She inhaled six times, then exhaled and pushed.
           
“Once more,” the doctor said.
           
She bore down and felt her leave.
           
“Is she ok,” she asked, her words a soft moan.
 
She heard the slap, the cry and then saw the doctor holding the baby by its feet upside down, the umbilical cord rising from her. The nurse took the baby and cradled it in her hands. The mother could see the small angry face and the fat arms and legs that moved with little grace. The head still supported by the nurse’s hand. His small penis and testicles appeared large in proportion to his body.
 
“It’s a boy,” she said.
 
“Yes. He’s fine. Everything in its place,” the doctor said.
 
“A boy,” she said again.
 
The doctor and the nurse remained silent watching her – their masks billowing like sails.
 
“Should I cut the cord?” the doctor asked.
 
“Not yet,” the mother said. “Give us a couple of minutes alone.”
 
The nurse handed her the baby and said, “These things happen.”
 
“He’s been out for four minutes. You only have twenty-six minutes left until its permanent,” the doctor said. “After that nothing can change.”
 
“I know,” she said.
           
Pulling up her knees and placing the baby on her pelvis, she leaned him back against her thighs. The cord ran between her legs and over his shoulder. She studied his face, his hands, his legs, and his penis.
 
“You’re a boy,” she said.           
 
The baby opened his eyes, and after a moment said, “Yes.”
 
“I was expecting a girl. I made it clear I wanted you to be a girl.”
 
“I know, but it’s not easy to change,” he said. “Why did you take so long to tell me?”

She eased back, looking away, and closed her eyes, ignoring the question. After a minute, she said, “I’m not married, and I don’t plan on getting married.”
 
“Who’s my father?”
 
“He’s not going to be around. There is nobody else. Just me.”
 
The baby looked at his mother, and she tried to read his expression; but it’s hard with a new born. At least, he had not started to cry and play on her instinct to hold him. Soothe him.
 
“Why did he hit me?”
 
"To make you cry. So your lungs will clear.”
 
“Doesn’t seem fair to me. Pushed out, dangled by my legs, hit and then you tell me you want a girl.”
 
She lifted her hand and lightly touched his arm with her index finger. Fluids coated her fingertip, and she could see the trail it left on the baby’s arm.
 
“This isn’t a fair place,” she said.
 
“I’m not sure I like it here.”
 
“That’s why I want you to be a girl. It’s harder on a boy not having a man around. I can’t teach you all that guy stuff.”
 
“Is it easier being a girl?”
 
The doctor knocked and asked, “Everything ok?”
 
“Yes. We’re fine,” she said.
 
“Only ten minutes left.”
 
“Almost done.”
 
Some machine in the corner hissed and began the slow rumble of its mechanical life. She thought she might cry.
 
“You want me to go back in and change don’t you,” he said.
 
“It would be for the better. I know what it’s like to be a girl.”
 
“It’s not easy to change. I need to stay in you for three months. Can you handle that?”

The mother and her child looked at each other. She saw their future: his disapproval, her inadequacies, and the possibility of love that might survive. She reached down and moved the child closer to her. Resting his head above her heart.
 
“Yes. I can,” she said.
 
Neither spoke. Their breathing slowly synchronized; he rose and fell on her chest. She felt the gentle movements of his hands.
 
“Do you need to kick me so much?” she whispered.
 
“I kick you to remind you I’m here.”
 
“I never forgot.”
 
“I’ll go back,” he said. “But promise me, you’ll eat better. Promise me, you’ll take care of us.”
 
“I will,” she said.
 
They waited for the doctor. She reached down and stroked his head. When the door opened, his hand grasped her finger.
 
“Don’t let him hit me next time. Tell him I already know.”