“I never said you were the villain.” She sighs, finally meeting my eyes. She looks older, tired. I blink and her lovely face is transformed back to the baby-faced toddler she once was, all red curls and rosy cheeks. A daughter is always a daughter, no matter her age. “I just wanted to make sure you were okay.”
I bite my lip, unsure if I should reach my hand across the table and take hers in my own. If she were Claire, I wouldn’t hesitate. Instead, I run my fingers through my graying hair. “I’m okay,” I assure her, nodding my head. My glasses slip to the edge of my nose, and I nudge them back with my knuckle. “I’m better now that I’ve seen you.”
Cassidy smiles sadly. I know better than to wait for any tears to fall. Tough as nails, she hardly ever cries. She didn’t even shed a tear when she broke her arm falling off some wild pony when she was nine. This trait she inherited from her father, which makes me smile.
“Me too,” she whispers, taking a sip of her cooling tea. It’s possible she’s just saying it to make me feel better, but I hope there’s some truth to it.
We sit quietly, enjoying a rare moment of contentment. The silence is broken by the slap of the screen side door leading into the house from the patio. The familiar tap-tap of Jack’s boots, heel first, then toe, two times on either side, fills the house. He lumbers down the hall toward us, his sizable frame too tall for the low ceilings of the old farmhouse, a house constructed in a different era and made for smaller people.
“How’re my gals?” he says, his booming voice warming up the kitchen. Catching my watery eyes, he winks, and my heart melts. “How about some eggs?” he asks, opening the fridge and taking out the ingredients for his famous scramble before either of us can answer. According to Jack, a hearty breakfast can fix just about anything.
Setting the carton down, he kisses Cassidy on the cheek. “Cassie-girl, that baby boy of yours is up in heaven now,” he whispers. Cassidy leans her head against his side. “He’s gone, but he’s still in here,” he says, tapping his chest once. He stands and takes the eggs to the counter and starts cracking them over the trash.
In the old days, I was jealous of how Jack always knew what to say. Not anymore. After thirty-five years of marriage, I’ve learned it’s okay to let the other pick up the slack when we’re lacking. Another woman might’ve learned this sooner, but I’ve never been a quick study. All that matters now is that Cassidy came home and is leaving here feeling just a little bit better than fine.
♦ 24 ♦
CASSIDY
After
August 15
ZIPPERING UP MY PREPREGNANCY jeans, now loose around the waist, I hurry to escape the harsh fluorescent lighting of the exam room. According to the scale, I’ve shed twice the number of pounds I gained during my brief pregnancy. Under different circumstances, this unexpected weight loss would thrill me. Now, I just wish for a belt. Satisfied I’ve left nothing behind, I make my way down the long hallway toward Dr. Julian’s office, where both Owen and the maternal-fetal medicine doctor are waiting.
Before sitting, I peck a kiss on Owen’s cheek. He’s sitting ramrod straight, his hands folded at his knee, long legs twisted awkwardly to fit between the chair and desk. I’m reminded of a schoolboy waiting to be reprimanded by the principal. Dr Julian sits across from us with a pen in hand, my file open before her. Smiling, she glances quickly at the clock. Since she’s one of the best fetal medicine specialists in the area, I’ve no doubt her time is extremely valuable. We’re lucky to have gotten an appointment on such brief notice.
“So, your exam looked good,” Dr. Julian begins, skipping straight to the point. From the start, I’ve appreciated her direct approach. Nothing worse than a chatty OB/GYN insisting on small talk while staring into your nether regions. “Your regular OB sent over all your files, and after looking them over, I’ve no reason to think you’d be a high-risk patient except for the miscarriage itself,” she says, flipping to a new page. It’s difficult to see what she’s staring at when the words are upside-down, but it looks like my hospital discharge papers.
“An autopsy of the fetus was performed, but there were no conclusive findings suggesting a genetic deformity,” she says. Owen squeezes my hand but keeps his focus on the doctor, his face pale and tightly drawn. “Combined with the previous genetic screenings also coming back negative, it’s unlikely the miscarriage stemmed from one of the typical anomalies.”
My chest tightens at the implication of this statement. Owen looks back and forth between us, unsure what to make of the words. Slipping my shaky hand from his grasp, I lean forward in my chair.
“So, you’re saying I’m the problem?” I ask, voice trembling despite my best effort to remain calm. For months I’ve held on to hope that there’s a reasonable and natural explanation for why my son didn’t survive, one involving a genetic abnormality that made my baby unsuitable for life. The alternative has plagued me with shame and guilt, haunting my dreams. It sits on the periphery of my everyday thoughts, mocking me, accusing me. If it wasn’t the baby, it’s me.
Dr. Julian shakes her head. “From my exam, I don’t see any reason to suspect you’re the problem. More to the point, you did nothing to cause this miscarriage.” Her eyes are kind and sympathetic, her voice confident. I’ve no doubt she’s said these same words over and over to grieving mothers. “Up until the loss, everything showed you were a completely healthy pregnant woman that did everything right. Unfortunately, these things just happen sometimes,” she says, echoing the same thing my sister and so many others have told me. Usually I’d take comfort in an expert reassuring me, but I’m still unsatisfied. I want a rational explanation based on factual, hard data. Some cause that produced such a catastrophic effect.
Biting back tears, I let Owen place a protective arm around my shoulder, resisting my initial urge to shrug him away. “There has to be a reason. It was a second-trimester loss,” I say. Hours’ worth of research races through my desperate mind. “These aren’t common. There has to be an explanation.” A foolish part of me wishes the doctor would just make something up. How can I figure out the solution when I’m not even sure what the problem is?
Dr. Julian closes my file and clasps her long fingers together. I imagine those hands catching babies, screaming with life. Her wedding ring glimmers in the light. I always take my own ring off at work, afraid of losing it at a barn. I wonder if she wears hers while delivering babies.
“You’re not wrong,” she says, carefully measuring her words. I sense a slight midwestern twang and note a diploma from Northwestern University hanging proudly on the wall behind her head. Boston accents are so prevalent here that outsiders stick out like sore thumbs. “Second-term losses aren’t as frequent as first, but far more common than you’d think,” she says, stating a fact I’ve come across in my own studies. “You were referred to me since after a late-term loss your subsequent pregnancies will be labeled as high risk and monitored more closely than your first, especially since we don’t have a concrete diagnosis for why you miscarried.” Her sensible explanation and plan offer me a slight sense of relief. She’s here to help, and when we decide to have another baby, she will help keep him safe, despite the risks.
“Is it okay to try again?” I ask, careful not to look at Owen. Since the loss we haven’t talked about another baby. Every time I want to bring it up, I stop myself, ashamed to even think of another child while still mourning the first. Of course, we both want to try again. I’m just unsure of the proper timeline.
“Is it safe for Cassidy?” he asks, his voice deep and startling, surprising both the doctor and me. Until now, he’s been the silent and supportive partner. “It seems soon,” he adds. “Is her body ready?” Uncertainty clouds his voice and worry furrows his brow.
“I’ve already gotten my period,” I add, but am quickly interrupted by Dr. Julian.
“Listen,” she says, laying her palms flat on the desk in front of her. “I’ve helped a lot of couples through some pretty tough tim
es.” Looking from Owen to me, she continues. “You’re young and healthy and your body is physically healed. Our hearts take a little longer to mend.” Out of the corner of my eye, I see Owen nod in agreement. He shares a look with the doctor, and I suddenly feel like the two of them are ganging up on me. “You’ll both know when it’s time to start again. I can’t make that decision for you. My job is to make sure that when you get pregnant again, we do everything to help you hold that pregnancy to term.”
Nodding, I’m afraid I’ll say something I’ll regret if I speak. Lashing out in anger will only show both of them that my heart and head aren’t ready yet.
“In the meantime, we’ll run some blood panels that test for anomalies in your system that may have affected the pregnancy. Usually they don’t run these tests until after three consecutive pregnancy losses, but I find the results can be useful sooner. We should have results in three to five days.”
Three consecutive losses. Why would anyone wait until a woman lost three babies before running a test that might help? Making a mental note to research this test, I can’t imagine there’s any good reason behind the protocol besides saving the insurance companies some money.
Dr. Julian stands from her desk, ending our meeting. Owen rises and offers to help me up, but I push my chair back and stand on my own.
“Thank you so much for your time,” I say, reaching out to shake her cool hand.
“You’re very welcome,” she says, holding my hand between both of hers a moment longer. “I hope to see you back here in a few months,” she adds sincerely. Any frostiness I felt toward her melts away, and I murmur another thank-you.
Owen follows me out of the office and back to the parking lot, jogging to catch up with me. He starts the truck but doesn’t pull out. Staring out the passenger window, I refuse to speak.
“Cassidy, are we going to talk about this?”
I let out a little snort. “What is there to talk about, Owen?” I mutter, still looking out the window. It’s a hot and soggy day. Heavy gray clouds hang in the sky, promising an afternoon storm. “You want to wait a little longer. Make a baby out of love,” I say, the edge in my voice razor-sharp. “I get it. No need to talk.”
As he shifts the car into reverse, the first few raindrops splatter the windshield. “You don’t get anything,” he mumbles, pointing us toward home.
* * *
Statistics was the only class I didn’t ace in college. Asking for help has always been tough for me, and I was scared that my peers—all supercompetitive premed students like me—would judge me for my apparent weakness if I admitted my struggle. About halfway through the semester I realized I’d never get an A and that even a B might be impossible if I didn’t get help, and soon. Ashamed, I asked a friend who’d studied statistics at Boston University. Even though it was a pain in the ass taking the T from Somerville to Boston twice a week, it was worth it. With her help, I squeaked by with an A minus and maintained my dignity. An A minus wasn’t a poor grade, probably better than I deserved, but I took it as a personal affront to my intelligence. I vowed to never let a subject get the best of me again.
According to medical journals, miscarriage is the term used for pregnancy loss before twenty weeks’ gestation. After this point it’s considered a stillbirth. I was technically nineteen weeks and three days when my baby died, so my paperwork reads miscarriage, even though I gave birth to a baby who was so very still. Miscarriage. A triggering word if there ever was one. It’s like I misplaced my baby, as if he was a set of keys or an errant sock, lost in the wash. What a terrible word to describe a terrible event. To make things worse, my hospital reports labeled my loss a medical abortion. This phrasing implies something else entirely and leaves me shaking and sick every time I open an insurance bill.
Statistically, as many as half of all pregnancies might end in miscarriage. The exact number isn’t known, since many happen before a woman even knows she’s pregnant. A missed miscarriage, they call it. For the sake of statistics, the risk is calculated using only data relating to confirmed pregnancies. Based on this, ten to fifteen of every hundred pregnancies end in miscarriage before the end of the first trimester. Second-trimester losses, those that happen between thirteen and nineteen weeks, occur in one to five of every hundred pregnancies. The common average, taking into account all the different losses, is one in four. Twenty-five percent. A quarter of all pregnancies end in miscarriage.
Repeating or “recurrent” pregnancy loss is when a woman has two or more miscarriages in a row. About one in a hundred women will suffer recurrent loss. Most of these losses, about 75 percent, have no known cause. On a brighter note, 65 percent of these women will go on to have a successful pregnancy at some point. As for the other 35 percent …
I consider the odds. Some of the websites give slightly different figures, but mostly they’re consistent. Intellectually, the numbers make sense. Cold, hard facts that should be undisputable, since they’ve been recorded, studied, and repeated in many different journals. Yet it’s still hard to ground these findings in reality. I’ve known more than four pregnant women, and not one has mentioned miscarriage. It’s possible one might’ve had an early unknown loss and gone on to have healthy children, blissfully unaware of the life that grew in her belly, over before she ever knew it existed. It’s also possible one lost a baby and never talked about it. Having experienced my own loss, I don’t talk about it much, but it’s all I think about. There isn’t a minute in the day when it’s not at the forefront of my mind.
A glutton for information, I greedily stalk the loss forums without sharing my own story. From the safety of my computer, I commiserate and compare my pain to that of the women posting while holding my own loss close to my heart. When I’m not on forums, I’m scouring medical journals and parenting blogs, absorbing every fact and anecdote, struggling to make sense of the vast quantity of information. Usually facts comfort me, but I feel like I’m stuck back in statistics class, staring at a bunch of numbers that don’t add up.
Like my own loss, most miscarriages have an unknown cause. Yet there are lists and lists of possible reasons. On one end of the spectrum, there are the obscure genetic disorders affecting the baby and/or mother, scary disorders that make the fetus incompatible with life. On the other end are reasons so basic it makes me want to cry. The age and weight of the mother, how much caffeine she consumes, her blood pressure. All these little things might affect the fetus negatively—or have no affect at all.
Statistics still confuse me. I’m never clear on whether the odds are good or bad. Since I’m a horse person, people always assume I’m an expert racehorse bettor. I may be able to pick a fast runner, but I have zero clue how the odds work. Is one in three good odds? If yes, good for who—the horse? The bettor? Would this be a safe bet? My inability to understand something that others intuit so easily frustrates me. Staring down at my notepad, covered in doodles and numbers underlined for emphasis, I wonder what it all means. I’m the one in a hundred who miscarried in the second trimester. Usually you want to be the one in a hundred, or a thousand or a million. You’re a winner when you’re the one in a billion who hits the lottery jackpot. Miscarriage odds produce only losers. In theory, my chances of having another loss are only 35 percent, which seems like a low number. But if I could be the 1 percent, 35 seems an easy number to hit.
My eyes are tired from staring at the blue light of the computer screen. The clock on the wall says 11:45 PM. Owen’s been asleep for well over an hour. He tiptoed into my study to kiss me good-night, and I tried to explain the odds to him. In typical Owen fashion, he proclaimed, “Lightning doesn’t strike twice.” He loves stupid phrases like that. Still annoyed from our appointment earlier, I didn’t feel like arguing, even though he’s wrong. In fact, lightning is more likely to strike the same place again, since the same weather patterns are more likely to occur at the same geographical site. Using this logic, my chances of recurrent loss loom even bigger.
I sit a moment longe
r, the laptop warm and whirring on my lap. I should go to bed, but my hand hovers above the keyboard. Fifteen more minutes. Clicking open another link, this one relating to maternal disorders causing late-term loss, I take comfort in the soothing buzz of infinite information purring at my fingertips.
♦ 25 ♦
CLAIRE
After
August 19
SMUG BEST DESCRIBES THE look on my sister’s face as she waltzes into my kitchen, settling herself on a barstool like she owns the place. The air around her sizzles with expectation, and from years of experience, I know she’s itching for me to ask her what’s going on. Rather than telling me why she needed to see me at seven thirty on a Saturday morning, she sent me an ominous text declaring she had news to share.
Always dramatic, she waits for me to beg her to spill the beans. Just for fun I pretend disinterest, choosing to make pancakes instead. I’ve thoroughly enjoyed watching her frustration mount since she arrived. Mixing the batter, I smile to myself, allowing myself a few more moments of sisterly indulgence. Sometimes it’s just too easy.
Looking up from the bowl, I sense her eyeing me. “Chocolate chip or blueberry?” I ask, savoring the little bit of steam I imagine blowing from her ears.
“Blueberry.” Her shoulders sink, and she grabs a banana from the bowl in the center of the island. “So,” she says, letting the word hang in the air, hoping I’ll pick it up and run with it.
I’ve played with her long enough. Exhaustion brings out my evil side, and she’s caught me before my first cup of coffee.
“So, what’s the big news you couldn’t tell me over the phone?” I ask, chuckling at the way she instantly brightens.
“Remember how I told you my doctor was running some tests?”
What We Carry Page 15