Warning: The subject matter of this post is dark and should probably be avoided by pregnant ladies and anyone else who does not wish to be reminded of grief or loss. I have thought long and hard about whether I wish to post this and I am aware that in doing so, I may offend some people's deeply held beliefs. For that I am sorry. But I don't like big dark secrets and it seems to me that this kind of reproductive experience touches more than a few women and their familes and should be talked about from time to time.
Early spring is difficult. Grief runs close to the surface and changeable weather seems to mirror my moods. This spring has been worse than last, perhaps because I am not on medication like I was last spring. And maybe because the sheer joy watching Grace grow makes me so aware of what we have lost. And with that sadness comes an unreasonable fear of losing my little family, making me want to gather them in tight. I get anxious when away for an hour or two and ring home a bit more frequently from work, just to be sure and tiptoe into her room at night just one more time to watch her soft breathing. This grief also turns me into a bit of a monster; distant, distracted, irritable and joyless. So I have decided to write it out.
I am often vague and imprecise, but with people I come to know well, eventually I have to tell the whole story our son, Frank. He was born in September 2002 at 20 weeks gestation and died eight hours later. It is always difficult for me to discuss the precise circumstances of his birth and death. Partly because I fear being judged, even though nobody has ever said anything harsh. Indeed, the only negative reaction I have ever had has been one of withdrawal. From an old work colleague. But my reticence is also in part because I still feel that I made a decision that was somehow wrong. Even coming from a lefty, right to choose, feminist sort of background. And I should be very clear too, that despite any of my talk of wrongness, I will continue to believe that all women have the right to choose whether or not to carry a pregnancy. And to choose whether or not to have genetic or other testing.
A while back, at the checkout of the Mediterranean supermarket, I overheard two older women in passionate conversation with the woman at the checkout about when she was going to start having babies. Although most of the conversation was in Italian, there was enough English for me to understand. My turn came and the woman looked at me and said something like, I'm just not ready. And I replied with something like, well you have to do what's right for you. She looked at Grace, asleep in her stroller. I said, I was 41 when she was born. The woman's face brightened. But then I had to say, I wouldn't have left it that late, if I'd had a choice. It was tricky. There were problems.
I always worry with these conversations because I don't want to say don't have a baby when you're older. For most women everything goes well, even into their forties. And despite everything that has happened, holding Grace in my arms after she was born was extreme joy. Persistance paid off for us in a big way. And continues to do so. But I also want to say to the woman in the supermarket and others, that there are risks and although it is most likely that everything will be alright, maternal age does increase the odds that something will go wrong. The worst conversations are when people say, oh but I can always have testing. As if testing will ensure that everything is OK.
When I became pregnant in 2002, I was 37 and would have been 38 when our baby was born. I had already lost two pregnancies early in our relationship. And while those losses were very sad, we were not really ready to be parents. A black year followed where our depressions bounced off each other and we needed to learn how to live well together, how to be happy and productive. Once our lives improved, I fell pregnant again fairly easily and felt we were finally ready for the responsibility of parenthood. We were both so happy and optimistic, as were my family and friends. Although I had the odd bolshie thought of refusing all tests, I just kind of assumed that I would have genetic testing, mostly for peace of mind and also because I felt it was the responsible thing to do at my age. Part of the deal for an older mother. I ruled out the screening tests as wishy washy. If I was going to have testing, I wanted a definite answer that everthing was OK. At the hospital, I was offered amniocentesis, due to my age. I wasn't offered the earlier test, chorionic villi sampling (CVS) or advised in any detail about the choices I would need to make if abnormalites were found. Besides, apart from failing maths in fifth form, I always passed tests, right?
The pregnancy was not easy. I had started a new job and was battling the usual first trimester fatigue and nausea. I was keeping my pregnancy secret as I hoped to be offered a permanent position. Then there was the continual cold and hemorrhoids (from iron tablets) so bad I couldn't sit for a week and needed an operation. Then there was spotting and threatened miscarriage. Then everything seemed fine again. At the end of winter I had the 16 week amnio. Mum came with me and we watched the ultrasound, fascinated as the doctor told us how strong and healthy the baby looked. In the next two weeks, spring came and I started to really show. I had already started to tell people at work. I felt our baby kick. I had well and truly crossed from the first trimester of uncertainty into mid trimester belief in our baby and the life we would all have together. The testing seemed like a formality.
The Monday the results were due, I rang the hospital from work. They told me that the results weren't in yet. I though little of it and went home. At six o'clock the genetic counselor rang and told me there was bad news. I held it together on the phone and made an appointment for me and G to see her the next day. Then everything collapsed inwards. The only place I could be was in bed, crying. We were both in shock. Later we sat on the back porch and called friends and family. Everybody was sad but I think already it was assumed that we would not continue with the pregnancy.
I had been presented with a choice but it felt like a non choice, in a tiny little box. No matter how I turned the options over in my head, I couldn't make any decision that seemed right in any sense. It felt wrong to end the pregnancy, killing our baby. It felt wrong to continue the pregnancy knowing that the baby could have a significant disability. One thought that greatly disturbed us both was the potential for our child to have no living relatives after we died and needing to go into state care. At the appointment, the genetic councilor was soft voiced and kind. She easily accepted our decision not to continue the pregnancy. Apparently about 95% of pregnancies where an abnormality is detected are ended. I was shocked to learn that I would not be having an abortion under general anesthetic but that labour would be induced and I would be awake. We were booked in for Thursday night. The next two days passed in a daze. I quit my job as I knew that I was never going to get a permanent position and I just couldn't face seeing the contract out. I ran around getting the car cleaned, errands done, just doing stuff. I drank at night and knocked myself out with painkillers.
At the appointed hour we turned up at the hospital. G stayed with me all night as I was given 4 hourly pessaries and morphine. In the morning my Mum came in and I sent G home. Inasmuch as I had a birth plan, I knew that I didn't want to have to worry about whether or not G was coping. The pain was extreme, but not focussed like full term natural labour pains. I kept having more pain relief and everything became very, very blurred. Sometime in the late morning the pains worsened and I became extremely bossy, sending the nurse for more drugs and laxatives. She only made it back just as I was turning over saying, the baby is coming. Mum caught the baby, a little boy. Complete and alive and very little. I burst into tears ( I think or did I just want to). The nurse asked me if I wanted to hold my beautiful baby. I said no. I don't remember being aware that he was born alive. He was placed in a plastic bassinet beside us. I made mum go and ring G and the rest of the family. Lying in the high white hospital bed, I felt it was important that my people knew. (Another thing I feel I should mention, the nurses at the public hospital we attended were beyond fantastic. Sensitive, caring and professional. I couldn't have wished for better treatment at such a difficult time.)
G came back and spent some time with our baby in a separate little room. The placenta wouldn't deliver and I went to surgery and had it removed under a general anesthetic. There was no way I was staying awake for that one. I don't think that I would have cared much if I didn't wake up, ever. Going home was a relief and the next week or so passed in a blur of check ups, going back to the hospital to hold my baby, follow ups, a hospital funeral and the odd stuff up. I concentrated on the paper work. Then out of the blue, grief hit me . I remember sitting at my computer looking for jobs to fill in my jobseeker diary with tears streaming down my face, insensible with rage. A friend made me go and see a doctor and get a medical certificate. The doctor booked me in for regular visits, becoming a lifeline of sorts.
The next five months were exceptionally difficult and I demanded a lot from those around me. G had his own grief and sometimes wasn't able to help with mine. And at various times I was probably pretty angry with him too, not that I was singling him out, I could be angry at anyone or anything. My mum was exceptional and would visit, spending the whole day gardening or just hanging out, talking when I wanted, being quiet when talking was too much. A month or two later, I was pregnant again and once again miscarried. Immediately I conceived again and two months later the baby died inside me. Everything seemed impossible but somehow, in the midst of all this I found another job and life went on. Later in 2003, I was referred to a recurrent miscarriage clinic and as well as a barrage of tests was offered counselling.
Counselling was a mixed blessing, the counselor was tough and made me confront things I needed to but wouldn't accept me saying that I felt part of our decision to end the pregnancy was wrong (could this have been to do with hospital policy and the fear of legal action?). In the end I had to give up counselling . More rage issues perhaps? Sometime later, I read The Art of Happiness in which the Dalai Llama is posed with this exact dilema. His response was that this an extremely difficult choice, either way might lead to great suffering of the child and/or the parents. He ended by saying that such a decision is beyond the power of a rational mind. To move out of almost perpetual blackness I needed to clearly separate my feeling of wrongness from that of grief. This allowed me to fully mourn the loss of our baby; as the baby who might have been (before testing), as the baby he was, as our son in every sense. I have also accepted that I will never ever feel completely right about this decision, even if in the same situation I would make the same (non) choice over again. Even when people say that I shouldn't feel guilty or that they would do the same thing in the same situation. It isn't exactly guilt that I feel but more a deep sense of wrongness. I have learnt to sit with the wrongness, which like the grief is mostly buried inside and covered with stone. Only every now and then it all still hurts all over again. But these feelings are episodic now, not constant as before, and I know they will pass.