THE SCORE.

At 5 A.M. on a cool Boston morning not long ago, Elizabeth Rourke--thick black-brown hair, pale Irish skin, and forty-one weeks pregnant--reached over and woke her husband, Chris.

"I'm having contractions," she said.

"Are you sure?" he asked.

"I'm sure."

She was a week past her due date, and the pain was deep and viselike, nothing like the occasional spasms she'd been feeling. It seemed to come out of her lower back and wrap around and seize her whole abdomen. The first spasm woke her out of a sound sleep. Then came a second. And a third.

She was carrying their first child. So far, the pregnancy had gone well, aside from the exhaustion and nausea of the first trimester, when all she felt like doing was lying on the couch watching "Law & Order" reruns ("I can't look at Sam Waterston anymore without feeling kind of ill," she says). An internist who had just finished her residency, she had landed a job at Massachusetts General Hospital a few months before and had managed to work until this day. Rourke and her husband sat up in bed, timing the contractions by the clock on the bedside table. They were seven minutes apart, and they stayed that way for a while.

Rourke called her obstetrician's office at eight-thirty in the morning, when the phones were turned on, but she knew what the people there were going to say: Don't come to the hospital until the contractions are five minutes apart and last at least a minute. "You take the childbirth class, and they drill it into you a million times," she says. "The whole point of childbirth classes, as far as I could tell, is to make sure you keep your butt out of the hospital until you're really in labor."