Trigger warning: pregnancy loss
On January 1, I committed to a new exercise program. I started working out vigorously 6 days a week and reduced my carbohydrate intake while simultaneously increasing my intermittent fasting. I was in the best shape of my life.
So when my period was late, I didn’t think anything of it.
But after a few days, I dutifully took a pregnancy test anway, just to be sure.
To my amazement, it was positive.
I hadn’t really believed that I could get pregnant without a lot of doctors and injections involved. After all, I had conceived my two older children with maximal medical intervention (plus the help of an anonymous donor).
And to get pregnant without medical intervention at 46? Impossible.
But we went to the doctor anyway and to my surprise, there was a tiny heartbeat flickering on the ultrasound. Impossible again.
Sergio was overjoyed and I was… stunned.
We had decided the previous summer that we were open to welcoming another child into our new family. Sergio and I had only been together a short time when we made that decision last summer, but pandemic isolation progressed our relationship with lightning speed. And I had always wanted to have just one more, but with a partner and enough time to actually enjoy the fairy tale.
But now that it was a fairytale come true, I felt so confused. Was it fair for me to have one more blessing in my life, after receiving so many? Did I want to give up the relative freedom of raising older children and to start over with the need for constant parental attention? Become exhausted and short on personal space again? Abandon our love for frequent, low-stress travel?
We started to fight. He desperately wanted this pregnancy and I was… deeply conflicted. I didn’t know how to be pregnant with a partner. I didn’t know if it was a good idea to go back to strollers and nap schedules and toddler proofing. Our lives were so good. The children -- our children -- were happy and thriving. We were enjoying road trips together. Life was so easy.
Finally, at ten weeks, I gave in to the inevitable. Ultimately, I realized there was no way I would choose to terminate a pregnancy. And therefore, I needed to commit to moving forward. And so I did.
“Okay, let’s do this. Let’s be all in, no matter what. Let’s have this baby.” I started to get excited.
And so the tide began to turn.
We went to our nuchal scan at 11 weeks pregnant. I was nervous, as usual, and Sergio was confident, as usual. We laughed as our baby kicked and waved on the ultrasound. We took videos. And then the doctor said, “Now it’s time to measure the nuchal fold, the most important part of the exam.” I didn’t hear the ominous warning in her voice, but motioned to Sergio to take my hand nonetheless. I knew this was an important moment.
She measured the space behind the baby’s neck and said, “it’s 4 milimeters. That’s not normal.”
Time stopped. A tear trickled down my face and under my mask. Then another.
The doctor said the nasal bone looked normal, but there was a problem with her heart, tricuspid regurgitation that was wildly abnormal. She finished the exam and wiped the ultrasound gel off my belly.
Silently I slid off the table and went to get dressed. I joined Sergio in the private waiting room and quietly took his hand and laid my head on his shoulder. We waited in silence for a very long time.
Finally the doctor rejoined us and kindly, gently showed us a calculation of our odds of Down Syndrome and other chromosomal abnormalities. Based on my age and the abnormal ultrasound findings, the risks were very high. She took some blood to run more tests.
I cried all the way home. We went out to dinner because I couldn’t face the children in that emotional state, but sitting at dinner, I felt all wrung out. We had nothing left to say. There was just an empty sadness.
We did choose a name for her, though.
It was chosen almost instantly from the spreadsheet of possible baby names that I had been keeping since we got the positive pregnancy test. It felt ironic to choose so quickly after deliberating so carefully with the spreadsheet, trying to find a name that worked in both Spanish and English, something we both loved.. But we had a feeling Isabella’s time on earth would be brief, and so we both felt the need to mark her presence with a name now, without waiting.
A few days later, we went to a different doctor to have a needle passed into my belly to biopsy the placenta. I cried the whole time because I had imagined that the baby’s heart had stopped between the two visits… and then was filled with relief that it had not. I felt guilty that I wished that it had.
The days passed with glacial slowness. Yet I didn’t want the days to hurry by, because I was dreading bad news so fiercely.
The CVS results came back. To our mutual shock and amazement, the results were normal! Sergio and I were united once again in joy. I allowed myself to relax and fully fantasize about babies for the first time. To imagine being Isabella’s mother, raising her as the beloved “trailing third” in a tight knit family.
And then a mere 24-hours later, the first doctor called. She had results from the bloodwork. And those results, combined with the ultrasound, declared our risk of Down Syndrome to be 98.4%.
We were dumbfounded. We had been told that the CVS results trumped the screening results. We called the second doctor. He reluctantly explained that this was a very rare situation, and there was no way to know which result was correct except for amniocentesis, which would require a 4-week wait before we could get the test plus two additional weeks to wait for the results.
My heart sank once again. We had been just barely managing to hide the pregnancy from the children -- trying to protect them until we knew for sure what would happen -- despite the fact that my belly was growing quickly. How could I possibly hope to hide it until 18 weeks of pregnancy?
More tears. Magically, Sergio and I remained united. He told me that he would support whatever decision I made. I knew how much he wanted Isabella, his first biological child, and my heart broke open.
The following week, we saw a third doctor to get yet another opinion.
He didn’t ask any questions, just started the ultrasound exam. He checked the Isabella’s heart. It was only 72 beats per minute, the same as mine. As a former NICU nurse, I knew this was terribly wrong. Her heart should have been beating at least 140 beats per minute. He checked some more measurements and then checked the heart again. No change. And she wasn’t moving, despite lots of poking and prodding of my belly by the doctor.
Silently I got dressed and waited in the hallway with Sergio, my heart breaking, tears pouring down my face.
When the doctor was ready, he started to explain the findings, that there was a hole in the baby’s heart and her nasal bone was missing (contradicting the first doctor) and her gallbladder was too big. Sergio interrupted and asked, “Forgive me, doctor, but Abby’s dying here. What does it mean, the heart rate?”
I cut in, “She’s dying, isn’t she?”
The doctor looked us in the eyes and gently said yes.
I asked, “Is there any hope? Any chance that she could recover?”
The doctor answered soberly but decisively, “there is no hope.”
Without consulting Sergio, I spoke up. “If there is no hope, I want to end it now. I don’t want to go home and risk hemorrhaging an hour from the hospital. Can we get admitted to the hospital right now?”
The doctor said yes, but recommended an amniocentesis first. He wanted to make sure there weren’t any genetic conditions that might impact the childbearing futures of Calliope and Amelie. Numbly, we agreed.
A few more medical personnel gathered and I lay on the table once again, my face turned towards Sergio’s, avoiding the sight of the needle penetrating my rounded abdomen. I didn’t care anymore what they did to my body. Still, I was startled by the sensation of pressure on my spine as they withdrew amniotic fluid. And momentarily overjoyed by the sight of Isabella moving once again on the ultrasound screen.
Despite all the bad news, if there was a chance she could still live, I would give her that chance. But the doctor reluctantly informed me that no, there was no hope. She was reacting only momentarily to the needle in her watery home. There was no chance her heart would speed up again. It was only a matter of time before her heart stopped entirely.
We went downstairs to the lobby of the hospital where, astonishingly, everything was already arranged. So different from my experience of American hospitals.
Then we went to our palatial hospital room and the process got started. The nurses and doctors were all so kind and unhurried. Medications were started to induce labor. Unlike in New York, I would have to give birth and only afterwards, have a surgical procedure to make sure Isabella was fully gone.
The next day, I delivered Isabella’s tiny body. I didn’t imagine that I would want to see her but when she arrived -- and the nurse dropped her on my bare foot! -- I changed my mind. It was a relief to see her perfect, tiny self. Despite my medical training, I had never seen such a small fetus -- 12 weeks, 6 days old. She had the most elegant fingers, just like her artistic big sister. A narrow face like Calliope and me. She was tiny and sweet and perfect.
I thanked her for making the difficult decision for us. She had lived and ended her life with perfect timing. I was grateful.
We came home that night, numb with grief and anesthesia. A friend had taken the children home with her so we had an evening to just lean into the exhaustion. The following morning, Sergio picked them up and we took them out to brunch, despite the fact that I was weak on my feet.
As soon as we had ordered our food, Calliope demanded, “Okay, now will you tell us where you were?” We hadn’t told them anything until that point about the pregnancy, the hospitalization, or why we were so out of touch for thirty-six hours.
I looked at Sergio, not knowing how to start. He bravely took the lead, “There was a baby in Mommy’s tummy. And she died.”
To my surprise, telling the children eased the ache in my heart. They were excited and happy to learn they had a sister… even though she had died. They had a million questions but no sadness. Calliope asked for an ultrasound photo to bury in the garden, since we had no body to bury. I couldn’t watch but Sergio took photos. She talks about Isabella frequently. My wise girl led us to emotional health. She has taught us that we can celebrate Isabella’s life and mourn her loss simultaneously.
Our hearts are gradually healing. We are grateful that she was a part of our family, even for such a short time. To feel her growing inside my belly was a blessing. To imagine our family growing was, ultimately, a joy.
I wanted to her share her story not to get your condolences or pity, but to share with you as courageously as many of you have shared with me. And to acknowledge that Isabella existed. She was here. She was loved. She mattered.
Abby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and former NICU nurse. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico.