“Is everything OK?” I asked Randy in a panic. It’s one of the clearest memories I have of Juno being born.
I had checked into the hospital the previous day to induce labor because my “advanced maternal age” put me at higher risk for perinatal complications, and a recent trial had shown promising data on improved birth outcomes when some pregnancies are induced in the 39th week. High risk care sometimes means a fetal heart rate monitor has to be strapped to patients for the entirety of labor, so that’s how I came to have an elastic band wrapped around a belly so big it had long since overcome the laws of physics. My knees buckled and popped when I walked, my own bones crying mercy under the weight of two humans claiming residence in one body. But sure, there must be some way we can ratchet up the discomfort. Let’s squeeze these fully formed people into a ponytail holder. Why not.
The monitor beep…beep…beeped. Baby’s heartbeat was healthy and strong. I felt calm and ready to go.
Everywhere I went, the monitor went with me. We lapped the hallways, chatting with nurses and avoiding rooms where other pregnant people were entering active labor. For several laps, we were joined on our walk by my beloved OB who came to check on me with her own new babe attached to her chest. We swapped war stories about breastfeeding and working motherhood.
The monitor beep…beep…beeped.
I had come to rely on the sound of the monitor beeping to count through contractions, regulating my breathing to the rhythm of baby’s heart beating: breathe in, beep beep beep beep, breathe out, beep beep beep beep. A meditative, tantric-like energy took over my body while I floated in and out of clarity. Breathe in, beep beep beep beep, breathe out, beep beep beep beep. As contractions intensified and I became less connected to reality, it was the steady beeping that keep me tethered to the earth.
By the time I entered active labor, things had begun to feel chaotic. I had progressed through the previous 12 hours without an epidural because if my first childbirth experience taught me anything, it’s that shackling a laboring person to a bed and caging a feral hog are one and the same. But my first childbirth experience also taught me that I am not cut out for active labor, also known as the home stretch, without an epidural, which I came to believe was the difference between serenity and anarchy. Or so I thought. I was wrong. This time during the home stretch, my epidural didn’t relax my body as much as I had remembered it did with Moses, and everything felt unnecessarily, increasingly wild. I was vomiting regularly, I couldn’t get a hold of my breathing, and the beeping on the monitor had become erratic and unnerving. Gone were the easy hours when the baby and I moved in sync, melodically and rhythmically; now we were just a mess of clanging cymbals and reverberation, musicians missing our marks, crashing loudly into each other and drowning out the growing-fainter drumbeat of the of the heart monitor.
And then the beeping stopped.
My IVF pregnancy had been blessedly free of complications. After we got through the first trimester of daily progesterone shots and massaging knots the size of a gorilla fist out of each butt cheek, things normalized considerably, like any other healthy pregnancy. Like many pregnancies, it was predictably uncomfortable and the heartburn alone made me question my life choices, but it was mostly a textbook pregnancy, and – having had one of those before – I knew what to expect: food aversions, carpal tunnel syndrome, and a shifting understanding of where my body parts should be at rest. What I wasn’t prepared for, though, was the panic. I figured after all we’d been through this might not be an emotionally easy pregnancy, but I couldn’t have predicted or planned for all the ways in which the panic would consume me. I seized on every opportunity to worry. I panicked at every urine test, every ultrasound, every time the doctor’s office showed up on my caller ID. And though those tests and phone calls turned out to be bad news exactly no times, I learned nothing because panic-prone pregnant people are the definition of insanity.
The most surprising of the worries was the fear that we had made a huge mistake. Yes, after the literal blood and sweat and tears plus the hours and dollars and needles we poured into growing our family, I began to think maybe we shouldn’t have. Maybe we fucked up. Maybe things were fine the way they were, and Moses actually liked being an only child. Maybe a new baby would ruin his life. Maybe my love would be divided. Whenever we asked Moses whether he thought we were having a boy or a girl, he would say, “A girl, because we already have a boy.” Randy and I both had an unimpeachable gut feeling we were having another boy, and I worried about how disappointed Moses would be. I would lay in bed with him after he fell asleep, hugging him, worrying and crying. I spent most of my OB visits strategizing how to ease the transition for him while he sat nearby, quietly operating the ultrasound wand on my growing belly with nervous excitement. Randy traveled a lot the summer I was pregnant, so Moses and I spent all our time talking and cuddling, picking flowers and making zucchini bread, going for long walks and holding hands. I felt so maudlin about it you would have thought someone died. But in a sense, that’s what it felt like. An inexplicable, unyielding grief.
As I neared the end of my pregnancy at the beginning of December, I became obsessed not with nesting but with saving Moses’ Christmas. My due date was December 29, so of course I was unreasonably worried I would go into labor exactly five days early, on Christmas Eve. It didn’t occur to me at the time that a Christmas birthday probably wouldn’t be very exciting for the baby as they got older and had to share their special day with Jesus. What did occur to me was that Santa might not know how to find Moses at our family friends’ house while I was laboring at the hospital, and I just couldn’t square that. This was, admittedly, dumb. Are you shocked to learn no other person was as worried about this as I was? For instance, my Jewish-atheist husband was low-key concerned I had lost my damn mind.
By early December, three weeks before my due date, I was experiencing contractions and had started to dilate. I was far enough into my pregnancy that I could deliver safely, but not so far that labor would interfere with Christmas. It was a best-case scenario for a crazy person who talked about Santa’s travel plans with a straight face. I left those early December appointments feeling elated, like I had won some kind of cosmic contest by getting the stars to align in my favor.
But then of course nothing would happen. No spontaneous labor. At my next checkup, I was dilated another centimeter. And then… nothing.
As I neared my due date and Christmas, my OB began to talk to me about considering a scheduled induction in my 39th week, the week before what’s traditionally understood to be full term, because a recent study had shown a small but statistically significant improvement in birth outcomes when healthy pregnancies are induced between 39 and 40 weeks.
Induction. Instead of going into labor spontaneously. Before my actual due date. Based on merely a small improvement. Pass.
And not just because Christmas was situated in the exact middle of my 39th week. OK, yes, it was because Christmas was in the middle of my 39th week.
One of my best friends is a maternal-fetal medicine specialist, which is the kind of doctor who sees a lot of pregnancies with complications. The kind of doctor who sat in so many dark rooms with us so many dark times. I met Amy when I was recovering from our first miscarriage not long after we moved to Portland. I’d heard from neighbors there was a doctor on our street, an OB to be exact, and that she was pregnant, but I hadn’t put any effort into seeking her out – on account of the fact she was pregnant, and an OB. Because when you want to be pregnant and you’re not, everyone else is pregnant or pregnant-adjacent. But this pregnant lady – a no-nonsense, straight-shootin’ Texan, far from home, like me – was so pleasant and funny, I loved her immediately. I couldn’t have known then what a heavy weight she was carrying in her own pregnancy, being a knower of hard things, because to me she was brave and strong, and her strength gave me comfort. Amy’s baby boy was born early and in the tender weeks after he came home, I visited her often. We talked some about my miscarriages, but not much. Just enough. Mostly, we talked about breastfeeding and sleep schedules and infant milestones. Once Randy and I started IVF, Amy fielded every kind of medical question I was too embarrassed to call my nurse line to ask, from how to administer intramuscular injections with shaky hands, to whether I could have just one goddamn glass of wine, to whether bleeding at 10 weeks was normal. Minutes after I asked her that last question via text at 10 p.m. one summer night, Amy was standing in our kitchen. I don’t know where she was or what she was doing before she rushed to my side at bedtime on a Wednesday; all I know is, she never once failed me.
When I was still refusing to let myself be convinced by my own care providers to have a Christmas baby, Amy, of course, weighed in, citing the same study.
“But what about Christmas,” I said.
Amy does this thing where she sucks in her breath through gritted teeth, her mouth formed in a half moon with her head cocked to the side, like you know she’s working really hard to soft-pedal her opinion without calling you dumb.
I doubled down.
“How will Santa know where Moses is?”
She sucked in, air whistling through her teeth.
I was not swayed.
I was still digging in the day of my last OB appointment. I was being examined by a senior physician and former medical school professor who had come out of retirement to help cover staffing gaps during the holiday week. He was kind and gentle, the exact opposite of the man doctor who made me cry about my “unfavorable cervix” before I went into labor with Moses. He talked to me while he tapped away on the computer, pretending to give me only partial attention, which was a very good trick because it made everything feel nonchalant and easy, but of course, it was not.
“Have you heard about the ARRIVE trial?” he asked.
In this randomized trial involving low-risk nulliparous women, we did not find a significant difference in the frequency of the primary outcome (a composite of adverse perinatal outcomes) between women randomly assigned to labor induction at 39 weeks of gestation and women assigned to expectant management. Nevertheless, the relative risk was 20% lower in the induction group than in the expectant-management group, and the corresponding 95% confidence interval suggests that labor induction is probably not associated with a higher risk of adverse perinatal outcomes than expectant management, and it may be associated with as much as a 36% lower risk than expectant management.New England Journal of Medicine
“I have,” I said.
“OK good,” he said.
Then he looked up from his computer and trained his kind eyes on me, seriously and quietly.
“And you also already know that because of your age and IVF pregnancy, the risk of stillbirth increases every day you go past term.”
You know that scene in Hamilton when Angelica Schuyler is toasting newlyweds Alexander and Eliza Hamilton when suddenly the tempo shifts and the bottom drops out from under Angelica – the sonic experience of anguish punctuated by Renée Elise Goldsberry rap-singing her way through “Satisfied,” the cyclonic vortex of songs within songs, speeding up and slowing down time? Rewind, rewind, helpless. The vortex swirled me back in time, through trying to conceive, IUI and IVF; through needles and knots; through surgery, procedures and despondence. The trauma of repeated pregnancy loss tightened its grip around my throat, and I struggled to focus my vision on anything other than the exam room walls twisting around us like taffy. I could feel myself falling, and flailing, grasping at anything that would ground me, anything other than certain calamity. Rewind, rewind, helpless.
We had lost the baby’s heartbeat on the monitor, and our medical team was never able to find it again. Our delivery room filled with doctors and nurses bracing for impact while I pushed and pushed and pushed. Randy stroked my hair and counted, my grip on his hand growing increasingly more bone-crushing. We both knew the next few minutes would be the difference between emergency and deliverance.
When the rewind vortex in my doctor’s office spat me out, it cured me of worrying about Moses’ Christmas, but it left me with an even higher-stakes anxiety over the baby’s safety. I ached for it. Looking back on it now, it seems my months-long focus on protecting Moses’ Christmas probably protected me from really spinning out with pregnancy panic, because without Santa to distract me from myself in those critical last minutes, I was in danger of coming undone. It was 4 a.m., and I had been laboring since 10 a.m. the previous day when I was induced at 39 weeks and five days pregnant – two days after Christmas. I was tired and emotional. Labor was harder than I remembered, and the silence coming from the heart monitor was deafening.
But I was determined. Powered by exhaustion and sheer will and adrenaline and panic, I took one more deep breath, and on the count of ten I brought that baby earth-side.
The nurse lifted our brand new human onto my chest. Nobody said anything. Shouldn’t it be more climactic in here? Where was all the noise? Where was the coughing and crying, the thrashing protests and noisy declarations of arrival? My skin itched with worry, buffeted by the quiet. Always the quiet. I looked around the room, reading faces for clues. Everyone looked normal, but I wasn’t convinced. The pressure in my chest ballooned, constrained only by the weight of a too-quiet newborn perched atop it.
And just when I thought the quiet might break me, an almost imperceptible squeak pierced the silence. And then another one. Squeak, squeak…squeak. I looked down to see a baby button nose poking the air politely. A shock of black hair and eyelashes as long as my arm cradled the wide eyes looking back at me.
The balloon in my chest collapsed, and for the first time in years, I could breathe again, finally unencumbered by the weight of it all. We did it. We really did do it. I did it.
When I started writing this story down, I didn’t intend to say much about miscarriages and infertility and IVF. I wanted to give context to how profound it was that Juno joined our family when she did, but I didn’t expect to go so deep into the darkness to get there. Now that we’re on the other side of it all, I understand the darkness was where Randy and I discovered ourselves, where we felt deeply each other’s humanity and found a way to love each other through the grief – in spite of it, or because of it. I see now the darkness was the gift that gave us the light.
Welcome to our family, beloved baby Juno.