All of a sudden something breaks. he feels the amniotic fluid trickle, then rush past him. Just below his head, the cervix is at last fully dilated. He feels his head push through a narrow channel, caught in the vice of a contraction. With the cervix fully dilated, he can now push through the birth canal, but it's not a journey even this world-ready fetus could make were it not for his own soft skull, which deforms in the narrow passage. Still, no pain for the fetus. Just pressure.
It seems to go on for an eternity. The umbilical cord is stretched thin. There's hardly any oxygen in his blood. The amniotic fluid is being squeezed from his lungs. His body fights fatigue.
Suddenly, there it is: A cold, bright, shouting light -- dry air! Sound turned up to a whole new level. Slippery hands upon his head. A clamp on his umbilical cord. He wails. Instinctively, he turns 90 degrees in the birth canal, and trusts the hands in this new world to pull his naked body free.
The fetus' holler is that very first breath he's practiced for. His lungs draw in the air and its air sacs open. The oxygen relaxes the walls of his lungs' blood vessels, causing them to dilate. Whereas in the womb the fetus' blood bypassed his own lungs and was shunted off to be oxygenated by his mother's, now the shunts close forever, and his blood begins to find its way into his lungs. There, it is oxygenated, and rushed into his arteries via his heart.
The world the baby has entered is strange and new. There's five times more oxygen available now than there was ever before, and the rush of its life-giving molecules stimulates his nerve cells. He still has a lot to master, for his umbilical cord has been cut and his placenta -- surrogate lung, kidney, protectorate -- is no longer a part of his life. Now his nutrients must come from milk. Now his kidneys must take charge of balancing his bodily fluids. But before he's given much of a chance to grasp the skills he'll need, he's given (and isn't this just like real life?) an exam -- an Apgar test -- which assesses his heart rate, respiratory effort, color, muscle tone, and reflexes. Then he's carried beneath the harsh lights, through the dry air, toward a new destination.
A sweet voice he recognizes speaks to him, and a second voice whispers in his ear -- his father. Who knows what the proud, encouraging sound waves mean, but they play like music to his ears. He nuzzles close in his mother's arms.
Beth Kephart's A Slant of Sun: One Child's Courage was a 1998 National Book Award finalist.