Notes: I am not well versed in Japanese culture, but it is my understanding that

1. "Aka-chan" translates to "little red one" and is apparently a way of referring to babies not yet named.

2. White is a color associated with welcoming new babies in Japan, much like American blue and pink.

3. Crying out during labor is considered shameful (even today!) and is just not done. In the normal course of things, anyway.

*WARNING: this chapter is graphic, and probably should be rated M, but I will not edit it down. You've been warned.*

What happens in this chapter is medically accurate, to the best of my knowledge but it is written from the perspective of someone that is not an expert. Expanded medical notes at the end of the chapter for the curious.

Thanks again to animanical, a wonderful beta reader!


...Crucible...

Kaoru, his wife, his home, his everything, was in labor. Megumi and Dr. Gensai were both there, and the two doctors had sequestered themselves in his bedroom, banishing him and everyone else from the room. They rest of them had all gathered in the main room and no one was sleeping. Kenshin was grateful that he did not wait alone, but Kaoru was in labor, she was in pain, and he was not allowed.

"It's alright, Kenshin, Jou-chan is strong," Sano's hand was warm on his shoulder, his voice uncharacteristically gentle. "...She'd never leave you."

"Yes." Yes, she'd never leave him on purpose, but Kenshin had learned young that fate was rarely kind. He swallowed against the dryness in his throat.

And so they waited.

Misao fell asleep first, propped in a corner and drooling a little. Yahiko lasted two more hours before he, too, began to snore on a cushion. Sano was the only other one awake, waiting, when they heard the quiet sound of a not-quite-muffled moan.

"...Shit." Sano said, and Kenshin was reminded of how young Sano really was. "I could use a drink. Ya want a drink, Kenshin?"

"No." Kenshin ran his fingers along the hem of his sleeve, the one that Kaoru had stitched for him that autumn. "No, Sano, this one does not desire a drink, that I do not."

Sano shifted, restless. "Alright, that's fine. We won't drink. We should do something, though." He shifted again. "What should we do?"

"...I don't know..." Kenshin had no reason to whisper, but did anyway.

They waited another three excruciating hours before Megumi appeared in the doorway. There was blood on her smock, and Kenshin's heart leapt into his throat. Her face was intense.

"Ken-san, we need you." Kenshin rocketed to his feet, and next to him Sano was tense enough to shatter. Megumi grasped his shoulder, her fingers tight. "I need you to be calm, Ken-san. Kaoru-san is… Kaoru-san is in pain, and she is afraid, and it is very dangerous right now. I need your help, and I need you to focus."

Kenshin nodded, wordless, unable to speak. Megumi led him briskly to his bedroom, giving instructions over her shoulder. "There is a problem, Ken-san. The baby needs to come out, now, and it is time to push. With a first baby, a woman may push for over an hour, but we don't have that kind of time." She turned to face him in front of the shoji. "Ken-san... there will be blood," she warned, and then she opened the door to a nightmare.

Kaoru was sweating and panting, and Dr. Gensai was helping her to her feet. Kami-sama, the blood! To Kenshin's horrified eyes it was everywhere: on the sheets, on Kaoru's robe, on Dr. Gensai and Megumi, on towels piled in the corner. Megumi pushed him into the room.

"Ken-san, stand behind her, here," Megumi guided him into place as though he were a puppet. "Hold her here, under her breasts, over her belly. Kaoru-san," and Megumi's voice was more gentle than he'd ever heard it, "Kaoru-san, you bear down when I say, push against Ken-san's arms. It's time to meet your baby, now." Megumi knelt at Kaoru's feet, hands on her belly, and began to coach his wife.

Kaoru's first push was accompanied by another moan, and Kenshin was transported into hell. His heart raced as he held his wife upright and close to his chest, balancing her while she strained. His whole world was in this room: sweat and agony and blood and suffering and red.

He turned his face into her neck and held her. Megumi had wanted him to soothe Kaoru's fears, but he couldn't, and the words spilling from him were something else entirely.

"Fight," he whispered into her neck. "Fight it, Kaoru, please. Win. Stay with me."

She moaned. Blood dripped onto the floor, splattering against his feet.

"Again!" Megumi's voice was sharp. "Keep going, again!"

Kaoru moaned and pushed and she kept on, over and over, and it lasted an eternity. They were standing in a crimson puddle, now.

"Please, Kaoru. I love you. Fight it. Please."

Kaoru moaned and Kenshin sobbed, holding her tight as she worked to bring forth their child. There was blood everywhere, and Kami-sama how could she survive this?

Kaoru suddenly went limp for a moment and Kenshin almost stumbled. Through the ringing in his ears, he heard a baby's cries.

"Good!" Megumi praised. "You've done well, Kaoru-san. We're almost done."

"...I'm so tired..." She was gasping, going limp, her weight almost completely in Kenshin's arms.

"No!" Megumi's voice was sharp. "It's not over. You must deliver the afterbirth, Kaoru-san. You must. Now, push again."

And Kaoru found the strength, somewhere, to push again and although there was no moaning, there was still blood, flowing down her legs, a never ending river of red. Kenshin could feel it on their clothes and terror clawed at his belly.

"There now," Megumi put aside a dish full of blood and flesh. "We'll put her down now, Ken-san." And Megumi moved, quickly guiding them to the futon; Dr. Gensai must have changed the oilcloth and sheets, because it was a clean island in a bloody ocean. "Ken-san, sit here, against the wall, and hold her her upright."

He quickly settled them both, and Dr. Gensai was immediately upon them, kneeling between Kaoru's legs as he ground a fist into her belly, as if they were mortal and pestle.

Megumi knelt at their side, holding an armful of white blankets. "It's time to nurse." She took Kenshin's arm, draping it across his wife, under her breast. "Ken-san, help her hold the baby." And just like that, Megumi placed a little white bundle on Kenshin's arm – the world blurred, and he couldn't see anything but the black of Kaoru's hair and the white of the blanket. Megumi reached over, tugging at Kaoru's clothes, moving the baby-bundle, forming Kenshin's hand around..around the baby's head.

Dr. Gensai sat back and sighed, "It's done. Kamiya-san, Kaoru-chan, it's over now. I'll tell the others the happy news. Kamiya-san, congratulations on your healthy son." He stood, bowed, and left quietly. And Kenshin didn't, couldn't, understand.

Megumi touched his shoulder. "It was a hard birth, but the danger has mostly passed."

"But the blood..."

"You've suffered severe blood loss yourself, Ken-san. Kaoru-san will recover: with rest, good food, abdominal massage, lots of nursing Aka-chan," and she nodded towards the bundle with a small smile. "And for the next few days, sitting up against the wall."

Kaoru was already asleep, but their baby was not. Kenshin's traumatized gauze fell upon their son, his son, nursing. Megumi was still there, moving about the room, cleaning the blood, but Kenshin's world crystallized to the two lives he held in his arms.

The baby was so small, so incredibly tiny, and Kenshin realized that he had never touched a baby so new. The little boy's features were a little smushed, his miniature nose a little upturned. The tuft of hair on his head was red, and his eyes were closed. His tiny lips were sealed around Kaoru's breast, his mouth working rhythmically. Kaoru was warm in his arms, and his son was eating breakfast. Kenshin forced words past his aching throat.

"Megumi-dono, please, what happened?" He couldn't explain why, but he needed to know. He had to know exactly what had happened, why he had almost lost his wife. She sighed, and paused where she knelt cleaning the floor.

"It was the afterbirth, the placenta. It lay too low, too close to the opening of her body. As the baby pressed down, she bled. It was the cause of the bleeding these last few weeks. I was afraid that this might happen, but I had hoped..." She shook her head. "It was merely chance, Ken-san. Unfortunate and unusual in a first-time mother, but not unknown. Kaoru-san did well with her pushing, and standing helped to pull the baby from her. And you lending your strength helped, as well." She looked up, held his gaze. "She will recover, and this does not mean that she cannot bear another child. The next baby will be easier."

Kenshin breathed in sharply, and turned his face into Kaoru's hair. Never, he thought. I will never risk her like this again.

Megumi stood. "Is Aka-chan done nursing yet?" Kenshin looked up, and the baby's mouth had indeed stopped working but the little lips still were still in place, quivering.

"...This one is unsure..."

Megumi looked, and smiled. "Ah, yes, he's done. He's just playing with his food, now." Gently, she removed the baby and fixed Kaoru's robe, placing the boy in the basket that Kenshin had finished weeks ago, a lifetime ago. "I'll let the others come in and meet the newest Kamiya, yes?"

His family came in, quietly gathered around, and greeted the new baby. They smiled and cooed and passed him from warm arms to warm arms. They came over to the Kenshin-and-Kaoru island against the bedroom wall, offering gentle words and reassuring hands, and Kenshin knew that he needn't apologize for his inability to speak with them.

Morning came, and no one left, napping in Kenshin's bedroom instead of going to their own. Supportive and comforting, they brought tea and breakfast. They chatted quietly and demanded nothing. And Kenshin sat, holding his wife, silently chanting wordless prayers.

Kaoru woke a few hours later, when it was time to feed the baby again. Megumi stayed to coach Kaoru on the finer points of breastfeeding, while the others stepped out to give them some privacy. Kenshin's heart ached when it was obvious that she was too weak to bring the baby to breast by herself. He held the baby for her, and Kaoru cried when she saw the baby's hair.

"Kenshin, he's so perfect." Even her voice was weak. "Look at his perfect hair!" She leaned her head against Kenshin's neck. "We'll have trouble with the girls around this little boy, just wait." And Kenshin was silent, because he still couldn't speak past the stone in his throat. "Kenshin? Kenshin, I worked very hard to give you a son. Please look at him."

Kenshin blinked away the blurry edges of the world and looked. "...He has your eye color, Kaoru-dono." Kaoru smiled, already drowsy.

"And everything else is yours, Kenshin. He looks just like his father." Her breathing was slowing into sleep. "I have the two most beautiful men in Japan." Kenshin looked at the baby again, and felt the painful ice in his chest begin to thaw.

.

.

.

Days passed and Kaoru slept most of the time away, but no fever developed and she woke to eat, and nurse, and once or twice just to talk with Kenshin in the quiet of night. The baby also slept, and Megumi assured him that was normal, that the baby would be awake more often as time passed, and that he was healthy and well. He did have a tendency to wake and cry and refuse to be comforted for about an hour each day just before dawn, and a yawning Megumi assured him that this, too, was normal.

Today, Kenshin was making breakfast, as he had walked with the baby again this morning and was unable to sleep after he had laid the nameless little boy in his basket next to his drowsing mother. He smiled as he made the breakfast soup, and felt none of the fear that had been his constant companion. The familiar routine felt good, like stretching unused muscles.

"Yo, Kenshin, smells good." Sano slouched in, leaning against the door. "Jou-chan and Aka-chan sleepin'?"

"Aa."

"We gonna do the naming ceremony tonight?"

"Oro?" Kenshin blinked, then quickly counted backwards and winced.

"This one does not have the right foods! Sano-"

"Yeah, yeah, I'm on it."

.

.

.

They ate dinner in Kenshin's bedroom, with a restrained but happy atmosphere, as Kaoru was not yet ready to be moved. With all due ceremony, Kenshin had written (in his very best writing, really) Kenji's name on the lovely white paper. The baby was unimpressed and slept through the entire thing. Kaoru sat up and smiled at them for almost an hour before her pale face had become paler, and the party had adjourned to the main room. Kenshin remained behind, tucking the blankets around his wife.

"Kenshin," she grasped his hand. "Thank you for the party."

He leaned over her and kissed her colorless lips. "...Thank you for staying with me."

.


Alright, medical notes, after not before, because I didn't want to lessen the emotional impact of what Kenshin experienced.

The name of this condition is Placenta Previa, and it can range from quite mild to a complete occlusion of the birth canal. The condition is hallmarked by painless bleeding in the third trimester. Treatment is mostly bedrest, and in modern times preparation for a possible C-section. The condition is self-limiting, because after the birth is over, no more placenta means no more danger.

The after care for a birth like this would be as described. Bleeding after delivery is a universal fact, but Kaoru doesn't have much to spare, so they would need to act quickly to stop the flow. Firmly massaging the belly massages the uterus which causes contraction, keeping after birth bleeding to a minimum. Nursing an infant does much the same thing.

The sitting up thing is not practiced in modern western medicine, but my sources state that this was common in traditional Asian practice. In China, many women still call postpartum recovery "sitting the month," although I don't believe that they actually SIT for it anymore. It does have some merit, perhaps, in that it might have prevented any blood pooling in the uterus.

/ Sites . Google site / japanesechildbirth /

In the 1800s, birth was dangerous. No hospitals, no blood transfusions. Very high infection rates, and astronomical infant mortality.

There's a reason that hardly anyone in anime has a living mother.