by Emma Brockes
In the end, I choose a prenatal group for expectant mothers only—no partners allowed—which also slyly eliminates the need to worry over whether I should be attending with L. The class is in a posh neighborhood on the East Side, run out of the back of a boutique maternity store where even the nipple cream comes wrapped in three layers of tissue paper and the racks are full of things I don’t want to think about: nursing bras the size of trampolines; breast pump paraphernalia that looks like you could smoke crack with it. As I ease myself down into a chair that first evening, the word “flange” floats unhappily in the corner of my eye.
There are twelve of us arranged in a circle around Claudette, the group leader, who tells us that she was a sales executive before the birth of her daughter, then ditched her corporate job to set up as a maternity guru. It’s the kind of potted bio inclined to make me sneer my own face off, but before my snootiness can get off the ground, Claudette goes on to say that the parenting industry is running way out of control and we should take every piece of advice, even hers, with a pinch of salt. She advises de-subscribing from all but the most reliable pregnancy mailing lists and consulting our friends more than we consult the Internet. Above all, she says, we should let go of the idea we can anticipate every outcome. Ladies, know your limitations.
Claudette asks us to go around the circle and give three details about ourselves: our names, what hospital we are delivering at and when we are due, such a narrow data request I wonder what she is playing at, until the first woman says, “Hi, my name is Tara, I’m delivering at Lennox Hill. My husband is a lawyer and—”
Claudette laughs gently and holds up a hand. “Yeah, we don’t do that,” she says. “What your husband does for a living—I don’t give a shit.”
Boo-ya! I am still feeling great about this when she adds, “By the way, does anyone here not have a husband?” No one raises her hand and I hesitate for a second too long. “Only we have quite a few single moms in the other group.” Now it is too late to say anything. Claudette, who doesn’t know I am single, looks over at me and I feel myself redden; perhaps there is a big F on my forehead for Fatherless children. “And we have only one twin mom, right?” she says. The other women look over. I smile and do a coy little wave.
This isn’t like concealing my life from the old man in Devon. There is no prurience here. No one is drunk and flirtatious. This is a maternity group in which it might be useful to seek advice for my particular circumstance. But if I fear the other women’s judgment, it’s for the very good reason that as I sit there, I am being horribly judgmental about them. There is the woman who turns up in flip-flops to indicate she lives on the block (i.e., she is incredibly wealthy and keen to show this fact off). There is the one who looks sixty years old—it can’t be her egg, surely!—and comes in every week fully made up and in a lot of gold jewelry. For a couple of weeks, I think the one with wild hair and gum boots might be more on my wavelength, until I find out that her dog has a surname.
Half the group doesn’t work and is treating pregnancy like a full-time job and of course, I am sniffy about this, too. They know which drugs they do and don’t want, which is better, cutting or tearing, and how many hours into labor they want surgical intervention. (This is fine, says Claudette, as long as they don’t alienate their doctors so monstrously it interferes with their care.) One woman asks how close to her delivery date she can carry on going to spin class. “Wait,” says Claudette, looking down at her chart. “You’re still going now?!”
I never come clean about my personal life and I never stop feeling it as a small, profound failure. Over the course of six weeks, however, something miraculous happens; our collective terror starts to eclipse our differences. Every week we sit in the circle, owl eyed and jittery, but less reserved with one another, and kinder. The rich lady in gold worries she doesn’t have an adequate support network. A youngish woman by the standards of the group has only one month’s maternity leave and doesn’t know how she will cope. Claudette answers questions about overheated apartments and difficult mothers-in-law and anxious husbands, through which we learn a little of one another’s lives, but not much, because once these issues have been dealt with, we are to a woman obsessively focused on the delivery. It’s like kids at camp trading ghost stories after dark: someone knows someone who had to have multiple surgeries after her kid came out basically sideways. Someone knows someone who could never sit down again. The worst of the rumors emanate from Europe, where, the circle has heard, women are allowed to die rather than be offered the option of a C-section. Claudette tells us about a member of her downtown class who comes from Sweden, where, she says only half-jokingly, they let you stay in labor for five days and when you ask for a C-section say, “Give it another hour! You’re nearly there!”
When I repeat this story to friends, it is with an expat superiority that implies I am tougher than these pampered Americans. When I meet an American at a party who tells me she recently gave birth—“I pushed for THREE HOURS before they jumped in and gave me a C-section!”—I nod sympathetically, while luxuriating in the thought, three hours?! Try three days, love, with only an aspirin and a cork to bite down on for comfort. I go on endlessly about how C-sections are overused in the United States—almost one in three births in 2013, compared with one in four in the UK and fewer than one in five in Sweden.
It’s a pose. Even my masochism stops short of making me want to push out two babies and I’ve been away from Britain long enough to waver in my blanket defense of the way the NHS does things. I have a friend in London my age who gave birth to twins vaginally and without a lot of bother, but I know of others who were in labor for a hellish forty-six hours, denied a C-section for what they suspected were either ideological reasons or reasons of cost. And so, while I continue to recoil from women who insist on their right to a highly individualized set of birth goals based on a few hours Googling “episiotomy,” when it really comes down to it, most of my chauvinism is for show. I will be thirty-nine when I deliver and as such I am weepingly, convulsively grateful to be in a country where the comfort of the mother comes first. (Actually, the preeminence of the mother’s comfort is a bit of a myth about American childbirth. The consumer might be queen, but there’s no question that C-section rates are high in the United States because they suit the hospitals. In New York, a surgical delivery can cost a patient’s insurer fifty thousand dollars—something I panic about every time I think of it—but to the hospital, a twenty-minute C-section can cost a great deal less than having a woman clog up the delivery room for twelve hours. Apart from anything else, it allows more babies to be born in a day.)
I have no interest in the mystical experience of giving birth. My “birth goal” is for all of us to be alive at the end and for me somehow to wind up not bankrupt.
* * *
• • •
“DO YOU WANT ME to come with you?” says L. We are in her kitchen a few days before the amniocentesis, the procedure in which amniotic fluid is removed via a large syringe through the belly. It is supposed to be painful and traumatic, not only because it carries a small risk of miscarriage, but because the testing of the fluid for chromosomal disorders brings with it the threat of bad news.
“No,” I say.
“OK,” she says cheerfully. “Good luck. Call me when you’re out.”
Before the amniocentesis that fall, I had never seriously considered what a late-term abortion is for. I think at the back of my mind I’d imagined it was a safety net for scrappy teenagers who didn’t know they were pregnant until six months in. It hadn’t registered that it was primarily to prevent the birth of severely damaged babies. Neither had it occurred to me that when campaigners talk about restricting abortion to the first twelve weeks, they are condemning a woman to carry a baby to term, irrespective of problems that emerge only in late pregnancy.
The amnio, therefore, is a frightening proposition, the last opportunity to exit the pregnancy if s
omething turns out to be wrong. Because of the small risk of miscarriage, some of the women in my prenatal group, particularly those who’ve had fertility treatment, say they aren’t going to have one, but it was never a question for me. Of course I’d have an amnio, and of course I’d have a termination if either baby turned out to be damaged. These were the assumptions I held going in, rooted in my deepest convictions about a woman’s right to abort. What I hadn’t realized was how nineteen weeks pregnant would feel. They kick more in the evening and when I lie down. They go berserk when I eat a bowl of lo mein. Baby A moves in short, sharp bursts and Baby B is more languorous, as if she were doing a gentle backstroke across a pool. Sometimes they fight, the bottom one kicking in the direction of the top one, who responds with an evasive squirm. “Cut it out, Baby A,” I say and am struck once again by the insanity of twins: two human beings having a brawl in my abdomen. Once a fortnight, their heartbeats thunder on the monitor. They are stupendously, thunderously alive.
A few weeks before the test, I am made to attend a genetic counseling session in Midtown, the only mandatory piece of pastoral care in the entire process from conception to pregnancy. After giving me the talk about Down syndrome, congenital heart defects and cerebral palsy, the counselor asks if I want the fluid gathered during the amnio to be put through a second layer of screening, at a cost of several thousand dollars.
I start to stutter, hopelessly. I had no idea there’d be an element of choice in all this. I know my insurance won’t cover the extra tests. And while, during fertility treatment, I rationalized medical decisions partly on the basis of cost—forestalling IVF for the cheaper IUI—that felt different. The worst outcomes were financial and emotional. There was never any risk of material damage. In this case, if I deny myself an extra level of certainty for the sake of a few thousand dollars, I may give birth to a baby who is devastatingly ill, or whom, rightly or wrongly, I don’t think I have the capacity to care for.
Or will I? The counselor explains that the second layer of testing looks for relatively obscure genetic defects, the severity of which, when detected in utero, might be impossible to judge. So I would potentially be aborting on the strength of a “maybe.”
I drag myself home, having told her I’ll call in a day with my final decision. I am livid at being put in this position. If I don’t pay for the extra tests, will it make the delivery more frightening? What does it mean to factor in cost when the stakes are so high? Just how bad must the news be to consider terminating the pregnancy this late in the day? Trying to answer these questions gets me nowhere. What does, in the end, is a moment of clarity so overwhelming that I remember precisely where I was when I had it; in the hallway of my apartment, three steps from the bathroom.
This is how it is, I think, and how it will be for the rest of life once the babies are born. From that day on, “maybe” is the best I can hope for. Maybe they’ll be OK and maybe they won’t. The element of faith even the faithless among us are compelled to feel once our children leave us to walk through the world is the basic condition of parenthood. It is the thing that permits us to function alongside the knowledge that, at any moment in the day, something terrible might happen, not to us, but to them. In the absence of guarantees, all I can do is get used to it. I don’t order the tests.
* * *
• • •
SO FAR, my experiences at the hospital have only been lovely and they change the way I relate to New York. When I first moved here, it sometimes felt like being twenty-two again and in my first job in Scotland, when I didn’t know whom to ring or how anything worked. Six years later, I still have to grope to find the correct American word for “sockets” (outlets), and “loo paper” (bathroom tissue), but for a brief period, being part of the life of a grand institution makes the city feel fractionally more mine. It is satisfying to know where every exit of the hospital comes out, or to avoid the Sabbath elevator on Friday nights into Saturday, when it stops on every floor, or how to take a shortcut from Dr. Y’s to the ultrasound department upstairs. This is where, one Thursday morning before the amnio, I turn up for the detailed anatomy scan, a painless if annoying exercise that can take more than an hour for twins, in which every limb and internal organ of the babies is measured. It requires both babies to be awake and stretched out, and if they don’t cooperate, it means canceling and coming back another day.
On the bus journey, I listen to the latest episode of Serial, the podcast everyone is talking about that fall, but when I get to the waiting room, I take out my headphones and stare vacantly around. I occasionally feel sorry for the men with their wives in the waiting room. When appointments run late, I observe them stealing glances at their watches, only to look up into the furious faces of their spouses. Perhaps it’s different when it’s not your first baby, but my appointment could be hours late and I would be quite happy sitting there doing nothing. This, it seems to me, is one of the best things about pregnancy; there is no way of speeding it up.
“Emma?”
Her voice is sharp and I look up. I had noticed this particular nurse before; she is short and rotund and usually quite cross. She is very cross today. “Come on,” she says irritably when I’m stretched out on the gurney, addressing my abdomen and looking up at the screen. Baby A has been a dream, but Baby B is asleep and won’t stretch out. The nurse shakes the wand on my belly. “Unfurl your hand so I can measure it,” she says. “Come on, baby!” She presses a button and the gurney tips my body, headfirst, in the direction of the floor. “This sometimes wakes them,” says the nurse, and I feel the weight of the babies slide glutinously toward my ribs. On-screen, Baby B uncurls a single finger. “Come on!” snaps the nurse.
Eventually, the baby stretches out just enough to be measured and the nurse slides the wand over my belly. “She’s keeping her legs closed,” she says approvingly. “Daddy will be pleased.”
I am so surprised by this remark, it takes me a moment to respond.
“Let’s hope it stays that way,” I say (what?!).
After we are done, I get dressed, go downstairs and call L on my way to the bus stop. “How’d it go?” she says.
“OK. I mean, she sexualized my twenty-week-old fetus. But apart from that, all good.”
I can never get any work done when I’ve had a scan in the morning, and when I get home, I sit on the sofa and flip through a book I have ordered from England. It is by a stout NHS doctor (I have no evidence to suggest she is “stout,” other than the slightly brisk march of her prose) and contains lots of information about how to care for a newborn. Her main piece of advice is that, until it becomes second nature, new mothers should keep a written record of when each baby feeds, sleeps and poops.
I just can’t see how I will do it. Trying to figure out how to keep track of two babies feels like the infant care branch of string theory: a mind-boggling math problem along the lines of if Baby A is hungry at nine a.m. but hasn’t pooped and Baby B poops at nine-thirty a.m. but isn’t hungry, how high does their mother have to turn up the oven when she puts her head in it at half past eleven? For my birthday that year, I ask Oliver not to buy me a present but instead to read the first three chapters of the baby book and, using his giant brain, figure out a diagram for how I’m supposed to do all of this. “When to feed them and change them, and how to monitor it all,” I say.
“It’s hilarious that you’re asking me this,” says Oliver, “but I’ll try.” And he does. He reads the material and makes me a chart in Excel, to keep track of who’s doing what—columns for when each baby poops, wees, eats and sleeps—and I stick it on the fridge door next to the ultrasound pictures and a drawing done by one of my friend Liese’s six-year-old twins, a smudgy figure in crayon (me) with the words “Babies Are Coming” written ominously over the top. I quake every time I look at it.
I start to have stress dreams. I dream that Baby A, the lower of the two babies, shows up on the ultrasound with a lizard’s tail,
which I reach in to pull off and instead detach its whole arm. There it lies in my hand, bloody and white and as limp as a noodle, with tiny curled-over fingers.
“You need to stop fussing with it,” says L flatly when I tell her about the dream.
“You think I should’ve let it keep the tail?”
“Yes.” She is, in so many ways, more liberal than me.
L had told me the amnio doesn’t hurt as much as people say but that I would be well advised not to look at the needle. On the morning of the test, I stand in front of my mirror at home and shiver at the thought of being stabbed—twice—not subcutaneously, as with the injections I performed on myself, but way down into the uterus. By the time the results come in, I will be two weeks shy of the New York state abortion limit, and if there’s a decision to be made, there’ll be no time to linger.
The doctor, whom I hadn’t met before, is reassuringly businesslike, exuding vibes of this-is-100-percent-routine and telling me, “Most women say it’s not as painful as they think it’ll be.” When he first entered the room, I thought I’d detected a tiny pause in his momentum when he registered I was alone, but if he did, he quickly recovered. It is the week before the Scottish referendum and, noticing my English accent, he says, “What are the Scots going to do—reinstate the Stuarts?”
“Very good!”
With twins, doctors inject blue ink into one of the amniotic sacs, to ensure they don’t test the same baby twice, and, as promised, the first doesn’t hurt. As he draws up the needle again, the doctor says, “This one is going to hurt more because of the baby’s positioning. She’s very low, near your bladder.” A moment later I feel a white-hot stab of pain. Yowza. “OW,” I say. Then, just as abruptly, the pain shuts off.