Since I was a child, I took it for granted that bad things happen at distant places – in news, in movies, or at worst, to other people. You read or hear about people talking about how unexpectedly tragedy struck them – an accident, cancer, loss of a loved one –, but the news do not really register. You feel deeply sorry for them, of course, and even reach out and try as well as you can to relieve their suffering, but it is hard to put yourself in their shoes. You do not really want to do it – why would you? In fact, one does not know how. At least, I did not. Until, my life was shattered one day, quite so unexpectedly. It was the happiest of times. My husband, Simon, and I were expecting our first child. Wine smelled terrible, cheese was unthinkable, and I banned the use of perfumes and perfumed toiletries at home, but there was this unbounded happiness in every breath. In expectation of our child, we indulged ourselves. We moved into a cartoonish yellow house, which we could barely afford. It had red tiles on the roof, and it looked as if it was imported from a funny children’s story. We bought a new and safer car. We probably only own the wheel at the moment, but it seemed perfect for a small family. Simon bought a new camera and a new TV, which had millions of web functions and could do Skype. We wanted to capture every moment of this new life, frame it in images, and share it with friends and grandparents dispersed in different continents. And we did all the other things that expecting parents do. Timing our days on the rhythm of the little kicker in my womb, we felt, dare I say, invincible!
And our baby kicked! At nights especially. In bed, I would hug Simon from behind his shoulders, pressing my womb gently on his back, hoping that he would feel the kicks, and whisper to his ear: “A boy or a girl?” He changed his mind almost every night. A dancing girl one night, and a playful boy the other. We did not know, you see, not because we love surprises but because our little one did not disclose her/his gender to us. We tried hard, 50 minutes to be precise, to a get a glimpse of what is between the legs at the 19th week ultrasound, but s/he refused to uncross them. The world was full of mysteries then, and everything had a hidden significance. Maybe we were not meant to know, I thought. Until we meet her/him in person, a few more months ahead.
Then one day, towards the end of my 22nd week of pregnancy, I felt no kick. It was a weekend, and I had to wait for Monday to get it checked. I was not alarmed, just slightly worried. I read far too many books about pregnancy, and knew regular movement was not to be expected before week 24. Monday morning I called my OBGYN office and in half an hour we were waiting for the midwife in the medical center. Even then, I was not worried. In fact, I was reading Martin Luther, whom I was supposed to teach to my freshmen students the next day; and Simon was busy with preparing for his American Political Thought class. We were almost sure that this extra visit would ultimately be unnecessary. Once we hear the baby’s heartbeat, we would go back home, and joke about how much Aetna would charge me for it.
But, I know now, life has a million ways to surprise you. If I could go back to that room where we were waiting for the midwife – I will call her Diane – in that cold, late November morning, I would stop reading, lie down, caress my baby, and imagine. Imagine our lives together rather than waste time with other things. Devour every second when I still thought that life to be a sure thing – scratch those seconds, indulge myself, go wild in daydreaming. Not knowing how terrible things could get, I did not do any of these. I waited, bored, for Diane to come, find my baby’s heartbeat, and just be done with this.
Diane finally came in the room, really late. Timeliness was not the best part of this OBGYN practice. She asked a few questions, looked somewhat concerned, dropped the liquid on my belly, and began the search for that glorious sound of a little heart beating. No sound at first, and then the racing sound of my heart, gradually grasping what that meant, in pieces, and all alone. She sent us to an ultrasound scan, which confirmed that our child died in utero at 22 weeks of gestation. Our child, not yet born, but so real. Not yet here but at the center of our lives. I could not look at Simon. I could not even cry at first. Everything felt so profoundly unreal. It was as if we were forcefully inserted into another, a cruel life. But at the same time, this was the most real thing that ever happened to me. Unable to endure its crushing force any longer, I collapsed to the floor. The feeling of the sharp edges and the icy cold of the concrete on my skin. This was real. White walls rose above me, like giant empty pages. I hugged Simon like never before, and we cried, loudly and for a long time.
Then Diane came back into the room, forcing us to raise our heads from each other’s shoulders and hands, and face the world again. She was sorry. I could see it. She was also surprised. There had been nothing wrong with my pregnancy, she said. I was young and healthy, and the baby had been doing wonderfully until then. I had too many questions but I did not know how to ask them. I did not have the force to ask them. There was no time anyway. I had to give birth.
In the intricate world of pregnancy loss and intrauterine fetal demise, which I unfortunately know a lot about now, weeks of gestation matter. While terminologies and regulations differ (a result, I suspect, of religio-political as well as medical reasons concerning the right to abortion, insurance polices, and whatnot), in most U.S. states, after 20 weeks of gestation,pregnancy loss is considered stillbirth, not miscarriage. The baby needs to be vaginally delivered – unless there is no other complication. Diane wanted us to go to the birth center that evening so that they could start inducing me. “We do not want to lose time,” she said, “and risk the mother’s health.” The process could take up to 3 days, so we were told to prepare for an extended stay.
Words flew in and out of my ears. I listened to this madness and clung to Simon – still on that concrete floor, soaking in the cold from underneath my legs. I wanted to run away – leave that room, the ultrasound machines, Diane, all of it! Just take Simon with me, and keep our baby in the dark and deep interiors of my uterus. Its birth and death place. As angry as I was at my own body – Why the hell did it not do what it was supposed to? Why did it fail me? Why did it let my baby die? – I did not want to let her/him out. I did not have enough of my child. Images and instances of the life that we will never have, and which I was not even aware I imagined, raced through my head. The first sickness, the first fight, the first time s/he gets angry at me. This was not right. It just wasn’t.
Why was this happening? Diane had no answers. There is usually no answer, she said. Nobody knows! It is such an understudied topic, despite its devastating impact. Terrible luck? Losing a child for no apparent reason at the 22 weeks of gestation. It happens so rarely. According to her, 1 in every thousand pregnancies. The Internet has many different answers. 0.03 % chance according to one study. Others claim 1 in every 160 pregnancies. In fact, once you find yourself at the wrong end of statistics, you do not really give a damn. God’s plan? Many old relatives said so. What kind of a plan is this? A little baby – my baby! My mum said on the phone, and I know she was trying to make sense of this: “God must love her/him more.” I thought I would lose it altogether. “I really, really doubt it.”
Diane said they will do tests before and after birth. It could be an infection, a cord accident, or a blood clotting disorder. But then again, and in fact, most of the time: “We just do not know.” On that note, she urged us, we should go home, get ready, and get to the birth center by 6 pm.
The birth center! People were raving about this particular one. How wonderful it was! How low the rate of c-section was! Like many expecting women, I had imagined the birth of my child, of course. Everything would be natural. Back then I trusted my body and nature. I wanted to avoid all interventions. Holding Simon’s hand, I would defeat the pain. And I knew it would be worth it when I heard my baby’s first cry, then the first kiss, and then her/his head on my shoulder: Hello my darling.
This was not going to be the birth I imagined. As we entered through the doors of the birth center, my legs began to tremble. Could I really go through this? Pictures of babies everywhere, toys, happiness. This was the worst day of my life. The staff saw us enter. Simon explained the situation. Oh, they were expecting us, and they were so sorry. They took us to our room at the far end of the corridor. An act of decency to spare us the cries of healthy babies. Welcome to the land of stillbirth! At the far end of a birth center.
A series of nurses, OBs, technicians got in and out of the room, starting each conversation with “This is terrible, I am so sorry.” No trace of the usual Western discomfort about physical contact here. I always found it surprising that my British husband turned red with a feeling of alarm when I touched strangers in this country – a child’s head in the supermarket, the shoulder of a waitress I liked, the new “friends” we made at a bar that I felt like hugging at the end of the evening. “You are not supposed to touch people you don’t know,” he would say. “They may get irritated.” He was right. Body was sacred and private in this country. Remember, my Pilates-Yoga teacher asked permission to touch before she helped us with moves. Even doctors needed confirmation to touch you. So different from where I come from, where touches and kisses are no big deal, and where bodily privacy is frequently interrupted. Mostly as a sign of affection, of course, and sometimes, unfortunately, the opposite. Back to the room for stillbirth, the land of heartbreak, where affection was abundant. Caresses and pats were interrupted only by the blood they took – and lots of it – and by the descriptions of the terrible things that awaited us.
First, the OB on call described the process of induction in detail. They will first use Cytotec, administered vaginally in 3 to 4 stages, with around 6 hours in between each dose. Because the baby was small, cervical dilation need not reach 10 cm, but at least 6-7 cm was necessary for the head to get through. The OB administered the first dose around 7 pm. We started waiting. I was now worried about Simon. He had a terrible headache. I wondered how he really was. Because I could not, he had to be strong for both of us. I could still see the shock in his eyes. As I did, he felt powerless, but all the more loving and kind. For this, my love for him magnified. I held his trembling hands hour after hour as we waited for the contractions and our baby to arrive in this longest of nights.
1 am. Still no contractions. The second dose was administered, and they gave me sleeping pills. Simon took some painkillers, and lay down with me.
I must have fallen into a drug-induced sleep for a few hours. When I opened my eyes, it was around 6 am. Simon was dozing in the chair-bed next to me. I felt cramps and pain around my abdomen. Our baby must have been on its way. The nurse brought breakfast, which neither of us had any appetite to eat. It was terrible anyway. Then another OB came in to check how much I dilated. Cold hands through my vagina reaching out to my dead child. She could touch the feet she said, but I was only 3-4 centimeters dilated. It was not enough. They administered the third dose of medication. And we continued to wait.
This was when it started snowing. No, this is not right. It also snowed the night before, but now there were lots of it. The first snow of the year. I got obsessed with it. They have already told us our child needed a name for its birth and death certificate – depending on how you look at it. Simon had been thinking about a name since the previous night. I hated the fact that we had to name this baby, and now. Like I hated all the other decisions we had to make like whether we wanted an autopsy or not – we did not – or whether we would like to arrange a cremation or burial – we chose cremation. But having to decide on the name hurt most. Staring out of the window, Simon asked: “What about Snow?” My eyes were full of tears. It was perfect. “Snow Kar,” I said, adding the Turkish for snow. Elegant, fragile, and unique as a snowflake, and as short lasting as our poor, dead, dear child. It was late afternoon of the second day now, and Snow Kar was still not coming.
But the contractions were really intense. The OB wanted me to have the epidural. There is no use in going through all the pain she said. It is hard as it is. Also they may have to go in and remove the placenta manually if it did not come out on its own. Having the epidural now will save time then. I said yes.
An anesthesiologist came in the room roughly half an hour later. He was a tall, middle-aged man. He explained the risks of taking the epidural. He showed me the forms that I needed to sign. In pain and shock, I could not even read properly. Did I give my consent? The illusion of choice! I signed. He asked the nurse how long I had been on the IV. You have to be very hydrated before taking the epidural. She replied that unfortunately we just started. He seemed a bit concerned. Worse, they had forgotten the IV in the fridge. As the freezing saline water mixed with my blood, I started shivering. The more that went in, the less able was I to control my limbs and jaw. I now think it must have been such a fitting image for how I felt. I had no control over my body, and what was happening to me, to us, and all I could feel was the cold in my veins. But, Simon was visibly startled. I wondered if he was afraid of losing me too.
The anesthesiologist said, “We have to start.” Despite trembling limbs and the possible dehydration. I needed to sit very still for around 20 minutes so that he could locate the correct spot on my spine, get into it, and administer a small dose to make sure he is in the right place, and then we would go ahead and administer the whole dose. Because my body was shaking, the nurse and Simon had to hold me from my shoulders. It was like a science-fiction movie, and I felt like a robot being un-made. He explained each move. Now he was touching my hips and cleaning the area three times to prevent infection. “Oh, this will be super easy,” he said, “you are so thin.” An incomplete pregnancy! This man began to annoy me. Then, he was anesthetizing the area so that he could get into the spine with something that Simon says looked like a screw-driver. He finally administered the trial dose. How did I feel? Any pain? “There is pain on my left side.” He did not hear me, or he did not understand. I am a foreigner, you see, with an accent. And I expect it takes some effort to understand a foreigner when she is giving birth to her dead child with refrigerated saline water moving through her veins. So instead of making the effort, he decided to talk to Simon and the nurse. They are native speakers: “What did she say?” I repeated: “I have pain on my left side.” A second time, he did not get it. “What did she say?” Simon was angry now, and worried. He and the nurse, who both understood me, interrupted each other frustratingly: “She says she has pain on the left side.” In any other setting, I would have taken a fight with this man. But I was too weak, and in too much pain. And he was playing around with my spine. I had to let it go.
But he did not. “What kind of pain?” I find this question to be particularly difficult. I don’t know. I cannot grade it on a scale of 1-10. “It is a sharp pain on my left side. I think it is getting better now.” Now I was also not talking to him. Simon asked: “Is it really better now?” “It is.” “OK,” said the anesthesiologist. My legs grew numb. We were in the right spot. He administered the full dose and laid me down. I was not supposed to move for 20 more minutes. When the contractions get worse, they will increase the dose.
The nurse and the anesthesiologist left the room and Simon and I were finally alone. I was shivering even more now as the effect of the epidural joined in the cold saline water. It was hard to form sentences. My jaw was uncontrollable. I looked at Simon: “Kiss me.” He later told me he found this a strange request. But I needed it. His lips on mine felt warm and momentarily stopped the trembling. He kissed me, and we cried like that, lip-to-lip.
I could no longer feel the lower side of my body. It was weird. But then I felt something leaking in between my legs. And a foul smell. I thought I pooped myself. This was getting embarrassing. We rang the bell and a nurse came in. I apologized and told her what I felt. “Let me take a look. Hmm, no you did not poop yourself dear, but I think our baby is coming out soon.” It was blood that I felt. She told me authoritatively that I should get some rest, and left the room. In an hour or so, I started to feel the contractions again. They were really intense now. Another anesthesiologist came in the room to increase the dose of the epidural. This one was a kind man. He said, “I am sorry for your loss,” as he left the room. Why are all anesthesiologist men? And all OBs and midwifes are women? The topic of another reflection.
A short while later, my legs grew so numb that I could not feel anything. It was now completely dark outside and it was still snowing.
Diane came back in the room with a trainee midwife. A lesson in tragedy. She checked my cervix. “We are almost there.” How about a little Pitocin to finish it all? Why not?
The final stage of labor began. Simon and I were alone in the room, and both of us were tired. It was around 6:30 pm now. We started to talk about the good things that happened to us in 2013. It was hard to remember but we tried anyway. “We got married,” I said. Simon looked at me with a little concern. “That was in the summer of 2012, canim.” He was right. I could not think straight. But then I remembered other things, and correctly. Simon defended his dissertation. I was about to finish myself. We conceived this wonderful baby. Yes, s/he did not stay with us, but gave us tremendous joy for 22 weeks. I felt so much love for Simon and for this child that my heart was about to burst.
But then I felt something. It was 7.04 pm. “Something happened, as if something is leaking.” We called in the nurse. She looked down at me, and said somewhat alarmingly, “Let me get Diane.” I then knew that our baby was there somewhere underneath the sheets. But I could not look down, or say this to Simon. I think I was afraid. I think Simon was as well. We waited. In 5 minutes or so, several nurses came into the room. Diane was on her way. And yes, our child was born.
As they descended on me, something I did not see coming, or indeed, thought possible happened. I started talking to God and to our child. If you could call that talking. At God, whom I did not know existed or not, I was angry. “Why, why, why?” To my child, I was apologizing – in million words and languages. Some of the nurses started crying. Simon was holding my hand. He was also crying.
I turned to one of the nurses and asked: “A boy or a girl?” A girl.
You were a girl, sweet, sweet baby. You had your father’s eyebrows, and I think my hands and feet. You had no hair yet, but if you did, I think it would have been brown and curly. You were as light as a snowflake, but all the nurses admired how tall you were. Your father and I held you long, memorized your features, and dream about you every night. We eventually brought you home, in a small blue urn. I keep you warm, lighting candles around your urn each night. This is a love letter to you; and I hope you will read it one day. I will not say farewell, but say this instead, in our secret language: “Annen seni çok seviyor.