Ashley was 22 years old, and she had been waiting for this day for 3 months.
Not because she was pregnant. She wasn't, not really, not in the flesh and blood way that made you waddle and weep and fear for your perineum. But Ashley was obsessed with birth. The raw, feral, screaming into the void kind of birth. The kind that left you torn and trembling and transcendent. And in the real world, you only got so many chances to do that. So once a month, sometimes twice, she took the train to the Nexus VR Birthing Center, paid her 300 dollars, and lived out the most brutal, beautiful hours of her artificial life.
Today she had booked the Premium Unassisted package. 12 hours of labor. 3 babies. Head down positioning for all 3. No midwives, no holographic doctors, no safety net except the equipment in the room and her own 2 hands. That was how Ashley liked it.
The center was a low white building on the edge of the industrial district, nothing fancy on the outside. Inside, the air smelled like chlorine and clean linen. A receptionist with a calm voice handed her a tablet. Ashley scrolled through the options. She selected "Unassisted Vaginal Birth." She selected "Triplets." She selected "Head Down, All 3." She selected "Labor Duration: 12 hours." She selected "Pain Intensity: Maximum." She selected "No Medical Intervention." She selected "Realistic Tearing Simulation: On." She selected "Placenta Delivery: Manual Required." She selected "Hemorrhage Simulation: Off." She selected "Cord Complications: Off." She selected "Shoulder Dystocia: Off." She wanted the birth to be hard, brutal even, but she wanted it to work. She wanted to succeed alone.
Then she walked to Room 4.
The room was circular, about 15 feet across, with soft gray walls that looked solid but could turn into any landscape she wanted. A birthing pool sat in the corner, empty. A cart held clamps, scissors, bulb syringes, 12 towels, a suction device, 3 sets of sterile cord ties, 2 emesis basins, a blue plastic tarp, a bottle of antiseptic spray, a peri bottle, 4 absorbent pads, and a digital thermometer. A low futon mattress was on the floor, covered in a waterproof sheet. There were no monitors, no IV stands, no screens. Just her and the supplies.
Ashley stripped off her clothes and folded them on a shelf. She took the small white pill from a sealed foil packet. It was the size of a jellybean. She inserted it into her vagina as far as her fingers could reach, 3 inches deep, pushing past the ridge of her pelvic floor until she felt the pill settle against her cervix. The pill would dissolve in 10 minutes and trigger a cascade of synthetic hormones: oxytocin, relaxin, prostaglandins, and a proprietary blend of neuromuscular stimulants. Her uterus, empty and normal sized 20 minutes ago, would begin to expand. Her cervix would soften and dilate. Her pelvic ligaments would loosen. Her body would believe, with total conviction, that she was 40 weeks pregnant with triplets. The VR headset hung on a hook by the door. She put it on. The gray walls dissolved.
She was standing in a meadow. That was the default setting, but she had overridden it. She had chosen "Birthing Cave." The walls became rough stone, damp and cool. A single lantern hung from a wooden beam. A pile of soft moss was in the corner. A low wooden stool sat in the center of the room. Ashley sat on the futon in the real world, but in the simulation she was cross legged on the moss, naked, her hands resting on her belly.
7 minutes later, the first contraction hit. It started as a low pressure in her lower back, just above her tailbone, then bloomed forward through her abdomen like a fist slowly closing. The synthetic oxytocin was binding to her uterine receptors, forcing her myometrium into a coordinated squeeze. She could see her belly tighten in the simulation, a hard ridge forming across the top of her uterus. Ashley breathed out through her mouth and smiled. Good. Right on time.
By the 1 hour mark, the contractions were coming every 4 minutes and lasting 50 seconds each. Ashley was on her hands and knees on the futon, rocking her hips in slow circles. Her belly had swollen to the size of a full term singleton pregnancy. She looked 9 months pregnant. Inside, the simulation had populated her uterus with 3 synthetic fetuses, each one made of silicone and weighted to feel like real infants, each one connected to a network of pressure sensors and hydraulic pistons that would mimic their descent through her birth canal. The first baby's head was pressed against her cervix, which was now 2 centimeters dilated. Ashley could feel it. The pill had also dilated her real cervix by 2 centimeters, a strange and invasive sensation, like something was prying her open from the inside.
By hour 3, her belly was enormous, tight as a drum, stretched with the weight of triplets. In the simulation, she looked like she was carrying a beach ball under her skin. The veins on her breasts were blue and bulging. Her areolas had darkened to a deep brown. In reality, none of that was true, her body was still 22 years old and unpregnant, but the VR headset fed signals directly to her visual cortex, and the pill sent matching signals to her somatosensory cortex. She felt huge. She felt heavy. She felt every pound of the 3 babies, a combined 18 pounds of synthetic flesh pressing on her bladder and her diaphragm and her rectum.
She had moved to the floor, no futon, just the cool rubber mat. She was squatting low, her thighs burning, her hands braced on a birthing stool she had pulled from the wall. The contractions were 2 minutes apart and lasted 90 seconds each. She groaned through them, low and guttural, sweat dripping from her chin onto her chest. The sound echoed off the stone walls of the simulation. In the real room, she knew she was alone, but in the cave, she felt like the last woman on earth.
At hour 5, her water broke. She was on hands and knees again, and she felt a deep pop inside her, then a gush of warm fluid that splashed onto the mat between her knees. The fluid was real, a sterile saline solution that the pill had instructed her body to produce and store in an artificial amniotic sac inside her uterus. She looked down and saw it was tinged pale pink. Good. No meconium. The first baby's head was descending. She reached between her legs with 2 fingers and felt the baby's head through the sac before it broke, a hard round shape wrapped in slippery membrane. Then the sac tore, and the fluid poured out, and she felt the bare silicone skull against her cervix.
The next 2 hours were the longest of her life. She moved between squatting and hands and knees, unable to find relief in either position. The contractions were a solid wave now, no real break between them, just peaks and valleys of agony. The pain was not just in her uterus. It radiated down her thighs, into her lower back, up into her ribs. She vomited twice, a thin yellow bile that she wiped from her chin with the back of her hand. Her cervix was fully dilated at hour 6 and 10 minutes. She knew because she reached inside with 2 fingers and felt the rim of her cervix, soft and gone, and then she felt the hard curve of a baby's skull, just 1 inch inside her vagina.
She started pushing without meaning to. Her body took over. The urge was like vomiting, a violent, unstoppable reflex that made her bear down with every contraction. She was squatting on the birthing stool now, her feet flat on the mat, her hands gripping her own thighs. She screamed. Not a movie scream. A real one. Raw and throat shredding. The scream lasted 15 seconds and ended in a wet cough. She pushed again, and the baby's head moved down another half inch.
The head crowned at hour 7 and 15 minutes. She reached down and felt it, a circle of wet hair, the skin of her perineum stretching white and thin. She could see her own vulva in the simulation, distorted and swollen, the baby's head bulging between her labia. The ring of fire was exactly what everyone said it was, a burning, searing, impossible stretch that made her want to push and stop pushing at the same time. She pushed harder, and the head emerged in a rush, chin to her anus, then rotating. She caught the baby's head in her own hands, feeling the soft spots, the molded shape of a skull that had just passed through her pelvis. One more push, a burning ring of fire that made her vision go white and her ears ring, and the shoulders slid out, then the rest of the body, slick and purple and screaming.
Baby 1 was a girl. 6 pounds 2 ounces. 19 inches long. Ashley laid her on the mat between her feet, wiped her mouth with a towel, and tied the cord with a sterile tie 2 inches from the belly. She did not cut it yet. The cord was still pulsing, a thick white rope threaded with blue and red veins. She watched it beat for 90 seconds until it stopped. Then she tied a second tie 1 inch from the first and cut between them with the scissors. The baby cried again, a high thin wail. Ashley put her on her chest, skin to skin, and felt the small mouth rooting against her nipple.
1 minute later, the second contraction came for Baby 2. Ashley was still squatting, the first baby crying against her thigh, the cut cord trailing from her vagina, a thin ribbon of blood and fluid following it. She shifted the first baby into the crook of her left arm and reached down with her right hand. She could feel Baby 2's head, already low, forced down by the weight of Baby 3 behind it. She pushed. The contraction lasted 70 seconds. She pushed 4 times during that contraction, each push a grunting, straining effort that turned her face red and made the veins stand out on her neck.
She pushed for only 4 minutes before the head crowned. Her perineum, already stretched by the first baby, tore with a sound like wet paper. She felt it rip from her vagina toward her anus, a second degree tear that bled hot and fast. The tear was 2 inches long and gaping, and she could see the raw pink muscle underneath the skin. She did not stop. She pushed through the pain and caught Baby 2's head, then the shoulders, then the body. Baby 2 slid out in a rush of blood and vernix, his cord wrapped once around his neck. Ashley unwrapped it with trembling fingers, 2 loops, careful not to pull too hard. He gasped and coughed and then screamed.
Baby 2 was a boy. 5 pounds 15 ounces. 18.5 inches long. He was smaller than his sister and came out furious, fists clenched, legs kicking, his face scrunched into a tight red mask of outrage. Ashley laid him next to his sister on the mat and tied his cord the same way, 2 inches, then 1 inch, then cut. Both babies were crying now, a duet of rage and cold and the shock of being born.
She had 30 seconds of stillness. Her body was shaking violently, a fine tremor that started in her thighs and spread to her arms and her jaw. Blood was running down her thighs and pooling on the mat, a dark red puddle about 6 inches across. She could see the tear in her perineum when she looked down, a ragged split about 2 inches long and half an inch deep. It hurt like a knife wound, a sharp specific pain that was different from the deep ache of the contractions. She pressed a towel against it and felt the blood soak through in 10 seconds. She pressed harder.
Baby 3 was still inside. The contractions had not stopped. They were coming every 90 seconds now, each one weaker than before because her uterus was exhausted, but still strong enough to make her grunt and bear down. She shifted onto her hands and knees because she could not stay squatting anymore, her legs were too weak, her thighs were on fire, her calf muscles had cramped twice. She lowered her head to the mat, arched her back, and pushed with everything left in her.
The third baby was the largest, 6 pounds 8 ounces, and his head jammed against her pelvic bone for 3 full contractions. Each contraction lasted 60 seconds. She pushed through all of them. On the first contraction, his head moved 0. She screamed into the mat, her fingernails scraping the rubber, leaving 4 shallow furrows. On the second contraction, his head moved a quarter inch. She felt the bone of her pubic symphysis grinding against the bone of his skull, a horrible friction that made her want to crawl out of her own skin. On the third contraction, she pushed so hard that blood vessels burst in her face, leaving a spray of red dots across her cheeks and around her eyes. On the fourth push of that third contraction, his head popped free of the bone and descended in a rush. Then his shoulders, then the rest of him slid onto the mat in a rush of blood and fluid and something else, a gush of dark old blood that meant her placenta was starting to separate.
Baby 3 was a boy. 6 pounds 8 ounces. 20 inches long. He was not crying. His body was limp and pale. Ashley grabbed him, wiped his face and mouth with a towel, rubbed his back hard with her knuckles, flicked the soles of his feet 6 times. Nothing. She bent his head back, opened his mouth, and sucked the fluid from his nose and throat with the bulb syringe. She did it again. On the third try, he gasped once, a wet ragged sound, then screamed, a high thin wail that made her laugh and sob at the same time. His color turned from gray to pink in less than 10 seconds. She tied his cord and cut it, then pulled all 3 babies onto her chest, all 3 of them squirming and crying and rooting.
She had birthed 3 babies in 47 minutes. Baby 1 at 7 hours 15 minutes. Baby 2 at 7 hours 20 minutes. Baby 3 at 8 hours 2 minutes. All head down. All unassisted. All alive.
She sat back against the wall, the 3 babies piled on a towel in her lap, their cords already cut and tied, their small bodies warm against her belly. The afterpains started 10 minutes later, mild compared to what came before, but still sharp enough to make her catch her breath. They were her uterus shrinking back down, the synthetic oxytocin still flooding her system. She waited for the placenta.
She pushed. Nothing. She waited 5 more minutes. Nothing. She pushed again, harder, bearing down like she was pushing for a fourth baby. A small gush of blood, but no placenta. She reached inside with 2 fingers, then 3, and felt the edge of the placenta, still firmly attached to the top of her uterus. She remembered her selection: "Placenta Delivery: Manual Required." She had chosen this. She wanted to pull it out herself.
Ashley took a deep breath. She inserted her whole hand, fingers together, sliding past her cervix, into the open cavity of her uterus. The sensation was indescribable, a deep pressure that made her nauseous. She found the edge of the placenta and peeled it away from the uterine wall, using her fingertips to separate the spongy tissue from the muscle beneath. It came away in pieces. She pulled out a handful of dark red tissue, then another, then another. Blood poured down her arm, hot and slick, dripping onto the mat. She kept going until she felt the inside of her uterus empty and smooth. Then she pulled her hand out, covered in blood to the wrist.
The placenta was in pieces on the mat, a pile of organ the size of 2 fists. She counted the lobes. There were 3, one for each baby, fused into a single disc. She laid it in an emesis basin and set it aside.
She cleaned the babies one by one, wiping the vernix from their skin, suctioning their noses and mouths again, checking their fingers and toes. All 3 had 10 fingers and 10 toes. All 3 had perfect silicone bodies, warm and soft and heavy. She wrapped them in separate towels and laid them in a row on the futon. Baby 1, the girl, was calm now, her eyes barely open. Baby 2, the smaller boy, was still fussing, his mouth making little o shapes. Baby 3, the largest boy, was asleep, exhausted from his difficult birth.
Ashley turned her attention to her own body. The tear in her perineum was still bleeding, a slow ooze rather than a gush. She cleaned it with the antiseptic spray, which made her hiss through her teeth, and pressed a clean towel against it. She would need stitches. She knew that. But for now, she just wanted to sit in the stillness.
The room began to power down. The soft gray walls flickered, the cave simulation dissolving into static, then into the real room with its white walls and fluorescent lights. The pill in her vagina had fully dissolved. Her belly shrank back to its normal flatness, inch by inch over the course of 5 minutes, until she looked like a 22 year old woman again instead of a mother of triplets. The tear in her perineum was real tissue damage, the VR system was that precise. The synthetic oxytocin had caused her real pelvic floor to stretch and tear. She would need 4 stitches from a real doctor later. But right now, she just held the 3 silicone babies, warm from the heating elements embedded in their cores, their tiny mechanical hearts ticking against her palms.
She pressed the call button. A staff member came in with a wheelchair and a glass of orange juice. Ashley was still crying, still shaking, still smiling. Her thighs were slick with blood and saline. The towel between her legs was soaked through. The 3 babies lay in a row on the futon, their towels now stained pink.
"How was it?" the staff member asked.
Ashley looked down at the three fake babies, their blank plastic faces, their soft weighted bodies, the tiny rise and fall of their synthetic chests. She thought about the 12 hours of labor. The 47 minutes of pushing. The feel of her own hand inside her uterus. The sound of the third baby's first breath.
"Perfect," she said. Her voice was hoarse. "Book me again for next month. Twins next time. 6 hours. Head down. Unassisted. And add shoulder dystocia training. I want to see if I can resolve it alone."
She handed over the babies, one by one, letting the staff member place them in a transport incubator. They would be cleaned, sterilized, and reprogrammed for the next client. Ashley let herself be wheeled to the recovery room, where she would drink her juice, eat a granola bar, and sign the waiver for her perineal repair at the clinic down the street.
As the door closed behind her, she was already planning her next birth.
