by Emilie Pine
But, very soon, there is blood. And it is every morning. Tiny amounts, yes, but enough to make me worry. ‘Relax,’ says the nurse. ‘It’s probably old blood,’ says the doctor. I want to believe them but my fear makes me look at the internet. I search online for ‘bleeding while pregnant’ as I wait to meet a friend, then again as I wait to catch a bus, and again as I stand in the supermarket, basket on the ground, in the pasta aisle. Because it shouldn’t be every day. Because it’s very red to be ‘old’. Because the internet tells me it’s an early sign of miscarriage. I go back to the pregnancy message boards. They allow me, on the one hand, to believe it’s going to be fine, and on the other they confirm my inner voice, which says it’s not. I’m not alone, that’s for sure, there are a million messages posted out there, and I read both happy and unhappy outcomes. I follow certain stories that sound like mine, and when a thread goes silent I ache to know why. Are they too busy being pregnant or too sad to post? I thought I’d be done with the anxiety by now, but instead of relaxing, I have shifted from wanting to be pregnant to needing to be still-pregnant.
It’s such early days in the pregnancy that barely anyone but us knows. I haven’t even told my father, as he is caught up in his own medical drama, post-liver failure. I find myself in normal conversations, with friends and colleagues, or just in random meetings, wanting to scream out loud the fact of my pregnancy. I need to share the symptoms, the little proofs (my jeans are definitely tighter), the reassuring truths (those two little lines), and the side effects (I am constantly light-headed as my body manufactures new blood in preparation). I feel it like a pressure building behind my lips, caught in my throat. One night in a stuffy theatre foyer, I faint. A sympathetic friend offers me a brandy. He’s only trying to be nice but I leave, muttering an angry excuse. The fainting makes me even more afraid, and the next morning, still in bed, I phone Holles Street maternity hospital. I tell them about the previous lost pregnancy and that I’m bleeding every morning. The woman on the phone says I should come to the drop-in clinic where I’ll get to talk to a midwife. It’ll mean the morning off work, and a couple of hours sitting in a queue, but I start to feel calmer.
This is, of course, the moment when I kick myself for not having private health insurance, the kind that comes with access to doctor helplines and scheduled appointments. Why, oh why don’t I have it? My mother advised me to take it out, my friends talked about the benefits of different packages. I visited friends and their babies in their semi-private rooms, and heard them talk about their consultant visits. All paid for by health insurance. But me? Nope, I got none. Idiot.
In the waiting room everyone else looks like they’ve had practice, and I’m the only one without a bump. I tick the box for ‘advanced maternal age’ (aka ‘geriatric’, the official medical term for new mothers over thirty-five). We have both brought books, and R actually seems able to read, but mostly I pass the time gazing at the other women and the posters tacked up on every wall, many on smoking and pregnancy, or the benefits of breastfeeding, others with helpline numbers for women experiencing domestic abuse. When I’m called, we go through to a cubicle and I explain my history to the doctor (midwives are scarce today it turns out). The ultrasound machine is brought over to the bed, and now we get to do the bit I’ve seen on TV. After a few anxious moments of pressing the sensor into my gelled abdomen, the doctor finds the foetus, clearly defined, and where it’s meant to be. Phew. But then she says that the machine is too old, so she can’t get a good enough image. Can I come back for a follow-up appointment in the foetal clinic? She prints off the picture of my uterus with the white blob that means ‘baby’. When I take it, I see that I’m shaking.
The second appointment is a few days later and together we wait in a corridor. As we’re waiting, the Master of the Hospital walks past, tidies some sheets on a trolley next to us, and, as an afterthought asks if we’re being looked after. I recognise her from the news. I say yes we’re fine, though I want to say that the Victorian skirting boards look grimy. In the Foetal Assessment Unit, the doctor from downstairs is here again, with another, senior doctor, who, it transpires, works for the same university as me. I have a moment of hoping this coincidence will make her well-disposed towards me, as if her liking me will make a difference. The scan this time involves an internal ultrasound. I pretend like I’ve done this before, as I follow instructions to take off my jeans and underwear and to lie with my feet together and knees falling apart. I wonder what R is thinking as he sits next to the bed. A plastic probe, covered in latex and lubricant, is inserted into me to see the hidden cervical landscape. It is not painful, but it is uncomfortable, and I am horribly aware, suddenly, that my body is no longer private, no longer knowable to me. My body is, as I experience it, red and fleshy, soft and warm. But on the screen there’s just a grainy greyscale, like a lunar landscape. The monitor is angled away from me, but even if I could see it properly, I wouldn’t know what I was looking at.
The examination is conducted in silence. At the end, they remove the probe, wipe it off, discard the condom, then give me a paper towel to wipe myself. Quietly they ask me about conception dates – could I have got it wrong? No, I couldn’t. I know not only the date, I know the encounter, the white sheets on the bed, the closed blinds, the light still on in the bathroom. I remember the tense conversation that preceded it when I asked if we could try tonight, and I remember when I said no, it wasn’t okay with me if he was ‘tired’. I remember it because we did have sex though he didn’t really want to, going through with it only to avoid my sighing cold shoulder. I remember it because it was the moment that I became an emotional bully. I remember it because when I saw the positive sign on the test, I felt that it had been worth it.
‘Yes, I have the date right,’ I say.
The doctor looks sad. ‘Let’s hope then.’
Oh no. No no no no no no.
Maybe I am wrong.
Maybe the date is wrong.
Let me count.
Let me see a calendar.
Let me rearrange the timeline.
As we leave the hospital, R says that he doesn’t know what’s been implied. I say I think they meant I’m having a miscarriage. He says that they told us to hope, so that’s what he’s going to do. I shake my head.
Seven days later, exhausted and numb with worry, we are back at the hospital. In the cubicle I am told to get ready for another internal ultrasound. I take my jeans off, lie back, feel the cold probe. Hope. But there is no heartbeat. After a few moments of silence, the midwife leaves to get a second opinion. The second midwife measures the foetus onscreen. ‘There’s been growth,’ she says. Following this statement the two women tell us that they ‘Can’t say anything or any more.’ What, what can’t they say? There is an insane moment where both women look at the floor, and the second-opinion midwife repeats it, ‘We can’t say anything. You’ll have to come back in a week.’ They leave the room.
I need to pause, I need to reason this through. Growth means life. But no heartbeat means no life. It is only with a great degree of hindsight that I think I understand. There is no life, but somehow there is growth, and growth means ambiguity. In Ireland, the equal status of the foetus and the mother in the constitution represents more than simply a ban on abortion. It means that in the case of any ambiguity, the life of the foetus is prioritised; and in our situation it means that it is illegal for the midwives to pronounce the pregnancy over. Ambiguity does not mean that there will be a baby. Instead, it means the total disempowerment of us as ‘parents’ of this ambiguous pregnancy. The midwives’ silence, though it is completely uninterpretable to us in the moment, actually speaks volumes. They can’t say, and we can’t know. I am furious. At the situation and, specifically, at them. I am a woman, in grief, and these women will not look me in the eye as a fellow woman and tell me that I’m not going to be a mother. It is quite something to find myself in the National Maternity Hospital, not only distraught at the end of a wanted pregnancy, but denied
the right to know what’s happening inside my own body.
We leave the hospital again and walk, stunned, in the direction of home. We’re both torn between rage and paralysis. Another week is just too long to wait. But what can we do? That evening, in desperation, I book an ultrasound appointment with a private clinic. It’s expensive, but – fuck it – maybe rich people get better treatment, better answers. Two days later we are in the waiting room and it is like another world, with plush carpets and soft drinks while you wait. But we’re the same edgy, needy people. I wonder will we get any different response here. When the midwife comes to collect us, our hope for an answer expands. She has an English accent.
In the room, in the moment when she turns on the ultrasound machine, the image of a perfect in utero foetus appears onscreen. I flush with the wild hope that this perfect recognisable baby has somehow transposed itself into me, but it’s just the residue of the last appointment, and as she moves the probe, the screen goes blank and it’s back to grainy moon surfaces and R holds my hand as we go through it all again. There is no heartbeat today either. The midwife turns back to her desk and writes some figures in a chart. I speak into the silence. I say that we need to know. The midwife hesitates. She says that legally she can’t say anything. And then she pauses. In her experience, she says, she has never seen a foetus at ten weeks develop a heartbeat. It’s the ‘No’ that I’ve feared and expected and I hate hearing it. I hate hearing it. But I’m almost elated to at last be given the answer.
I don’t remember much from the days that follow, beyond a vague recollection of our shared despondency. I think we went to work, I think we saw family, I think we tried to pretend that we were okay.
Five days later we are back in the hospital for our last scan. This time there’s no growth, no ambiguity. We cry in the hallway, then we’re taken to a private room. It’s small and narrow with a couch at one end. I sit down but there isn’t quite enough room for both of us, so R stands. He looks at a pile of leaflets on the side, and says, ‘I think we’re in the bereavement room.’ With the weird giddiness of grief, we start to laugh. Of course this is the moment that the surgeon chooses to come in and I can’t help thinking that he’ll judge us, will think that we’re not devastated at all and that, maybe, our miscarriage is just as well. Or maybe he’s seen everything in here. Either way, I’m not laughing now. The surgeon explains that I have had a ‘missed miscarriage’. Since my body is holding on to the foetus, I need to have a surgical procedure to remove it. Everything is very different now that there’s no baby and I’m back to being the primary patient. Suddenly, I’m the one that matters.
On October 18th I am admitted for what they call an ERPC. It’s another terrible acronym; this one translates as ‘the evacuation of retained products of conception’.
The original doctor, from the first appointment, comes to my bedside to do bloods and check my stats. She has paperwork and she asks me, as ‘the mother’, to sign a form for the disposal of the foetal remains. This catches me out. I cry. The nurse sends me a counsellor. She gives me a folder on coping with miscarriage and I tuck my first ultrasound printout into the back. And then it moves swiftly: I’m taken to the operating theatre, I’m back on the ward, I’m being discharged. My mum picks us up. The rush-hour traffic is at a standstill. R nearly loses it, frustrated by the delay, by the day, by absolutely every single fucking thing. I realise that no one is minding him because he’s expected to be the strong one.
I take a week off work, my boss is understanding. My family are supportive. My sister calls my dad to tell him, and then he phones me, his voice solemn with concern. At the weekend, we have lunch with R’s family, studiously avoiding any mention of what this week has really meant. When the conversation turns to the house we’ve just bought – the house with the extra bedroom that I so want to fill – I get upset. R’s dad hugs me and R takes me home. No one else knows. Though the miscarriage is the only thing on my mind, and I feel like I’m falling apart, I don’t talk about it. I don’t even want to talk about it. It’s too raw, and it’s too hard, and it’s too shameful. And, besides, since no one else has ever talked about, or even mentioned, their miscarriage to me, I believe I should be mute too.
TWO MONTHS LATER, when I go back to the hospital for a follow-up consultation, I walk past a row of huddled, smoking women, heavily pregnant, their bellies barely covered by their dressing gowns. How is that fair? I silently demand. I would be a better mother. I deserve it more. I try to push these terrible thoughts away, but a visceral jealousy courses through me. At the consult, I ask about physical post-miscarriage symptoms. I say that my period has not returned and the nurse says that’s normal. I say that my body feels different, and she gives me a compassionate look, but says nothing. After I leave the hospital I go and buy some new bras, in a smaller size, angry that my breasts, which should be buoyant with pregnancy hormones, have become smaller, as if my body, like my fertility, is shrinking.
It takes months for blood to return. And my bleeding, once so regular, is now so rare and so scanty that I barely recognise these abbreviated episodes as periods at all. I am always told that I look young for my age. But I feel the opposite, as if I have internally aged, as if my sluggish, broken, failed uterus is poisoning me from the inside out. As if I’m barren. It’s hard to argue away this feeling, a dejection that settles and suffocates. I drag myself through, rather than out of, the torpor.
The one person I confide in is the GP, until she starts talking about ‘Mother Nature’ and how I need to ‘let nature take its course’. This seems inestimably stupid to me and I retort that no one thinks it’s a good idea to let nature take its course when someone has cancer. I am so deep into this that I don’t even see the problem with comparing not being pregnant to a serious illness. I say that I am drowning, not waving, and I need help. The GP agrees, reluctantly, to run some tests. As the (pregnant) practice nurse takes my bloods, she suggests a mindfulness course for ‘inner peace’. I snort. But when she says that she knows women who have conceived after acupuncture, I start to listen seriously. I decide to check acupuncture out – it’s expensive but I can claim some of it back on my new and exorbitant health insurance plan. I phone the number she gives me.
As so often with semi-alternative therapies, the interview with the acupuncturist feels as healing as the treatment itself promises to be. His consultation room is in a basement, its walls festooned with pictures of babies. I sit in a comfy chair and he asks me about my physical and emotional state. As usual, I feel weird describing the bodily minutiae of it all, but he nods at everything I say. Finally he asks me if I’m easily distracted. I say no. He looks sceptical. He tries again. Do I do multiple things at once? ‘Oh, yes,’ I say. He tells me then that I am typical of someone with too much busyness and not enough quiet, too much yang and not enough yin. Usually, I react badly to being told I’m overdoing it – a mantra not just of GPs but of my family, and friends, and colleagues – but I am here for an answer, and it helps that he frames everything within an ancient tradition of understanding the body, because isn’t that what I’ve been trying to do this whole time? Understand my body?
And so begin ten weeks of lying on his couch, trying (despite myself) to be more meditative as scores of fine needles rebalance my energies. He also has me taking massive doses of spirulina, a gagging green powder that I can tolerate only (at my sister’s advice) mixed with black-currant squash. ‘Come on,’ I think as I glug it down. ‘Come on,’ I think as I lock my bicycle to the railings outside his office. ‘Come on,’ I think, ‘let me make a baby.’
But I don’t get pregnant and my fertility signs – blood and mucus – don’t improve. Disheartened at the lack of change, as I pay for the final scheduled session, I feel my faith in this endeavour ebbing. I should continue, he says, and I sense the unspoken verdict in the air, that I am an extreme case, irretrievably unbalanced. Maybe if I were more easy-going. More placid. More, well, more maternal, all cuddly and warm. Maybe if I wer
e completely different, if I could swap out every cell, and gene, and chromosome in my body, maybe then this would work. In the early hours of the morning, unable to find sleep, I realise that what I’m trying to be cured of is being me. Maybe my late thirties is the age to admit I’m never going to change my personality, or my body. Because I may not be pregnant, but I don’t hate myself, even with my too-much-yang nature. I like that I have ten things on the go, all at once. I like that I’m always planning for the next thing. I like that I bring a high energy to my life, that I see it as a challenge. I like that my favourite thing to do on the flight home is to look at the airline route map to pick my next destination. But then I remember the baby photos, and all the ‘thank you for getting me pregnant’ cards on his shelves. In the morning I text the acupuncturist to wish him Happy Christmas and to say I’ll see him in the new year.
I host Christmas for the first time. R’s family joins us, and there’s my mum, and my sister and her partner. And there is an unborn member of the family. My sister, V, is nearly nine months pregnant.
She told me in May. We stood in my kitchen, as I made tea, and she was nervous and I reacted badly. I should have thrown my arms around her in celebration, but I only managed a forced ‘congratulations’. I am ashamed of this reaction, embarrassed that I could not, for one moment, shed my narcissism. I felt cheated. And I felt every one of the five years that separate my older body from her younger one. It took me a full twenty-four hours before I felt any joy for her.
Seeing my pained reaction, V decided not talk to me about her pregnancy and not to show me her ultrasound scans. I didn’t even realise, I didn’t even ask, until my dad bragged that he had the latest in utero shot printed out and fixed to the side of his computer monitor, where he could keep a constant eye on the next generation. I begged her to send them to me too, to include me. She had an early scare when she, horribly like me, had some bleeding. But her emergency scan showed a healthy foetus. As her pregnancy developed, and her bump grew, we all gravitated towards her. It has long been the case that while I try to manage everyone in the family, V is the one we all turn to for care. Feeling bad? V will listen, say the right thing, and serve you homemade cake with your favourite kind of tea. I sometimes think that without her we would all just drift apart. Whereas I am usually off, being busy elsewhere, she is here, she is home.