  But the woman teaching this class, an older and delightfully round woman, was very personable and seemed to me to be knowledgeable. She lectured us on bathing the baby, care of the umbilical stump, and diapering; and she passed on to us information about the general care and feeding of a newborn. We got to see a movie, too--the babies in the movie were certainly as old as us by the time we saw it--which prominently featured Johnson & Johnson products. In fact, in one shot the shampoo with which the baby was being washed very slowly and deliberately slipped down her face into her eyes, and it was very clear that she didn't cry. This was a truly monumentally subtle piece of product placement, I can tell you.
  Despite my reservations, we did get some good information, such as how to best swaddle a baby and so on. We learned how accurate those in-the-ear thermometers are, too--it turns out, slightly less accurate than your hand.
  ``But, as one of the doctors here likes to say,'' the woman told us, `` `No matter how much fish you've eaten, you don't have enough mercury in you to accurately take a baby's temperature.' ''
  What made the class unbearable for me, though, was that any useful information was buried amid so much repetition and restatement for the benefit of the slower members of the audience. It was like, ``Now, you can get one of these that's electric, and it will have a cord like this, and you can plug this into this outlet--or the one right above it--and if you don't have an outlet near where you need it, you can get something called an extension cord, and you just plug that into the outlet--or the one right above it--and then plug this cord into the other end of the extension cord....''
  Try that for two hours straight. And then come back next week for another two hours. It makes home dentistry look inviting.

The other class we took was a breastfeeding class. Now, I personally was looking forward to this class. I wanted to volunteer, in fact. I figured I could be the best breastfeeder around.
  This class, unlike any of the others, was held in the cafeteria. When the person at the information desk told us that, another mother who had hooked up with us said, ``The cafeteria?''
  ``Where else?'' I said. ``The class is, after all, about food.''
  The breastfeeding class was given by the same woman who, all those months ago, had originally taken us on our tour of the maternity ward. This time she no longer looked businesslike or matronly--she looked friendly and comfortable in a sweatshirt.
  Sadly, no volunteers turned out to be necessary--the instructor had brought along a doll. She complained about the doll, which was about four times the size of an actual baby, incredibly puffy, and bright white. This thing couldn't be mistaken for a baby from a mile off on a cloudy day. However, it did have an open mouth with a little stuffed tongue sticking out of it, demonstrating that the baby's tongue will indeed stick out. And then, to go with the baby, the instructor actually pulled out a stuffed breast. I do not know where they sell these things. I don't think I want to know. But it did make the class worth the price of admission.
  We also got to see a little manual breast pump firsthand. It looked a lot like the kind of water pistol you wished you had when you were in third grade. It was pretty cool, and I stuck it to my leg to test the suction. It sucked.
  In addition, we were shown another video, this one starring a plump woman who ran around from room to room showing new mothers how to nurse and being very friendly and surprisingly familiar with their mammaries. Which is not to say that a woman handling another woman's breasts is in and of itself a bad thing; it's just not something I encounter often, and rarely with babies around. But it is surprising to me to discover, after all these years, that breasts are, in fact, dual purpose organs; and it's even more surprising to discover that my brain can easily separate the two functions. There was nothing in the least bit titillating--if you'll excuse the pun--about this breastfeeding video.
  But how much titillation can one expect from breastfeeding? Not only is it deeply organic, deeply mammalian, but it is also odd. Other animals seem to have no trouble figuring out quickly how this works, but humans get all confused. First, the mother must hold the baby right, either in the cradle hold, which sounds nice, or the football hold, for which term someone needs a talking to. The last thing I need conjured up is visions of teams of topless lactating mothers tossing babies around and spiking them in the endzone.
  Anyway, the mother has to get the baby into this wrestling hold and then tickle their cheek with her nipple. In theory, the baby is supposed, upon having their cheek tickled, to reflexively turn their head and open their mouth really wide. Judging from the video, they reflexively do this after several minutes of reflexively sitting there confused and looking for all the world like Winston Churchill contemplating the Allied front. Because of this reflex, it's necessary for the mother to time perfectly her nipple insertion maneuver, whereby she takes advantage of the split second for which the baby's head is turned and mouth open wide, shoving the entirety of her nipple and aureole deeply into the baby's face. In the video, the baby looked surprised at this treatment, then indignant, and then their face vanished into the folds of their mother's flesh.
  So it was not titillating at all, but it was amazing. Amazing that the human race got this far, that is, considering the apparent lack of useful instincts in grown humans. Babies seem to do okay--but the adults, they're all fairly useless. I would never have considered feeding a baby this way.
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