We Need to Talk
By Deirdre Frank
My emotions soared and plummeted between excitement and anxiety when my period neglected to show one July. We didn’t exactly plan on having another baby, but that window dangled inches from closing on us forever. Getting knocked up at thirty-five is considered a geriatric pregnancy (so says the tactless medical term probably coined by some privileged white guy), and it comes bundled with an increased risk of complications like birth defects, high blood pressure, and diabetes. Each consecutive year, odds of facing such complications increases exponentially. Suddenly, thirty-five started to seem as old as it did when I was a little kid.
We epitomized the new all-American family, blended and chaotic. I taught English at the college, and Jack had been promoted to assistant manager for the same company he’d worked for since he started his first job at sixteen. In our almost ten unmarried years together, we somehow managed to accumulate two kids—one from his previous marriage and one together—a sulcata tortoise, a pacman frog, one newt, two salamanders (twins named Ashley and Mary Kate never mind that we didn’t know their sex), three cats, and a spacious three-bedroom rambler in the desirable Cherry Hill neighborhood of a small seaside town nestled in the rain shadow of the Olympic Mountains where we’re fortunate to have more sunny days than the rest of the soggy Pacific Northwest. Our lives were full.
My first appointment at the women’s clinic was eight weeks out. I’d have to wait two whole months to hear my baby’s heartbeat. Anxiety faded and I began to imagine how growing into a family of five might change us. We rationalized waiting until after the first trimester to surprise the kids, when the risk of losing the baby decreased drastically. Our five-year-old daughter dreamed of taking on the role of a big sister, and our son was already an exemplary big brother.
Summer crept by despite packing it full of free concerts on the pier Wednesday evenings, and as many long days as we could squeeze in at Lake Crescent until the sun set, which was well after nine most of the season.
September arrived, and the kids settled into their school routines. The kids’ father worked days, so he couldn’t go to the appointment with me when Thursday morning finally came, but there’d be plenty more doctor’s visits over the next months. I pulled open the heavy glass door, my tummy still easy to hide beneath a loose blouse. The waiting room was empty except for a woman on the phone behind a desk. She motioned for me to sign in. I did and then grabbed a Parents magazine to skim while I waited.
About halfway through an article titled “Why It’s Important to Talk about Miscarriage,” the receptionist called me, “Diane.”
I scrambled my stuff together and headed back to check in.
“I’ll need to make a copy of your insurance card and driver’s license, and you’ll need to fill these out.” She grabbed a pen disguised as a pink silk carnation from a bouquet on the counter and passed me a clipboard.
“Certainly.” I ruffled through my purse to find my wallet and handed over my cards.
“You can give the paperwork to the medical assistant when she rooms you.”
“Sure thing.” I took the clipboard and returned to my seat. “Thanks.”
I had time to disclose my entire family’s medical history, parts of my personal life I hadn’t even shared with my partner yet, read the clinic’s privacy policy, and finish the magazine article before the MA beckoned me back. I followed the young woman in scrubs through the formulaic assortment of cubicles and a maze of white walls to an exam room. I offered her the clipboard and carnation (there’s no way I was accidentally slipping that into my bag), and she interrogated me about my apparently boring medical history.
“When was the first day of your last period?”
“June 21,” I said, scrolling through my iPhone’s calendar, “I think.”
“Are you monogamous?”
“Yes.”
“Is your partner?”
“Yeah.”
“Well, you can never really know,” she said casually. “Would you like an HIV test in addition to the normal screenings?”
“I guess.”
“We need to collect a clean urine sample.” She passed me a small plastic container with my name and birth date printed on the lid. “Wash your hands with warm, soapy water then catch a midstream sample. That means let out a little bit of pee first, and then fill the cup as much as you can,” She pointed me to a bathroom down the hall and to the right.
“All right. Thanks.” I followed her instructions, trying my damnedest not to pee on my hand, and returned to the room.
“Remove all your clothes, including your bra and underwear,” she ordered back in the room, “then put this on with the opening at the front.”
“Okay.” I took a green gown, faded and pilled from too many washes. “Thank you.”
“Have a seat on the table and Dr. Bush will be in shortly.” She closed the door behind her.
I stripped my dress over my head, unclasped my bra, and slipped out of my panties. I folded my clothes neatly and placed them on a vacant chair. Naked except for the worn-out gown, I got lost in posters depicting the developmental stages of a fetus and waited.
Knock. Knock. The handle turned and the door squeaked open. A petite woman who looked younger than me glanced up from my chart and flashed a bright smile. She told me to lie back on the table. The paper protecting the surface of the table from my body crinkled beneath me, and goosebumps pricked my skin. “How often do you give yourself breast exams?” Her clammy hands circled my breasts peeking from under the gown.
“I try to monthly, but not as often as I should,” I admitted.
She stretched a pair of latex gloves over her hands, “Put your feet in these, and scoot all the way to the edge.” She motioned to a set of stainless-steel stirrups at the foot of the table. “You should be far enough along today to hear the baby’s heartbeat.” She inserted what felt like at least two fingers into my vagina and pressed her other hand into the softness between my belly button and pubic zone. I grimaced and fixed my gaze on the faux blue sky and fluffy white clouds filtering out the abrasive fluorescent bulbs overhead.
“Your uterus feels a little small.” Her fingers slid out from my thighs. She dragged a clunky relic of a machine to the bedside and generously smeared warm, translucent gel across my belly. The device emitted an incessant white noise while she guided the ultrasound wand across my abdomen. She pressed harder and harder on my belly, playing hide-and-seek with my fetus for at least ten minutes before giving up. “Don’t worry. It’s probably still too early.” I must have looked concerned. “This machine is out of date and temperamental,” she reassured. “Just to be safe, I’ll refer you to the hospital for a transvaginal ultrasound. OMC’s state-of-the-art technology takes much sharper images of your uterus.”
Dr. Bush called radiology, and they squeezed me in despite their booked schedule. I enjoyed some sunshine on the short walk across the street to the hospital. Another woman in scrubs directed me to the radiology lab through another labyrinth of sterile halls. I had no sooner started away from the check-in counter when I heard my name called from behind. I swapped smiles with a woman who spoke in a heavy European accent that made her difficult to understand. Hints of chemical cleaner assaulted my nose as I followed her to a narrow windowless room with a bed tucked in the corner. At the foot of it loomed what looked like a brand spanking new computer compared to the one at the clinic, multicolored chords sprouting from it like tentacles. She left me alone in the poorly lit room and promised to return.
Behind the privacy of a curtain, I undressed once more and assumed my position on the table. I heard a soft knock. “Are you ready?” inquired a muffled voice from the other side.
“Come in,” I answered loudly making sure she heard me through the thick fire-safe door. She came in and sat on a stool at the foot of the bed then turned the monitor away from me. She smeared more of the clear warm goo over my stomach, and this time on a wand shaped like a sex toy. “This might feel a little uncomfortable,” she warned. “Put the wand in your vagina, then I’ll take over from there.” She handed it to me coolly. I spread my legs in front of her and delicately inserted the dildo-shaped object, and motioned for her to take it. She attempted to distract me with casual conversation while poking and prodding inside me, searching for a sign of the baby. “You have other kids?”
My face twisted. “A boy and a girl.”
She swished and swirled the wand and pushed heavily on my stomach a little longer, then just stopped. “Wait here. I’ll be back.” I lay alone in the dark.
She returned promptly with another woman who I assumed was also an ultrasound tech. They took turns exploring my crotch with the foreign object and glancing at the screen obscuring their expressions. Their whispers were difficult to make out. After several lingering minutes, they smiled at me, and the one with the accent gave me permission to get dressed. “We’ll send the results to the radiologist. It’s after 4:00 o’clock and she’s gone for the day, so expect a call sometime tomorrow,” I was informed.
“Thanks.” That was it? I couldn’t wait to get dressed.
*
On Friday evening, I took the kids to a school play. My daughter had auditioned for a role in Hansel and Gretel. Like almost all the other kindergartners who’d auditioned, she was cast as a wally bird with no lines. My son sat with the other older kids who had little brothers or sisters in the play. My husband was stuck at work, so I sat by myself in the front row, documenting our daughter’s acting debut with my iPhone so he wouldn’t miss it. The clinic didn’t phone. I’d have to wait through the weekend.
*
The Saturday matinée was final curtain call and the last time I’d have to sit through the production. From the back row, I watched dozens of elementary-aged schoolkids living their fifteen minutes of fame. My phone vibrated in my purse. No one seemed to notice me sneak out of the theater. By the time I was in a safe speaking range, I had a new voicemail. It was the clinic. The midwife asked me to call back in her familiar syrupy tone, but it didn’t sound urgent. I wouldn’t be able to sit still in the theater, so I searched for a private nook and settled on a bench under the shade of a madrona before I dialed back. It was a recording. “If you are experiencing an emergency, dial 911. Otherwise, stay on the line to speak with an operator.” The recording repeated several times until eventually a human came on the line: “Good afternoon, how can I help you?”
“Hi. Dr. Bush asked me to call back.”
“Give me your name and a number where you can be reached. I’ll contact the on-call provider and someone will call you back within the hour,” recited a monotone voice.
I didn’t have time to go back to the theater before my phone vibrated again. The clinic’s number appeared on my screen. I crossed my fingers.
“We received the results of your ultrasound yesterday, but I was out of the office. I didn’t want you to have to wait all weekend.”
I held my breath.
“The transvaginal ultrasound confirmed there’s an empty amniotic sac,” her voice trailed.
“What does that mean?” I couldn’t help asking even though I already knew.
“The baby wasn’t viable,” she clarified. “It’s called an anembryonic pregnancy. It happens when a fertilized egg implants in the uterus, but for unknown reasons the embryo never develops,” she regurgitated a textbook definition.
Finally, the words I dreaded hearing out loud: “There’s no baby.”
I didn’t blink.
“I’m sorry.”
“Are you sure?” I muttered almost inaudibly.
“There’s nothing you could have done.”
“Is there any chance there’s a mistake?” I pleaded, still hopeful.
“It’s not likely, but we can schedule another ultrasound if that makes you feel better.”
“Um. Yeah. I’d like that.”
“Can you come to the office on Monday?”
“Sure.”
“Ten o’clock?”
“Okay. Thank you. G’bye.”
I didn’t want to keep the news alone.
I called Jack. It went straight to voicemail.
I texted: The clinic called. No reply.
I texted again: You should call me. Still, no reply.
It was intermission by then. The kids’ school was nearly deserted for the weekend. A handful of parents and children passed by laughing, probably heading back to the theater to find their seats. Little wally birds bustled about on set inside. The school bell echoed off buildings full of empty classrooms. I returned to my seat at the back of the auditorium. The kids performed to a packed house. I played my part and laughed when the audience laughed and clapped when they clapped. The cast got a standing ovation. A rogue tear stained my cheek.
Jack finally called back after he’d clocked out for the day. “I’ll talk to you when you get home,” I whispered.
When he did, it was my turn to say it out loud, “There’s no baby.”
*
At the women’s clinic on Monday on the same table in the same exam room, the midwife echoed the same sad news in person. She figured the embryo had stopped developing four weeks earlier. Even though I was twelve weeks pregnant, my baby only measured eight. “Do you have any questions?” she asked.
“I can’t think of any,” I lied. Why haven’t I miscarried if the baby stopped growing? It’s all my fault. I shouldn’t have had that glass of wine at the wedding. It could have been that sushi. Or that deli sandwich. I’m being punished for being a shitty parent. My womb is a barren wasteland. “I guess have no right to be sad if there was never a baby,” I snapped. I was pissed. At her. At Jack. At myself.
Her voice sounded distant, “Don’t think that. You thought you were pregnant for almost three months. That’s a long time to bond. Miscarriage is just as hard as losing a child. It takes time to grieve.” She handed me a pamphlet with bold, blue letters across that top that read Coping with Miscarriage.
She offered me three alternatives to remedy the unfortunate situation I found myself in: medicinal, surgical, or natural. She could insert a pill in my vagina to force my body into false labor to pass the tissue. She could perform a D & C to dilate my cervix and scrape away any remnants of the abnormal embryo. Or I could let nature take its course and my body would get rid of the empty sac on its own. The least invasive option was an easy choice.
*
I noticed light spotting on my panties Tuesday morning, almost as if once my mind knew the truth, my body stopped feigning pregnant. I took a steaming shower and pinned my curls in a French twist and dressed for work. I wore a panty liner to complement my floral print blouse, powder-blue pencil skirt, and black patent pumps. A noticeable blood clot oozed from my body during my morning lecture. Refusing to break character, I pretended it didn’t happen. I stared out the window and watched the last fiery leaves drift to the damp ground, leaving the maples bare. My stomach ached.
Like every other day after school, I met the kids at the bus stop. We walked home together as the other mothers and their children dropped off to their own homes one by one. At dinnertime, we circled around the table and exchanged snippets of our day muffled between bites of tacos. The kids showered and brushed their teeth before bed. My stomach twisted.
Bedtime was eight o’clock. It was Daddy’s turn to read Good Night Moon. He kissed our little girl while I snuggled our son, and the guys were off down the hall to perform their own special bedtime routine. My daughter and I sang a duet of “Twinkle, Twinkle, Little Star” and juggled starlight lying side by side in her twin bed. After a few more lullabies and just one more hugga mugga, I tucked her in for the night. I felt like going to bed too. My cramps were getting worse.
*
The clock glowed 2:13 a.m. early Wednesday morning. My daughter’s arms, heavy from sleep, draped across my chest and her moist breath tickled my cheek—she had a habit of sneaking into our room after we’d fallen asleep. My stomach throbbed. I hurried to the bathroom.
My underwear looked like a horror scene. I put on a heavy-duty diaper-sized pad and went back to bed to try and sleep through it.
Around 3:38, I woke to the sound of heavy rain on the roof and what felt like an alien trying to tear through my abdomen. I trudged back to the bathroom. I sat on the toilet rocking back and forth. I passed one golf-ball sized blood clot. Then another. At the climax, my belly tightened in pain reminiscent of labor. I pushed by instinct until I was empty. Splash! A hunk of flesh the size of my fist sunk in the crimson water. The unoccupied amniotic sac. The baby my body failed to grow. Waiting to be flushed down the toilet like a piece of shit. I erased any trace of the grotesque feature that aired during the wee hours and tiptoed back to bed at 4:11, careful not to wake anyone.
Deirdre Frank has fancied herself a writer since she won first place in the Young Authors of America contest in fourth grade. After hoarding her stories for years, she is coming out as a writer. She writes creative nonfiction highlighting the lessons the most mundane and arduous experiences often reveal. She teaches English and yoga in the Pacific Northwest.