I came to realize that for me, having a second child somehow signified committing to adulthood even more so than I already had. Not that I fancied myself a perpetual kid by any means, but somehow, I was resisting—staving off—the next phase of my development by foreclosing on the idea of engaging in motherhood a second time around. It meant growing up a little more, I thought, and I wasn’t sure I wanted to do that. So I urged myself to look into previously unexplored places in my psyche to get a handle on where these thoughts were coming from, who I was, and who I wanted to be, maternally and more generally. There was a lot to consider. This identity conundrum required me to deliberate long and hard.
I ultimately decided that I wanted to find out.
Almost as quickly as the first time around, I found myself holding a welcomed positive pregnancy test. Unlike my pregnancy with Liev, however, my head was tucked in the toilet bowl morning, noon, and night. Sick as a dog, I dragged myself around, hoping the second trimester would grace me with less ghastly symptoms and some much-needed peace. But those late-morning drops of blood that appeared in the bathroom of my dermatologist’s office at sixteen weeks along signaled that calm wasn’t coming. A relationship that had barely begun was no longer. My four-month-long pregnancy was done. I had been so pleased by how swiftly this new pregnancy had arrived, yet devastated by how hastily it had left. How strange, the ways in which the passing of time can be both a comfort and a torment.
The end of my daughter’s short existence spurred on the beginning of my altered, grieving life. So much had changed—and I soon realized how earnestly and readily my soul had begun preparing for another child. Even if I could have gone back in time, I flirted, would I?
• • •
There were many reasons that it wasn’t long before the will I try again? question started looping on high speed in my mind after our loss. It was daily, in fact, that I found myself turning the idea around in my head—and depending on my frame of mind, it was either something that would ignite me or scare me outright. While there was a version of me who wanted nothing to do with being pregnant again, there also existed another part of me that saw a subsequent pregnancy as an opportunity to reset, to rebuild, and to perhaps create the larger family we both now wanted.
We are not going to go down on this note was a mantra my husband and I quipped about, one that playfully got us to put one foot in front of the other even when our collective grief was blinding. Luckily, moments of humor and optimism showed themselves, despite how bogged down we got. We could rely on each other for laughs and a pinch of positivity amid those ambiguous days.
So it was decided: we were going to try again. We wanted to. We wanted to make every effort to not go down on this note. And so, we dared to undertake pregnancy once more. Was this courage, stupidity, denial, ego? I guess I’ll never know exactly, but I think it was a little bit of each.
And just like that, there they were: those two familiar pink lines. A positive pregnancy test. Again. Jason and I were equal parts relieved and petrified. As consoling as it was to be pregnant once more, I carried with me the heavy weight of possibility. Knowing well that what happened to me so recently could theoretically happen again, I toggled between gratitude and fear.
I was grateful it happened so quickly, of course. I didn’t have to experience that gut-wrenching disappointment—that moment of hoping to see a positive test and seeing a negative symbol instead—but getting pregnant on the first try, for me, came with its own set of complexities. It ultimately meant that I wasn’t afforded much time or space to grieve, let alone cope with the realities of what it might feel like or mean to undertake another pregnancy. And even though this was a choice I’d consciously made for myself and our family, it didn’t take away from the gravity of what I was undertaking. I had been pregnant for four months, then without warning, I’d spent the following four months not pregnant, then suddenly there I was, pregnant again.
This third pregnancy rendered me anxious to my core. Being pregnant for a year and a half in total, with a break of four grief-stricken months, was an exercise in mind-numbing uncertainty—an ongoing oscillation between hope and anxiety. I was terrified for four of the nine months and on pins and needles the remaining five.
• • •
Considering how whiplash inducing this whole experience was for me, it wasn’t hard to surmise just how overwhelming it was for my patients. The loss of my pregnancy brought with it a newfound set of professional quandaries, challenges, and most importantly, resonances. Now, to make matters more complex, I was a walking advertisement for pregnancy after loss. My ever-changing body evoked palpable feelings in those around me: envy and resentment, empathy and compassion, anxiety and wonderment, and unabashed hope. My body broadcasted where I was in my journey, and patients couldn’t help but wonder if their experiences might mirror mine, and vice versa.
I disclosed to many of my patients fairly early on that I was pregnant again. Since I’d lost a pregnancy so recently, I wanted to be as forthcoming and transparent as I could with those who would take the news somewhat in stride. What’s more, my petite frame revealed even the earliest signs of pregnancy, so I didn’t want to leave them wondering on their own. Better for them to have the facts, I thought, than to be fixated on guessing about my pregnancy status.
Not everyone would take the news well, though, and I was well aware that my pregnancy might be burdensome for some and outright anxiety producing for others, so I held back from sharing with some patients until I couldn’t any longer. The timeline was intense, after all, and bordered on triggering for some. I understood this, and knew I’d have to prepare myself for some difficult conversations. I didn’t want my news to distract from theirs. I didn’t want my belly to take up more room than it already was.
I vividly remember one particular session with Madison, whom I’d been seeing for several years. Madison had suffered two pregnancy losses—a miscarriage in the first trimester, another in the second—and had struggled to conceive in the first place. Upon walking into my office on that afternoon in early April, she noticed straightaway my larger-than-usual belly and confronted me—not aggressively, mind you, but forthrightly.
“Wait … you’re pregnant again?” She looked at me with incredulity. “Sorry …” she attempted to backtrack slightly. “I just wasn’t expecting that.” She looked down at her feet while she unzipped her jacket and muttered, “It all just comes so easily for you.”
Bump envy is something I hear about daily in my work. Looking in on other people’s lives, it can be tempting to imagine that the path to pregnancy was “easy” for her, and her, and her. For everyone else. It can be tempting to assume that the beautiful, blooming baby bumps around you got there unscathed. But how can we know for sure? We can’t, of course, but the appearance of pregnancy, coupled with the romanticized version of gestation often shown in media—be it television shows, movies, or social media—makes it far too easy for so many of us to deduce a person’s reproductive journey by focusing solely on the end result. You are pregnant, therefore trying to conceive must have been easy for you. You have a baby, therefore pregnancy must have been easy for you.
From the outside, sure, it undoubtedly looked like I had everything back the way I wanted it; yet on the inside, I felt anything but steady. If we know the statistics, then it’s actually safer to assume that the women walking by you whose bellies prompt an oozing of envy have stories of adversity all their own. Struggle is universal—manifesting in different arenas for all of us. We don’t know what anyone else has been through, until we do. And even if my reproductive timeline looked enviable, pregnancy this time around felt like tightrope walking; there was nothing blissful or easy about it. It was rife with charged emotion that spanned both ends of the spectrum. I was grateful—elated, even—but no ounce of my joy was enough to counter the anxiety and fear I shouldered. It seemed as though my feelings would change by the hour; I felt petrified, hopeful, distant, excited, enigmatic … I don’t kno
w that there was a feeling I didn’t have over the course of a single day.
My ob-gyn assured me that I’d likely find some respite after hitting the sixteen-week mark; but as that milestone came and went, it only offered a modicum of the equanimity I was so desperate for. I spent the first four months terrified that I’d lose the baby at any given moment; and even though an element of my fear eventually softened, I spent the remaining five months of my pregnancy walking on eggshells, expecting at each trip to the bathroom to see blood when I wiped. Even in spite of having received news that the fetal chromosomes were healthy, I couldn’t shake the unmistakable fear that something could go wrong at any time.
With my patients’ stories lodged in my psyche, I was all too cognizant of the fact that I was not immune to a repeat trauma. After joining that one-in-four pool, I somehow felt like any of the other horrendous reproductive statistical outcomes were somehow more likely to reach this pregnancy. It wasn’t necessarily a helpful or productive way to think about conception after loss, I know, but a grieving mind has a way of meandering into dark corners—especially given the amount of anxiety that a postmiscarriage pregnancy can usher in. Beyond anything else, pregnancy after loss for me became a lesson—albeit one I wish I hadn’t had to endure—in being present; to do nothing more than inhale, exhale, repeat. It was all I could do to keep from being swallowed whole by anxiety.
This practice of staying present was never more riddled than it was in the moments when I was home with my son. I was stuck in a perpetual state of worry, unable to untether myself from the overwhelming concern that my grief-shredded state of mind might color his childhood experiences. I’d find myself all too aware of my less-patient reactions to things that previously didn’t push my buttons, things that all toddlers are wont to do. I felt like I could actually see myself in real time as I stretched to muster my previous ability to parent calmly. The trauma reared its ugly head in inopportune moments (not that there is ever an ideal time to be thrust back into this kind of havoc) and sometimes overtook my parenting strategies; I watched helplessly as that hallmark irritability rose in me. It felt, at least to me, like it was splintering some of our precious moments together, and I was so hard on myself about every time I thought I hadn’t reacted the way I should have. The way my previous, pre-loss self most definitely would have.
This is the post-traumatic experience—our past remains ever present. Encumbered by the weight of our traumas, we feel the sting of every terrifying possibility. Worrying that my relationship with my son would be affected, worrying that something would go wrong with my pregnancy. Worrying. Constantly. Anything could happen, we think to ourselves. So why should we believe for a moment that the worst-case scenario won’t? The naivete that perhaps existed for us in the past is long gone, replaced by an acute awareness of the risks and dangers that may or may not be dotting our paths, just out of our lines of sight.
Having experienced a miscarriage did not fortify me from having to face whatever horror the other shoe dropping could, or would, bring. I felt just as susceptible to any other type of loss, as though a new iteration of that familiar nightmare might be lurking around any corner. Day in and day out, I felt acutely aware of all the ways in which this pregnancy was so antithetical to the others: fraught with fear. So, seeing the effects of my two back-to-back pregnancies as they rippled through some of my sessions with patients was hard. I didn’t want my personal life—my obvious and protruding maternal trajectory—to in any way affect my patients, of course, let alone hurt them outright. But in sessions like that of Madison’s, perhaps I (or more specifically, my growing belly) inadvertently did. My conspicuous desire to try again—to attempt to grow my family once more—became a focal point for some, and stirred feelings deserving of my pointed attention.
• • •
Even though I’m in support of women sharing their pregnancy news whenever they feel ready, there is a nuance to sharing about pregnancy early on—and particularly so for me, in my role as a psychologist specializing in reproductive and maternal mental health. I’m distinctly aware of how sensitive I must be in considering my patients’ histories. No matter how delicately I shared my pregnancy experience—and share I must, at some point—it was bound to activate negative feelings in some.
But what better place—one might argue—to be triggered than in the safe and supportive context of your therapist’s office? A space where feelings are addressed, talked through, and understood, together? Transference, a very basic and central concept of psychoanalytic theory, was bound to materialize during this period. And my work, now more than ever, was to take this in stride: to show up for my patients fully, to listen carefully, and to create a context in which all could be laid out and discussed. This was, of course, always the case in therapy, but given the fact that I was now part of their therapy process—my pregnancies, the lost one and the other that thrived, both activating feelings in them—my role had changed. Compassionate therapist though I still was, I now also carried the potential of being the problematizer too. We talked through all the feelings that arose.
But unfortunately, sometimes no amount of talking about feelings stimulated by this quick, next pregnancy of mine helped. To my dismay, one of my longtime patients, Paige, left therapy during this time. She’d been trying to get pregnant for years, to no avail. No pregnancies, no losses, and no children, Paige pivoted and decided to “give up” on family-building altogether. More than my bulging belly, it was the hope she saw in my eyes—later dashed and then returning once again—that pushed her to a place of intense discomfort in the context of my office, she told me. Hope that dissipated long ago in her eyes. Hope she held on to for years on end. Hope she loathed to see in others, especially now. So, sitting with me week after week became—understandably so—“more pain than it was worth.”
I think of Paige, still. And I even hear from her on occasion. About thirteen months after Noa was born, I received a holiday card from Paige in the mail. The photo on the cover of the card was of her, her partner, and their newborn baby. In it, she shared their adoption story and her nascent impressions of motherhood, and reflected on our work together.
The bonds braided over years of weekly sessions can sometimes bring about a depth and emotional intimacy that—no matter the circumstances—prevail. I feel fortunate and honored that this was the case with Paige. Because, of course, it does not always work out this way. I am grateful when it does.
• • •
Up until my loss, all I had known was my smooth pregnancy with Liev, and a steady clinical practice, with a specialization I knew only professionally, not intimately. Things changed. I became a person oscillating between hope and anxiety, trying desperately to foster the former while tamping down the latter as a grief-stricken wife, mother, daughter, therapist, and friend. In spite of knowing that my third baby was chromosomally healthy, the terror of loss continued still. Until she arrived safely, my daughter—and this thriving pregnancy of mine—felt more like a pipe dream than an eventual reality. And then, at long last, she came.
11
“The discordant refrain of what-if what-if what-if?”
My labor with Noa started gradually and progressed steadily. It rained that day, and I insisted on heading out on a hike in the hills in the early morning drizzle, with the hope of somehow getting things moving. By afternoon, contractions began, and as they quickened, my husband and I headed to the hospital.
Once we got settled in the hospital room, I recall hearing Jason talking with my doctor and the nurses, and moving about the room; I chimed in too. But the closer I got to the final stage of labor—transition—the more I required quiet and deep concentration. The intensity of the contractions demanded singular focus, most especially in those final hours.
I’d opted to forego pain relief. I had delivered Liev with the help of an epidural, but after experiencing the torment of delivering alone in my own home and the unmedicated D&C that followed, it became deeply important to me to
bring this baby into the world while I was fully present, feeling it all. Soon after getting pregnant this time around, I realized how poetic and powerful it would be if I had the chance to give birth without numbing, without taking the edge off. I hadn’t really had an option as I labored through my miscarriage, but this time I’d have a choice, and I planned to embrace the pain willingly. There would be no fear of imminent loss this time. I wanted to feel my body go through this, and to bring about a new ending to the story I’d never intended to write at all. I wanted this birth—which I hoped would be a live one—to provide me with something reparative: the start of a lifelong relationship.
I spoke little, aware of the fact that if I left the steady confines of my mind, the physical pain might overwhelm me and propel me into another laboring direction altogether. The intensity of an unmedicated birth required stillness—I was in an internal, meditative state where I sat in silence on the birth ball. I stayed calm and quiet, inwardly facing the pain of childbirth with the knowledge that it was serving an important purpose—that each contraction was bringing me ever closer to meeting this baby of mine.
Pain is something we typically want no part of, be it physical or emotional, as it often signals that something is wrong, that something should be quelled. But not in this case. I went into labor with the mantra that in labor, pain is purposeful. Pain was a dance between my daughter’s body and mine, a necessary conduit to her entry into the world. I stayed the course, and did what I could to shut out the uncertainty—the question of whether or not she’d make it, if she’d be okay. Loss, after all, has that way about it: colors are muted, sepia tones wash over what would otherwise be a bright(er) landscape. As the hours passed, I continued in my necessary retreat inward, focused on my breath. This pain is purposeful, on loop. Breathe. In and out. This pain is purposeful. It is normal. Everything is okay, I’d silently encourage. I can do this, I’d reassure myself. We can do this.
I Had a Miscarriage Page 14