Review
“With science, history, and his own personal experience as a father and a doctor, Mark Sloan has given us a truly enlightening look at childbirth. Birth Day is an absolutely fascinating read about the most important journey any of us ever makes.”—Sara Ellington, co-author of The Must-Have Mom Manual
“In Birth Day, Sloan skillfully blends personal anecdote, hard science, and bizarre historical detail to deliver a fertile and amusing account of the womb-to-world journey that every one of us has made. Without a doubt, this book will educate, entertain, and prompt you to call your mother in gratitude.”—Katrina Firlik, M.D., author of Another Day in the Frontal Lobe
“No one has described the intricate timing and sequence of a baby’s miracle transition from inside its mother to breathing on its own more clearly or beautifully than Dr. Mark Sloan. Sloan covers the various approaches to pain management during labor and their effects on both mother and child, and he supports adding nitrous oxide–safe and widely used for labor in so many other countries–to the very limited alternatives now available to women in America.” —Judith Pence Rooks, CNM, MPH, author of Midwifery and Childbirth in America
“I have given birth twice but until this book never grasped the true wonder of what happens to mother and child during childbirth. An amazing, tender, funny book about our bigheaded species.” —Adair Lara, author of Hold Me Close, Let Me Go
“Birth Day is a wonderful book. Dr. Sloan has accomplished the impossible, combining the history, biology, sociology, and medicine of childbirth into an informative, yet amusing story. Expectant parents will find this book useful and reassuring. So will physicians..”—Donald Caton, M.D., Emeritus Professor of Anesthesia, University of Florida, and author of What a Blessing She Had Chloroform
"In Birth Day, Dr. Mark Sloan delivers a rare and compelling blend of humor, compassion, insight, and scholarship- all swaddled in a remarkably engaging literary style. As illiuminating as it is fun, this book shines a gentle light into all the nooks and crannies of what must be the most universally familiar of all great mysteries: the act of being born. I heartily recommend the book to everyone who has ever played a role in that act, birthers and brithees alike! You'll learn a lot- I did- and it won't hurt a bit."—David L. Katz, MD, MPH, FACPM, FACP Director, Prevention Research Center, Yale University School of Medicine
“Over three thousand births later, Dr. Mark Sloan has lived to tell—and tell beautifully. At once decoding the mystery of childbirth while preserving its wonder,Birth Day is saturated with scholarship, humor, and heart.”—Linda Phillips, author of Sweet Remedy
"What boosts Sloan’s book above other pediatrician memoirs is his Captain Kangaroo–like humor and compassion. After attending roughly 3,000 births, and tending the medical needs of countless other children and their moms, he seems outstandingly suited to his specialty. The topics he discusses were born, if you will, out of his own experience, professional and personal, so in talking about them, he combines anecdotes and overviews of the various aspects of fetal development and birthing. With its crisp and upbeat tone, Sloan’s book is good company for parents experienced and prospective alike."—Booklist
"[Sloan] marvelously captures the precarious nature of childbirth—both its joys and its anxieties—while treating readers to an informal and captivating history of the medical practices surrounding birth in America… [He] ranges surely and splendidly.” —Publishers Weekly, starred review
"Sloan, who practices in Northern California, is a graceful writer, and his narrative, like the works of Jerome Groopman, flows easily between memoir, anecdotal reporting and hard science… Given the subject, "Birth Day" has a natural audience in curious, new and expectant parents. But anyone interested in the complex and, yes, miraculous way we all make it into this world will find lots to wonder over and ponder here, too." –Washington Post
About the Author
Mark Sloan, M.D., has been a pediatrician and a fellow of the American Academy of Pediatrics for more than twenty-five years. He is one of the highest-rated pediatricians (by patients and peers) in Kaiser Permanente’s Northern California region. His writing has appeared in the Chicago Tribune and San Francisco Chronicle, among other publications. He lives in Santa Rosa, California, with his wife and two teenage children, who continue to provide him with a wealth of practical pediatric experience.
From The Washington Post
From The Washington Post's Book World/washingtonpost.com Reviewed by Nora Krug You might expect a book about childbirth to be written by an obstetrician. But the author of "Birth Day," an exploration of the science and history of childbirth and early infancy, is a pediatrician. His decision to "throw in my lot with the babies" translates into a book focused more on the results of childbirth than on the act itself. Sloan, who practices in Northern California, is a graceful writer, and his narrative, like the works of Jerome Groopman, flows easily between memoir, anecdotal reporting and hard science. In a chapter on the first five minutes of life, for example, he contrasts the stories of two babies -- one born vaginally but with the umbilical cord wrapped around her neck, the other in a more complicated emergency cesarean -- to illustrate how a newborn makes the precarious transition to breathing on its own. Given the subject, "Birth Day" has a natural audience in curious, new and expectant parents. But anyone interested in the complex and, yes, miraculous way we all make it into this world will find lots to wonder over and ponder here, too.
Copyright 2009, The Washington Post. All Rights Reserved.
Excerpt. © Reprinted by permission. All rights reserved.
Chapter One
Twenty Babies: An Unexpectedly Quick Introduction to Vaginal Birth
I delivered twenty babies in the summer of 1977. I was hardly more than a baby myself, just turned twenty-four and starting my third year of medical school. At that point I was toying with the idea of becoming a family practitioner or a general surgeon. Babies didn’t much figure into my future.
This is how my obstetrics rotation was supposed to work: a medical student was typically paired with an intern, who in turn was under the direct supervision of a senior resident. The senior resident did the complicated cases—forceps deliveries, cesarean sections, and such—while the intern handled the routine vaginal births. My role as a medical student was more or less like Cinderella’s in her pre-princess days: do the dirty work, like IV starts and blood draws, and stay in the shadows to avoid the wrath of the overworked intern and resident. A “good” student—one with the sense to do his work quietly while openly admiring the skills of his elders—could expect the chance to deliver an uncomplicated baby or two as his reward.
Two things conspired to make this particular rotation different. The first was that it was early July, a traditionally scary time to have a baby in a large teaching hospital, since the interns are only a week out of medical school and generally have less experience delivering babies than the women whose babies they’re delivering. The second thing was that, for reasons I can’t recall, the OB resident staff was a few bodies short of a full complement. This meant that the interns and residents had to cover many more patients than usual, which didn’t leave them much time for supervising green medical students embarking on their first hospital rotation.
And so one sweltering Chicago morning I stood in my crinkly white coat before Mitch, a stocky, gruff senior resident with a startled head of jet-black hair and a permanent dusting of cigarette ash down the front of his scrubs. We were in the hallway outside the maternity ward. Gurneys with moaning women aboard rattled by like Model Ts on an assembly line, pushed by a corps of tough-looking nurses. Mitch had paused between a C-section and a vaginal birth to give me my orders: I was to join Ben, a brand-new intern from a tony private medical school, on what Mitch called the “firing line”—a row of wheeled labor beds separated by unadorned canvas curtains.
Mitch clamped his hand on my upper arm like a bailiff leading a felon into court and marched me through the labor room’s swinging doors to Bed 4, where a tiny nurse with Popeyesque forearms was helping a hugely pregnant woman out of a wheelchair.
“Okay, you had some OB training in your physical assessment class, right?” Mitch asked. No, I told him, I hadn’t. My physical assessment class had been at the veterans’ hospital down the street. There, I had watched men with terminal lung cancer chain-smoke cigarettes through their tracheostomy tubes, had seen others who had lost limbs to diabetes or D-Day land mines, and had personally examined what a senior resident described as the case of the year—a cabdriver who got scurvy (scurvy!) from a decades-long diet of plain White Castle hamburgers and Coke, period. Not only had I not seen a baby born at the VA, I told Mitch, I hadn’t seen a single female patient. The woman climbing onto the bed in front of us would be the first woman I had ever touched with medical intent.
Mitch scratched the stubble on his cheek. “Well, you’ve read about childbirth, haven’t you?” I said that I had. Just the night before, in fact: half a chapter, with diagrams. Took me twenty minutes.
“No problem, then.” He slapped me on the back. “Just sit there”—he motioned me to a rolling stool between the woman’s now propped-up legs—”and call me when you see a head.” Then he left.
I sat there for two hours. I killed time by rearranging the contents of my pockets, cleaning my stethoscope, and, once I had overcome my shyness, talking to the woman who was to produce the head I had been ordered to be on the lookout for.
Her name was Tonya. She was two months younger than I was, and in between contractions I learned that for the last five years she’d been a secretary at an insurance company downtown. This was her third child—her oldest, a girl, was just two and a half—and she absolutely hated childbirth. She compared the pain of having a baby to the pain of being stabbed, which she had been, twice—both times being cases of mistaken identity, she assured me. But childbirth was worse, she said, because “it’s like they won’t take the knife out.” Childbirth and knifing: two experiences I had never had. I took Tonya’s word for it.
Our conversation gave way to long stretches of silence as Tonya’s labor intensified. She panted as her contractions came, her hands gripping the metal siderails of the bed with such force that I thought she’d bend them. Between contractions she stroked her belly with her hands, her eyes closed.
Ben, the intern, came and went in a sweaty blur, muttering to himself as he lurched up and down the row of beds. He shook my hand on one pass. “Everything okay here?” he asked in a strangled voice. “Good,” he said absently, not waiting for an answer. He patted my shoulder and scuttled out the labor room door. I went back to my pockets, moving my reflex hammer, tuning fork, pens, and alcohol wipes from one side to the other and back again while I waited for something to happen.
A sudden eruption of curses drew my attention. Startled, I looked down between Tonya’s legs and saw the top of a tiny head peeking out from her vagina. I shouted for Mitch and then Ben, but neither responded. The nurse who’d been working the firing line was gone, too—off helping them, I supposed.
A pale student nurse appeared behind her clipboard at the foot of Tonya’s bed. “I think they’re doing an operation,” she said. Her eyes widened at the sight of Tonya’s baby’s head. “Maybe I should go look for them?” She dropped her clipboard in my lap and took off at a half-trot. The double doors swung shut behind her. Now it was just me, the swearing Tonya, and the top third of a birthing baby’s head.
I remembered a picture in my night-before’s reading where the obstetrician has his hand placed confidently on the emerging newborn’s head. So I did that. I put my gloved right hand on Tonya’s baby’s head. It was warm and wet, and squishier than I had imagined it would be. Contact made, I exhaled for the first time in what seemed like an eternity.
My relief was short-lived. I had mastered the art of placing my hand on a birthing baby’s head, but what came next? Would the baby just kind of fall out of Tonya on its own, I wondered, or was I supposed to grab on to that puckered patch of scalp and pull? I silently cursed myself for not finishing the chapter. Caught between pulling and not pulling, I chose a middle, temporizing route. Like the Dutch boy at the dike, I put my hand on the baby’s head and pushed back, hoping to persuade it to pause just long enough for Mitch or Ben to come and save me.
Tonya’s curses were getting personal now. She had finished damning her absent husband for putting her through this agony not once, not twice, but three times, and now she turned her attention to me. “Get that damn baby out of me!” she shrieked, glaring at me over the top of her belly. “Get it out now or I’ll cut you!”
Dutch boy be damned. I was losing the battle. There was now an entire head under my hand, face and all. Amniotic fluid bubbled from its nose. Its mouth opened and closed in some horrible parody of breathing. Caught between threats of mayhem and my feeble attempt to hold back eons of childbirthing evolution, I closed my eyes and surrendered myself to whatever came next.
Suddenly a pair of hands pushed me aside. Mitch reached in, grabbed the baby’s head and yanked with so much force that I was afraid he was going to tear it off. He pulled the head sharply downward—the right shoulder appeared at the top of the birth canal—then up, and the left shoulder popped out from below. The rest of the body followed, like a rabbit pulled from a magician’s hat. Mitch plopped the baby in my lap—a big, squalling, slippery boy—and then clamped the cord with a pair of long hemostats and cut it in two. A minute later he tugged on the remnant of the umbilical cord and out came the placenta.
A nurse wrapped the baby in a white receiving blanket and handed him to Tonya, who cried and smiled and cootchie-cooed her thirdborn, seeming to have forgotten for the moment about killing me. His name was Robert, she said, because he had his grandfather’s cleft chin.
“That wasn’t so hard now, was it?” said Mitch, as he jotted a note on Tonya’s chart. I didn’t answer him—couldn’t, really. I just sat on the stool with my mouth hanging open, dumbstruck. My scrub shirt was soaked in sweat. There was blood on my socks and shoes. Mitch stripped off his gloves and tossed them in a trash can at the foot of Tonya’s bed. He yanked me into the hall, where two more mothers-to-be in wheelchairs waited. “Okay, then,” he announced. “Time for the next one.”
Had I been a little more observant—and less panicked—I would have noticed that Robert’s head had rotated one way as I held it, and then back again as his body emerged. I would have pondered the pushing, pulling, and pain of having a baby, and the torpedoish shape of the baby’s head as he lay in my lap. I would have marveled at Tonya’s rapid...
