The Last Chapter
- A Story of Fertility and Loss
The Last Chapter
A few years ago, my girlfriends and I decided over Mexican food to write a book about being pregnant. It would be hilarious! All the things you didn’t know but you wished someone had told you. We were all on the verge of starting families. We all had a baby, some more than one. We even wrote a few chapters (the best being Chapter 3 – How do You Spell Episiotomy?). And they were hilarious.
We laughed. And then.
Of all the things I didn’t know about pregnancy, this one hit (hits) the hardest. I didn’t know how hard it could be for two responsible, financially stable, willing adults, with good jobs and a home, the means to provide, and more love to give than you can measure, to get pregnant, carry, and deliver a healthy baby.
This is the last chapter of our book on pregnancy. It is my story but it could be the story of so many other women and men who want, want, want, need – but can’t.
The Sound of Silence
October 2017. ‘We call it a Chemical Pregnancy. A Silent Miscarriage. Really – it’s the most common type of miscarriage and most women don’t even know they conceived. You might notice your flow is a little heavier. Maybe a little cramping.’ My family doctor doesn’t look up from his keyboard where he is pecking away. ‘I blame these high sensitivity pregnancy tests. Really. Testing five days before your missed period? Your body hasn’t had time to consider whether it actually wants to be pregnant at that stage.’ He huffs, and looks up. I am silent. He says my name in a way that lets me know he is exasperated with me. ‘You were only trying for a month. This is nothing to be this upset over. It might even have been a false positive, in which case - you are upset over nothing. You will get pregnant. You have one healthy child. You can have another.’
I nod. I thank him. I leave. I vow never to speak to or see him again.
A silent miscarriage. Most women don’t know. Well I did know. And it felt pretty fucking loud to me.
(You were real. We got excited. We talked about new cars, and where your room would be, and the trips we could take on my mat leave. You were real. Finding out you were not coming was a hard punch.)
The Christmas Present
It is easy to get lost in yourself when you want to become pregnant but can’t. The time between cycles drags. Pregnant women surround you like a mean taunting gang of high school girls. Your Instagram and Facebook pages become celebrations of the life you want but fear you will never have. Conversations with friends become difficult. The worst is the well-intentioned advice on how to fix things. Or the inadvertent ignorant comments from people who don’t know your circumstances. You smile. You nod.
You feel more than anything so fucking alone.
You are not.
Mid November, I was pregnant. We went for the heartbeat check and I watched the little flutter. We told our parents at Christmas – early yes, but hell we had a heartbeat! The chances of a miscarriage after seeing a heartbeat drops to around 5%. I rang in the New Year with my head hanging over a toilet bowl. By the end of January, my pants were getting tight and my belly was starting to show, much sooner than it had with my son. I started making plans to turn the guest bedroom upstairs into the new nursery. I unpacked all my old maternity clothes and felt a giddy sense of excitement hanging them up in my closet. My husband insisted it was another boy. We texted potential names to each other. I was beginning my second trimester, close to the fourth month mark. I was happy.
I was unprepared.
‘You need to speak to your doctor about this exam’. The ultrasound tech, an older man with a heavy accent, stared down at me. ‘What’s wrong?’ I ask. He refuses to discuss. I demand to see the baby. He refuses at first. I cause a scene. He shows me, reluctantly, and I see…. two perfect arms, and two perfect legs and they are kicking and dancing and what the fuck could possibly be wrong? He would not let me see any more than that.
We are sitting in my OBs waiting room. We had to wait two days before we could get in to see her. It was an eternity of worry. When I checked in, I reached for the pee strips they make you do before every appointment. The receptionist stopped me. ‘That won’t be needed.’ My blood ran cold. It was bad. It was very bad. My husband is on his phone. I wonder if I should warn him. I say nothing.
It was indeed very bad. ‘Edwards’ syndrome. Trisomy 18. Your baby’s syndrome is very severe. Most babies with this syndrome don’t present on an ultrasound until closer to 20 weeks. Your baby will almost certainly not live to term. If your baby lives to term, your baby will almost certainly die within a very short period of birth.’ (I might almost certainly die of a broken heart right here in your fucking office.)
We leave the office by the back entrance. I stumble walking to the car. (Keep going, one foot after another.)
We wait days for the Genetic Department of Mount Sinai to call us to discuss next steps. (First, your baby will die. Second – nope, sorry, that is the only step.)
I walk a lot. It is February; it is freezing. I sit by the lake in High Park. One day I come home to an empty house and scream, just fucking SCREAM, at the top of my lungs, over and over, until my throat is hoarse. I feel better after that for a short while.
The Amnio and the Mobile
Tests. Blood work. ‘Confirming the diagnoses’. Prolonging the inevitable.
I am lying on my back in the amniocentesis department of Mount Sinai. I have two gowns on and mesh bags over my feet. My husband sits next to me. I’m trying not to be afraid. ‘Let’s start with the ultrasound to see where baby is positioning, before we begin the insertion phase to draw the fluid.’ Sure. Sounds great. I stare upwards as the warm gel is smeared across my belly. Someone has placed a mobile directly above the ultrasound table. Butterflies dance above my head. I want to laugh at the lunacy of this – no woman lays on this table for a happy reason. I’m so focused on marveling at the insensitivity of the fucking mobile that I almost don’t hear my husband speak. His voice is small. Choppy. ‘It sure looks different than with….’ Our son. Yes. It does. I realize he is crying. My sweet, strong, stoic husband is crying. He takes my hand, says my name. ‘Look at me’, he says. ‘I don’t see a heartbeat. I don’t think there is a heartbeat.’ I nod. I see only him, his face, his eyes. I keep nodding. The spell breaks. I turn to the doctor. ‘I’m so sorry,’ she begins.
Wailing. There is wailing (its me, its me) and there are hands, hands, all over my legs, arms. I can’t think. I need to see the baby…. And there, on the screen, there…. Slumped in the corner of my uterus, a little body, with two perfect arms and two perfect legs, no longer kicking, no longer dancing, just still, quiet, gone. (I didn’t know. I didn’t feel it. I should have known. A good mother would have felt it.)
My husband helps me walk out of the room to clean up. My legs are shaking. I’m crying. The other couples in the waiting room stare at me, horrified. In the bathroom I get changed. I’m overcome by anger, rage, shaking me to my core. I want to smash something. I pound at the soap dispenser. There is nothing else to hit. I turn on the taps and start tossing handfuls of water at the mirror, blurring my reflection. It is petty destruction. I soak the room. When I leave the bathroom, the waiting room is empty. The other couples have moved away. I understand. I am what they fear. I might be catching.
At home, I stare at my belly in the mirror until I can’t, I just can’t, look at it anymore. I avoid the mirrors after that.
My husband was right. It was a boy. My son. Our son. I lay on the floor of the guest bedroom and cry. I hold my belly and whisper to my child. (Please can you hear me? I can’t bear the thought that you died alone, in my womb. I was here. I was always right here. I have loved you from the second I knew you existed. I’m still here.) I close the door when I leave. It will be months before I go back into that room.
The Therapeutic Abortion
Almost Valentine’s Day. Almost two weeks after we first found out there was a problem. I’m being buzzed through the first of two security doors at the Morgentaler Clinic for Women. I am here to have a D&C to surgically remove the ‘product of conception’. I grimace at the jargon. Up until they found my son had passed, the doctors called him ‘the baby’. After – the ‘product of conception’.
I fill out intake forms. I’m asked if I am sure I want to have this abortion. I write ‘The Baby Died’ at the end in the ‘More information’ section. I wonder if they got the hospital’s referral. They did; everyone fills out the same forms. My forms go in a gray folder marked “Genetics”.
My husband is not allowed to go in with me. They give me an Ativan to calm my nerves. I change into my nightgown. I’m in a waiting room with other women. I wrap myself in a blanket. I close my eyes.
The doctor talks to me before the procedure. If I had been able to have the procedure at the hospital, I would have received medicine the day before to soften my cervix because of how far along I am (was), so it would be easier and hurt less when the cervix is pried open. But the hospital was backlogged. At the abortion clinics, everything is done same day. I would have to hold pills in my cheeks for an hour and a half to soften my cervix. I’m one day shy of 15 weeks. At 15 weeks, they have to give patients the pills. It’s a bright line. I can choose not to get them at 14 weeks 6 days. The doctor has dark eyes, kind, tired. ‘You have been though a lot. You can handle the pain.’ I opt not to get the pills. I just want to get the fuck out of there.
I’m on the table. There is an ultrasound screen, so a nurse can guide the doctor. There is a second nurse to hand him equipment. The first nurse is also there to help me with the laughing gas. He begins. (I’m sorry, I’m sorry, I’m sorry.) And. Pain. I feel like I am being ripped apart. My nurse slaps the mask on my face and orders me to breathe deep. The other leans over to hold my legs down. (Forgive them all, they were trying to be kind. They are soldiers in a difficult and necessary war) My head is swimming. I can’t focus on the room. The machine sounds like a vacuum, like an industrial version of a car cleaner. And. I see on the screen my baby. I blink. He is gone. Bile wells up. It is over.
The nurses help me to recovery. I’m horrified and trying to process what I saw on the screen. ‘How could you let me see that?’ I sob at them. They keep telling me it will be ok. How sad they are for me. I am not grateful. I try to spit on one. I just dribble down my chin. They barrel me into a chair. It looks like a salon chair. It’s one of many, arranged in a large circle. Like a nail salon. There are crackers. I pick up the bowl and throw it. I am a petulant drugged child. They draw the curtain around me so I don’t disrupt the other patients. After a while, one of the nurses tells me my blood pressure has returned to normal range. I wobble to the change room, get back into my clothes, stuff a pad into my underpants, and stagger out to find my husband to take me home.
That evening, I am seized by a powerful cramp. My uterus is contracting, trying to return to normal size. Something about the contraction, the unfairness of it, the unfairness of everything, of having a contraction with no baby, of having only the product of conception somewhere in some medical grade box being shipped to a fucking lab for an autopsy, just breaks me. (I am broken. I will never be not broken.)
In my aftercare package, there is a letter to give to my doctor for my follow up care appointment. It reads: ‘Dear Health Care Practitioner. Your patient has had a therapeutic abortion.” I laugh out loud. To a follow up feedback email, I write “Consider calling it something other than a ‘therapeutic abortion’. It isn’t a fucking spa”. I don’t send it. I laugh again. It is not a good kind of laugh.
My 18 month old pats my cheek. ‘Mommy sad. Mommy you ok? Hug mummy.’
Yes, mommy is sad. Yes, mommy is ok. After a few days I can move around more freely. My sister comes. She smells like the ocean. She feels like home. When she leaves, I decide to go back to work. Even broken people need to move forward.
A Bathroom in St. Joe’s
We keep trying.
It’s the end of April. I’m almost 7 weeks pregnant. I’m standing outside my OBs building. Panic wells in my throat. I feel sick. I have to pee. I’m five minutes late for my ultrasound. Heartbeat check. Milestone #1.
I swore I would never come back to this fucking place. What am I doing here? I should have insisted on another ultrasound lab.
After day 2 of a hangover, I decided I had the flu or …… Damn. I called the OB. Blood tests. Check. Game plan set – ultrasound after 6 weeks to confirm a heartbeat. Genetic test at 9 weeks to clear that hurdle. And then we would all live happily ever after.
I should have gone to another lab. This fucking place is cursed. I’m in the waiting room now. Sweating. My name is called. Its Him. Are. You. Fucking. Kidding. Me. He acts like he doesn’t remember me. I stare daggers at him. The rage I feel at seeing him is a nice distraction. (It’s not his fault, it’s no one’s fault)
There is no heartbeat. The baby is measuring a few days behind expected schedule. ‘There are many reasons, do not be worried, we will try again in two weeks’. I leave the clinic. I knew it. This fucking place is cursed.
I feel bleary. Heavy. I will not cry. I will be positive. It is going to be fine, in two weeks. (Either that or the baby is dying. Shut up, shut up, shut up.)
May 1. Instagram is a sea of Justin Timberlake. It’s gonna be MAY. I’m almost 8 weeks. Close to safety. (Hang in there.) The next night, I feel it. A twinge. An overwhelming sense of wrong. I go to bed immediately after putting down my son. If I lay perfectly still, it will pass. I can will this to pass. (Don’t leave me, don’t leave me, don’t leave me.)
I wake at dawn. Nothing. I’m ok. It’s ok. I’ve beaten it, I think. The bleeding starts an hour later.
The doctor’s office is neutral: It could be normal. Many women bleed in first trimester! Try not to exert yourself. Take a personal day. If you start passing clots, or feeling cramps, go to the emergency room.
I spend most of the day watching Netflix, laying still. Mantra on repeat: Don’t leave me, don’t leave me. By that evening, the bleeding increases. Clots. A hot dull pain starts to spread across my back. (Is this what they mean by cramps? I didn’t know it would be like this.) I start to tell my husband we need to go to the hospital. And then I think – fuck it. No. One. Can. Help. Right. Now.
I sleep. Try.
In the morning, the pain has magnified. Hot waves across my lower back. I recognize this pain. May 2016. Early labour with my son. Early contractions, before the big ones started. Its gonna be MAY. I go to St. Joe’s emergency room. I tell my husband to go to work. ‘Call you when I know anything.’ I already know it’s done.
The emergency room is hot, busy, loud. I can’t sit. I pace, rubbing my back. I am hit by waves of tightness, pain, followed by a gush of blood. I keep changing my pad. I wait. And then,
heat across my back. Pain, stronger than ever. I rush to the bathroom. I sit. I’m panicking. Pressure on my stomach, back – I’m straining, not sure where things will exit. Everything contracts. (I’m pushing. Am I pushing? I need to fucking PUSH)
And then relief. Gush. Plop. Relief.
I’m crying, sobbing, ugly fucking hiccup sobs, because I know, I just know…. I stand and look. At my baby in the toilet. (It’s not a baby yet, it’s just cells, and tissue and blood, a little red celled gummy bear…it doesn’t even have arms and legs so it’s not a baby yet… except it is and it isn’t and oh my god just stop crying people can hear you..)
Except. Except I can see. Except I know. The pressure is less. The pain is dull again. I think about calling my husband. I don’t. I just stand, hunched over, hands on the rim, and stare. And cry. Cry until I can’t breathe. Breathe. Be numb. And then, quietly, finally quiet, I wash my thighs, wash my face, wash my hands. And flush the toilet (goodbye, goodbye, I love you, I love you). I close the bathroom door behind me quietly and go and wait for the emergency room doctor to call my name.
The Birthday Party
We keep trying.
It’s June 30, a sunny Saturday afternoon. We are in the car, heading to a birthday party for my friend’s one year old.
I’m pregnant again. I’m bleeding again. Not a lot. Just enough. (Please stay, please. I love you.)
This time it’s early. (Is that better? Its better. I’m sorry.) Just over four weeks. We had only just found out. The following week, my blood work would confirm the pregnancy. It would also confirm the pregnancy hormone levels were too low, and declining. It would not be viable. But there would be no pain this time, just a heavy red tide of death. (A Silent Miscarriage. I’m fucking SCREAMING inside.)
At the party, I pretend I am a doll. I smile. My pretend dimples show. ‘Work is great. Busy. Yes, amazing weather.’ (I’m bleeding, I’m bleeding, I’m losing another one.) I see my dear friend who is over eight months pregnant. ‘How are you feeling?’ I ask her, because I care, I really do, and ‘You look amazing!’ I tell her, because she does, she truly does. (I’m bleeding, I’m bleeding, I’m losing another one.) ‘Not drinking eh?’ says another friend, eyeing my water glass knowingly. ‘Designated driver’ I reply, smiling. She smiles back, as if we share a secret. Nope. Sorry. Wrong. (There is still hope, don’t give up.)
Mostly I try not to talk to other adults. I keep busy with the kids. My wonderful son. My friends’ wonderful children. The birthday girl. At some point during the party, I excuse myself and sneak out the front door and go and sit in my car with the air conditioning on full blast and just cry.
It’s Canada Day. My girlfriend and I are at Massey Hall. We are laughing. (Is it ok to laugh? Fuck it. It feels GOOD to laugh.) My stomach hurts in that good way after a really funny joke. At the end of the concert I clap and cheer and whistle. I decide in that moment that I’m alive. I am lucky. My son is happy and healthy. My husband is happy and healthy. For the first time in a long time, I am overcome by the feeling that it will all be ok.
Over the next few weeks, I stop holding it all in. I randomly tell people. I need to tell people. I can no longer do this alone.
I tell my husband I think we are under a curse. He laughs at me. He tells me we can do a rain dance with our son to clear the evil vibes out of our house. The next day I put Uptown Funk on at top volume and my son and I run and jump and dance and yell. The walls shake. We laugh.
I open the door to the guest room. (It’s not a nursery, it’s not a tomb, it’s a guest room.) I open the window. I change the sheets on the guest bed. I lay it in for a little while.
I visit with family. I lean on them. No – I throw myself at their feet and beg that they pick me up. They do. I grow stronger.
I try to forgive myself. You cannot simply love something into being, any more than you could wish a life to blossom. This is not my fault. It is not something I did. It is not something either my husband or I deserve. It simply is.
I try to stop feeling ashamed.
I try to forgive my body. My perfectly flawed and aching body, with its raging hormones, its mood swings, and its practically manic highs and lows. My hair that has thickened and then fallen out and then turned gray. My stomach, hips, thighs, each of which that have widened, drooped, dimpled, than slimmed with each passing, then widened again. My eyes, sometimes dull and sad. The fine lines around them, around my mouth. (Forget it all. It was worth it. The toll of trying. It will always be worth it.)
I say goodbye. I tell my babies I love them. I do. I always will. They are me and I am they. I will carry them with me always. But. I also have to let them go. On the east coast, I whisper words into the ocean. I tell the ocean to watch over them, tell the sun to keep them warm. On the Mira River, I swim out, alone, and say each of their names, aloud, so that the waves can carry them away. I sit on a dock with my brother until 3 am and we let each of them drift off into the fog.
I leave pieces of their souls in the places that I grew up, the places I love. They will be safe there.
I choose a day to remember them. August 16. Our son’s due date.
(I will never kiss your face, your hands, your toes, your belly. But I will be your voice. I will tell of your life, however fleeting. Your brother will know of you. My family and friends will know of you. And in doing so, you will always be loved.)
We will keep trying.
I end this chapter here. I hope for me, my husband, and for all of the people out there who are struggling with fertility issues, who have lost babies, who are losing themselves – I hope there is a happy ending. But this is life. And life is not fair or kind. Life can be cruel and wonderful and without reason. I can only wait and see.
Note from The WOMB: If you are struggling, in anyway, in anyhow, we are here to support, love and lift you up. Make an appointment with our counselling team today and/or connect with other families who have experienced loss in our Healing Circle for Pregnancy and Infant Loss.