One woman’s choice.
Even though I’d been taking birth control pills and never missed a single dose, I still got pregnant. I’m that .01 percent.
And even though the subject of marriage, let alone child bearing, had not yet come up between Andrew and me—we’d only been dating for three months—we got engaged. Neither one of us had any idea what we were doing or what to expect, but there were things we strongly believed to be true: that we were in love, that our baby was made from this love, and that we were going to do our best to nourish the new life we had created together. We’d had sex, the pill didn’t work, and we made a baby. The question of whether I wanted one was moot. I knew that somehow my whole life had led me there, and I felt I had to take responsibility for my actions. Step up. Grow up.
Weeks passed. I cried often. At night, and quietly, I cried because I was mourning my old life. The more people Andrew and I told that we were pregnant, the more isolated and separated I felt. Separated from my classmates at Sarah Lawrence: not so much a voice in the workshop roundtable as the subject of popcorn gossip. Separated from my role as a sibling: no longer the spirited younger sister but the knocked-up one. Separated from the prolonged layover from youth I had been enjoying: I was no longer only my parents’ child, I was one of them. I was with child. I’d have to learn, quick. Learn how to meal-plan. To swaddle. Audition for daycare. Make budgets.
As if having no grip or control over these sudden shifts and new roles wasn’t baffling enough, my body—it was an adult body now, a machine, an animal, primal—was also changing, morphing and growing and doing things I didn’t know it could do. I felt like Violet, in Willy Wonka’s Chocolate Factory, after she’d eaten the Everlasting Gobstopper. Now my body wasn’t even under my control, leaving me more isolated from and unfamiliar with this new self, this new life.
I felt doomed: Andrew had an established career as an engineer; I was a struggling writer with impending student loan payments. I was worried about what kind of mother I’d be, that my personal goals would melt into unattainable dreams. I felt condemned, resentful, and the result of these feelings produced, on top of everything else, an overwhelming guilt.
Andrew, on the other hand, was optimistic and embraced the surprise with his own brand of humor. For instance, when we had our transvaginal ultrasound at eight weeks, the one where the delivery date is predicted, Andrew asked my doctor if he himself could perform the ultrasound on me. Patiently, she said no. Then he requested that the ultrasound be performed on him and flaunted the back pockets of his jeans. Again, Andrew was denied. Finally, he asked my doctor if the machine was advanced enough to predict if the baby was gay, and if not gay, would it be able to tell us if the baby was going to be a Republican. The room fell silent. I was sprawled on my back in a paper gown, legs locked in stirrups as Andrew wheeled his stool very close and whisper-yelled into my ear, “Don’t worry, darling. I’ll love our child just as much if it is gay. But not if it’s Republican.”
When I was nearly eighteen weeks pregnant, I realized, rather strongly, that I had to know the sex of our baby. I needed to see little baby hands and baby feet, to finally pick a name. I needed for this pregnancy to start feeling real, start feeling delightful. It was time for me to feel what I believed real moms, good moms, pregnant moms felt: giddy, pretty, glowing, strong.
She said she could tell by the curves of my face—its cashew shape and durable cheekbones—that it would be a boy. But deep down, a barely audible voice was telling me something else: This was going to be a girl.
Andrew and I were on the 6-train headed to Beth Israel for an ultrasound appointment. Despite it being morning rush hour, I’d gotten a seat. It wasn’t luck—I’d put on my woe and weary Ellis Island face, stuck out my belly until someone finally slid over.
“No more surprises,” I demanded, looking up at Andrew. His face looked pretty. Long, giraffe eyelashes fluttering over ardent brown eyes; the heat was making his forehead sweat then shimmer. “Everything already is exciting,” I told him. “It is not humanly possible for us to be any more surprised.”
“All right, all right,” he said. “Let’s make a bet. Boy or girl?”
Earlier that week, a peddler selling origami key chains from a table on the sidewalk in Chinatown stopped me on the street to congratulate me on my baby bump. I pulled together a gracious close-mouthed smile. She said she could tell by the curves of my face—its cashew shape and durable cheekbones—that it would be a boy. Although I hadn’t felt any kicking yet or experienced the wives’ tale signs (craving heels of bread, green urine), I agreed with her. But deep down, a barely audible voice was telling me something else: This was going to be a girl.
The waiting room at Beth Israel was threadbare and grim: linty floors, molasses-paced service, stale reading materials and an empty water cooler. We skimmed magazines. Thirty minutes passed.
Forty-five minutes, then the double-door leading to the exam rooms swung open and disgorged a large pregnant woman and her male counterpart. I tried not to spy but the woman looked horrible. Weeping, pink-faced, distraught. Andrew nudged me and we looked at one another. “That sucks,” I mouthed, thinking, sick baby. They exited the waiting room, I tried not to watch. How bad could it be? Stillborn? I couldn’t imagine what could be worse. Another five minutes made our wait fifty minutes, fifty-five, sixty.
Over an hour later, my name was called and a young technician led us into a small, dim room. The room was shadowy and baby blue, smelled cold and sterile. I crawled onto a paper-topped table, leaned back and stared at the pockmarked ceiling, believing this was the moment when things would finally start to feel good and real.
The ultrasound commenced. Perched in the left corner of the room, where the ceiling met the wall, a black-and-white screen displayed what the scanner was picking up under my skin. The image was indecipherable. Sonar swirls of hurricanes on a weather map. A strange, foreign submarine radar. Andrew pointed to the round mass and showed me what he thought was the head. Is that what it is? I wondered. Not a cloud? The ghost of a raisin? Am I seeing the head? Hands? A spine? Are those feet? Funny, they’re facing inward, like a loose-stringed marionette.
We asked questions but the technician said nothing. I expected her to feed our excitement, but she was stone-faced. The probing continued while the room remained hushed and blooming with awkwardness. I imagined she was bored with her job. As usual, I took it personally. Beyond my feet and backed up against the wall was a young woman, a soft brunette in a white lab coat, observing. It was her job to watch and record; she was a medical resident. But she’d stopped taking notes. She’d pressed her clipboard against her chest and appeared rather uncomfortable, almost as though she didn’t want to be there. Almost like she was backing herself into the farthest part of the room.
“Would you please explain to us what we’re looking at?” Andrew asked, but our technician remained silent. Then, abruptly, the probing stopped. “Is it a boy or a girl?” we asked, and she tightened her lip. “Just talk to us.” She said she could not.
Instead, the technician printed some pictures, dryly mumbled that the doctor would be coming in momentarily, and scurried away.
In the semi-darkness, I sat up and leaned back on my elbows. “Do you think everything is okay?” I asked. “Why is everyone acting so cold?”
When we were purchasing the first pregnancy test, Andrew playfully asked the checkout girl if she thought the test results would be positive or negative. The clerk was disinterested. “I hope it’s positive,” he said, looking at me hopefully. “But I hope it’s not ugly.”
Now, squeezing my hand, Andrew, of course, said everything was okay, but his optimism was whisper-thin. “You have Medicare, Boo,” he reminded me. “You know what kind of care that means.”
“Yes, I am definitely seeing some abnormalities here,” she said, looking at the screen. I didn’t know where to look so I pressed Andrew’s hand over my face while Dr. Stein began listing off what she saw.
Suddenly, Dr. Stein entered the room talking to but not looking at us. “Our technician believes she may have found some abnormalities, so I’m going to go ahead and have a look.” Her voice sounded less alarmed than it did unswerving, and at first I was calmed by this. She’s just correcting the technician’s mistake, I thought. That’s what she’s doing.
This time, Dr. Stein looped the wand around my belly, pushing with pressure that felt neither hard nor gentle.
“Yes, I am definitely seeing some abnormalities here,” she said, looking at the screen.
“What are you talking about?” Andrew asked as I rolled back onto the bed. “Exactly what are you seeing?” I could tell he was getting upset. I didn’t know where to look so I pressed his hand over my face while Dr. Stein began listing off what she saw:
Here is the irregular heart structure.
There is almost zero brain development.
Here is the Spina Bifida.
There are the clubbed feet.
All is lost. All is not lost. Lost, not lost.
This was the mantra I repeated after receiving the news about my pregnancy. Dr. Stein rapidly fired all types of information at us. Words I couldn’t pronounce. Holoprosencephaly. Images I could not forget. Collapsed skull. Deformed spine. Broke heart. Lost. Not lost.
“Mira, would you still like to know the sex of the baby?” is what she said as she flipped on the lights and turned off the ultrasound machine.
Lost. It’s what I repeated before the technician wrote “girl” onto a piece of paper and handed it to Andrew. Not lost. It’s what I said when Andrew revealed it to me later, in between tears during the car ride home. The mantra prevented me from acknowledging other thoughts that were surfacing, thoughts of guilt, blame, culpability. Thoughts like, maybe you caused this. Thoughts like maybe your body is broken. Thoughts like maybe you willed this to happen.
Weeks before the ultrasound, at my wit’s end, I locked myself in our bathroom and raged against my baby. I spent the entire afternoon sprawled out on the tiled bathroom floor of our apartment like a piece of road kill stationed alongside the toilet. I couldn’t control my vomiting. All I could get myself to do was moan. I was all alone in the apartment, but I could hear the sounds of thousands of lives right on the edge of my periphery, not even fifteen feet away, kept separate only by a piece of drywall, or a glass window—voices of strangers reverberating in the hallway, children shrieking on the playground’s monkey bars, UPS trucks, honks and sirens, food delivery to the next-door neighbor. Eventually, I fell asleep and awoke to the sound of our dog barking as Andrew arrived home. When he called out for me, I pressed my shoulder blades against the bathtub and pushed my swollen feet against the bathroom door. “Go away!” I answered. From behind the hollow door, Andrew laughed, told me I was adorable, but I refused to let him in.
“Can I come hang out with you in there, Medium Boo, please?” His words sounded muffled, like his lips were pressing upon the tiny gap where the stile met the frame.
“I just want to be alone,” I told him, and pulled my knees into my chest as much as I could dropping my heavy head into the space between them.
“This thing is a fucking parasite,” I said not sure whether or not I meant it.
“You’re so mad. Why are you always so mad?” Andrew heaved a sigh. “That baby loves you. And I love you.”
I had been trying very hard to reciprocate this new kind of love Andrew was talking about. Was it love? I’d never experienced anything quite like it. The new love completely unfamiliar, almost foreign, but at the same time it felt proverbial and natural. Also, it was fucking frightening. It was the kind of love that required a colossal amount of responsibility and tenderness, buoyancy and endurance, bravery and confidence—traits I wasn’t sure I had, or would ever have. It was frightening because, from what I understood, in order for it all to be successful, I had to be strong, but I was having difficulty being strong because the new love that was growing inside of me was, at the very same time, draining every bit of love juice that I had right out of me. I had control over nothing.
All is lost. All is not lost. This is what I thought as the needle went into my belly during the amniocentesis that immediately followed the ultrasound. It’s what I repeated in my head moments after the amniocentesis as we met with the genetic counselor, Dr. Iglesias, who explained the scientific facts of what may have gone wrong during the baby girl’s development in my womb. We were in his office, and it smelled like lettuce and mayonnaise and the rest of the lunch he had just finished. Dr. Iglesias sketched out the twenty-three chromosomes. They looked like Cheetos. “It could have been chromosome number 3, or 7, or 21, or 23,” he told us, pointing at his drawings with his pen.
“Purely a genetic fluke, nothing you could have done,” said Dr. Iglesias, who then asked for our family medical histories, and our medical histories. He handed us pens. We were confused, shaken, tired. “If it doesn’t die before you deliver it, it will have very serious problems,” he said. “It would likely not achieve consciousness and certainly would not live without some kind of extraordinary intervention.” That’s when I was given three choices: terminate the pregnancy now, do nothing and likely miscarry, or induce and deliver vaginally a baby who will die or be dead. Terminate. Miscarry. Induce.
“But I am still pregnant,” I insisted.
Six hours later, after we finally left the hospital, completely defeated, I called home to deliver the terrible news along with the even more terrible choice ahead of us. I handed the phone over to Andrew, who cried hard then explained the chromosome lesson to my parents. “Sick” was the adjective we used to deliver the prognosis to the rest of our families and friends, but we decided to call our baby “Lilly.” Not “it.”
I had ten days to make a decision:
1. Terminate the pregnancy next week.
2. Do nothing at all and possibly miscarry.
3. Induce and deliver vaginally next month.
Right after the ultrasound, specialists and doctors began loading me with information I couldn’t digest (“the prosencephalon failed to develop into two hemispheres,” “unviable outside the womb”) and stopped sounding like they were talking about a baby, but rather something made out of metal (“it is flawed.” “doesn’t have a working brain.”) Their words were technical and cold and offended me, made me defensive and argumentative. After the second day, I quit talking to the doctors and specialists altogether. Andrew began serving as my ambassador. I’d ask the questions, he’d get answers and relay the information as gently as he knew how.
“She can’t breathe on her own,” he’d say.
“How can we be sure?”
“They said she’s not quite a stillborn, but there is a strong possibility she may die in your womb,” he’d explain. “Do what you want, but she could die inside you. Any day.”
Other than that, Andrew didn’t assert his feelings about the choices I’d been presented with and I didn’t ask for too many details about my options. I could only handle so many facts, suggestions, opinions, feelings. The more voices I heard, the harder it became to decide.
My mother suggested Option #3: induce and deliver vaginally next month. She said that way I could be conscious. I could be awake, lucid, 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 was a very important element in the process of healing. But when I thought about Option #3, I pictured myself draped in baby blue paper gown, feet in slippers, head in a hairnet, pushing, sweating, bleeding, delivering a lifeless, barely recognizable red hot creature, or a grey blue mass, and it terrified me. No one wanted to speculate what I’d be giving birth to. Would Lilly make sounds? Coos? Cry? Would she move? Would she be alive? And then after I gave birth, what would the doctors do with Lilly? How long would I get to hold her? Would I want to? No one mentioned how, at five months, a vaginal delivery would still be painful. Or how much I might rip or tear. If I delivered, would I still adhere to my mantra of “natural” and drug-free childbirth? While inducing and delivering sounded the most natural, Option #3 horrified me. It was what I least wanted.
Then there was Option #1: Terminate the pregnancy. Also known as the Dilation & Excavation. Dilation of the cervix, excavation of the fetus. The procedure could only be performed up to twenty weeks into a pregnancy; I only had a few days until that window closed. Dr. Stein nudged Andrew to nudge me to hurry and make a decision. She gave him the facts, which he then would share with me. The D&E would take three days and would be quite painful. First step: dilate the cervix by inserting laminaria rods. Andrew told me that I’d be put under anesthesia. I wouldn’t be awake to see the process. He mentioned forceps, but when he started to explain the actual excavation process, I made him stop. I didn’t want to hear the specifics—what was the point? The details didn’t matter because the result was going to be the same. I just wanted to pick the path that was least cruel, but I wasn’t sure for whom. (Do I choose what is the most respectful for Lilly and let her live out her life naturally? Or do I do what would be the least painful for me?) I knew no one could give me an answer, but no one—not Dr. Stein, not Andrew, not my parents—needed to explain what I already knew: once Lilly left my body, she would be gone forever. Without me, she was powerless. I was the only thing keeping her alive.
Even though I believed in choice and reproductive freedom, I wasn’t sure if I deserved to have such an easy way out.
The word “violent” began fluttering in and out of conversations. My father, a family doctor, told Andrew and me that from what he understood, if I terminated the pregnancy, the procedure would be a “violent” one. A late-term abortion meant violent surgery. While it sounded the least natural, it was what I was leaning towards, but with such a word being used to describe the end of my pregnancy, I worried that my parents would think of me as a violent person. A savage.
Even though I believed in choice and reproductive freedom, even though I trusted others to make decisions for themselves, when it came to my own freedom to do what I felt was best for me, I wasn’t sure if I deserved to have such an easy way out. I didn’t believe in bad luck; I just thought I had failed—as a woman, as a daughter, at motherhood—and that I should be punished. It was a crazy thought but nonetheless, it was there; grief and sorrow are unpredictable, strange, messy.
“Listen to me, Mira. ‘Partial Birth’ abortion is an inaccurate term,” is what Dr. Stein told me, over the phone, when I’d finally accepted her phone call. “You must understand that.” She explained how the term I had used to describe the D&E was a political one. Incorrect. Inaccurate. Charged with meaning. That the phrase was coined by the National Right to Life Committee, and that it was not recognized as a medical term by the American Medical Association. Or the American College of Obstetricians and Gynecologists. That the term “partial birth abortion” was false. A generalization. A terrible term. She told me that my situation, right now, was my body’s. That I hadn’t done anything wrong, that I couldn’t have prevented any of this, that I needed to understand this, and that this was a decision I needed to make for myself based on what was best for me. And that the best decision, the healthiest choice, for me, in her opinion, as a health professional, as my doctor, was to terminate the pregnancy, immediately. The only one who was going to survive this was me. Period.
That’s when I finally began to view my doomed pregnancy as something that was fated, inevitable. Not as a destiny I had any control over. Lilly was dead and she was not dead. She was never truly alive, but I was.
Mira Ptacin is founder and director of Freerange Nonfiction. Her writing has appeared or is forthcoming in Lumina, McSweeney’s Internet Tendency, Adult Swim, The Morning News, Nerve.com, Epiphany and was recently featured in the collection The Moment (Harper Perennial 2012). She just completed a memoir about the uterus and the American Dream, from which this piece is excerpted. Follow her on twitter at @miraptacin or visit her website.