In the Waiting Room

From the editors: In this beautiful essay, Tara Parmiter, writer and writing instructor, explores the emotional landscape of infertility.

The official term she used was “missed abortion.” Five minutes earlier we had been sitting in the scanning room, the technician gliding her ultrasound wand through the sticky gel on my abdomen and broadcasting grainy black and white blurs on the computer monitor. It was the day of our nuchal transparency test, about 10 weeks into the pregnancy, and we nervously but giddily waited to learn about that mysterious fold on the back of baby’s neck and whether it warned of any chromosomal abnormalities. I knew our chances for such problems were increasing—I was already 34, after all, just a year shy of the dreaded 35 mark—but it hadn’t occurred to me to think the test could reveal anything worse. Suddenly, we were learning a whole other story about pregnancy, about miscarriages that occur in silence, about clinical procedures to empty out the remains of our hopes.

Since by profession I am a writing teacher, that afternoon I started a pregnancy journal and for the next five years I recorded our disappointments, longings, confusions, and failed attempts to recreate what had happened so simply that first time. “Everywhere I look I see women with bulging abdomens, birds nesting, trees blossoming, fathers snuggling a baby against their chests, and I felt so wonderfully connected to it all, “ I wrote that afternoon. “I had a second heart beating inside of me, and now it’s stopped.”

Two days later we were in a very different waiting room, the waiting room of an abortion clinic where the doctors were going to perform a “D&C,” or dilation and curettage, to remove the contents of my uterus. Wrapped up in my own grief, I didn’t give much thought to the other patients in the room or what had brought them there; I supposed we were all sitting on those uncomfortable seats because we had to be. My husband witnessed one woman, though, who must have been in our situation and a bit more fragile. After slogging through all the paperwork, probably landing on the form that painfully asked you to sign that you agreed to have an abortion, she accosted the ladies at the front desk. “Do I have to be here?” she cried, loudly enough for all her fellow patients to hear. “My baby died, I’m not killing it.” I’m glad I wasn’t there at that point, for I’m not sure I could have held it together. I too wanted to ask, “Do I have to be here,” not just in the clinic, but in this situation. I didn’t want to be experiencing this pain, and as the years passed and we seemed forever stalled in the waiting room, I kept returning to that question: Why do we have to be here?

My husband and I had consciously chosen to wait to have children. Though we had met in college—we even lived on the same floor freshman year—we had waited five years before dating and then ten more before marrying. Waiting was an essential part of our romance, a story line I loved to retell when others asked how we got together. When we finally did try to conceive, we lucked out so quickly that I assumed all we had to wait for was that happy due date nine months down the road. The missed AB shook us of our complacency, however. In the months and then years to follow, I finally had to acknowledge that clichéd ticking clock: what if we had waited too long? What if my body could no longer produce a viable life? What about those frightening health risks that multiplied for both baby and mother at a staggering rate once you passed that 35th year? I found myself thinking wistfully of all the periods I had grumbled about in my lifetime, wondering if my ovaries had already squandered the best I had to offer. After all these years of waiting, could there be any Faberges left in those baskets?

I cannot say whether this experience is necessarily different for younger women—even if you have years to try, the desire for something now is undeniably powerful—but I can say that because of my age I was intensely aware of the passage of time. Each month started a new cycle of hope and possibility, ending with the depressing red proof that we needed to try again. As an academic, I thought research might help me cope with my anxiety, so I started scouring the Internet and library shelves for insights on how to help us conceive. I turned to nutrition and altered my eating habits, grabbing more leafy greens, choosing the organic strawberries to avoid pesticides and increase my intake of iron—I even considered swallowing those slimy-looking oysters for their amazing doses of zinc. I turned to science and learned how to listen to my body, charting cervical fluid to maximize our peek conception days, peering at saliva under a tiny microscope to judge by the ferning patterns when I would be ovulating, starting each morning with a thermometer under my tongue to count the twelve days of elevated temperature in my luteal phase (the time between ovulation and the start of menstruation). When I grew tired of playing science fair, I read through on-line forums written by other women trying to conceive (or TTC, as they put it), and as I learned to decipher their comments about their DHs (dear husbands), the abhorrent AF (Aunt Flow), and their “angel babies” (miscarriages, like mine), I found myself wishing them “sticky thoughts” (i.e., hoping that a fertilized egg would implant). But none of this research got us any closer to success—instead of sticky thoughts we were just stuck.

The other downside of my obsessive researching was that it made me hyper-vigilant, prompting me to analyze each little creak in the settling house of my body and to wonder, “Could that be a sign that I’m pregnant?” It is amazing how many pregnancy symptoms the imagination can conjure in the two week wait between ovulation and menstruation, particularly considering that few women actually sense any definitive symptoms at such an early stage. Rationally I knew I couldn’t know anything until I menstruated or not in roughly two weeks, but that didn’t keep me from spending the intervening days reading pregnancy web sites to review, yet again, those indeterminate early signs.

What I hated was being on the far side of the moon; in those early years of space exploration, the astronaut’s wives had had to wait forty-five heart-rending minutes to hear whether their husbands would return triumphant to earth or shoot off into space. I knew I shouldn’t compare my uncertainty to theirs (if it doesn’t work this month, we would always say, at least we can try again!) but being out of communication range with my uterus for two whole weeks was almost too much to bear. My body couldn’t divulge its secrets yet, and so I would have to wait, wait for a chemical message to leak its way out and eventually whisper its news to the smiling face on the pee stick. If only conception could be like one of those carnival games, I wrote in my journal, something that flashes neon and immediately blares a congratulatory siren to announce that you’ve won—bull’s eye! You flipped the frog onto the lily pad, you whacked the mole, you toppled the cans, you smacked that yellow haired clown in the kisser, you scored big! Winner! Winner! Winner! But instead, you have to sit in the silence of the waiting room, trying to get your mind off your body, and preparing yourself for good or ill. My research had told me there’s a 20-25% chance of getting pregnant each month you try, and suddenly I found those odds remarkably slim.

This sobering realization did not take long to impress itself on us. In the months after the missed AB, we kept trying to conceive, but I seemed burdened by the feeling that I needed to make up for lost time. I think I had placed too much emphasis on a single square on the calendar: I was determined to be pregnant again by my original due date, for if not, what was the point of having lost the first pregnancy? I had some sort of idea about the balance of the universe, the fairness of things: well of course I needed to be pregnant by the due date, otherwise there wouldn’t have been any reason for the first pregnancy to have ended. But there was no point to the missed AB, I reminded myself; it happened, without malicious intent, without the desire to punish us or hurt us or make room for someone else.

We even learned that the missed AB was caused by a chromosomal abnormality called Turner syndrome, in which a misalignment in early cell division leaves the baby with only one set of chromosomes instead of the usual two, one each from mom and dad. Turner syndrome is not related to maternal age and does not suggest any problem with the parents’ ability to conceive again; it just happens, and most of the time, as with us, these babies spontaneously abort. All this information was mildly encouraging—the loss was still hard to bear, but at least I understood the science behind it and that science suggested we still had hope of conceiving a healthy child.

I found myself thinking of the mother goose in E. B. White’s Charlotte’s Web: when asked why she had seven chicks but eight eggs, the goose simply replies that the last one hadn’t hatched. “I guess it was a dud,” she says and lets Templeton the rat take it off to add to his horde of random treasures. It may sound a bit callous to shrug off that unhatched egg as a dud, but at the same time there’s an honest recognition of life in that statement. I wouldn’t call our first time around a dud, but I did realize that I had to accept the loss and move on with life. I had placed too much significance on getting pregnant by my due date, as if that would negate the pain. My deadline, though understandable emotionally, was arbitrary, and I hoped that once it was passed, I could relax and trust nature to do its work.

But no, soon years had gone by and with conception still evading us, I began to marvel that anyone ever makes it through to birth. The alchemy of our existence is mind-boggling. Just think of all the complications that can happen in that rapid nine-month growth spurt, not to mention the odds of starting the journey in the first place—transmuting lead into gold seems a much more likely prospect. I couldn’t help thinking of all the warnings we had been told as teenage girls that it only takes one time… Twenty years later, I wished pregnancy would be that inevitable!

I finally had to confront another unsympathetic medical term: infertility. Just writing that ugly word brings up images of barren, blighted landscapes in my mind when I had hopes, instead, of being a lush and green earth mama. The medical profession doesn’t mince with words: if you’ve tried to conceive for a year without success, you are infertile. That doesn’t mean you’re incapable of conceiving, but it sure sounds like that to a frustrated layperson. At first I couldn’t bring myself to accept such a damning diagnosis; in one of my lower moments, I spent an afternoon in the stacks of the public library reading a book on infertility—I couldn’t bear to check the book out, or even take it to a chair to read in a more comfortable spot, for that would require admitting that I needed such a book. So instead I leaned against the cold metal shelves, turning through the pages and silently crying. What if all our waiting was for naught?  Each year of trying our chances of conceiving were probably plummeting, and perhaps some day all the obsessive scrawlings in my pregnancy journal would amount to nothing more than a record of frustrations and lost hopes.

Given my intense longing, it surprises me how long we waited to visit fertility specialists. Perhaps our optimism kept us pushing off that trip, hoping that this last try would be the one; we both believed that what would be would be, and we told ourselves that if we never managed to conceive, we would find another way to have children in our lives. I liked to joke about a baby dropping from the sky, our own little Kryptonian we could raise as our own and whose secret powers we would hide from the world; a tiny part of me held out hope that perhaps that’s how this quest would truly end! But perhaps we were also frightened off by that bleak word “infertile,” unwilling to claim that name for ourselves.

We waited a year after I got a referral from my OB-GYN, treating that little slip of paper like an emergency button, a last resort, something we would only press when all our other hopes were dashed. When we finally did seek help, we were relieved to find out that nothing was actually “wrong” physically, so the doctors set out instead to speed our chances of fertilization. At first they gave me Clomid, an ingestible medication that stimulates the growth of multiple eggs instead of the usual one per month; when that didn’t work, they upped the dosage, and when that still didn’t work we moved on to Follistim, a more aggressive injectable medication. Every month we’d go through a new cycle of blood tests, fertility drugs, ultrasound, IUI (intrauterine insemination), and then a two-week wait before we started again. It finally felt like we were gaining some traction, but it still took a year of these medical interventions before the wait was over: for the first time since the missed AB, I was pregnant.

Of course, that’s when I remembered that in life the wait is never really over; we just move from waiting for one thing to waiting for the next. In the first few months of pregnancy my anxiety did not subside; if anything, the waiting between doctor’s appointments became even more intense. Perhaps I was still so shaken by the missed AB that I could not wrap my head around the idea that a baby could thrive inside of me. All my earlier research had consoled me with the assurance that many fetuses spontaneously abort in the first trimester; before the days of home pregnancy tests, many women wouldn’t even know for certain if they had been pregnant or if their cycle was just off. Though this information had been mildly comforting the first time around, I did not want that kind of consolatory comfort now. Every time we went to the doctor in the first few weeks I had a nagging fear that the baby would be gone; the first one had slipped silently away, what was to stop this second one from doing the same?

I was in a new kind of waiting zone, wanting to leap up and down with joy but still unwilling to let myself get my hopes up too high. I must have been one of the only crazy pregnant women longing for unpleasant symptoms rather than the subtle “maybe I am, maybe I’m not” discomforts I was experiencing. Why couldn’t I just do something dramatic, I wondered, like throw up in the middle of class? That would be pretty solid evidence that the baby was still there, and would certainly give my students an interesting story to write about.

But though my symptoms were relatively mild, this pregnancy stuck, and soon we had passed the day of the infamous nuchal transparency test, the one that had sent us spiraling all those years ago, and then the day of the full body scan, where we could see a little well-formed skeleton and a blithely beating heart. With each new scan the baby grew bigger, and with each new week its movements became more pronounced, more reliable, more like the blaring carnival games I had mused about years before as we struggled to conceive. Those nine months were still a long wait, but the nagging doubts gradually gave way to more hopeful anticipations. Our daughter even kept us waiting in the end, arriving a week after her due date, but by that point I was more than willing to overlook the slight delay.

Looking back over my journals I vividly remember the strain of our continual wait; as a woman steadily getting closer to 40 and thinking that her chances of conceiving were slipping away, my voice in those journals sways back and forth between optimism and dejection, between a Pollyanna-ish determination that all would work out well to an angry resentment that everyone on the planet seemed to be popping out babies except us.

Now that we’re out of the waiting room, it would seem like I could just close that book and move on—our daughter is a gift who keeps surprising us with joy every day and we’re so delighted we kept trying through all the disappointments. But that is all the more reason to share the story, because these stories are the often unspoken histories behind the children we bring into the world. My mother told me at one point that we don’t usually hear about the long struggle couples go through to have a baby; those stories can be full of pain and longing, uncertainty and embarrassment, jealousy and despair, and if we’re lucky enough to conceive and bring a healthy child to term, we focus on that shining narrative, not the murky days before. But just as our long years of waiting are an essential part of my husband’s and my romance, the long years of waiting are also an essential part of my daughter’s story, one that I plan to tell her and that I want to share with others who may be struggling through their own waits. Perhaps we need more often to break the silence of the waiting room, turning to face those couples sitting by us and remembering that while we were all brought here by our private woes, our stories might bring each other solace while we puzzle out why we have to be here and why we choose to stay.

parmiter_taraTara Parmiter received her B.A. in English from Cornell University and her Ph.D. from New York University, where she teaches in the Expository Writing Program. Her research interests include literature and the environment, urban nature writing, children’s literature, and popular culture. She has published on topics ranging from the imagined landscapes of L. M. Montgomery’s Anne of Green Gables novels to the green gothic landscapes of Stephenie Meyer’s Twilight saga to journey narratives in the Muppet movies.

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