July 2, 2009

Another one year ago post... July 2nd, 2009, in the morning, I still had hope that Sierra was alive, that my ultrasound that day might even show that she had grown a bit.  She moved so little in those last couple weeks that I really was not certain if I'd felt her or not in the few days before July 2nd, but I thought I had.  The ultrasound was at 2:00 PM.  We went in and the sonographer said that the doctor didn't want a growth estimate this week, so she was just going to check for a heartbeat and look at the fluid level (which had been consistently very low).  I knew this was because my ultrasound the week before had shown a big decrease in placental function.  I protested, though, feeling like the doctor was giving up on my baby, and said I still wanted to know her size because we were still considering delivering her.  The sonographer's eyes were kind and slightly sad, and I caught myself then and said, "Well, let's just see if she's still alive, first."  The transducer was only on my belly a few seconds before she shook her head and said softly, "No, she's not.  I'm so sorry; there's no heartbeat."  As she pointed out Sierra's still heart, I told her, "It's okay; we were expecting that."  She responded, "I know, but it's still very sad," and that was when I started to cry.  I reached over to hold Tim's hand and we both wept silently as she finished the scan.  (Of course it wasn't okay, but for some reason I felt I needed to comfort her.  And alongside the heartbreak, I did also feel a bit of relief that it was over, although this wasn't in any way the ending I'd wanted.)

We went home to collect some stuff, and then went back to the hospital a few hours later.  Labor was induced that night and Sierra was born at 11:16 AM on July 3rd.

She was tiny, just 12.1 ounces and 10 inches long.  Her feet were about an inch and a quarter long.  She had probably been gone four or five days, the nurse told us gently, and her fragile little body had some indications of this.  But her feet were just lovely - perfect miniature replicates of Tim's, with the second toe longer than the first.  I'm starting to be able to look at her pictures now, and especially these footprints, with affection as well as sorrow and remorse.  This is my daughter and I love her.  But oh, how I wish she were alive in my arms right now.

June 2, 2009

The last ultrasound photo I have of Sierra is dated June 2, 2009 - exactly one month before the ultrasound that would show that her heart had stopped.  This photo is blurred because of the lack of amniotic fluid, and it's one of those frontal face "alien baby" shots, not a profile.  It made me cry when I showed it to a friend the day after it was taken.  I didn't like anything about it, but I kept it on my desk all of last June to remind myself she was still with me.  After her death and birth, I put her handprints on my desk in the same place that picture had been, and I put the picture at the very end of her photo album.  I still don't like it - the skeletal face, the fuzzy image that reminds me our placenta failed - but it will stay in the album.  It's the last picture I have of her alive.

More miscarriage memories

So the D&C was scheduled for April 17th, and on the 16th I went to the hospital to complete a bunch of paperwork.  As I sat in a small office near the front doors, filling out forms, a woman came into the lobby area with her newborn and several members of her family.  I was surprised at how painful it was to see this mother with her new baby while in the process of losing mine.

On the morning of the 17th, we went to the hospital.  I remember feeling very much alone as I left Tim and Austin in the waiting room and followed a nurse back to the pre-op area.  The first thing I had to do after undressing was get on the scale, and I noticed that I had lost 5 pounds in just a couple of days.  I guess it really is over, I thought.  The nurses were very gentle with me, holding my hands, bringing me kleenex, saying they were sorry.  The doctor came in at some point to explain the procedure, and when she said that she would "remove the contents of my uterus," I started to cry.  Those contents included my baby.

Eventually the anesthesiologist came in, and he greeted me with, "So you're having an abortion?"  I know "spontaneous abortion" is another term for miscarriage, but I responded, "No, I'm having a D&C to complete a miscarriage; I wanted this baby, but it died."  He immediately apologized, and then got down to business.  The drugs worked fast and the rest is very hazy.  I vaguely remember being wheeled into the OR, told to shift myself onto the table, the mask, counting backwards, and darkness.

The next thing I remember is hearing two nurses talking.
"Is she okay?"
"Oh, yes, fine.  But it's a very hard thing, and all that emotion has to come out at some point."
I can also hear someone crying - loud, harsh sobbing - and gradually I realize that I'm the one making that sound. (This was a really strange experience and I can't exactly describe it - I was awake before I realized I was awake - or something like that - it was just weird.)  The nurses I heard are on either side of me, wheeling my gurney to the recovery area.  There's a box of kleenex on my chest and the one who spoke second is looking at me with sadness and compassion in her eyes.  They get me situated and the first nurse leaves quickly.  The second one stays; she will care for me for the rest of the time I'm in recovery.  As soon as my conscious mind caught up and realized I was awake, I stopped crying, and now I just feel numb and sleepy.  The nurse gets Tim and Austin; they come to see me but Austin is afraid, clinging to Tim and peeking at me.  I realize I don't look like Mama - my face is swollen from the drugs and tears and I'm pretty spacey - and this makes me sad.  They stay a few minutes, then head back to the waiting room.  The nurse is wonderful, very compassionate.  I think I doze for a while longer, then wake up enough to go through the paces - have the IV removed, drink juice (she brings me crackers with peanut butter, too, noticing that my surgery was delayed and it has been almost 24 hours since I've eaten), stand up, walk to the bathroom, pee.  Then I can get dressed and go home.  A friend has left a casserole in our fridge - moussaka - it tastes marvelous.

The next day is a Friday, but I don't go to work.  It's a gloriously sunny, blue-sky day.  Tim sets up the hammock in our yard and he, Austin, and I lie in it together.  I feel empty and sad and alive and loved, all at once.

Two years ago today...

I'm in an ultrasound room at the hospital, the little local hospital, not the big one where I would have all my ultrasounds with Sierra.  This hospital generally doesn't do maternity ultrasounds, but the sonographer at my regular practice across the street is out sick and I'm bleeding, so I've been sent to the hospital to have it checked out.  I've had to undress from the waist down and put on a gown and robe over my shirt; I've never had to do this for a pregnancy ultrasound and I feel awkward, hot, and anxious.  The sonographer who came to get me after I undressed looked almost as nervous as I felt, and she stammered when I asked her if Tim and Austin could come in with me.  Eventually she decided to allow it, retrieved them from the waiting room, and now here we are, all crowded into the small, darkened room.  I lie back on the table and try not to wince as she squirts cold gel on my belly and appologizes that the warmer isn't working.  Tim is tucked into a little chair by my knees, 19-month old Austin wide-eyed and quiet on his lap. 

She moves the wand across my belly and I crane my neck to see the image, to search for the flickering heartbeat that I saw on an ultrasound six weeks earlier and heard again just three weeks ago.  By this point it should look like a baby.  And it does, pretty much, but the image is small and I can't see any movement at all.  The sonographer takes some measurements quietly and without looking at me.  Finally she asks, "How far along are you, again?" 
"Thirteen weeks, two days." 
"Oh...ummm...the baby is measuring 11 weeks, 1 day."
Tim finally speaks up, "It isn't good, is it?"  She frowns at him, then finally admits she can't see a heartbeat, and I think yeah, I knew that already.  And then she gets a little agitated, tells us not to jump to conclusions, she isn't sure and she isn't supposed to say anything anyway and she needs to get a radiologist to confirm.  And Tim and Austin have to leave the room.  And then she shoos them out and walks out behind them before Tim or I can say anything more than, "But..."  The door shuts and I'm alone.  I don't cry; I am too shocked.  I just wait.

The sonographer comes back a few minutes later with the radiologist.  They put the wand back on my belly and peer at the screen.  It's turned so I can barely see it now.  They talk very quietly to each other.  After a minute they decide to do a transvaginal ultrasound.  The sonographer grabs that wand, and says, "You've had one of these before, right?"
"Actually, no, I haven't." And I'm scared and you made my husband leave.
"Oh, well, it's just like a tampon."  And in it goes.  More peering at the screen and talking in near-whispers.  Finally the radiologist tells me that there is no heartbeat but we should go across the street to the OB office and one of their doctors may want to confirm.  He says he's sorry, but his eyes just tell me that he is uncomfortable and can't wait for me to leave.  I think about how much I do NOT want to cry in front of these people, and I do manage to hold it together, get dressed, locate Tim and Austin.  Tim is angry and looks as shaken as I feel.  We walk across the street.

We are treated completely differently here; everyone is gentle and sympathetic - and unfortunately, all too familiar with this sort of thing.  The receptionist calls a nurse who immediately takes us to a room and alerts the on-call midwife.  She comes in a little while later, and it's the midwife I feel closest too, the one who delivered Austin.  She hugs us all and says "I'm so sorry.  This baby seemed fine just a couple weeks ago.  Tell me what happened.  When did your bleeding start?" And suddenly I begin to sob and can't answer.  She gives me tissues and another hug, sits and talks with us for a long time, assures me I did nothing to cause the miscarriage, tells me she has had miscarriages too and they are heartbreaking.  Austin flirts with her and smiles at Tim and me, playing peekaboo with Tim's hat.  "He sees your tears and knows you need him - and no, this experience will not hurt him."  We tell her about the ultrasound and she says she'll talk with the radiology department about how they treated us.  We decide I should have a D&C. 

To this day, I regret not asking for pictures from that ultrasound.

Seven months

After passing the six month mark, I actually had a string of pretty good days.  We flew across the country to visit my family, and while the plane trip was tough, being there was good.  Traveling as a family to go see family made me very aware of the fact that someone was missing, but beyond that it was really okay.  But then last weekend Tim and I had a silly argument and just that was enough to push me right back down into a really dark place.  Last week and the beginning of this week, I've really been struggling.  I miss her so much, I'm so sad, and I'm so frustrated that I was starting to feel better and now I'm back in a darker place than I've been in quite a while.  Last night I dreamed I was pregnant, full term, in labor, but I had barely any belly bump at all and I knew the baby was going to be born too tiny to survive.  People were asking me how I could go through a whole pregnancy without the baby growing.  I woke myself up before the baby was actually born. Today I was a weepy mess, fighting to concentrate at work, and now I'm exhausted.

I know that grief is not linear, that it's normal to feel like you're taking one step forward and three steps back at times, but I haven't really felt that yet - not until now - and it's just discouraging and frustrating.  I also feel like I'm just now grasping the fact that she's really gone - forever - and that at least some of this grief will be with me forever, and the weight of that thought is crushing me. 

Last week I stumbled onto a website with a list of babies born alive weighing less than a pound who survived their first year, and in several cases, went on to be relatively healthy teenagers or adults.  I'd seen this list before, but not since we were trying to decide if we should deliver Sierra, weighing an estimated 12 ounces, or not.  Not since Tim calmly and gently said, in response to me saying that some of these tiny babies do survive, "well, some people win the lottery, too."  Delivering her certainly would have been a huge gamble, one where the person with the most to lose would not have had the option not to play.  In the end it just seemed too risky to deliver her, and we chose to let her go relatively peacefully in my belly.  I thought I was working toward peace with that decision, but that damn website has me wondering again.

The word IF just keeps echoing in my head...if I hadn't continued to nurse Austin while I was pregnant with her...if I had gained more weight, eaten better despite the food aversions I had at first...if I had been as physically fit as I was when I got pregnant with Austin...if I had gone on complete bedrest instead of just restricted activity...if she had been just a few ounces heavier...if she had been just a few weeks farther along...if the placenta had been just a little less damaged...if we had delivered her anyway, at 27 weeks and 12 ounces...would she be here in my arms right now? would she be healthy?  I'll never know and I'll probably always wonder.  I don't know that I'll ever be completely at peace with our decision, although I hope, with time, I'll be more so than I am now.  We love you, baby girl, and we did the best we could.  I'm so sorry.

Six months

A year ago (give or take a day), despite being in a hotel room (with Austin) at a scientific meeting, Sierra was conceived.  Six months ago, she was born, having died a few days earlier.  January 3rd to July 3rd - her entire life, only six months, all of it in my womb.  July 3rd to January 3rd - my life without her, so far.  Six months.  She has now been gone for as long as she was here.  A year and a day or two ago, she didn't exist.  Her entire life was contained in 2009 - the first half spent growing her, and the second half spent mourning her loss.  Not the way it was supposed to be at all.  She never saw the world outside of my belly, but she was here and she was real and I miss her.

I find that I keep repeating that - she was here and she was real.  I say it to others, almost defiantly, but I'm trying to convince myself, too.  She was here for such an incredibly short time. 

As I lit her candle at the dinner table on Thanksgiving, I said I was doing it because it was our first Thanksgiving without her.  But as those words came out, I was thinking, but we never had a Thanksgiving with her.

Six complete months.  Twenty seven weeks and five days.  I always add the five days, or round up to twenty eight weeks, to make sure to count every day that she was with me.  Such a short time.  And if she feels like just a dream to me, how can I possibly expect her to be real to other people?  But she was here and she was real and I miss her.  And I love her.  And I always will.

Five Months

December 3, 2009

Dear Sierra,

I miss you so much, baby girl.  The darkness and coldness of winter - and the holidays - have only increased my longing for you.  I remember so clearly your brother's first Thanksgiving and Christmas, and I think of how you should be the same age he was at this time in 2006.  On Thanksgiving we lit a candle for you (and Uncle Todd and some others missing from the table) and it burned between Daddy and me for the whole meal.  But I kept imagining you sitting in my lap or in the infant carseat like Austin did his first Thanksgiving.  My mind adds you in everywhere - kicking happily on a blanket on the floor while I'm playing with your brother, in the backseat in your carseat when I'm driving, riding snuggly in your sling while I'm shopping.

Thanksgiving was sort of hard, but good too.  Austin was sick, and one of our friends had very definite ideas of how the cooking and everything should go and made me anxious.  And, of course, you were missing and I was sad.  But we did have a good, low key celebration with just a few friends in a very beautiful spot in Vermont.

I usually love the build up to Christmas.  This year I feel like I just don't have the energy or the heart for it.  But I'll do it for Austin.  I'm grateful for his enthusiasm.  He's so excited for it this year, making his list for Santa and planning what gifts he will give to Daddy, Grandma, his Aunties, and so on.  I will do it for him, and I'll think of you and how you would have loved the lights on the tree, the excitement of your brother, the motion of snowflakes in the wind, the sparkle of your first ornament.  I wish you were here, little one.

All my love,
Mama

***

I'm still thinking of ways to include Sierra at Christmas.  I want to get her a "baby's first Christmas" ornament with her name on it, and I'm trying to decide what to do with my Christmas cards.  I might put in a card with a picture of her footprints and her name and date - basically a birth/death announcement, which I never did formally.  Or I might just write an "In memory of..." line under our names when I sign the cards.  I'm going to include a picture of Austin, which is what made me think of including her footprints, but is that too sad for Christmas cards?  Any advice or suggestions?  How are you including your baby(ies) this holiday season?

At the first support group meeting I went to, not quite three weeks after Sierra's death and birth, we did a writing exercise.  The writing prompt was to look at a collection of hearts - glass, metal, cloth, wood,  different colors and textures - and write about the state of your heart.  Here's what I wrote:

In September of 1993, I was a first year student at Smith College, contemplating an exercise like this - the state of the heart.  My writing that day was full of optimism.  At this moment, the first thing that enters my mind on hearing the word heart is Sierra's heart on the ultrasound monitor - five weeks of it beating defiantly in spite of a placenta that was failing her - and then - the last week - nothing.  It was so still.  And now, almost three weeks later, I don't quite know what the state of my heart is.  I don't know how to go forward from here.  I miss her so much - she should still be in my belly.  I suppose the obvious metaphor is one of the glass hearts on the table in front of me - glass breaks, shatters into sharp bits - but those glass hearts look strong at the same time - and I am finding strength I didn't know I had, through this whole experience, strength and patience, but I wish I didn't have to find it this way.

At first I had this real sense of "if I can birth a dead baby, I can do anything."  It made me brave; I didn't care what people thought, and all the little day-to-day challenges in my life seemed manageable.  But it didn't last.  Now I feel anxious and overwhelmed by the little stuff, wanting to hide in my office at work, or better yet, stay in bed all day.  But I don't stay in bed all day - Austin won't let me, and I'm very grateful for him.  I guess I've found the way forward - just keep putting one foot in front of the other - but it sure is hard sometimes.  I still know the strength is there, but, as I keep seeing on other blogs, the true test isn't birthing the dead baby, or holding her body, but living without her. 

A friend told me recently that she could see that losing Sierra had changed me, that I was visibly sad.  She knows me quite well, we talk a lot, and she lost her first husband 14 years ago and understands grief -but I thought I was the only one who noticed that even when I think I'm hiding my sadness, it's there in my eyes.  Apparently I'm not as good at hiding it as I thought, but it was actually gratifying, in an odd way, to have someone notice that I've changed.  I do think I've changed in positive ways too - I have gained strength - and patience, and compassion.  But right now, I'm mostly just sad.

Four Months

Nov 3, 2009

Dear Sierra,

Has it really been four months? Four months since we said hello and goodbye, since I held you - tiny and perfect and so heartbreakingly still and silent. How I wish I could have seen you alive, even if only for a short time. I still remember how the tip of my index finger just fit on your little cheek and how prominent your cheekbones were. I'm so sorry you were so thin, struggled so much those last few weeks inside me. That was all I could say to you that day as I held you - I love you and I'm so sorry.

You were born four months ago today, in the summer, when the days were at their longest. Now it's nearly dark when I leave work, and geese rise from the canal and fly honking into the dusk. The trees have changed from bright green, to brilliant orange, pink, red, and yellow, to more muted gold, amber, and brown. Most of the leaves are on the ground now. I wish you could see all this change, wish you were here, tucked warmly against me in a sling. Your brother has always loved fall leaves; even as a tiny baby he would focus on their colors and movement. I bet you would have too.

Last night Daddy and I talked about you for the first time in a while. Daddy sees you as a tomboy, as I was growing up. He thinks you'd be a feisty little one, capable of fending off your older brother's rough affection - or returning it in kind. We both love and miss you very much, and we hope you are with your uncle.

I wish I knew where you were, baby girl. I want to think that our energy continues on in some way after we die, that we go somewhere else, but I don't know where that somewhere is. Twice I've thought your uncle was with me. I see you everywhere and nowhere. Did you choreograph the moonrise for me tonight, lovebug? It was gorgeous; I got out of the truck and stood at the edge of the canal, watching the huge, orange moon rise over the water and turn the edges of the clouds pink and silver. Ducks quacked and leaves rustled in the wind, it was not quite dark, I was alone. It was all very peaceful.

I miss you so much, Sierra. The longing to have you alive, whole and healthy in my arms is just as strong as the day you were born - even stronger maybe, now that we've passed your due date and you should most definitely be here. I wish things had worked out differently - I'm so sorry that they didn't.

All my love,
Mama

9/11

Tonight I'm remembering another whose life ended too soon...not as a baby, but too soon nonetheless. Tonight I'm remembering Maile Rachel Hale, lost in the World Trade Center on 9/11/01, at the age of 26. She was a sweet, inquisitive, lovely woman and a good friend. We met during a semester-long maritime studies program in college. She loved the ocean, Hawaii (where she grew up), her family and friends, and chocolate. Although she majored in chemistry, she won an award for a history paper she wrote during our semester, and I admired that. In 2001, she was living in Boston, but just happened to be attending a conference at the World Trade Center that September day.

I've learned a lot about Maile since she died, remembering her with others and hearing their stories of her. She wasn't my closest friend from that semester - we were all close, in the way of people who share an experience that can't be explained without having been lived - but our friendship was certainly still evolving when she died. And that's what breaks my heart the most - the lost future. That's what we mourn when lives end too soon. Her future, and our future together, as friends, continuing to learn about each other and watch each other's lives unfold. I wrote something to that effect in the guest book at her memorial service, and it's even more obvious to me now after losing Sierra. The 9/11 anniversary has been particularly hard this year.

I miss you, Maile. I wish you were still here; I know you would have done great things on this earth. I wish you could see me now, still working with the ugly fish you liked to tease me about. I wish you could know that the boyfriend you approved of is now my husband and see our children. Maybe you do know. Maybe right now you are holding Sierra, both of you whole and happy and hoping that I am remembering you with smiles as well as tears. I hope that you are, and I do cherish the happy memories.

Maile's memorial service ended with Dar Williams' song "Better Things." Here's a bit of it:

Here's wishing you the bluest sky
And hoping something better comes tomorrow
Hoping all the verses rhyme,
And the very best of choruses to
Follow all the doubt and sadness
I know that better things are on their way.

Here's hoping that the days ahead
Won't be as bitter as the ones behind you
Be an optimist instead,
And somehow happiness will find you.
Forget what happened yesterday,
I know that better things are on their way.

September

The seasons are very definitely changing here. Sometimes the transition from summer to fall is a subtle one. This year it seems to have happened overnight. Suddenly the air is much cooler, the humidity and mosquitos are gone, and the leaves are already starting to turn. And the calendar says September. Already? How did that happen?

This is a month of contrasts for me...It started with the shockwave through the whole babylost blogging community of the loss of sweet little Jet. That one I didn't even see coming. Next we have September 11. My world was turned completely upside down on 9/11/01...and I'll say more about that tomorrow. Then September 14, Austin's third birthday and our seventh wedding anniversary. Austin is old enough to anticipate his birthday with excitement this year. September 15, one of my closest friends is moving halfway across the country. She has been one of my lifelines this summer, going to lunch with me once a week, letting me talk about Sierra as much as I want, crying with me, saying all the right things, just the best. We'll still talk on the phone, of course, but it just isn't the same. On September 26 I have a reunion for a program I did in college; the people I met there are still some of my closest college friends. I'm really looking forward to seeing them, but if Sierra were still alive I wouldn't be going. And that brings us right up to September 27.

September 27 was Sierra's due date. Strangely enough, it was also Austin's, and I just can't stop thinking about the difference between this time in 2006 and now. How full and happy I was then, how empty and sad now. I should be just about to have a baby, getting ready for her to be here, for everything to change. Instead, I plod along, struggling to understand that nothing is changing, that she is gone and always will be. I feel burned out at work; I should be just about to start maternity leave, but instead I'm working through endless piles of the same kinds of data. All around me people are going back to school, starting new jobs, making changes and I'm just...stuck. Stuck longing for a baby I will never hold again. I miss you so much, baby girl. I just can't move past this right now - how much I miss her, how she should be in my belly, about to be born. I have no pregnant belly, no baby, and it's just so wrong.

Sierra was born on July 3rd - high summer here. We spent all of June worrying about her, all of July and August mourning her. I thought summer was her season, and it is, but the start of fall is hitting me hard. This should have been the season of her birth, the season of bonding with her outside of the womb. I guess if summer is her season; fall is her "should have been" season.

This sounds so scattered...and I really can't come up with any way to make this anything larger or deeper than simply a lament that she isn't here with me. But I'm going to let it stand, because this is where I find myself right now.

Sierra's story, part 1 - the beginning of the end

At the end of the last post, I set myself up to tell Sierra's birth story...but I have to start farther back in time than that. The story begins with an ultrasound - a normal ultrasound showing a healthy baby (or so I thought). At 17 weeks and 4 days, we went for the "big" ultrasound. Everything looked good, the baby was measuring just right for gestational age, and we made the happy discovery that Austin's prediction that he was getting a little sister was accurate!

This ultrasound had been scheduled a bit earlier than the typical 18 to 20 weeks because we were planning another one to look at the heart in detail at 22 weeks - a fetal echocardiogram - and my midwife knew I wanted to try to minimize the little one's ultrasound exposure, or at least spread it out over time. The echocardiogram was because my husband's brother died of a heart condition no one knew he had, there was a (fairly small) chance it was genetic, and we (my husband especially) needed the reassurance that the baby's heart was okay.

The day after the 17 week ultrasound, I got the results of my AFP test and learned the AFP was elevated. This had happened with Austin, too, and he is fine, and besides, we just had an ultrasound the day before that turned up no red flags. So I wasn't very worried. Elevated AFP is a marker for open neural tube problems and the doctor had looked carefully at the baby's skull and vertebrae during the ultrasound.

However, when we went back for the next ultrasound, at 22 weeks and 4 days, I mentioned the AFP test and the sonographer assured me that she would check the baby's spine again. I relaxed, still not concerned and looking forward to seeing my baby again. She squirted the gel on my belly, began moving the transducer around, then asked casually, "Do you think you've been leaking fluid at all?" Ummm...I don't know. Maybe a little. There were actually a couple of times I'd wondered about that, but I never needed pads or was aware of any gushes of fluid...Why? I asked her, is it low? "Yes, quite low." Oh. I still wasn't that worried. She looked around a bit more, then went to get the doctor. When she left, I looked over at my husband. The concern in his eyes made me wonder if I should worry, too. He asked me what the low fluid meant and I said I didn't know. The doctor came in then and started looking and taking measurements. The sonographer, understanding something we didn't yet, took the somewhat antsy Austin out of the room in search of stickers, crayons, and paper. The doctor then said, "I do see two things that concern me..." Two? "The fluid is very low and the baby hasn't grown the way we would expect. She looks normal and healthy, but is likely not getting what she needs to grow and produce urine." Amniotic fluid at this stage is mostly baby pee. Turns out elevated AFP can also be a marker of placental problems and everything was pointing that way.

Austin came back into the room about then, with his art supplies, and the rest of the conversation was punctuated by him applying stickers to my shirt and my bare belly. The doctor talked of the baby's increasing demand on the placenta, then said if the baby could make it to 25 or 26 weeks it would probably be best to deliver her at that point. Until then, all we could really do was watch and wait and have ultrasounds weekly (so much for minimizing exposure...). As dire as this sounded, I still clung to optimism. She didn't say the baby would necessarily die, just that she would probably have to be born very early. It seems a bit ridiculous to me now, that I was still as hopeful as I was at this point, but when it is your baby, you hold tight to any bit of hope.

The next week I had a visit with a midwife and a follow-up ultrasound at the midwives' office. Still no change in the fluid. The midwife was honest about her concerns and told me as gently as she could that this situation was usually "ominous" and I should see a maternal-fetal medicine specialist at another hospital - in fact, I should probably transfer my care to them, to this larger hospital that had the NICU that my baby would require, should we decide to deliver her. The midwife then looked at me and said she wanted to give me a hug but maybe I didn't want her to upset the control I was (barely) holding onto. I decided I wanted the hug anyway. I can't stand the thought of losing this one too, I told her through the tears. My last pregnancy was a loss and now this... "I know," she said, her hand still on my shoulder and sadness in her eyes. "We just have to hope this little one can hang in there long enough."

An introduction, of sorts

I am a mother. Whether of one or two or three is in the eye of the beholder, I suppose. This much I know: I've held three in my womb, and hold three in my heart. I've given birth to two, and hold just one in my arms now, just one who walks this earth beside me.

* * *

My first pregnancy brought me a sweet baby boy, now a lovely, boisterous, almost-3-year-old. My last two pregnancies combined have totalled 40 weeks - but haven't resulted in a baby I can bring home. One ended at 13 weeks, the other at 27 weeks and 5 days. The latter ended just over five weeks ago - she should still be in my belly. Most mornings I stand in the shower and think, "only me in here," looking down at my slack, empty, slowly flattening belly.

I miss her so much, my little Sierra girl. Two weeks ago we camped on the beach, a couple hours from home. I wrote her name in the sand and watched the waves erase it almost immediately. I wrote it again, then walked away from it as her big brother Austin ran playfully ahead. It felt a bit like birthing her lifeless body, then leaving her at the hospital...