“I wish I could,” I lied, “but I’ll be here the whole time. I will make sure every nurse does her job, that the doctor is here, that every single detail goes off without a hitch. All you have to do—the only thing you have to do—is lie right here and do what the nurses tell you. Can you do that?”

Hope lit in her eyes. “I think so.”

“That’s right. You can.” I turned to the nurse. “I need two more pillows, cool washcloths, and”—I picked up the pitcher on the rolling table, shaking it to find it empty—“ice chips. Where is the crib?”

The nurse managed to look both annoyed and afraid. “It’s on its way.” She scooped up the pitcher. “Be right back,” she said sweetly to my sister but shot me a look on her way past.

I ignored her, instead helping Ivy sit so I could rearrange the sawdust pillows at her back. Then holding her hand, wiping the sweat from her brow, soothing her when she came unraveled, which was about every third contraction. Texting Dean updates, overseeing the nurses, feeding Ivy ice chips.

The doctor ran in—literally ran, snapping gloves on as she entered—rolling up on a stool to acquaint herself with the state of my sister’s vagina. Minutes later, Ivy’s thigh was in the crook of my elbow as she bore down, teeth bared and face crimson. When the doctor announced the crown of the baby’s head, I made the mistake of glancing down to find her vagina made unrecognizable—first by that poor, elastic orifice’s size and shape, then by a mushed-up purple face covered in muck—and with a scream, a rush of fluids, and a strangled cry, the space in my heart grew to accommodate another person.

Ivy sagged, crying and peering through the gap between her knees as the doctor held up her baby, wailing and wrinkled and shining with gore and absolutely, life-changingly perfect. Tears welled in my eyes, emotion jamming my throat as I leaned into my sister, kissing her damp forehead.

“You did it,” I whispered. “She’s perfect.”

Nurses flocked, huddling around the baby for a cursory cleanup.

“Do you want to cut the cord?” the doctor asked.

It took me a moment to realize she was talking to me.

“I … yes,” I answered, the weight of the honor overriding my overall disgust at cutting an organ still attached to my sister.

I approached the table, taking the scissors as they held the wiggling purple baby, her mouth open and screaming and a shocking shade of red against ashy skin. The doctor held the cord between pinched fingers, which was already clamped at the baby’s belly button, indicating where I should cut. So I did, cringing, trying not to think about the gamey texture or strength at which I had to saw at it to disconnect the baby.