I was afraid of the pain.  Almost from the minute I knew I was pregnant with twins, I dreaded “the trauma of childbirth.”  I could handle the three to five months of nausea, the insomnia, the weight gain, even the responsibilities of the next eighteen or so years, but not, I thought, “the most agonizing pain known to mankind.”

My sister-in-law in Ohio gave birth to a six pound twelve ounce boy in two hours with an epidural.  “It was almost fun,” she told me.  “I could feel him coming through the birth canal, but it didn’t hurt.”  She showed me the video – Elton John played on a boom box, her mother bustled about.  My brother narrated the event.

“That’s what I want, too,” I said.  Except instead of Elton John, we’d have Enya.  There’d be champagne chilling in the mini-fridge.  Of course, I’d have the epidural.  And my mother wouldn’t be in the delivery room – just my husband.

But I live in Japan and no one that I talked to here had ever heard of any kind of anesthesia during normal childbirth.  A Japanese friend, who gave birth to a nearly ten-pound baby, was in labor for twenty-four hours with no pain relief.  In Japan, I’d heard, a woman in labor was supposed to endure her pain in silence.  If she cried out, she’d failed in some way.  I vowed to be silent.

Even though they don’t use anesthesia, Japanese women have age-old ways of reducing the pain.  A small baby makes for an easy delivery and several women gave me advice on restricting the size of my twins.

“You should go for walks,” a mother of two told me.  “You don’t want the babies to get too big.”

“Don’t let your legs get cold,” another woman advised.  “Cold legs can lead to a miscarriage.”

In my fifth month of pregnancy, my mother-in-law announced that it was time for an obi – a thick band tied around my waist to keep the babies from getting too large.  I was horrified.  It sounded worse than Chinese foot-binding.  Twins are usually underweight and I didn’t want to do anything to impede their growth.

I asked my obstetrician about the practice, just to be polite.  I had no intention of wrapping my middle.

“In the old days,” he explained, “people had their babies at home.  There was no recourse in the event of a difficult birth.  They did whatever they could to have an easy labor.”

I didn’t go for walks.  I lazed around on the sofa admiring baby clothes in the Land’s End catalog.  I watched CNN and ABC news on satellite TV.  I snuggled under an afghan, keeping my legs warm.  And I threw up.  And then I started to bleed.

During my hospital stay for a threatened miscarriage, my room was across from the delivery room.  I heard women screaming out in the night:  “Itai!  Itai!  Itai!”  (“It hurts!  It hurts!  It hurts!”)  “Iya!  Iya!  Iya!”  (“No!  No!  No!”)  I was terrified.  I wondered if it was too late to change my mind.

The doctor recommended cerclage, a procedure in which the cervix is sutured shut to help prevent premature labor.  After my first scare, he didn’t have to work hard to persuade me.

“Do you want anesthesia?” he asked me.  “And if so, what kind?”

He told me that some women went through the operation with no pain relief at all.  It sounded brave, but I am a wimp.  “Give me the spinal,” I said.

Before the operation, I was jabbed with a needle in the arm.  When it was time for the epidural, I assumed the fetal pose and waited for the prick in my spine, my delicate spine.  In my home country, an anesthiologist would have handled this part, but there was no one extra there, just the obstetrician and nurses.  My mind was haunted by newspaper stories of mixed-up medicines and incompetent hospital doctors.  If he missed, would I be paralyzed for life?

I was nude and everyone else was garbed in sterile blue, mouths hidden by ridged masks, only dark eyes visible.  They didn’t say anything except “This’ll hurt.”  I wanted to ask someone to tell me a story, to distract me with words and questions like Dr. R. back in South Carolina.

I felt a cool hand pressing on my thigh, keeping me still for the needle that was about to go in.  The first time, I flinched a little, but didn’t make a sound.  It didn’t really hurt until the liquid was injected, and then it ached so much that I clenched my jaw.

I heard the doctor sigh.  “Sorry.  Gotta try it again.”

It took two more jabs before the needle was properly inserted.  Each time I felt the same ache, but I didn’t cry out.  Not even a whimper.

I borrowed videos on Lamaze from the hospital.  The woman in the first video made it look so easy.  She didn’t scream, although a few tears trickled down her cheek.  The baby slithered right out of her and was suddenly at her breast.

The Lamaze method: Breathe in.  Breathe out with the pain.  In, out.  I practiced.  I thought that maybe it wouldn’t be so bad after all.


I was surprised by blood again when I was six months pregnant.

Threatened premature labor,” the doctor said, and sent me to bed for the duration.

I was hooked up to an I.V. and my movements were restricted.  I brushed my teeth while on my back and ate my meals at a forty-five degree angle.  For ten days, my feet did not touch the floor.  Even so, my belly continued to tighten with contractions and blood stained the white sheets.

I was transferred by ambulance to another, bigger hospital – one with lots of incubators and a brand new NICU (neo-natal intensive care unit).  This time I had roommates – two other women who were expecting twins in July.  Mine were due in September.

The other women were there according to hospital policy.  Since there is an increased risk of premature labor for multiple pregnancies, women expecting more than one baby are put under observation as a matter of course in the eighth month.

We passed around magazines and brainstormed baby names.  We traded snacks and old wives’ tales.  We worried together about the pain of childbirth.  My second night there, we talked about ordering a pizza in a few days.  It was like an adult slumber party.

A friend brought me novels.  I read all day.  Once in awhile, a nurse came to monitor the babies’ heartbeats.  They kicked and squirmed and their hearts were strong.

My parents called each morning from South Carolina and my mother-in-law dropped by with washed pajamas and cream puffs.  My sister-in-law’s husband’s aunt came by along with a friend of my husband’s family.  “You shouldn’t read,” she told me.  “It excites the mind and is bad for your baby.”  She said that I should lie quietly and talk to my babies.  For three months.

My husband came every day after teaching high school P.E. and coaching baseball.  He brought my mail.  One evening, he brought a letter saying that one of my short stories, published the previous fall in a small literary magazine in Illinois, had been chosen by a famous poet for a literary anthology.  I couldn’t wait to tell my parents.

I was starting to relax.  I was even beginning to enjoy myself.  The doctor announced that I could start using the toilet again.  The catheter was removed and I began testing my shaky legs, taking my first tentative steps toward wellness.  Or so I thought.

The next morning, I woke soaked in blood.  My roommates slept through my frantic call to the nurse.  Soon, I lay on an operating table awaiting an emergency C-section.  I was surrounded by Japanese-speaking strangers wearing blue gauze masks and matching smocks.  My husband  was outside in a waiting room with my wedding ring in his pocket (no jewelry allowed during surgery).  The rest of my family was thousands of miles away.  I had lived in Japan for ten years, but it had never felt as foreign as it did at this moment.

Itai, itai, itai,” I said.  I’d gone through thirty minutes of labor and already my vow of silence was shattered.  I was secretly impressed, however, by my ability to communicate in a foreign language in such extreme circumstances.

I’d expected everything to be different.  I’d expected ice cubes in my mouth and my husband’s fingers kneading my lower back.  Instead, I was clutching the hand of a stranger and I was scared.

Someone told me to curl up in a ball.  I eased onto my side and curled.  I felt the needle slide into my spine, but this time it didn’t hurt at all.  My lower body became warm and then went quickly numb.

The obstetrician started swabbing my middle with antiseptic.  Another man, identified as the neo-natal specialist, entered the room.  “Twenty six week baby very difficult,” he told me in heavily accented English.  “I will do my best.”

I looked at the clock.  It was eight thirty in the morning.   I didn’t want to think about what was going to happen in the hours, days, weeks to follow.

I was sorry that I’d ever wished for an easy birth.  With a few extra weeks in the womb, my babies’ lungs would have fully developed.  They’d have enough fat on their bodies to maintain the proper temperature.  They would have received vital antibodies and nutrients through the placenta.  These gifts of the body made my fear of physical pain seem petty.

Minutes later, the obstetrician sliced open my abdomen and pulled out my son.  I couldn’t see what was happening because a screen had been set up over my chest, but I could feel the liquid ooze over my belly and the fish-like squirm of my 964-gram baby boy.  “Kawaii,” the nurse holding my hand said.  “He’s cute.”  I heard his cry – a tiny mewling – and then he was whisked away.

“Now we’ll go in for the other one,” Dr. M. said.  He quickly delivered my 690-gram daughter, the one who had lived beneath my heart for six and a half months.  And then she was gone, too.

I lay on the table, resigned and passive.  This was supposed to be one of the most joyous moments of my life, but I felt like a failure.  Although I’d tried to do the right thing throughout – abstaining from coffee and alcohol, avoiding travel and smoky rooms – there was a chance that my babies wouldn’t make it through the day.

Because I was recovering from surgery, I didn’t see my children for twenty-four hours.  My husband was allowed into the NICU and he reported back to me.  “They’re cute,” he said, “but not like that.”  He pointed to the babies on the cover of one of my books.  “They look like little baby birds.”

The following evening, I was wheeled to the NICU and I saw my children for the first time.  Their bodies were scrawny and red, but they had all ten fingers and toes.  I couldn’t see their eyes because they were fused shut.  They had dark hair on their heads and soft hairs on their shoulders and faces.  They both had little beards.

The neo-natal specialist told me that although there were many hurdles ahead, the babies were doing incredibly well.  “Don’t worry,” he said.  “Trust me.”

When I was well enough to walk again, I joined the other expectant and new mothers at the dining room table.  My former roommates were eager for details.  “Did it hurt?” they asked me.

“No, not at all,” I said.  And I was disappointed that I’d missed out on the pain.

– Suzanne Kamata
Author of Losing Kei (Leapfrog Press, 2008)
Editor of Love You to Pieces: Creative Writers on Raising a Child with Special Needs (Beacon Press, May 2008)
and Call Me Okaasan: Adventures in Multicultural Mothering (Wyatt-Mackenzie Publishing, 2009)