The cord

Umbilical cords - dead flowers - the five remembrances

Hello everyone, I have migrated this newsletter to Substack as it’s a bit easier to manage and share writing here. As always, feel free to send to anyone who might enjoy it, or share wherever. I also love it when people write to me.

---

These days, my job is attending to births and their aftermath. I go when the baby may be in trouble: to obstructed labours, emergency Caesarean sections, premature deliveries, when infection has set in. My job is to look after the baby: to attend to what can and does go wrong as one human body cleaves from another.

I wait, standing in my baby-blue hospital scrubs some distance away from the birthing action, and watch. I turn on the heaters and test my equipment. When the baby is out, I start the clock. The baby is often blue, not breathing, sometimes not moving, like a statue memorialising themself in this initial baby form. The health care workers rub the baby’s back and feet, trying to get them to take that first inhalation, summoning up the pressure to inflate their lungs, followed by the exhalation of that first cry. If they are good-enough in these first breaths, the midwife or obstetrician will hover the baby up towards the parents, as proof of life.

The umbilical cord stretches taut, throbbing and shimmering with blood as the baby is lifted. The longer the cord pulses, the more blood travels from the placenta to the baby. Within minutes, the alien tissues of the jelly coating of the cord will collapse and then dry, ending the circulation and the connection. This is why, when the cord slips out first during birth, the baby’s life is in danger; like an astronaut floating in space whose oxygen line has been cut. But as the baby starts to breathe on the outside, the cord rapidly becomes obsolete, mattering less with every second that passes.

It is insensate, fat and gelatinous. Sometimes it’s as thick as a baby’s arm for the children of the gestationally diabetic. In the very premature babies, the cord is smooth and slick, less twisted. Sometimes the cord is so thin and fragile I can barely believe it functioned, but then I look at the two live bodies tethering it and see that it manifestly did.

I find the cord unnerving, the way it doesn’t fully belong to the baby or to the parent, and how it looks nothing at all like skin, in truth nothing like anything else in the body. White and helical, it reminds me of those twisty phone cord on old landlines, which used to connect the handset to receiver. For this reason, I don’t like to touch the cord - it feels too-intimate, a transmission not meant for me, like walking into a disagreement between loved ones, or seeing a personal text on a colleague’s phone. When on occasion the cord falls accidentally across my forearm, slimy and hot, still shuddering with that private meaning, I feel a deep mammalian emotion I can’t yet name, somewhere between revulsion and awe.

In the first minute of life, I assess the baby’s grasp on life — their colour, how much of an effort they are making to breathe - as they are held above their parents, cord still vibrating with blood, ring ring ring. When I nod, it’s time, scissors flash, the cord is severed and the baby is brought over. When the clock beeps, I give the baby their initial Apgar score, an assessment of their overall health in that moment. In those first minutes, if all is well, whoever has come with the birthing parent - a partner, a mother, a sister — will be ushered over to trim the cord to a more manageable stump. The hands of health professionals, usually in silicone gloves smeared in blood - take the phone, take pictures of the cord being trimmed, their expression usually one of shock and anxiety but trying to smile. And when I look at that stump directly, the two umbilical arteries and one umbilical vein stare back out, oozing a final remnant of the blood exchanged in both directions.

When I touch the cord now with my gloved hands, I feel the baby’s pulse, usually racing along at three times’ the rate of the birth parent, so fast it’s hard to count. The baby goes on breathing, turning pinker and pinker with each breath and heartbeat. And within a day, the cord will be crisping and shrivelling up like a dead leaf: lifeline one minute, vestigial appendage the next.

---

I’ve begun meditating with my friends. We sit together for a few hours, once a week, and listen to something to help guide us. Recently my friend brought us a lecture on how the awareness of transience can guide us deeper into life. I’d come across some of the concepts before: two years ago, when in the months that my partner and I knew he was going to die, I bought a stack of books to try to help prepare for what was being asked of us both. They sat, unopened, for those months, and beyond. I was desperate for some wisdom or guidance to help make sense of what was happening, to help me become who I needed to be for him. But when I tried to open them — while he slept or read next to me — I saw the letters shimmer and coalesce on the page and could not absorb anything, to the point I gave up, and instead just lay there and watched him breathe.

At one point, he was very sick and we were sleeping in the hospice for a week. It was the end of the Wet and occasional torrential storms were still hitting the coastline, lightning and rain thrown down at velocity for moments only to clear again. I went for a long cry-run in the storm one day and returned back to the room to find him and our friend sitting on the bed together, also completely soaked. He’d gone for a walk and returned with flowers he’d picked from the hospital garden for me — frangipani, native pea and honey myrtle. I was overwhelmed with this act of love: at a time where he struggled to speak, bringing me delicate tropical flowers to his hospice bed. It spoke to how much, and how gracefully, he continued to give to all of us in incomprehensibly difficult and painful moments. I kept the flowers, first in some tissue paper, then in a stack of novels, and then I migrated the small posy into one of the death books that I couldn’t read, where I knew I wouldn’t have to face it for a while.

Sitting with my friends, I thought of my flowers, now brown and crisp as a disused umbilical cord stump, pressed in the index of a book about impermanence. The lecture reminded us of the Five Remembrances. These form part of a Buddhist discourse on how to live, by reminding ourselves of what we already know — some intrinsic realities of inhabiting these tenuous human forms:

I am of the nature to grow old. There is no way to escape growing old.

I am of the nature to have ill health. There is no way to escape ill health.

I am of the nature to die. There is no way to escape death.

All that is dear to me and everyone I love are of the nature to change. There is no way to escape being separated from them.

My actions are my only true belongings.

(Translation by Thich Nhat Hanh)

Even now, with the truth of all this so obvious, I still feel myself react against the remembrances. Like everyone else, I’ve wanted to stop time so often: to give myself a chance to think, for things to stop changing, for the morning to not come, to undo my mistakes. But navigating a fresh season of grief, loss and change that has me sometimes gasping for air, I find this is the closest thing I can give myself to a pep talk that works. If we can embody the understanding of impermanence, and that our time together is finite, we can reach to what is generative and expansive and remember that these moments matter more than we can often bring ourselves to imagine. I want to bring you frangipani, to contemplate the transient, squishy perfection of a newborn, and to witness this iteration of life living through us, in all the mess, while we are here together.

Thanks for reading,

Leah

Thank you to my friend Joshua Foote, whose conversation + observations on the cord helped me write this piece.

---