replacement

 

With our surrogate, Kyrie, just a few weeks away from what we hope will be the safe delivery of our son, I've been thinking a lot about the relationship between this possible new baby and the twins we lost a little more than two years ago. Of course, this new child can't be a literal replacement for the twins. But there's less to distinguish them than one might think.

 Part of that is simply the mechanics of IVF. One afternoon in April 2006, on the third floor of a big hospital in the Northeast, ten embryos were coaxed into being. Curled in their petri dishes, cells dividing, the embryos, from my point of view, were interchangeable. I hoped that at least one of them would grow to be my child, but I didn't care which one and I didn't give much thought to what would happen to the others.

The doctors chose two embryos -- call them A and B -- to transfer and froze the rest. A and B became the twins and we all know how that turned out. So, in April 2008, they unfroze embryo C, which is now, at least theoretically, the baby due at the beginning of January.

Although the selection of which embryos to transfer wasn't entirely random, chance clearly played the guiding role. Right now, I could just as easily be mourning the loss of embryos D and E or cautiously celebrating the impending arrival of F. And that cascade of contingencies make it that much harder to attach significance to the individual identity of any of them.

Moreover, over time, the twins themselves have become mostly an abstraction. I have almost no actual memories of them -- a positive pregnancy test, a dozen increasingly ominous ultrasounds, a month or two or flutters and kicks. What memories I do have are really about myself, my hopes, my wishes, my painting an imaginary future in pastel shades of pink and blue. And, though much more hesitantly, I find myself now thinking almost the identical thoughts, transferring the old dreams to this new child and wondering whether I can see this child -- at least in some non-literal way -- as one of the twins returned to me.

Because I tend to think in metaphors, and extended and heavy-handed ones at that, let me put it this way. Imagine you're looking into a series of lighted kitchen windows at dinnertime. In one lucky house, all the chairs at the table are filled with cheerful family members. In the house next door, there are chairs with no-one sitting in them, but you notice that they're drawn close to the table, still part of the family circle. In yet another house, the table at first seems full, but if you look in the next room, you'll find the unused chairs carefully, lovingly stored away.

And then, in the house I hope one day to live in, there's a chair that, in the manner of Schrödinger's cat is simultaneously occupied and empty.  And in it sits a little boy who is at once here and, well, absolutely elsewhere.

 

Your thoughts on the concept of the replacement child? A dangerous or unfair idea? An understandable rationalization? Something in between?

What does your dinner table look like?

from a distance

The raspberries are almost over, but tomatoes are still green and it seems quite possible that the beginning of January will never get here. Our surrogate, Kyrie, is 18 weeks pregnant. I didn't really think we'd get to this point and it's hard to imagine that we'll ever get beyond it. 

There's a certain air of unreality about the whole thing. At least physically, it's nothing like last time at all. There's no morning sickness, no paneled and pouched maternity clothes, no flickering quivers against my stomach, no dull leaden slug lodged under my ribs. I don't turn sideways in front of mirrors, pulling up my shirt to let my hands play up and down the pale convexity of a belly become a gibbous moon. Right now, I'm sitting on the back porch, and the only thing I'm considering is whether I should pour myself a second glass of cheap white wine. 

It doesn't seem to count. It doesn't seem like it's really happening. Unlike last time at this point, I haven't told anyone -- not my coworkers, not my family, not my friends. I've been to the appointments, but I don't look at the ultrasound screen and I never talk to the doctor. It's like it's happening to someone else. It is happening to someone else. 

I don't really have any negative feelings about the concept of surrogacy --maybe because, long ago, I had a successful pregnancy or maybe because I know that the odds are overwhelming that any future pregnancy of mine would end the same way the last one did. And probably that's why I sometimes forget that surrogacy is, for a whole variety of reasons, fairly unusual and quite controversial.

But I've been wondering what you all think. Comment honestly (and anonymously, if you'd prefer). You're not going to upset me or hurt my feelings and I realize that there are reasonable arguments to be made on both sides. What's your view on surrogacy? What limitations (if any) do you think should be placed on it? Should it be available to someone like me who, theoretically, could carry a baby to term, but runs a high risk of another death or a catastrophically premature baby? Would you consider working with a surrogate? Could you imagine being a surrogate? Why or why not?


Time and again

Last time I was this pregnant was the day my baby died. It was a busy, crazy day that turned into the evening our after started. Our son was born the next day. That was exactly eighteen months ago.

I want to say something profound. Dates, numbers, coincidences. I also want to say that it's just a day, it holds no power. (Right? Right?) The boy who is still alive in me is no more or less likely to die today than any other day. But today I am unmistakably more anxious than yesterday. 

He looks like his brother. We know that from the ultrasounds. It started with the nose. I saw it on the anatomical scan, and almost gasped. A had this weird nose that nobody else in the family has. Of all things, I didn't expect the nose. Since then we have seen the cheeks, which are not surprising-- they are my dad's, mine, Monkey's, and A's. Other features are less clear, but the time before last the ultrasound tech pointed out his big hands (A had long fingers) and that he had some hair. A's hair was curly. 

Is it just that were he to be born today, I would know what to expect? What he would look like, what his weight would feel like in my arms? He is smaller than A was, but not by much-- half a pound or so, likely. That was the thought I was working on this weekend, as the doctors worked to stop my preterm labor-- that I may, in a matter of hours, again hold my son in my arms, that were that to happen, I would need to let myself be in both places at once, simply because I don't think I could stop myself from going back.

The birthing rooms in my hospital are pretty similar, though the beds in some face one way, and in some-- the other. The rooms where I had given birth to my two children so far happen to frame one side of the same wall of rooms-- Monkey's right up by the ORs, and A's down the other end of the hall, where there would be minimal interaction with the world of live babies being born, where they could then walk us out through the back door, so we wouldn't have to run into any happy people. The room where I was this weekend, fittingly, I guess, was half way down the hall between the rooms where Monkey and A were born. This room was set up the same way as Monkey's, with the bed in the room facing the bed in A's birth room. If I peered really hard through the walls, and through time, I could see us in that other room. Monkey's birth was behind me, has been for over six years now. A's, in some way, was, and still is, in front of me. 

 

So tell me, please, if you have had a subsequent birth already, how did it feel? How did it go? If you are still hoping for one, what goes through your mind as you think of it? Or do you give that part any thought at all? If you are not going to get one, what does that do to you?


this cup pass from me

I am carrying a child who is almost precisely the gestational age her brother was when he was born.  And when he died.  And this is scaring the shit out of me.

26 weeks, 1 day is actually pretty decent for a micropreemie.  They told me Finn had at least a 75% chance of survival without major complications, statistically...even if he was a white male fetus, that most vulnerable creature of the species.

I have learned, more viscerally than any professor could ever have hammered through my skull had I actually braved such a subject in my studies, that statistics lie.  Or that only fools believe they will come out on the positive end of them, at least.  He did have major complications, ones that proved insurmountable, fatal.  Despite steroid shots, his lungs collapsed.  One so severely that they tubed him directly through his skin, through his tender, papery flesh and the tissue of his tiny ribcage.  I do not even know if there was anesthesia...I was ten rooms away, trying to recover some feeling in my legs and a blood pressure reading high enough to qualify as alive, to prove to the nurses that I could stand so that they'd let me hop in a wheelchair and go to him.  When we finally won that fight and were ushered to his incubator, the wounds of his own battle were already vivid upon him.  His little fingertips and toes were blackened from lack of oxygen, and his chest had been cut, his throat tubed.  Before his mama ever held him.  Before there was ever a gentle touch or a voice that spoke his name.

Then we did hold his hand, and he squeezed our fingers, and we stroked his little feet and marvelled at him, and in the end hours upon hours later when the outcome of the battle was undeniable we surrendered and unplugged him and held him and tried to fit a lifetime of love and comfort into one last hour, before he was gone.  We were lucky, beyond measure, to have that time. And he was medicated, probably more than I even realized, so I do not think there was pain for him at the end.  I allow myself to think that.  I need to think that.

But for the longest time the rest, those brutal early hours, were something I simply did not allow myself to think about at all, because there was this primal cry that would rise in my throat and choke me.  Because my baby, my tiny baby, had been born to a shock and suffering that even now I know I only know the half of.  Because that was the first of his brief hours of life.  And because it was me who enabled it to be that way, me who made the decision, at 26 weeks exactly, that we would rescind our previous "no heroics" designation and go all out to save the baby I believed by then could be saved.

I don't exactly think I made the wrong decision...that's not why I lie here in a cold sweat before dawn some mornings.  The odds were that he might have survived and thrived.  I would, I think, have felt worse had we done nothing and lost a baby who might otherwise have come through okay.  And I don't exactly feel guilt, because I made the decision without guile and on the basis of the best advice I could get at the time.   But owning that decision and the pain that it - that I - caused that tiny boy will sit with me, part of me, until the day I die.  It is, if I am honest with myself, the cruellest thing I have ever caused to happen to another human being, no matter my intentions, my investment, the depths of my love.  And what wakens me in the thin light of 4:30 am these days, heart pounding, is the fear that sometime in the next week or two I may have to face it again, to choose again.

Choice is often and in many ways a privilege.  When you have no real control over the outcome of your choices, though, it can feel like a mockery, like a bitter joke.

They ask me if I want the steroid shots and I say, i don't know and I cast my eyes around the room like a trapped animal, wondering hell, do i look like i'm writing this story, like i'm in charge here?  The truth is if my cervix is showing significant weakness of course I want them NOW and if it's not I want to wait because they are most effective when given within two weeks of delivery and preferably after 28 weeks but sometimes it's weak and soft and sometimes it's not, that tricksy cervix.  The truth is these same practices have taken far less significant decisions out of my hands in the past, in the crises of labour, so the fact that they defer to me on this Big Thing just leaves me wary, puzzled.  The truth is they don't know what's going to happen and I don't know what's going to happen and I don't want control of Big Decisions in this liminal boundary zone because I know it is a fool's game. 

I am chickenshit, burnt crispy.  I want to abdicate.

The little life that hangs in the balance...for my own sake, sure, I want her at all costs.  But for hers?  That is the road I do not seem to know how to walk this time, the road I wish I could close my eyes to and ignore until it is safely past and I get to believe, maybe, that I will not have to choose again whether or not my child's brief life will be one of pain and machines and invasive procedures, until we reach a place where I can breathe and hope that I will get to play mother this time, not hapless, impotent god.

I whisper, please.  give me a few more weeks, and i'll happily pretend that I'm bossing you around for the rest of my life.  

 

Layers

I don't remember what I was wearing that day. I remember my long black winter coat because before I left I asked Monkey for a hug. But I don't remember what I was wearing under it, what I must've seen all day as I caught sight of myself-- my sleeves as I typed, my pants as I sat down, my belly as I balanced the laptop on my lap while I waited for Monkey at gymnastics that afternoon or as I waited for the kicks that never came that night. I remember the dinner I ate as I tried to coax those kicks, but I don't remember what the shirt was that covered the belly on which I balanced the plate. I remember that the radio was on as I drove to the hospital, and I remember that I thought the program was interesting, but I can no longer remember what it was about. Now that I know that the full moon was in fact supposed to be there, I can verify that the memory that started knocking on my brain's door recently, of the full disc as I drove, wasn't a figment of my imaginataion fabricated later on-- I really did see it. But I don't remember what I was wearing. Not as far as anyone else could see, at least.

I remember what I was wearing under my shirt. A bellybra, that wonderful contraption that distributes the weight of the belly over the whole back, making it much easier to function. Even if I didn't rememeber, this detail I could reconstruct, as I never went a day without it the last couple of months of A's pregnancy. But I do actually rememeber. I remember because the nurse asked me about it as she was preparing the probe to look for the heart beat. I gave her a glowing review, and she said she needs to remember it for next time because her back was killing her the last couple of months with her first-- what with being on her feet all day. I wonder, given what happened in the next 5 minutes, does she remember it now?

When I first discovered that I couldn't remember what I was wearing I thought of it as a good thing-- next time around, I reasoned, I wouldn't have bad associations with any of my maternity clothes, I could wear all of them again. Except for that bellybra, of course.

 

I am 28 weeks 4 days along today. If you come to my house, I doubt you can miss the belly. And yet, when I am out and about, I still wear a shawl. Unless it's over 90 degrees outside, and then I put on this net-like thing that goes over my head, is long, and a bit shiny, but is far less of a  disguise, though it still makes me feel a little covered, a little protected.  I waddle, by the way. Thanks to the pelvic pain that makes it hard to walk straight. So I waddle, and the belly sticks out farther then the boobs, and has for a couple of weeks now. And still I insist on having something that gives me some illusion of maybe fooling someone out there.

At first I thought that the shawls were my protection against the stupid that is out there, against the untouched who think a pregnant belly equals a live healthy baby 40-X  weeks from now. I didn't want to talk to them. I didn't want to deal with their "congratulations" and their "is this your first?"s. I didn't want to give them an opportunity to tell me all about their utterly normal life where assumptions of invincibility hold. A bit later I understood that I was also avoiding having to tell people that I am not jumpy and comfy because the baby before this one died. I didn't want to have to tell the story, anew.

It's a weird thing, really. I want people to know about A. How few people know that he existed used to be one of the biggest crazy-makers in my head. It's better now, the crazy is, but this particular thought is still sad to me. It seems, though, that I need to control the context in which I want people to learn. I don't know that it is even possible, but I seem to want to introduce him in some way that isn't all about pain. I want people to see that the pain is there because of how much we love him, how much we wanted him, how much we miss him now.

I remember, so very vividly, being pregnant with A, out and about with Monkey, and conscious of how lucky we were and of how much our luck can hurt to look at. I was thinking of infertiles at the time, but boy can a sight like this hurt a dead baby mama's heart.  I remember, too, last spring seeing pregnant bellies and babies wherever I turned my head. A veritable sea of happy that had no room for me. I started coping by making up sad stories for these happy people I saw on the street-- this one had five miscarriages before this baby, that one needed an IVF or three. I knew, even as I was making up these stories that they can't all be true. But that was what I needed to do to be able to navigate the world around me.

Recently some of the dead baby bloggers have been confessing to having a hard time with other people's pregnancies.  Is it any wonder? And what I realized, reading these bloggers, is that my shawls are a little about all of you too. If I can help it, if I can help it at all, I don't want to add to your hurt. I don't want to, as Bon so aptly put it, stab you with my roundness.

 

My sister is getting married this weekend. My parents arrived a few days ago and other family is about to descend on us in mere hours. To some degree, I have been measuring this pregnancy in intervals of and between significant events. For the last few weeks I have been terrified that this baby would die before the wedding, adding new layers of terrible to what would be horrific any day all on its own.  Before that I was similarly scared he would not make it through the week Monkey and JD spent in the Old City. 

That Monday, Memorial Day in fact, I wan't feeling as much movement as I had been used to. I tried the water, and the couch, I tried this, that, and the other. And finally I couldn't handle it anymore, and I went in to triage. A friend of mine is a high risk OB in my practice, although he didn't start there until last summer. When I first heard that he was joining the practice, I thought I didn't want him to ever have anything to do with my care-- I didn't want him to have to feel bad if shit hit the fan again. But as I pressed the intercom button outside of triage that Monday, I saw my friend walking down the corridor. And suddenly I very much wanted him to be there. I was alone and scared, and not until that moment did I know how much I wanted to at least not be alone.

It is good to be a friend of the attending, let me tell you.  He brought the shiny new ultrasound machine, not the old clunker that told the doctor all those months ago that A was dead. He was gentle, and kind, and attentive, and exactly what I needed. He didn't just do the one peak to make sure the heart was beating-- he sat there for ten or fifteen minutes carefully studying everything, watching my son wiggle behind my anterior placenta that with its movement-cushioning ways was the likely culprit behind that day's freakout. Twenty more minutes on the monitor and one fine-looking strip later I walked out of the triage room next door to the one in which they told me A was dead. I was light-headed, shaken a little.  But I managed to only be ten minutes late for dinner with a friend. And the next morning I took a deep breath and pulled that bellybra out of the drawer.

 

When A died, six months seemed like a ridiculously long way off, like it should be enough time to close the gaping wound, to let my heart scar over.  And now, nearly a year and five months out, what I am wondering is whether there is ever an end to the layers left to uncover. I suspect not so much.

once and again

I think I was probably well into my adolescence before I understood that the word "pregnant" could actually be spoken above a stage whisper.

When I was eighteen and groping my way blindly through the minefield of college sexuality, "pregnant" was one of the scariest words in my vocabulary.  When I was twenty-four and at my first real baby shower, traumatized by the balloons and the sorority-style squealing and those bizarre paper hats, "pregnant" felt like a word from some foreign language I couldn't fathom being fluent in.  When I was twenty-nine and in the midst of a divorce and a PCOS diagnosis, "pregnant" began to feel like a heartbreaking word, one that might slip through my fingers forever.  When I was thirty-two and the pee stick turned shockingly positive for the first time, "pregnant" became a magical incantation that I whispered to myself, secretly, almost in disbelief that such wonder had ever come to pass.

It was the next spring, at thirty-three and deep in the bone-numb grief of mourning my firstborn, that I lived all those incarnations of the word - the shameful and horrifying and foreign and heart-searing and secretly longed-for - all together, each time I encountered a ripe belly.  They echoed all the long weeks up to my due date: that could/would/should have been me. Bellies seemed to sprout up everywhere, the world a sudden minefield of them.  And each one, beautiful and poignant, full of possibility, made me gasp for breath and sent my shoulders hurtling up over my ears and my eyes skittering to the street.   To a babylost mother, there's little so evocative, so exposing and so wrenching as a healthily glowing pregnant woman, the Other, our opposite, blithely traipsing down a path that has dumped us remorselessly overboard and marked us Not Wanted On the Voyage.

Which makes the whole conversation about pregnancy after loss a little awkward, and being pregnant, in the company of fellow Medusas, a little like being the elephant in the proverbial room.

I am twenty weeks pregnant today...a round, portentious number in a body becoming more round and portent by the day.  I am on bedrest, that strange half-life, existing and interacting mostly online.   I am disembodied, in a sense, and perversely grateful for the cloak of this purdah, this enforced hiding from the world.  Because in being pregnant, I already embody enough of my own nightmares that I'd just as soon not trigger anyone else's while they're innocently out for groceries. And yet here, in this good company, I know my words have just the same power to wound as my silhouette would if you ran across me in the checkout...that in owning the elephant, I risk sending someone's eyes darting away from the screen, hot with tears; I tread on scars and the plaintive sorrow of why not me?

I don't want to, but I do, just in being here.  I know that, and I am sorry.

I know I am profoundly lucky that pregnancy after has come easily, or at least conception has.  I had my second son, then a nine-week miscarriage, then a positive pregnancy test that's brought us safe thus far to this midwayish point, all tenterhooks and cervical stitch and quivering, half-naked hope I can still barely look in the eye.  But it is in the hope where the luck resides: hope spins futures, however cobwebby.  And it is futures, dreamed and cast to ruin, that haunt those who mourn.

In the early weeks after Finn died, when I was still waking shocked to find my body empty and no longer pregnant, I wanted desperately to turn back the clock.  I felt wrong, robbed.  I wanted to be pregnant, to rectify this hole that had somehow ripped its way through the space-time continuum.  As acceptance began to beat its way into me, and I flailed like a fish on a line trying not to confront the weight of my grief head-on, I wanted again to be pregnant...to force the hand of fate and try to peek, somehow, into a future I could no longer imagine.  But these were not the clinchers, not the reasons that led me to throw caution and the pill back to the wind.  It was more a compulsion than a decision, ultimately...an inarticulate, animal pull, like a cat in heat.  I felt reckless.  I wanted to breed, to be fecund, to ripen, to throw myself at pregnancy with all the fierceness I could muster.  I wanted to make babies, hundreds of babies.  I wanted it like I have wanted nothing else in my life, like it was the brass ring, the hope that would bring back hope.

And yet when I locked myself in my bathroom to take that home pregnancy test, five months after the death of my baby, I didn't feel hope.  I felt ridiculous, exposed, foolish.  I imagined cackling harpies crowding at the door, taunting me: look at the crazy lady whose baby died, conjuring up pregnancy symptoms!  pitiful!  nutjob!  bwaa haa haa haa!  Even when the test turned positive, they didn't have the decency to disappear, those harpies...they just altered their tune a bit, drowning out any hope I summoned, reminding me that I had no reason to expect that all would go well.

I did not trust my body.  I did not trust my instincts.  I once again had something precious to lose, to fear losing, and oh, how I feared with all my heart.  I became fixated on dates, on counting, on parsing out days until the heartbeat, the ultrasound, the window for x to go wrong, the next ultrasound, viability, the gestational age at which Finn died.  

I still do it.  For a brief window last fall, I had the most uncomplicated few weeks of pregnancy I've ever known.  Even with Finn, I'd begun bleeding a few days after I found out I was pregnant, and had thought for a week or more that I was miscarrying.  With my second son, I bled from the day of the positive test, harpies bleating, and died a little each time I peed for the entire seven months after.  So when my pregnancy last fall hit the six, seven, eight weeks with no sign of blood, I began to strut a little, inside, began to race ahead of myself with hopes and fantasies...began to think, this is what it feels like to be normal.  I felt the strange conviction that all would go well.  Ah, hubris.  The nine-week ultrasound showed that the fetus had never made it past six weeks.

So this time too, again, I leapt in still bruised, still with healing yet to do.   I leapt in acutely aware that what I want and what I think mean squat, in terms of outcomes of this pregnancy, understanding that if we were lucky enough to get out of the first trimester there would be bedrest, possible medical complications, all these things that scare the living shit out of me.  I still forgot that for days before every ultrasound I would manage to convince myself, subconsciously, that the baby had died...and thus leave with good news but feeling worse, as if the inevitable torture had merely been postponed.  I still forgot that the societal discourse surrounding pregnancy - all bloom and celebration and oooh, fight stretch marks! and let's have a shower at twenty weeks! and if something were wrong, mama would know - would make me feel like drinking rat poison...or like feeding it to the oblivious smiling hordes, so certain in their entitlement, their claim to a "rewarding" pregnancy.  I still forgot that I would choke on the words, "I'm pregnant," just as if I were an adolescent or a frightened eighteen year old...that I would feel sheer terror at the prospect of having to expose that much of my secret soul - my fragile hope - to people even long after my body was negating the need for an announcement. 

What I did not forget is that it is a gift, this one more try.

++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++

What is your relationship to pregnancy after?   Is it a possibility?  Something longed for?  Feared?  If you've had multiple losses, did you find your relationship to the subsequent pregnancies different?  Did you choose an alternative path to having further children? 

If you have been pregnant after loss, what was the experience like for you?

And lastly...is this a topic you're comfortable encountering here, and if so, under what circumstances and terms?