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Friday, September 2, 2016

Pressure Cooker.

Dear Josie,
 
My three pregnancies were not terribly unlike the progression of hot sauce choices at a Taco Bell:  "Mild", "Tragic", and "Are you insane?"    In that order. 
 
When I was pregnant with your older brother I never thought he could die.  It never occurred to me.  Not once.

During my ninth month, the amniotic fluid grew extremely low.  I remember my doctor saying that this was  fairly common;  that it could happen towards the end of a pregnancy and that we were going to watch it.   She told me to take it easy and to drink plenty of water.  It was the last month of school and I was in the process of moving in with your father, but I did my best. 

The week before his due date I had a normal check up.   There was your run-of-the-mill, uncomfortable cervical check and I was one centimeter, maybe.  I was told that an induction would occur no later than two weeks past my due date, which was June 8th.  I was satisfied.  "See you next week!" I beamed, hobbling away casually, with certainty.

"Hold on," my doctor stopped me.  "Aren't you scheduled for an ultrasound?"

In my blissful unawareness, I had actually forgotten that we were supposed to be checking my fluid levels.  I had forgotten this most important, most crucial thing, and had I continued walking out the door your brother would not be here today. 

Moments later, the ultrasound technician wiggled her wand across my belly. "Wow," her eyes widened.

"What?"  I was half sitting up now, finally concerned.  "Is it low?"

She looked at me.  "It's zero."

Needless to say, I was induced that afternoon.  And your older brother, my very first baby, was born the following morning,  June 3rd at 11:40am.  There were zero complications, save for some variable decelerations during my contractions, for which I was given an oxygen mask.  He was born kicking and screaming and indescribably beautiful, and we all passed him around happily.  I remember the doctor asking if I wanted to see the placenta.  I made a face and refused, slightly grossed out.  Your father made a joke about it later and I never gave it another thought until you died.

Now I wonder.

Had there been clots in his placenta, too?  Was that the reason for the low fluid?  Was I not part of the "common" few to whom this occasionally happened?  Was this a chronic thing for me?  For my pregnancies?
 
I was still naïve during my pregnancy with you, but not in a maddening way. More of my friends had become parents.  I had scanned "Google" a time or fifteen hundred in search of remedies for high fevers and strange rashes, stumbling upon several worst case scenarios accidentally.  I had read about fatal dresser accidents and deadly viruses and international cries for awareness.  I was aware that children died.  I knew that tragedy could strike, but it had never really touched me.  Never my child.

During my third pregnancy I was the opposite of naïve.  Of blissful.  Of anything resembling a normal, well adjusted, confident human being capable of taking anyone's word for anything. 

In nine months I researched every pregnancy acronym in existence.  AFI and AFP and HCG and NST.   IUGR and HELLP and FL and GD.   If someone told me everything "looked good" I never believed them, no matter the letters behind their name.  I worried about fluid levels sure, but I also worried about heart rate and head size, neurological response and cardiac acceleration.   I obsessed over fetal protein levels and adequate folic acid intake.  Cord circumference, flow, attachment and compression.  I worried about a sudden increase in blood glucose and fetal stroke and tripping on my way to the car.  There was no sanity.  Every minute was its own ,unique trauma. 

At my 34 week appointment the perinatologist noted a rise in my blood pressure.  "We'll see how you look at 36," he said.  "If it's high, we might consider a 37 week induction."

That night I convinced myself that your brother simply HAD to arrive at 37 weeks, if not to spare him from a sudden blood pressure spike or a lackluster placenta, then surely from a cord accident or a spontaneous abruption.  The morning of my appointment I ate a bag of peanuts.  I stopped at Quick Trip and bought a 44 ounce Pepsi, chugging the entire thing before pulling into the hospital parking lot.  I grabbed my purse, along with the heaviest item in the trunk of my car, which happened to be the teacher's edition of a Pearson Biology textbook.  Then I walked up the three flights of stairs to my doctor's office.  Twice. 

The nurse actually gasped when she took my blood pressure. 

"Oh," I offered, aloof. "Is it high?" 

"You could say that," she said, while calling the doctor. I smiled, visions of an abrupt hospital admission danced through my head, equipped with 24 hour monitoring and a baby by morning. 

The doctor entered and shrugged.  "What's all this about?" he joked.   As he began to take his own reading I grew concerned.

"Let's just give you a few minutes," he offered, calmly. "It could be your nerves."

Despite my best efforts, I could feel my heart begin to slow then.   It was almost as if he were willing it so; as though my plans were so transparent and he were directing my every lying, bulging artery to deflate.   The numbers fell quickly.  Within minutes we were in a semi-normal range, and when he reassuringly said, "Looks like we can make it to 38 after all!" I burst into tears, absolutely convinced  he had just handed your brother a death sentence. 

He offered me a tissue and gently placed his hands on my shoulders. "Your baby is very healthy, Nora," he said.  "Your baby is going to make it."

I could barely breathe.  "Maybe,"  I managed, looking up at him.  "But I won't."



Sometimes I wonder what people see when they look at him; how some must view him as a replacement or a band aid, although he is neither.    But I wonder if he shows them all he has taught me, namely how you can lose everything.  That you can be the saddest mother on the playground with the biggest broken heart, shattered even.  You can walk around in a constant, muggy awareness of what you have been denied, feeling every inch of all you'll never have; your life, the least desired and the most feared.  You can be so completely lost and still sense a gratitude that spans the skies; that you can touch the bottom and feel the top all at once.   
 
And you can be the most hapless soul; you can bury a child and still feel incredibly fortunate, incredibly blessed.  Lucky, even.

The luckiest.
 

Love,
Mom