Womb Half Full, Mother Half Empty

TW: mentions of pregnancy loss

The familiar sound of crinkling paper was the only one in the room as I maneuvered my bare bottom across the examination table. I lied back as if I were actually comfortable.

“Do you know what this is made of?” I asked my husband, who was typing on his phone.

“What what’s made of?” Jeremy replied.

“This paper that’s in every doctor’s office. It reminds me of the parchment paper I use to bake cookies.” Jeremy rubbed the paper, feeling both sides. He wasn’t thinking about paper.

“Check that cabinet over there. Let’s swipe some!” I said with a devious smile.

“You’re Crazy.” He chuckled.

“We’re paying enough for this appointment, might as well – “

There was a knock at the door just before it opened. A tall slim woman I had never seen before entered, and another woman followed. The room was dark, making it difficult to make out their features.

So strange. My body, my trust, and my life are in their hands, and I don’t even know what color hair they have. They’re moments away from looking inside of me, advising me, and I will pay for them for it. I smiled at the women and kept my thoughts safe as they let themselves in.

“Hi there! Forgive me, but how do you pronounce your last name, Mrs. – “ said the slim one.

“Co-shun, Kocian-Williams, but you can call me Jackie.”

“I had it right then! Just making sure. I’m Joanne, one of the Obstetrician Gynecologists here.” She turned to the other lady. “Linda is one of our Registered Nurses.”

I gave Linda a smile and nod. I had already met Linda when she called me back from the waiting room.

The only available appointment for that day was 7:45 AM. I have never been a morning person, but this couldn’t wait until Monday. Entering the office at this ungodly hour, I was shocked to see a full waiting room. Women were everywhere, beautiful and confident. Some pregnant, some not, women of all ages, women in all stages of pregnancy. It seemed like a joint waiting room for Oprah’s Book Club, a taping of The View, story time at the library, and the DMV. Televisions were on. Babies were crying. Some women were on their phones. “If you ever call me before 9:00 AM and no one is in serious danger or dying, you will be in serious danger,” I said as we followed Linda from the Lilith Fair tailgate party.

After introductions, Joanne seamlessly transitioned to doctor business. “You’re a new patient here?”

“Yeah, we moved a week after the COVID shutdown for my husband’s job. I didn’t have a doctor here yet.” I answered.

“Ah. And is this a desired pregnancy?” 

“Very! We’ve been trying.”

“Congratulations! And you’re about eight weeks pregnant?”

“Ish. I have a history of pregnancy loss. We’ve lost four pregnancies already. My anxiety wouldn’t let me wait another couple of weeks, and I knew they wouldn’t schedule me before the magical eight-week milestone. The last pregnancy was ectopic.” I explained.

“I am so sorry for your losses.” She said without taking her eyes off the screen as she noted my medical history.

“When was your last menstrual cycle?”

“Umm.” I hesitated and looked at Jeremy.

“Your best estimate will be okay.”

“No, I remember.” I turned back to Jeremy. “Help me remember. I know it was a Thursday night because we were having date night that weekend. We were all pissed off because of lady time.”     

“Oh! Yeah, you looked super-hot in that outfit. I what you’re talking about.” He answered.

“Look at your calendar. It would’ve been last month on a weekend we didn’t have Grace.”

Joanne was still typing. Linda was getting all the necessary gels, towels, gloves, everything else they needed to explore my uterus.

“It was Thursday, the 11^th.” Jeremy said.

“Of last month?” Joanne confirmed, and I nodded. “All right, then you are seven weeks and one day.” She shifted her stool to face us. “We may not be able to detect a heartbeat at this stage, and that’s perfectly normal. If we can’t detect a heartbeat today, we’ll schedule another appointment for a week from today.” The screen illuminated the left side of her face now. She appeared relatively young, a brunette with dimples.

She stood and guided her rolling doctor’s machine toward my lower half. The instruments hanging off the side looked like guns in holsters, ready for a dual. The transvaginal ultrasound wand was pre-condomed.

That condom with its cute little hat will never fulfill its purpose. I chuckled silently to myself as I imagined ejaculating ultrasound wands.

I assumed the uncomfortably familiar position: feet in stirrups, hips positioned on the edge (they won’t have to tell me that again), blanket draped over my knees and hips. Jeremy took my hand and kissed it. I smiled and mouthed, “I love you.” His eyes watered and I chuckled.

“Oh!” Joanna said. “We are using the abdominal ultrasound today. I only need to see your tummy!” she said excitedly.

“Really!? I’ve never been far enough along for that one! This is exciting!” I repositioned myself, thrilled that my crotch was no longer exposed. I lowered the blanket and lifted my shirt. Linda handed Joanne the device that looked like prescription deodorant.

“This will be a little cold.” Joanne warned.

The cool gel felt great gliding across my stomach. My hands were clammy, my forehead was beading. As Joanne rolled, Linda operated the rolling doctor machine. Joanne, Jeremy, and I had our eyes glued to the monitor on the wall. Joanne could have told me the image was a screen saver of the wonderous depths of the Arctic Ocean, and I would have bragged to all my friends that I saw a picture of newly discovered deep arctic sea creatures at my gynecologist’s office.

Joanne asked Linda to capture different quadrants of my uterus before rolling on. Do uteruses have quadrants? Joanne continued rolling and Linda snapped away.

“I’m having a hard time seeing anything from this view, but you’re early! Nothing to worry about. But we need to use the transvaginal wand after all.”

“Should’ve known I wouldn’t escape the probe.” I smiled and rolled my eyes. Joanne mirrored my smile. “I’ll make it quick!”

“That’s what she said!” I said under my breath. Joanne and Linda chuckled.

“Heavens, I hope not!” Jeremy added.

Joanne laughed louder. “Y’all are too silly!” God, I hope we aren’t the funniest people she’ll see today. Jeremy smiled back at me. Did I telepathically communicate to him, or is he grinning at his own thoughts? Nah, he’s not funnier than I am. Satisfied with meaningless victory, I turned my attention back to adjusting my hips back into position for optimal uterus exploration. My pits had transitioned from slip n’ slide to tsunami.

Diverting my eyes from the stranger between my legs, I caught a glimpse of the condomed wand. A glob of lube suitable for a horse was dripping down its…shaft? In what scenario does a human female need that much lube? Why would she think I needed that much?

“You’re going to feel a gloved hand touching. Now cold gel,” No kidding. “And now some pressure.” I squirmed, making my best look of disapproval to Jeremy. He squeezed my hand. I was officially the mule for a wand, a human condom, and three cups of lube. Anything else you need to put in there? I thought.

“Moving to the left,” Joanne explained. She probably ordered some screen shots from Linda, but I checked out. “Moving to the right, now. Relax your hips again for me, please” Lady, my hips were never relaxed.  

I let my knees fall outward, thighs still clenched.

“I can see you are uncomfortable. I’m going to remove the wand, and then we’ll look at the images. Okay?” 

“Okay.” I hyperventilated.

“You’ll feel me pulling out.”

“I know all about that from my single days.” A small chuckle from my audience.

Joanne and Linda gave me a minute to clean up and get dressed.

“Were you looking at the screen?” I asked my husband. “No. I was watching you. I can’t tell what I’m looking at anyway.”

Joanne returned alone and turned the monitor back on and asked me questions about my previous pregnancy losses. I didn’t need a doctorate to know where this was going. She stood at the screen, pen in hand for pointing.

“There are key characteristics of an ectopic pregnancy that we look for in an ultrasound. The embryo is here.” She pointed. “It’s right on the edge of the fallopian tube, where it connects with the uterus. You said your last ectopic pregnancy occurred in the left tube?”

“That’s right.”

“Okay, we can rule out a blockage due to that.”

“Today’s ultrasound is inconclusive, unfortunately”

“What?” Jeremy asked. “How is it inconclusive?”

“No heartbeat was detected, which isn’t out of the ordinary for a six-to eight-week-old pregnancy. You could have ovulated late, which changes things drastically at this early stage. But the placement is also in question. Also, there’s no ‘the ring of fire.’ An increase of blood flow to the pregnancy.”

Do not bring Johnny Cash into this, I judged. And I spaced into the music of Johnny and June Cash.

“You have not felt any pain at all?” Joanne snapped me back.

“None. The last one it was excruciating. And I wasn’t as far along.” I defended.

“Please make an appointment for next Friday on your way out. Your bloodwork is the missing piece to this puzzle. The on-call doctor will call with those results tomorrow.” She sighed. “Unfortunately, again, our offices are closed until Monday. Answer every call tomorrow. Every single call. If your hCG level has not at least doubled since your last lab, please go to the ER.” She paused for acknowledgment. I obliged. “I know the ER isn’t ideal and I wouldn’t recommend the ER if it weren’t necessary. Untreated ectopic pregnancies are 100% fatal.”

“Yeah. I mean of course I’ll go if it is ectopic.” I zoned again. I have no memory of the rest of the visit, or of anything until the call came the next day.

The call came late in the morning. My hCG had flat lined.

My memory of the day is an unfinished jigsaw puzzle. A puppy missing an eyeball. Half of a sunset. A smiling woman reaching out to nothing. A picnic for one. A scene that I could tell would be beautiful, if I could only see the complete picture.  

“Adam is coming over to stay with Grace today.” Grace had arrived the night before. It was our week with my stepdaughter. I don’t remember spending a single moment with her. I was so distraught over the fear of never becoming a mother that I was incapable of being a mother.

Meanwhile, Jeremy jumped into action like the Marine that he is. “Your parents are taking them for pizza later. Adam will take Grace back to her mom in the morning. We have nothing else to worry about. Let’s go take care of you.” I followed his directions.

“We are going to the beach after this. Is that all right? It’s a full moon. I think we could use a little vacation,” he had informed me on the way to the hospital.

I was taken back almost immediately. Settling into the room, I remembered how I could keep forgetting. “Hey, last time, they were pretty liberal with the morphine and I will be milking that hard. Don’t say anything when the nurse asks my pain level. I need it.”

Without hesitation, my husband said, “Yeah. I don’t want you sad or stressed when we get to the beach.”

By the time the morphine arrived we were told that I’d need to get another ultrasound. I was introduced to another dark, cold exam room, another stranger in scrubs, more expensive parchment paper, another blanket that blocks the view of my vagina from only me, another machine on wheels, more lube, and another wand with another condom. The light from the monitor lit up the scrubbed-up stranger’s face and badge, just like in the other exam room. She was a sonography and radiology technician rather than a gynecologist, or doctor of any kind. After being jabbed several times in the thighs, pelvis, and butt, I guided the lubed condom wand exactly where it needed to go, with her hand attached to the other end. She pretended not to be embarrassed, and I pretended not to be annoyed. She was worse at aiming the thing when it was inside of me. She made me aware of walls and parts in there I never knew existed.

Back in the exam room the nurse brought more morphine. The TV wouldn’t turn on and no one returned with that new remote Jeremy asked for. My husband climbed in the tiny bed with me, and we watched “The Office” on my phone until my battery was dangerously low and we had to turn it off.

I had no other specialists to see, no TV to watch, no social media to scroll, no book to read, and no sleep to access. I had the warmth and comfort of my husband holding me. I had the curse of waiting. Before I knew it, I had reality. Like an ignored creditor who garnishes wages, it crept its nasty way into my head. There was no more ignoring this.

The tears came quickly and uncontrollably. I let myself be held, I let the ugly tears flow. My eyes would be bloodshot and puffy. My nose would be raw, and my cheeks would be dry later, but in that moment, I was in forever. I didn’t care who saw my despair-stained face, who heard my grief-choked voice or my incoherent guttural sounds that are only known to loss. 

Forever must’ve ended. I hiccupped one last time and exhaled more sadness. “Thank you.”

He squeezed me harder and kissed my cheek. Sometimes the best responses are the ones without words.

The doctor finally came to my room. She was out of breath, visibly overwhelmed, and disheveled. “I sincerely apologize for this long wait today, and I want to thank you for your patience the last few hours.” I had not been patient. “I am the only doctor in delivery today. Again, I’m so sorry. What we have here is an ectopic pregnancy in your right fallopian tube. This means – “

“This is my second one in two years. I understand.”

“One thing I need to go over with you is the treatment, which will me one single dose of Methotrexate administered by injection. Do you consent to the termination of your pregnancy?”

I had no fight left. I closed my eyes and sighed. “I know you have to say that. But no. I consent to life saving treatment for me. I don’t plan on dying today.”

“I understand that this is incredibly difficult. But I do need your verbal consent.”

“I know. Yes.”

“Thank you. I will put it in for the Methotrexate right away. I am very sorry for your loss.”

A static sound came from a hospital issued devise on her hip. She lifted it to her ear. “Room 405 is ready.”

“I’ll be right there.” I gave her an understanding nod. “I have to get going. Again, I’m sorry.”

I laughed without warning. “She really doesn’t know how incredibly insensitive that was!?” He wrapped me in a hug. I buried my face into his chest, and felt like things would finally be okay. “I’m sorry.”

He let go of the embrace to look me in the eyes. “For what? You didn’t cause this. I love you so much and I will be just as happy if we never have kids. I have two biological kids of my own and I don’t know what it’s like to be pregnant, it’s not the same, I know. These last few years have killed me not knowing what to do for you every time we lose a child. I wish I could do more.” His voice cracked.

“Whatever you’re not doing, keep not doing it.” He smiled. “But you’re wrong. I disappear. I check out, just gone. Everyone is fed today, no thanks to me. Everyone. Adults, kids, dogs, chickens. I don’t know how, who, when. I’m getting supportive texts from my mom and I didn’t tell her. I’ve got a support system because of you. Your daughter is fed, sheltered, safe, and has a plan while we go to the beach. I did nothing!”

His eyes were flooded, and the levy was going to break any second. “Do you know why I did all that?” Before I could answer, he did. “Because you are my wife, and we are a family. You don’t have to go through things alone anymore.” I nodded. “Jackie, Grace is your daughter. You are her mom. And you’re fantastic at it. Grace loves you. She tells people she has two moms and three parents. Please don’t forget that.”

A few more tears fell. “I won’t. But please remind me when I forget again.”

The nurse entered, not wielding narcotics this time, but my life-saving drug. I jumped out of that bed the moment I saw that huge syringe. She was reading side-effects when I turned towards the exam bed, pulled my leggings down just enough to expose the meatiest part of my left cheek.

“No question, then!” She laughed.

“I’ve had this before. I remember.”

“Let’s get it done, mama!” I pulled up my t-shirt, so she had a proper canvas to work with. I grabbed the bed and braced myself. After this, no more pain today.

“I’m counting down to three for you. One, two,” I started my slow exhale.

“Three.”