The ambulance took Jemma and me to the closest hospital, Hollywood Presbyterian Medical Center. There were thankfully no medical issues with Jemma’s birth — the biggest complication was actually clerical.

A perfectly professional hospital official visited me in the recovery room and passed along a packet: I was going to have to visit the county public health department on my own to register Jemma’s birth. Because she wasn’t born on the premises, Hollywood Presbyterian said it could not start my birth certificate; they couldn’t verify that I had actually given birth to Jemma. (The hospital adheres to Los Angeles County’s guidelines on out-of-hospital births, a spokeswoman later explained.)

If I had given birth in the hospital’s parking lot — as a woman a few months before had done — it would’ve been a different story, the official told me ruefully.

The California state health and safety code holds hospitals responsible for registering births at their facilities. Officially, the state says that if a physician or midwife does not attend the birth, the parents are responsible for registering their babies. But there is a modicum of discretion for hospitals in interpreting the law.

Even though I delivered the placenta at Hollywood Presbyterian and I was taken there by the people who assisted with the cutting of the cord, it is within the rights of a hospital to choose not to evaluate the nature of the evidence and send someone like me on to county public health to complete the paperwork, said Dr. Diana Ramos, director of reproductive health for Los Angeles County’s public health department.

“As obvious as it may seem, it’s up to the hospital to make the final call,” Ramos said. “They’re pushing it off to the legal realm.”

I wish I had had Jemma in the car in Chicago or New York. In Illinois, the state department of public health actually asks hospitals to assist parents by completing the birth record when babies arrive the way Jemma did. And in New York City, most hospitals will report a birth of this kind.