Poor Your Soul

by Mira Ptacin

  But the baby will die, so continue anyway? Should doctors induce for a vaginal delivery? Will she miscarry? Should she terminate? Termination. Abortion: there’s the hook. It’s an ongoing debate. Hot-button issue. We’ll have to decide on the point of view, and how to frame it. The author will have to choose her words carefully: baby or fetus? “Fetus” when referring to an unborn child in the post-embryonic state—it sounds neutral and scientific. The term “baby” implies that we are talking about . . . a baby. We also have to decide on what to call the termination of the pregnancy. Partial-birth abortion? Sounds ugly. Such a harsh word choice. It would really influence the tone of the narrative. Like “heart attack” or “female genital mutilation.” Next: hero or villain? Then, pregnant out of wedlock. Selfishness—this could be her moral wrong. So how does she alleviate it? Should she be passive? Also: what ethical standards are we going by? How does she make her decision? By listening to her instincts. If her heart is pure, yes, she will know. If it isn’t, we shall see.

  No, thank you. I’m going to keep this one to myself.

  xyx

  After the ultrasound, the doctors told me I have three choices:

  1. Terminate the pregnancy next week.

  2. Do nothing at all and possibly miscarry.

  3. Induce early and deliver next month.

  Not long after the ultrasound, the doctors and specialists stopped sounding as if they were talking about a baby, but rather about something made out of metal. Their words were technical and cold. I got defensive and argumentative. So when I have any questions, Andrew gets answers and relays the information as gently as he knows how.

  “She can’t breathe on her own,” he’ll say.

  “How can we be sure?”

  “Lilly has no brain development.”

  “What if the doctors just aren’t trying hard enough?”

  “They said she’s not quite a stillborn, but there is a strong possibility she may die in your womb,” he explains. “You can do what you want, but she could die inside you. Any day.”

  Andrew hasn’t asserted his feelings about any of the decisions I’ve been presented with and I haven’t asked for too many details about my options. I can only handle so many details, facts, suggestions, opinions, feelings. The more voices I hear, the harder it is to decide.

  My mother suggested Option #3: Induce and Deliver. She said, that way, unlike with Option #1, I could be conscious. I would be awake, lucid; I could play a part in it, push, deliver. “You’d get a chance to see your baby, hold her and say goodbye.” Mom said this might give me closure, and that closure is a very important element in the process of healing. But when I think about Option #3, I picture myself draped in a baby-blue paper gown, feet propped, wearing slippers and a hairnet, pushing, sweating, bleeding, delivering a lifeless, barely recognizable, red-hot creature, or a gray-blue mass, and it terrifies me. My mother hasn’t speculated as to what I would be giving birth to. And after I gave birth, would Lilly be alive? Would she move? And for how long? Would she make sounds? Coo? Cry? When would doctors decide to take her away? When would I want to let them? Where would she go? Option #3 sounded like the worst choice. What my mother didn’t bring up was whether or not at five months a delivery would be painful. Or how much I might rip or tear. If I delivered, would I still adhere to my mantra of a “natural” and drug-free childbirth? While inducing sounded the most natural, it was what I least wanted. Option #3 horrified me.

  There is Option #1: Terminate. Also known as “dilation and extraction.” Dilation of the cervix, extraction of the fetus. Dr. Stein has been nudging Andrew to nudge me to consider termination. She gives him the facts, which he shares with me. The D&E would take three days and would be painful. First step: dilate the cervix by inserting laminaria rods (“They’re made out of seaweed,” Andrew told me. “Can you believe it?”). Andrew mentioned forceps, and when he started to explain the extraction process, I made him stop. I didn’t want to hear the specifics—what is the point? The details don’t matter because the result is going to be the same. Dr. Stein checks in on Andrew every day with a sense of urgency. She needs a decision from us soon. The procedure can only be performed up to twenty weeks into a pregnancy; I only have a few days until that window closes.

  I am currently exercising Option #2: Do nothing and wait.

  I haven’t made up my mind, but I am aware that once I arrive home from California, Andrew, my parents, and the doctors will expect me to have picked one of the three options and made a decision. I have promised myself that today, before I come down from this mountain, I will have brought down the gavel. Focus.

  I clutch my abdomen. I just don’t want to be selfish.

  For nearly five months, Lilly and I have spent every second together, but I still haven’t really felt her. There have been many times when I’ve held perfectly still at night, anticipating some kick or flutter, but she’s never once kicked or fluttered. I’ve waited for her to give me a sign, for her to make this all seem real and recognizable, but I’ve never felt what I thought I should: a spark, another presence. There is my large belly, there is my nausea, but I don’t feel her. I feel completely alone. Is it because I don’t recognize her? Or is it because she’s not really there? I’ve felt a million different things, but I can’t tell which one is her.

  I thought the ultrasound would make Lilly feel real, feel alive within me. I thought that once I saw her on the screen, the magic would envelop me. I would feel like a mother, not a child. I thought that once I saw the baby—not an invisible ball of emotions, but an actual baby—I would feel relief and love would take over. But the ultrasound was not what I had anticipated. Lilly remains a phantom. After the ultrasound, I began to feel that Lilly’s fate was my fault. That my fears and anger from the unplanned pregnancy had damned her. Even though I believe in choice and reproductive freedom, even though I trust others to make decisions for themselves, when it comes to my own freedom to do what I feel is best for me, I’m not sure that I deserve to have such an easy way out. I don’t believe in bad luck; I just think I’ve failed—as a young woman, as a daughter, at motherhood—and that I should be punished.

  My pocket vibrates. I open my eyes, puzzled and squinting, and reach down for my phone. It’s Andrew. He asks me how I am holding up, tells me he’s okay, that Maybe is doing okay. His voice is bland and weak. He asks me how classes are, am I sleeping all right, eating okay, making friends; I lie and say that all is well.

  “That’s good,” he says.

  “My writing instructor is really fantastic.”

  “What else?” he asks.

  “One of my new friends told me I am a hot pregnant lady,” I tell him.

  “That’s nice,” Andrew says. “Anything else?”

  “She asked me if it’s a boy or a girl. I told her that we’ve named her Lilly.”

  I try to keep the dialogue moving quickly, but our exchange becomes choppy, the pauses expand. The conversation hesitates, then halts, then Andrew brings up what I’ve been circumventing.

  “Mira, did you decide?”

  “Decide on what?”

  “Boo, come on. Your decision. About Lilly?”

  And abrasively, I say nothing back.

  “Mira,” Andrew says. “I just got off the phone with your dad.”

  The word “violent” has been fluttering in and out of the conversations between Andrew, my parents, and me for the last three days since the options were presented. Dad told us that from what he understood, if I terminate the pregnancy, the procedure is a “violent” one. A late-term abortion means a violent surgery. What did this mean, “violent”? While it sounded the least natural, it was what I was leaning toward, but with such a word being used to describe the end of my pregnancy, I started to look at myself as a savage. I thought my parents would also start to look at me as a selfish brute and this made me defensive. Their opinion mattered too
much. Their peace of mind was vital. They’d already lost a child. They lost a child in a moment that I may have been able to prevent.

  Ever since Julian’s funeral, I had calculated nearly all my bold moves in a way that would do the least damage, that would keep the most people safe. Finally, no more news of death or dying. In getting pregnant, I’d created more death. Just when they started getting excited about the baby, we learned that her life wasn’t viable. I’d done it again. I was the worst. I tried not to get pregnant and I got pregnant. I tried to sustain life and I killed it. It’s as if no matter how hard I tried to protect them, no matter what I did or didn’t do, my actions kept harming my family. It was as if I was cursed: I couldn’t not hurt them.

  And now, no matter what, this baby is going to die. And I have to choose how. A late-term abortion meant a violent surgery, was what my father had said. And while my father meant this as a procedure that was the most violent on the patient, I kept thinking of it as an ethical issue. If I choose to terminate, would my parents view me as a selfish brute? A murderer? Their opinion weighs heavily on me. If I choose to terminate, I’ll be what the pro-lifers hate. I’d choose what many call partial-birth abortion. Why? It’s not that. It’s not just three words. It’s not “changed my mind.” It’s not “quick fix, please.” Or “kill this baby.” Partial-birth abortion. It doesn’t just end there.

  “Your dad called me after talking to Dr. Stein,” Andrew says.

  Frustrated and terrified, I start to cry, and listening to the ugly noise I’m making causes me to cry harder.

  “Shhh, shhh, Boo, calm down,” he says. “Look—”

  “They think I don’t care.” Now I’m sobbing, taking long heaves of breath between my words. “You think that because I wasn’t excited I don’t care,” I say, but when I say the words, something doesn’t feel right.

  “Stop.”

  “Jesus!” I cry. My mind is spinning like a car on ice. I have been looking everywhere for it, but the only answers are opinions. “I’m hanging up.”

  “Listen to me, Mira,” Andrew says. “They talked to Dr. Stein. They think you should terminate.”

  “What?”

  Andrew relays Dr. Stein’s message: Partial-birth abortion is not an option. Partial-birth abortion is a political and inaccurate term not recognized as a medical term by the American Medical Association. Or the American College of Obstetricians and Gynecologists. It’s inaccurate, a generalization, a terrible term. She says that my situation, right now, is my body’s. That I have a choice in what I do with my body. That, as a doctor, she strongly recommends the healthiest option—dilation and extraction—and that I couldn’t have prevented any of this and that I haven’t done anything wrong. She tells them that I need to understand this, and that this is a decision I need to make for myself based on what is best for me. And that the best decision, the healthiest choice, for me, in her opinion—as a health professional, as a woman, and as my doctor—is to end the pregnancy. That the only one who is going to survive this is me. Period. This doomed pregnancy is something that is fated, inevitable. Not a fate that I have any control over. Lilly is dead and she is not dead. She was never truly alive, but I am.

  I lean back into a bed of twigs. There is nothing left in my mind. Beneath my eyelids, I see blue-black, and I can’t think of a single thing. I will sit in this nothingness for as long as I can, and when the sun sets, I will make my way back to camp.

  Under my eyes, I feel airy and weightless. I drift, doze. I fall into a trance—and suddenly, a blast of air and a firm pressure presses onto my face and my chest. The sense of a presence or the feeling that someone is watching me flashes me back into lucidity, and when I shoot up to see who is there, I’m still alone. There is nothing, other than the setting sun and a navy sky.

  By the time I return to base camp after having just barely caught the last gondola down the slope, the dining hall is empty and the writers’ colony appears completely cleared out. Only a handful of summer kitchen staff members remain, mopping the cafeteria floors and stacking chairs.

  twelve

  “They’re going to be using seaweed,” I whisper into the phone. One hand is holding the receiver and the other is cupping my mouth. It’s four o’clock in the afternoon and our roommate still hasn’t left for a friend’s house on Long Island—hence, the hushed details of my personal life.

  “Seaweed?” asks the voice on the other end of the line. “As in a weed from the sea?” It’s Amanda, my best friend back home in Michigan.

  “Yes,” I say. “The surgeon is going to put seaweed in my vagina. To open up my cervix.”

  It’s close to dinnertime and I’m still in my baggy, pink pajama bottoms and a grainy T-shirt that reads: Strictly for my ninjas! Amanda gave it to me last November for my birthday and it’s my favorite shirt.

  “As in kelp ?” Amanda says.

  “That’s what I’ve been told,” I say. I’m paraphrasing to her the information about the procedure that my dad gave me earlier in the day, which wasn’t much.

  “That can’t be right,” she says. “It just sounds like some holistic new-agey voodoo shit. Are you sure you heard them right?”

  My father had mentioned something about the seaweed before the doctors and nurses got around to it, but other than that fact, he didn’t know much about the procedure I had picked—Dad had never performed it and he wouldn’t perform it, and he’d never seen the surgery being done, either. The most he could give me were a few bits and pieces, remembrances of things he’d read in medical journals and textbooks.

  Seaweed? Baffling. When I told Andrew about it, he jumped on the computer and began investigating.

  “It’s called a D and C,” I tell Amanda. “What does D and C stand for, babe?” I ask Andrew.

  Drone-like, Andrew is sitting across the room from me at our square, wooden table, researching the upcoming three-day-long procedure. My fiancé’s big, brown eyes are hastily scanning the screen of my laptop.

  “Dilation and curettage,” Andrew says without looking up, and I repeat it to Amanda.

  “Cutterage? Seaweed and cutting? ” Amanda starts to whimper. “Oh my God. Just what are they going to be doing to you?”

  “No, not cutterage. Curettage. As in cure,” I say.

  “I think Dr. Reich said you’re too far along to get a D and C. I think the surgery is a D and E,” Andrew replies without looking up. “Not C. And it stands for dilation and extraction.”

  “I mean D and E,” I tell Amanda. “I think the surgery is a dilation and extraction. But please, don’t worry. Please. It’ll be fine. I promise, I’ll be fine.”

  At least I’m pretty sure. To be honest, I don’t really know what to expect when I show up at Beth Israel for my appointment tomorrow—day one of the three-day procedure. My surgeon didn’t ever really get to that part, the part about what’s going to happen the next day, the day after that, the day after that, and on and on from there. After I had made my decision to terminate the pregnancy and handed myself over to the medical specialists, the only thing I remember being told was where I had to be and when, when I could eat and drink and when I couldn’t. The rest, I assumed, was going to be a surprise.

  But right now, none of those things really matter to me. The particulars, the specifics. At the moment, I don’t care. Right now, I can barely stand to think about anything beyond this moment.

  I hang up the phone with my friend, promising to keep her posted, and waddle over to the table. I stand behind Andrew and run my fingers along the curves of his shoulders. They feel like billiard balls.

  “It says here that the laminaria is really seaweed,” Andrew says.

  “Weird,” I say, glancing over him at the image on the screen.

  He continues. “Found in the North Atlantic and Pacific and in the warmer waters of the Mediterranean Sea.”

  I lean in.

  �
�They’re seaweed sticks. And they’re some sort of algae, see?” Andrew moves his head to the side of the computer screen so I can get a closer look. The monitor reveals an illustration of a big, pea-green plant with flat, billowy blades.

  “Weird,” I say again.

  “I know, right? And here,” he says, tapping on a thin paragraph on the screen, “here’s you.”

  Andrew traces the words from left to right across the screen with his middle finger and reads them out loud: “The name also refers to the function of these algae used to dilate the cervix when induction of pregnancy is necessary. It serves to absorb moisture and then expand, subsequently expanding the cervix.”

  As I listen to the description, my imagination kicks in. In my mind, I draw pictures and put together a scene: fleshy anemones, green leaves, and tadpoles, all shadowed by the undersides of lily pads.

  He continues: “The laminaria rods are inserted into the cervix, and over the course of several hours, they slowly absorb water and expand, dilating the cervix and eventually prompting labor.”

  A pond. A dark basement. An underwater forest, shrunken and quiet. Rolling mounds of brown sand folding over and over again, morphing into un-shapes.