Late one July night, I hunched at my laptop reconciling bank accounts for our small Iowa farm. Outside, the cicadas whirred in the sentinel hemlock trees, while the window air conditioner in our bedroom around the corner fought the humid air around me. I sat flushed, my stomach roiling.
I was anxious about our struggling farm, which my husband and I were both supporting with other jobs, and about how we couldn’t seem to go a week without fighting. I was still learning to navigate my husband’s temper, having grown up without once hearing my parents drop an f-bomb.
Now I was 27 weeks pregnant with our first child, a natural progression in our marriage of eight years and a big reason we moved home to the Midwest, but in all honesty, I still wondered whether I should bring a baby ― a son, I knew ― into a relationship I didn’t fully trust.
I had been both so angry and also so shaken after a series of arguments ― probably about money but more about the insults he was willing to throw at me in all-out rage ― that I researched abortion clinics and services available in my state, even though it was far too late.
As I finished entering farm expenses, the clenching in my stomach dropped lower and started to feel familiar. Were these cramps? I pushed the thought aside and shut down my computer, my head buzzing with that feeling of having burned up REM sleep. I brushed my teeth, assessing my hormone-charged long hair in the mirror. It was the longest it had ever been. I sat down to pee and knew instantly what was wrong. I was bleeding ― not enough to scare me but more than I should sleep on.
Ryan’s skin was sweat-sticky when I shook his shoulder to try to wake him.
“Shhhhh,” he mumbled, groggy and bone-tired. “Get some sleep. We’ll see about it in the morning.”
He had a big day of manual labor ahead of him, and a trip to the emergency room would cost us the rest of our night. Besides, this wasn’t the first time I’d stayed up too late with worry. It’s my nature.
This time, though, my fear was warranted. An hour later, a nurse was pushing me in a wheelchair down the corridor of our small-town hospital, where fluorescent light bounced sick-green off beige walls and floors. She took a tally of my symptoms and asked how far along I was. When I told her, she murmured fretfully, “That’s too early. Too early,” as though I honestly didn’t know.
While the overnight staff scrambled to get my scant medical chart together, the doctor on call pushed ultrasound gel over my abdomen with the wand. A minute passed. He let out a sigh of frustration, scraped his rolling stool closer to me, in the bed, and began again, his strokes slower, probing for the whole story.
But I already knew, and I think Ryan knew, too: The baby was dead. I didn’t look at the ultrasound screen, even as the doctor pointed to the very still image there and said the words.
I hadn’t wanted to think about how little I’d felt my son move in the past few days. I had no experience to go on, after all, and I didn’t want to be the expectant mother who turned up at the clinic for a hangnail. Now, before I’d even settled firmly into the idea of mothering, I faced another unimagined reality: I would need to birth a baby that was dead.
It’s true. If your baby should die in its third trimester, you will carry this knowledge with you for hours, possibly days, along with the disintegrating tissues of your fetus, until your estrogen armor cedes to your immune system and your body begins the work of ridding itself of this now-infection-prone mass of clotted blood and bone.
I took Pitocin for 24 hours to help me push my baby into the world. In that time, I accepted many doses of painkillers, including narcotics, that I hadn’t considered or planned to take. Drugs aren’t my style ― it’s rare that I even take ibuprofen for a headache ― but in the alternate universe of my birthing suite, with a white paper rose of mourning taped to the door, it sounded like the standard of care. It began to feel impossible not to feel mechanically defective, with my risk of hemorrhaging managed as carefully as fuel leaking from a downed fighter jet.
So it seemed that the moment of my son’s birth drew near entirely outside of organic order. There was no escalation of contractions, no hands rubbing my back, no gritting of teeth or wailing, knees apart. Instead, I jolted awake from drug-laced sleep directly into late labor, curled on my left side, clinging to the bedrail.
As I screamed for help, my husband ran into the hall, roaring at the staff for assistance and more meds. By the time they arrived, my baby had already been born in a sickening gush. Again, I didn’t look.
Staff swept my son away and cleaned my body, I am sure, as efficiently as preparing for surgery. They tried not to press us in the swollen silence that followed, but they needed answers to another set of questions ― more choices I hadn’t anticipated: Did I want to bathe my son, for the first and last time? Would we want pictures of us holding him?
Outside that sterile-swabbed environment, these questions make sense, but inside it, they feel as monumental as deciding whether he should live or die. And it’s true: You are choosing, in those moments, what you will remember about a child and his or her short life ― a life in which that child will make no other mark.
My advice? Do it.
I said, “No” to bathing, I guess because I wasn’t sure I wanted to move the full weight of my son’s little limbs, to turn his head to discover that baby-fold under his chin, without an ounce of feedback. I’ve lifted dead calves from the afterbirth of cows; it’s a piercing thing to move something that should, by the hair-breadth of other circumstances, be wriggling free. We said, “Yes” to holding him and to pictures, and to this day, I can see in my son’s tiny, not-yet-gray face the line of his father’s brow, and how his nose and cheeks would have grown round and merry, like mine.
Sometimes, though not often anymore, I study those photos for clues to what happened. I remember that I tried hard, at the time, not to overlook anything. I authorized an autopsy. I wrapped up and delivered every glistening, livery clot of placenta to my physicians, hoping this piece or that would contain the answer to how it all came apart. None did.
Whatever abnormalities appeared were no more significant than those of other pregnancies, the ones where the baby, naturally, lives. There’s only one thing to know for sure, something I’m more than a decade in the learning: You may never confirm why your body refused to support your child, or whether your baby somehow ceased to receive it.
So you will climb out of bed, after days or weeks of leaking breasts, of residual bleeding, and back into the pace of living. You will be marked as a woman who lost a child, even as others around you move on and forget ― literally, you’ll forever be a mother who had a child within your care and yet failed to deliver it to its rightful place,
The nurses who tended to me the night of my son’s birth knew this guilt would find me.
“You’re still young,” they whispered. “There’s still time.”
One after another, in the small disjointed moments that filled those long hours, they shared stories from their own lives, all of them to suggest that I might still have a child who would live. All that was true, but so is this: My son died, and I’ll never know whether or how I could have saved him.