When I was five, I listed several things I wanted to be when I grew up: teacher, archeologist (my mother had wanted to be that and had explained what it was), author, and mother. I have always thought of myself as an archeologist of sorts, dusting off bones from my clients' emotional digs, figuring out how they fit together to make an understandable history. I teach graduate students. I write. But I have not become a mother. What does it mean to be a woman who is barren, unable to grow anything in the land that is the body?
Infertility is about the body. One's identity becomes defined by what the body does or does not do. During my first miscarriage, I experienced slow, aching cramps and the punch of the uterus as if it said "no, not now, not time." There was no happy announcement of pregnancy, only the feeling of sadness when the bleeding came. By the time we learned I was pregnant, it was already over.
The second pregnancy began with more Clomid, a medication we were using to stimulate ovulation, and a new set of medical procedures, including a test called a hysterosalpingogram. No one understands why some women unexpectedly get pregnant after having this test. Perhaps a slight blockage exists, perhaps the dye they use is like Liquid Plumbr. Envision pipes opening up as the gunky stuff drains away. During the test, I lay on the table with the sheet covering my bottom half, the nurse and the doctor both directing me: "Here you relax...Here you breathe... We'll see your uterus above on that screen." I had to turn my head from the hard table to see it. But first I focused on an image: blue dye being threaded into me, the shock of its entry almost like sexual intrusion. Not rape; I wanted this, didn't I? The goal was to find the blocked places, to make my body a host that could grow things. The dye entered and my body fought back. Above me, my uterus floated, distinct, not looking like those pictures in biology books. Mine is elongated, a shapely part of me like a pink heart. Tubes stretched out from it. Momentarily fascinated, I ignored the physical discomfort as I looked inside myself.
The test took place two weeks before my nephew, Michael (my sister's third child), was born. My husband and I visited the hospital, bringing my sister Chinese food--greasy egg rolls, noodles in sauce. She was tired, but happy. She tried not to be too happy, mindful of our struggles with infertility, as she gave Michael to me to hold. Looking back, I wonder if my uterus at that moment opened and if somehow that muscle inside me relaxed, allowing my egg to roll downward and inside. I picture the egg, cartoon-like, smiling.
The night after Michael's birth, we conceived. My husband dreamt that night of a blond boy in a bucket. He told me the next morning we were pregnant, but I didn't believe him. And then, suddenly, we were. It was Christmastime and I was tired, green and hungry. I told people early; I couldn't contain our news. For a long time after the first miscarriage, we'd waited to try and get pregnant, and we'd waited through more cycles on the medication. Now, I read things about babies. I imagined ourselves dividing over and over inside me. We had a nickname for it. We called it "Pea." I stayed green and tired and full of indigestion. My temperature stayed up. My breasts began to hurt all the time and grow larger. My husband noted this outward sign. He began to buy books about finances, investments. He was worrying about building our nest with enough twigs and sticks to weave securely for the egg, the blond boy in the bucket.
On Super Bowl Sunday, we returned from brunch with friends and part of me felt different. Several days earlier, I had finally stopped taking my temperature, believing at last my hormone levels would remain high. Then it appeared: a rusty red spot as I wiped myself. I started to panic. I went to the bathroom every hour. Each time it was still there, another drop. It was a stop sign, a red light, a flashing siren light on the top of a police car telling us to pull over, stop driving. I called the doctor--not my doctor, but the doctor on call. He sounded irritated. He was probably watching the game, eating snack foods, and drinking beer. I told him what was happening. "Call tomorrow for an ultrasound appointment," he said. "There's nothing to do today."
Should I rest, lie down?
"You can do that if you want," he said. "It probably won't matter."
In the hours that followed, I thought about my wedding day when my sister was several months pregnant with my second niece, Maddie. Right after the reception, she began bleeding. Her doctor put her on bed-rest for more than a month. We still shiver to think of Maddie's not being; we were so close to losing her. After the phone call to the doctor, I lay in bed and cried because I knew what was happening. My uterus was clenching, not to hold on, but to let go. It was like a star falling. You don't exactly see the trajectory, only the brief light and the memory that once it was reality if only for the briefest breath. I lay flat and very still. When I was a child with a fever I'd look at the corners of my bedroom ceiling and imagine walking on it like it was the floor. What a strange possibility if the whole world could be upside-down! In the suspended shadows, I'd hang in the wrong direction and try to experience that fevered moment before the world swung back.
The next morning when I called for the ultrasound appointment, they told me to drink fluids. I drank ten, twenty, thirty ounces. I was still drinking on the way to the hospital. I was still bleeding. "Many women spot early in their pregnancies. I've read this and it could be true," I told my husband. "My sister bled and it was bright red and Maddie is here now. It could be true, couldn't it?" My husband nodded a little distractedly and held my hand. It felt as if he had already begun dissembling the nest, knocking twigs everywhere.
At the hospital, the technician ran the probe over my abdomen. "You didn't drink enough. Go drink more," she said accusingly. I was sitting in a room with pamphlets about sexually transmitted diseases and bladder infections and I was drowning myself with water. I felt myself float like a balloon and still the technician said it was not enough water. She said with annoyance now, "We can't read it this way. We'll do a transvaginal. Now go urinate." I peed and peed and peed. Then she brought out the condom-covered probe which I helped her put inside me. It reminded me of a stick shift on one of those driving video games. She stared at the incomprehensible screen that was turned slightly away from me. My husband seemed not to notice the weirdly pornographic quality to the whole interaction. "I can't see," the technician said, "I'll be right back." But I knew already what I knew--that something had happened. The radiologist came in and said, "I'm sorry. It stopped growing a week or so ago." She compared the size of the yolk with the technician's developmental chart and moved the probe around again inside me. I began to cry then, just wanting to get up and go somewhere like those animals that howl and howl deep in the forest.
But first we had to walk back to the obstetrician's office. My doctor was almost tearful at the news. The nurse practitioner was actually crying. She asked me, "Do you want to wait? Or we can do a dilation and evacuation (D&E) and see if we can get a tissue sample. Then we can maybe figure out what happened. You don't have to wait and then bleed. You can know it's finished." I could barely think because I was that animal howling, but I made the D&E appointment for the next day. I knew that was better: I couldn't stand to wait.
The next day we checked into the hospital. I told the admissions person the reason for our visit and cried. I told the nurse and cried. I told the doctor doing the surgery what happened when she asked, and I cried again. I stripped off all my clothes and put on the blue gown and bracelet. My husband sat with me. He held my rings because I was not allowed to wear them into surgery. It was a funeral of waiting.
After they came to take me into surgery, he waited in the other room like those old movies where they show the father pacing the waiting area during the baby's delivery. I was still sobbing when they finally wheeled me into the operating room. The masked surgical team put my feet up into high stirrups. The anesthesiologist said something that I didn't hear because it was suddenly dark. My obstetrician had cautioned, "Don't worry about whatever you say or do during the procedure." Afterward, when I woke up after the surgery, my face was wet, and my hands held a ball of damp tissues. I knew I'd said and done things I couldn't remember as they carefully cleaned out that beautiful elongated space inside me that must have clenched its muscled will against the intrusion, the loss, and the flowing out.
After the second miscarriage we both took the nest apart. A friend once told me about some misguided birds that had built a nest by her front door inside a large flowerpot. One of the eggs--a finch egg, she thinks--was accidentally knocked out and broken. Thinking about that story, I wondered if the bird missed the shattered egg. After the D&E, I stayed home for a few days in the dark house in stunned silence. I read two murder mysteries in twenty-four hours. I slept, but mostly I just sat quietly and took pain-killers for the cramps. It was raining outside, a winter rain, the hard, cold kind. I sat in my living room for almost three hours before I noticed that it was raining inside the house, a steady drip in the entranceway. I put a pot under it and sat some more. My husband didn't know what to do. He held me, but as is the way with wild animals, I'd found a cave and remained in it.
We visited a high-risk specialist who told us nothing we hadn't figured out already. She offered us a different medication, the possibility of a study. We both underwent full panels of genetic testing and filled vials of blood in the lab. The results of the D&E testing came back. The obstetrician showed us the numbers and pronounced them "normal." He told me they couldn't be sure if they had obtained the right tissue. It was so early in the pregnancy that the tissue they used may have been from the embryo or my own body. He was gentle and encouraging about trying again. He said, "If you want to and whenever you feel ready." There seemed to be no answers for what was termed "secondary infertility." After all, I'd finally been able to get pregnant when on medication, hadn't I?
When I visited my sister during this time, I didn't hold my nephew. He was exactly nine months ahead of the child I was missing. My husband and I decided to try again and spent more months on drugs and off drugs with no conception. The anniversary of the first miscarriage passed. Then the anniversary of the due date of the second miscarriage approached. I tried to speak to my husband from the cave. "It's a harder time than I expected," I said, "The 28th will be difficult." He said he understood. The 28th passed and he said nothing. On the 29th, I climbed out of my cave and tried to beat some conversation out of him. Where had he gone? He no longer guarded the cave, no longer grieved as I did. "I want our old life back," he said. He said he didn't really want children, maybe never did. Men and women grieve differently, the literature claims. I wanted to rip at his seeming indifference with unforgiving claws.
We talked to try to resolve our differences. But in order to have children, we needed to agree to proceed with the medical process we'd been going through. And then we needed to decide at what level we would stop treatment. Imagine two people posturing like a bull and a
matador. After several conversations like this, our battle became scripted. One wave of the cape and we were off. We began to avoid the ring. We began to avoid sex. Once when we were scheduled to have sex--neither of us called these times making love at this point--my husband turned to me and said in a business-like voice, "Okay. Let's pretend we are in a lab and they are forcing us...." We then took turns elaborating this scenario so much that our laughter rang over the bed and bounced back to us until we could make love.
How can I explain what the infertility journey does to a sex life? First there's fun, the joy of trying to make something. Then there's the fear of making something you will lose. Then there's the stress of having to make something on a schedule and the fact that hoping at all becomes so painful. The pain is like a small, deep cut that won't heal.
When the third miscarriage happened, we barely talked. I knew the pregnancy was over three days before the bleeding started. I was now so attuned to my body that I almost swore I could feel when the egg released. I tried to control what I could. I kept my butt elevated for twenty minutes after sex even though it was futile. But I told myself maybe it would matter and at least I could do something. When the bleeding for the miscarriage began, I cried in the bathroom at the community mental health center where I worked, big heaving sobs that I tried to stifle since I told myself the patients used the same bathroom and I didn't want to upset or have to comfort them. I was glad I'd had the D&E last time since each change of pads and tampons in the bathroom now made me wonder, Was this life, Was this?
In the infertility specialist's office, the new doctor, a reproductive endocrinologist sat across from me. He said, "You seem stressed by your situation," and asked me if I wanted to see their psychologist. This would be funny at any other time since I'm a psychologist married to a psychologist, and had already been seeing a psychologist on and off during the whole ordeal. This new doctor seemed to believe that, because I was starting anew with him, the past three years and three miscarriages didn't count. "Here are the new vitamins and new blood work and more medication," he said. I wasn't very hopeful, but I took the medication and felt myself ovulate days before I was supposed to. I took the ovulation test at work between seeing patients and brought it home to my husband, because I didn't even trust myself to read its results right any more. He thought I'd ovulated too. He said this carefully, since I was wild with hormones. When I called the doctor panicked and afraid we had missed another opportunity to get pregnant, the doctor said I couldn't have ovulated. We scheduled time to have sex as soon as the doctor's office called back because we knew it was the "right" time. We lay on the yellow, sun-warmed afternoon bed and tried to make a baby. We didn't.
At the next doctor's visit, when he told us we could try stronger drugs or in vitro fertilization (though there were still no known reasons for the miscarriages) and when he said the words "let's take another blood test," I knew. I knew, just as I knew when it was time to break up with somebody or change jobs, that it was time to stop. I told my husband on the way home. I didn't say it directly, however. I told him (half in the cave) that I was getting rid of all the oversized clothes and borrowed maternity outfits I'd been keeping. Once home, I angrily cleaned out closets and drawers. I was getting rid of the clothes that no longer fit me or were no longer about whom I was or wanted to be.
That night and for the whole week following, as my husband and I climbed into bed, we listened to a confused mockingbird singing in the dark just outside our window. He was looking for a mate, looking to make a bird family. He was singing at the wrong time, but what a song of trills and warbles and fakery! He sang as if his life depended upon finding his mate. The week after his glorious midnight performances brought only silence. In all that darkness, could he have found something?
I began working out every day at the gym and lost all the weight I'd gained, reclaiming my body. I began writing poetry again, stories and words about grief. I quit my thirty-hour-a- week administrative job at the community mental health center. I remembered that I once liked my husband as a friend and that, while neither of us were perfect dealing with our infertility or each other, as a couple we'd survived.
Bodily scars linger. I have bigger breasts from the pregnancies and, possibly, some other physical effects from the medications I took. I struggle with my feelings about what it means to be female and not give birth. I recently walked into a hair salon where four pregnant women and one woman with an infant sat. It reminded me in an instant that I am different from other women: I won't hold a child that looks like my husband and me.
But there are also moments of solace. My husband jokingly holds our favorite cat up next to his cheek and grins. "See the resemblance?" he asks. We can laugh about this sometimes. A few months ago, I attended the opening of an art exhibit held by a young woman who'd been one of my first long-term psychotherapy clients. She made textured and original ceramic pieces symbolizing parts of her personality, and she'd wanted me to see them. (They were too big to bring to my office.) She stood next to me with shining eyes and excitement at the fulfillment of making something, and I recognized that I'd helped in this. The years we worked together created something in her that, in turn, created something else, healthy and full of her life-energy.
I am an aunt. In some cultures this is an important and respected position-- someone who doesn't have her own children, but loves others' children as if they were her own. My first niece, Sarah, is eight-years-old, as old as my relationship with my husband. We attended her birthday party and watched as she blew out the candles on the orange, pumpkin- shaped cake that my sister had crafted. My family sang "Happy Birthday" in all different keys to her happy face. I suddenly felt tears push at the back of my eyelids as the thought welled up that I would never make a cake like this for my daughter.
My five-year-old niece Maddie was pleased that I hung her artwork on my kitchen door. "Aunt Debbie," she asked holding a small fistful of tiny yellow flowers she'd bunched up with tape borrowed from my drawer, "Can you hang these up? These are for you." I looked at the small wilted weeds, the same yellow as her hair and her ruffled dress. She was smiling at me and I was acutely aware of the ache her gifts sometimes caused. She was not my own child, yet my deep love for her touched the emptiness inside me.
My nephew Michael was talking. He said, "Aun Bebbie." When I visited my sister, he played a new game with me, jumping off the low coffee table into my arms over and over, sure that I'd catch him. And I did, every time, though each time he flew into the air and I held him, I remembered what had slipped from my grasp.
How long does it take to give birth to oneself as a childless woman? A year after we had stopped all the procedures and the medications, given up the idea of trying, and continued along our changed life path, I suddenly became pregnant. On a television show, a surprise situation like ours should have turned out fine. It didn't. I had another early miscarriage. For a while after this, I half-heartedly entertained thoughts about adoption. This was fantasy, a way to imagine a life of mine that ran parallel to this one, in some other universe. That alternative life included a little boy or girl running through our backyard, playing pretend under the peach tree. I began to realize that I'd always be barren if I continued to hold onto the idea that a child should be in me and produced by me. If I believed this idea, planted in me when I was a child myself, I'd always have only a weed-filled field, scrub trees, and emptiness. Here, in this infertile place, I kept the grief about "Pea" and the other lost embryos, along with the fantasies about what might have been.
A second floor room in our house had been painted bright yellow before we moved in, six years ago. I said it would make a great baby's room. Each morning it filled with sunshine, and several contented cats stretched out in the warm spots. A few weeks ago, my husband suggested I moving my home office from the corner of the basement into the yellow room. To take my creativity upstairs meant reorganizing our whole house--moving heavy furniture to different rooms, carrying what seemed like endless numbers of books from bookshelf to bookshelf, opening boxes, tossing files I hadn't looked at in awhile, cleaning out old pictures, and deciding what I should take with me. In the middle of the chaos, my husband leaned over my shoulder as I ordered office furniture online. He joked in a low inviting voice, "Come upstairs, out of the cave, write happy things in the yellow room."
Once I moved into the yellow room, I could see from my windows, the neighbors' houses and their children running between the fenced backyards. In our own yard, the peach tree, planted from a dried pit, is now mature enough to begin the process of bearing juicy fruit itself.
Inside my new room, I see lots of photographs of my husband and me with our nieces and nephew, snapshots of our friends and family, and pictures of the places the two of us have visited together. High on a bookshelf, almost out of reach, sits a small, closed box--a gift from my husband's aunt before the second miscarriage. Inside, protected in white tissue paper, nestles a pair of green, hand-knit baby booties.