“You’re doing fine,” the nurse says, her eyes kind. “Deep breaths. Nice and steady. Have some of this.” She hands me a cup of ice chips, but another wave of pain breaks over me, and I bat her fingers away, the ice skittering into the corner. The beep of the heart monitor hammers like a boat motor.

“I need to talk to Chase.”

“Chase? Is he your husband, love?” The nurse reads monitors as she speaks.

“I need him. I need my bag!”

She pats me once on the knee. “I’ll go find him for you.” As she leaves, she passes a doctor in the doorway. “This baby’s coming fast. No time for an epidural.”

The doctor glances at the monitors at the foot of my bed, then looks up at me. “Let’s get ready to push, Ruth.”

He says something else, but it’s like I’m watching him through glass: I can see his mouth moving, but I can’t fathom any of the sound. I’m all grit and sweat as I grapple to bear down. Then Chase is there, and I grab at his hand.

“Chase, my bag.”

“I’ve taken care of it,” he says. “Concentrate on this now.”

I squeeze his hand as another contraction rips through me. He flinches, but he doesn’t complain. You’re doing great, he mouths encouragingly, but his face is tight.

I push and push, curling in and in on myself, forgetting everything else around me, trying to survive. Every now and again, I slide out of the present, as if I’m somewhere else in the room, wake-dreaming through these moments and other, older ones. I see Pim on the gate. His little knees beside me. Then, as another contraction rips through me, I blink feverishly at the sight of Alex beside me, switching off all the monitors. She’s wearing a surgical mask, only her eyes showing above it, and she’s moving in toward the lower half of me, a scalpel in one hand. I scream out loud and the outline of her shimmers away. It’s the pain, I think, grimacing through the dream fever, trying to keep a grip on what’s real.

And then there’s one last effort, so strong that my lower half feels galvanized—a stinging, savage heave that splits my body in two—and everyone’s crowding my knees, all eyes above masks are smiling. I peer down to see. They’ve got a towel around little legs, little arms, dabbing at a face as they check it. The doctor passes me a bundle in a raspy blanket.

“Congratulations, Ruth,” he says. “You have a baby boy.”