by Emilie Pine
Christmas goes well. We pull crackers. We eat too much. We load up the dishwasher.
THEN ON DECEMBER 30TH my mum calls to say that V is in the maternity hospital and that she needs company; her partner is at work and can’t be reached. She’s only at thirty-seven weeks, so I figure that the baby is making an early appearance. At the registration desk they have no record of V being in labour. I phone her. She texts back that she’s in the Foetal Unit. On the fifth floor, I give V’s name to the two staff at the nurses’ station. They exchange a look, a look that means bad news. But I have no idea of the scale of the badness.
I am led around the corner to a private room. There’s a bed and an ultrasound machine. There’s a chair in the corner, where V is sitting. She holds her bump. She is sobbing. She tells me in gasps that her daughter’s heart has stopped.
I hold her and hold her and wish for the world to go away, for time to stop, for the words to be unsaid. In total disbelief I look at the midwife, who looks embarrassed. Soon my mother is there and V’s partner is on his way. He phones to ask where we are and I meet him at the top of the stairs. ‘What’s going on?’ he asks me. I stop and tell him and he runs to the room, takes V in his arms, shuts the door. We wait in the corridor. The nurse offers to bring my sister tea. I insist that she doesn’t like tea, as if that matters today. After a while, V and her partner emerge. She reassures us that she’s okay and they want to go home.
Two days later we are back in the hospital for the birth. There are four of us in an overheated room off the main maternity ward. V is in the bed, and her partner, my mother and I are arranged on chairs, trying not to watch her, as we all wait for the drugs to begin her labour. They give her the full dose of painkillers and, when her contractions start, the maximum epidural. As the nurse explains, nothing can possibly harm the baby now. V and her partner are taken to the delivery room, Mum and I wait some more. Mum wants to talk, she cries and I pat her back but I don’t want her to cry, because then I’ll have to cry, and I cannot cry because I have built a wall of steel around my heart and I need it to keep standing.
Late that night, Elena Jane is born. It is New Year’s Day, 2015. Baby daughter, beloved grandchild, adored niece.
Mum and I are allowed into the delivery suite. V is lying propped up, holding her daughter, who is swaddled in the blue cotton blanket all newborns are wrapped in. V looks up at me and smiles. I say ‘Beautiful baby girl,’ not sure who I mean, my sister or her child. We hold V as she holds Elena. Elena looks perfect, only impossibly still, and there’s a tiny little rip on her eyelid, with a little blood, where her delicate skin was damaged during her birth. When I take her, her compact little body is too light, but she’s warm, still holding the heat of her mother’s body.
It is so quiet in that room as we stand around the delivery bed. Remember this. This is the only time you will ever hold your niece. This is the moment when she is the closest she will ever be, out in this cold world, to being alive. This is the end and the beginning. Remember this.
V asks me to take photographs of her and Elena. She smiles and offers her beautiful child for the camera. I do not know where she finds the strength. The next week I have the photos developed at one of those print-your-own shops. I’m inept with the machine and the manager comes over to help. He tells me his own son was stillborn two years ago. He doesn’t charge for the prints. I have copies made for all Elena’s close relatives. When I send them to my dad, he protests, ‘How could you? How can you look at them?’ Because V managed to smile, I tell him, as she held her daughter. All you have to do is look.
In the days after Elena’s birth, we all need something to fill the time. Mum cleans every room in her house. V and her partner drive around Dublin, try to pack away the baby things, drink coffee at Mum’s house. We hug each other. We talk about funeral arrangements. We rarely make eye contact for fear of the tears we’ll see. And for me, suddenly, after twenty-three years of vegetarianism, I have a deep craving for meat. I see no reason to resist it. In the time between Elena’s death, her birth and, ten days later, her funeral, I eat everything in my path.
And I shop. I shop for the house renovations that we have finally started. I pick out bathroom fittings and tiles. The January showrooms are surreal places. I have to leave the first one, my flood of tears startling the shop assistant who had asked me what kind of bath we wanted. At the second, I just point at the simplest, cheapest models. I shake my head when asked to choose between mixer taps. I look at the shiny chrome and I wonder why this is what I have chosen to do on the day that Elena is lying in the hospital mortuary, the place they call the ‘angels’ room’.
On the day of the funeral, I go to see Elena one last time, to sit with her in the hushed room at the funeral parlour, to tell her that I love her and that I will look after her mummy. At the chapel, I watch my sister’s shoulders. She holds them straight. I have never seen anything more heroic.
The time with Elena was so fleeting. V was pregnant for nine months and knew her daughter, her movements and rhythms. For each of the rest of us, we watched from the outside as V grew large with her, felt her kicks. Even for Elena’s father, this was the limit of knowing her before she was born. And with so little to remember, I find myself deliberately playing and replaying my few memories. It annoys me that though my impressions of the days around her birth are incredibly vivid, I forget small details, the order of things, the exact time she was born. After her funeral, I find myself telling strangers about her, I install her picture on my phone, I call her by her name, all just to keep hold of her. Since Elena’s presence in this world was so delicate, so fragile, I love her extra fiercely, asserting and re-asserting her existence. Even now, I think of her every day and wish, every day, that it was different. I don’t want to celebrate her in her absence, or to hold her in my heart; I want to hold her in my arms, laughing or crying, but not, not as I held her in that delivery room, so beautiful and so soulful, but so unquestionably, so irrevocably gone.
Milestones come and go. Relentlessly. V’s due date. One month since Elena’s death. One month since the funeral. We spend the first Mother’s Day together. V makes a rainbow cake. Then comes the autopsy results, showing no underlying genetic problem, just a tragic heart anomaly. V’s partner starts to raise money for the National Children’s Hospital, to support the Heart Unit and the children for whom there is still the hope of treatment. We all wonder if there was any way that Elena could have survived. What if we’d known? Could some intervention have changed the outcome? My colleagues donate the proceeds from a charity lunch and cake sale to the fundraising project. V’s partner and his friend do a parachute jump. V and I do the Women’s Mini-Marathon. Before the race, we all get together to hand over the cheque to the representative from the hospital. We’re in a crowded hotel basement function room. People mill around in groups, branded with t-shirts bearing the names of different diseases. Every person has a story, a child whose survival, or whose memory, compels them to be there. It is a way of doing something when there’s nothing to be done.
Very soon, V’s maternity leave is over. But soon too, with joy, relief and nervousness, she tells us that she’s pregnant again. This is a pregnancy that goes well, that doesn’t have a sad ending, that results in nine months’ time in a healthy baby boy. This is the pregnancy that she should have had the first time around. It’s bittersweet. It’s hard. It’s healing.
INSPIRED BY MY SISTER’S COURAGE, I decide that I need to know what is wrong with me. We register at a fertility clinic. I start a series of tests and examinations to find out more about my reproductive system, convinced there must be an identifiable reason for not conceiving. The consultant says male infertility is easier to deal with, and so I actually feel disappointed when R’s sperm count comes back normal. It must be me. But test after test shows there’s nothing actually wrong with me either. I go for weekly internal ultrasounds, horribly accustomed by now to the probe, and hopeful each time that some non-compliant part of my c
ervix will reveal itself. I am ovulating, which seems to be the holy grail, though my cervical lining is thin. The fertility drugs will boost this, I’m told, but I’m not reassured, because no one can answer why my period cycle is nowhere near what it used to be pre-miscarriage. Why is it that no one but me seems that bothered by this? I have pages and pages of daily charts of my ovulation, discharge and bleeding. I show these charts to every doctor that I see, and every single time the doctor smiles patronisingly, barely glancing at the top sheet, before shoving the charts in the back of the folder.
Still, I persist. In late summer, I’m in Holles Street Hospital again. God, I hate this place. This time I’m in for an exploratory procedure. As usual, I’m naked from the waist down, lying on a plastic-covered reclining chair, feet in stirrups. My fertility consultant is here, and two nurses. There’s another internal probe, but this one has a camera at the end of a long tube that sprays warm water. The water will clear any blockages and the camera will see what’s going on with my fallopian tubes and ovaries. It is painful from the beginning and it gets worse as the camera moves further inside me. I start by asking questions but soon I cannot speak. I am so afraid of betraying myself by crying out that I deny even to myself how painful it is. The nurse sees my clenched face and gives me her hand. I crush it.
When it is over, the consultant tells me that women often compare the pain of this procedure to childbirth. She calls me a hero and suggests I take a couple of ibuprofen. And then she tells me that there are no blockages, no unhealthy lining, no dodgy tubes. I should be pleased, but I realise I wanted there to be something concretely wrong with me. I stand to go, still leaking water. ‘Was there anything else today, Emilie?’ the doctor asks. There is so much else. Fix me, I want to say.
But maybe I can’t be fixed. When we go back to the fertility clinic the consultant says that since I was last tested, at thirty-six, my egg reserve count has depleted significantly. She likens the reduction of fertility to falling off a cliff. She says that the decrease makes IVF urgent. ‘Don’t wait,’ she says, ‘Don’t wait even six months.’ As soon as she says the words, I nod because I’m ready to do IVF, to sign the papers, to go through it all for what I want. I treat it as if it were a straightforward decision. But then I remember to ask about the process. We listen as she explains the injections, the medication, and the egg-harvesting procedures. Did I mention that I hate injections? Having seen me get bloods taken, R shudders at the expectation that he’ll administer the shots. He asks what the likelihood of multiple births is. We’ve heard of more than one couple with IVF twins. The consultant smiles and says there’s minimal chance of that happening. It seems an insufficient answer.
To lighten the mood, I think, she remarks that after all the injections, all the petri-dishes, and all the lab-fertilising of eggs they ‘throw them in and hope something sticks’. Throw them in. The casualness of this pronouncement makes me feel like throwing something myself. Despite the tests and the internal probes, from where I’m sitting, and the lack of answers I have been given, these people seem to know next to nothing about what actually makes a pregnancy work.
I ask about the odds of conceiving. She says 28%. In the days after the consultation I do a little further research. With my age and egg reserve, it’s more like 20%. I’m confused, again, by the lack of transparency and the absence of answers. Read the other way, it’s an 80% likelihood of not getting pregnant. If it were a case of paying this clinic the €9,000 they quote us and getting a baby at the end I’d be there like a shot, brandishing my chequebook, no matter how many injections and how much stress the hormones caused. But the odds are bad, and it’s a lot to pay, and I don’t know how much more disappointment I can take. In the foyer of the fertility clinic, we look at each other. I say that we can raise enough money for one round of IVF and I vow that I’ll stop at that. But R looks sceptical, because he knows me better, and we both know that I hate to fail, and so if it doesn’t work the first time, I’ll beg and borrow for a second cycle at least. Let’s talk about it, he says.
We end up in the park across the street, though it’s threatening rain. The seemingly ever-present bulk of the hospital is visible through the trees, so we pick a bench facing away from it. We sit a little, and wait, knowing that the words we say will be crucial. And we have what is probably the most important conversation of our lives. He says the odds are terrible, and I give him that. He says that the process looks to be miserable, and I concede that too. He says the whole thing is making him unhappy. Me too, I say. But, I add, being unhappy now makes me more determined to grit my teeth, in the hope of a better future. He says it makes him question the whole thing. He points out that we’ve been bickering lately. A lot. I open my mouth to contradict him, but yeah, we have. Still, I say, it’ll be worth it in the end. And then there’s silence.
I knew that sex on demand had not been great for our intimate life, but I hadn’t realised that we were so far apart. For months I’d been feeling lonely; it didn’t occur to me that he might feel the same. I had ignored and shut out his objections, impatient with his hesitancy about IVF and seeing his oppositions as another frustrating example of the ‘leave it to mother-nature’ dogma. I was terse when he pointed out that I’m not sick, and that it’s good news that there isn’t anything actually wrong with me. I’m broken, I countered. Look at me. Un-pregnant equals broken. When I elected to go for the painful and invasive tests, he was sympathetic but simultaneously reluctant. I snapped at him that I was making all the effort.
We have both wanted a baby and we have both tried so hard and we have both felt the heartbreak of miscarriage. And now we both have to face something else: the reality, and the emotions, of perhaps not becoming parents. We sit on the park bench and I feel sad and lost, but he takes my hand, and I listen. I listen as he suggests that we remember our lives are about more than infertility.
My close friends who have tried IVF have not been successful. My best friend underwent several cycles unsuccessfully. She and her husband are now divorcing. I have watched other friends go through similar anguish. On the other side, I also know parents who have had children after miscarriage, and parents who have happy endings, wrung from multiple fertility clinics and multiple rounds of treatment. And we know people who have managed to adopt, though that in itself was a gruelling, years-long process. I am torn between recognising the hardship that fertility treatment puts couples through, and believing that if I just try a bit harder then I could be a mum.
But I can no longer avoid the fear that I will lose what I have in the pursuit of what I may never have. If things continue as they are, then there may be no baby, and there may be no relationship either. We agree to pause. This means more than not going ahead with IVF. Not ‘no sex’, but ‘no sex to a fertility schedule’. We’re going back to normal. It’s now late September and we decide to return to the conversation in four months.
And instantly things improve. I sleep better. We’re nicer to each other. The bickering evaporates. It’s like we have been set free. Really. It was amazing to me then, and it still is. A friend once advised me, as we watched his toddler daughter learning to walk, to just make a decision. Either do it, or don’t do it, he said, but don’t lose yourself in the limbo of maybe doing it. Now, I understand the wisdom of this. Making a decision is incredibly empowering. Following our park bench conversation, I occasionally catch R looking at me, checking to see if I am really okay or just pretending. Having done it my way for so long, now we’re trying it his, and I see him taking responsibility for my happiness. But stopping really does come as a liberation to me too. Because, finally, I can stop obsessing about my body. I can stop noticing what movement of my cycle I am in. I can stop the charting, the monitoring, the peeing on sticks. And I can comprehend how oppressive it has become. And I can relax.
The relief for all of us through all these months is that V’s second pregnancy is going really well. It is not without its stresses, and it is an act of pure faith for them as par
ents to risk it so soon, but the baby is healthy. In comparison, my own baby-thoughts feel minor. And soon it is January again, the first anniversary of Elena’s death, and her first birthday party. Though we celebrate her life with a birthday cake, New Year’s Day will never, now, feel like a moment of renewal, but only a reminder of her loss.
In mid-January R and I look at each other. It’s a long look, a charged look, a look tender with mutual compassion. It’s a look that confirms it: no IVF.
IT CAN BE DIFFICULT to leave the ‘trying’ behind. As we attempt to get back to how we used to be and to begin to accept that maybe there will be no baby for us, there are moments that challenge my resolve. One day I decide to tackle the leftover ovulation tests and baby-making books that hide in the bottom of the wardrobe. It’s a bit of a watershed, to throw these all away, and I’m dismayed by the pile of plastic. I can’t see any markings on the packets so I phone my sister to ask if she thinks they’re recyclable. She hears the panic in my voice. ‘Oh, Emilie,’ she says sympathetically. ‘Just throw them in the bin.’
The decision not to undergo IVF was not lightly made. Talking about ‘fertility’ is a bit like when you’re a kid (or a university lecturer) and you learn a new word and, suddenly, you see and hear it all the time. Everywhere we turned there were reminders. Once we’d realised conception wasn’t happening easily, it seemed as if there were ads for fertility clinics on every radio station. Newspapers carried full-page ads, one with the slogan ‘Everything you thought you knew about fertility is wrong’. This particular ad runs, literally, for years. At the time of writing, it’s still running, still getting scrunched up by me as I shove it in the recycling bin. The coincidences go on. My favourite podcast includes a segment on relationships that broke up because one half of the couple didn’t want children. I read a great film review and when I check the author’s byline I see that she has written a book on her decision not to have children.