Taking Charge of Your Fertility, 20th Anniversary Edition: The Definitive Guide to Natural Birth Control, Pregnancy Achievement,

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Another September: Creating Life and Art in a Terrifying World

1. We arrive at the maternity ward late on a Tuesday afternoon in September. That evening, I’m scheduled to be induced. The day before, I received an email from Katherine: “I can't believe I'm writing you today. What absurd timing!” She said we’d received an offer on my new novel. She knew, of course, that I was about to have the baby. “Obviously please don't feel ANY pressure to respond to this right away!” I sent back a quick, happy reply. I called my husband, Jake, who brought home celebratory Choco-Tacos in lieu of champagne. A day later, my son is born. This confluence of events—the baby and the book contract—was in part by design. My book was not yet finished, but I wanted to have the offer in hand before the baby arrived. It was a decision perhaps more emotional than practical. At 41, I was overjoyed to be having a baby; I’d always wanted to be a mom. Still, I’d heard about the crisis of identity that could accompany new motherhood and worried that once I was a mother—and maintaining my full-time job as a professor—my writing, which had always been so grounding, would fight for space. If I had a book contract, though, it would mean I was writing a book, which would mean I was still a writer. Rather than intimidating, this felt clear and comforting. This book would get done. 2. We had spent nearly two years trying to get pregnant. The summer we got married, I stopped taking the pill. I read Taking Charge of Your Fertility. I started taking my temperature, timing my cycles. I emptied the top drawer of our bathroom cabinet and filled it with plastic-wrapped testing strips, one for ovulation and one for pregnancy, green and blue. That fall, three months after the wedding, I went in for testing at a fertility clinic, sitting in the waiting room that would become so familiar over the next two years. I wasn’t yet too worried. In the exam room, the doctor narrated the internal sonogram. Better-than-average egg count. Evidence of recent ovulation. A large fibroid on one side—it looked monstrous on the screen. Afterward, in his office, Dr. P told me what I knew: At 39, getting pregnant could take longer. There were more risks involved. Still, he said, given what he’d seen, he felt confident; they would monitor my next cycle and tell me when to have sex (this was the kind of impersonal personal directive I would become used to soon). Then we talked about books. Turned out he was an avid reader. I’d recently sold a novel, about a family, which was coming out the following spring. Funnily enough, one of the characters in the novel goes through fertility treatments. I’d done research for that storyline—imagine how much more detail I’d have had to work with now! There was, in that waiting room, a careful lack of interaction. Nobody spoke above a whisper, which seemed a nod to privacy, even though everybody knew what everybody else was doing there. Couples talked in low tones. Waiting husbands thumbed cell phones. A sign hung on the wall: Never never never never give up hope. A little cheesy, I thought, but sweet. There were no kids, per office policy, for they could be upsetting, though I found the absence of them almost more upsetting, the implication that our situations were so dire we couldn’t handle having a child in the room. I was going for regular appointments with Dr. P. Bloodwork, ultrasounds. Frequently, we talked about books. After two months, he ordered further testing. He prescribed Clomid. He recommended we start IUIs. He scheduled an HSG test, where dye would be shot through the fallopian tubes to make sure the fibroid wasn’t in the way. On the day of the test, we met him at the hospital, in the radiology unit. As directed, I’d taken eight Motrin before coming. It was a Friday in December, the waiting room still and silent. News of the Sandy Hook shooting was playing on the TV. Five years earlier, after the Virginia Tech shooting, I’d written a novel I’d since abandoned. I’d watched an interview with the gunman’s creative writing teacher, who tried to alert someone about the disturbing material she’d seen in his work. A writing teacher myself, I was haunted by this interview. I spent the next three years working on a novel in which a student writes a paper that suggests she’s depressed, suicidal; when no one intervenes, tragedy ensues. I sent it to Katherine, my agent, but after several close calls with editors, conceded something wasn’t working. Reluctantly, I shelved it. I wrote a novel about a family, about mothers. (I was always writing about mothers, even then.) For the IUI—to my mind, a sophisticated turkey baster—Jake was encouraged to stay in the room. “That way, if you get pregnant,” the nurse said, “you can say that he was there.” Afterward, as I lay still for 15 minutes, we speculated about our imagined baby, possibly being conceived that very moment. We were feeling hopeful—this was a new step, a further step. Maybe it would work. When a few weeks later, I tried one of the blue test strips—it was a Saturday, and we were going to a dinner party—we both felt heartsick. We consoled each other, reasoning it could take a few tries. But a new reality was settling into my bones. We drove to the party then sat in the parked car, me suddenly crying so hard we had to turn around and drive home. For the next several months, our lives were at the mercy of timing. I showed up at the clinic at prescribed hours. Bloodwork, ultrasounds. Mondays, I taught my classes then raced to acupuncture we couldn’t afford. Once a month, we received disappointing news. Hard as it was, Dr. P encouraged us to project into the future, to imagine what further steps we might regret not having taken—which was startling but ultimately simple. We couldn’t afford to do IVF; deep down, we didn’t think we’d need to. As the months passed, expectations were shifting. I struggled between feeling the need to stay hopeful—as if hope, like acupuncture, could increase our chances (because who knew: Maybe it could?)—and the need to be realistic, a constant negotiation between thinking positively and protecting myself. The tone of our appointments was changing too. Dr. P grew more somber. We rarely talked about books anymore. He told me he was retiring. That after six months of IUIs, he’d recommend stopping. “For people accustomed to doing whatever they set out to do in life,” he said, “this can be hard to accept.” It startled me: I hadn’t realized I was that person yet. Throughout those months, my writing felt unmoored. I had finished revisions to the family novel but hadn’t yet started something new. My job as a professor—and my other job, trying to get pregnant—was consuming and exhausting. People encouraged me to give myself a break from writing, but I was happiest when I was working on something, when I had another life running parallel to my own. My mind kept wandering back to that shelved novel—the teacher, the paper. I was starting to imagine a different version: A student writes a troubling paper for a college comp class, but this time the student is a gunman in a shooting. His teacher read the paper, which may have indicated he was violent, but didn’t intervene. It would be difficult to write—even more so now, when mass shootings had become so horrifically common—but I thought about the advice I often gave my own students: Take a small truth, a true fear or worry, and exploit it, push it to the nth degree. Dr. P had discouraged us from trying IVF. He was cautious about the odds, the expense. For it was extraordinarily, prohibitively expensive: approximately 20 thousand dollars. Covered by insurance in some states, but not Pennsylvania. Despite this, we decided to try it, just once. If we didn’t, we feared we’d always wonder. We used all the money we received for our wedding, which covered half, and family loaned us the rest. We filled out reams of paperwork and attended the injection training, where we met with a nurse in a tiny room. Tiny table, tiny chairs—everything felt kindergarten-sized. I understood the IVF basics: the drugs taken to stimulate eggs, the best of which were taken out, fertilized and put back in. Because pre-filled needles were (even more) expensive, we would prepare them ourselves. The nurse spread out her supplies. She showed us how to mix the hormones with the sodium chloride. How to inject air into the syringe. How to give a shot with a swift, unhesitating motion—like a dart, she said. As I watched, I started feeling faint. Something in me was shutting down. When she had us practice prepping a needle, I was trembling so much I fumbled it. Then I was crying, and apologizing. Because how many couples had done this? Millions? Obviously we could too. We took our instructions, drove to the pharmacy, put thousands of dollars on two credit cards and left carrying bags filled with drugs, vials of powder and saline, gauze pads and alcohol wipes and variously sized needles and a red bin that said, “CAUTION HAZARDOUS WASTE.” For the next few weeks, our dining table became an amateur pharmacy. Jake mixed needles and stuck them in my thighs. At the clinic, they monitored the results. When initially it seemed no eggs were viable, I started crying again in front of the nurse, a different nurse. This time I just pretended it wasn’t happening. There was a sign hanging from the ceiling about the exam table, like a mobile above a baby’s crib. Sometimes It’s Just When We’re About to Give Up that the Miracle Happens! And sometimes it’s not, I thought. Then worried I’d jinxed myself by allowing such a non-optimistic thought. The morning of the egg retrieval, we arrived early. I stashed my sweats and eyeglasses in a little locker, one of several little lockers. Dr. P was now retired. My new doctor was sarcastic and smooth. “Nice outfit,” he quipped when he saw me in the scrubs, a line I’m sure he’d used a million times. My bed was separated from the next bed by a thin divider. A gentle IV nurse prodded my hand for a vein. I tried to stay calm. Stay present. I could hear the woman in the next bed on her phone with her husband, chatting easily, as if she were getting a pedicure at the salon. For the next four days, we anxiously awaited reports on how our two embryos were developing—like a parent-teacher conference, getting reports on how our children had behaved. On the day of the transfer, we met with the embryologist back in the tiny room, tiny table. She showed us pictures of our embryos, printed on slippery black and white paper. One looked bumpy. “Low quality,” she said, apologetically. The other was smooth, but small. Gradewise, a C. I struggled to keep it together as I was taken into surgery. I tried to think positively—tried, by force of will, to twist my sadness into belief—as I was asked to confirm my identity and the little bundles of cells were handed into the room. The picture of our two embryos hung on the refrigerator door. They were microscopic, but looked like the surface of the moon. For the next 15 days, I attempted to stay occupied. It was June, so I wasn’t teaching. I returned to the new novel, scheduled a call with Katherine to discuss it, started taking notes. The blood test was at 10 in the morning. The nurse made her calls at 1:30 in the afternoon. I asked her to leave a voicemail so Jake and I could listen together. At exactly 1:30, as the phone rang out on the porch where I’d deliberately left it, I felt a blast of fear. When Jake got home, he’d stopped for flowers—consoling, or celebratory. We put the phone on the coffee table and sat together on the couch and pressed play. “Hello this is—” From her tone, I knew. It was careful and kind. “I’m sorry to tell you that your—” I remember thinking how strange it must be to be the person whose job it was to make those phone calls. “Please discontinue all medication.” We cried, then threw away the needles. We were done. Afterward, there was a period like grieving. We didn’t regret trying IVF, but didn’t second-guess not trying it again. In that way, at least, we were resolute. The harder part was re-envisioning the big picture. I’d always imagined being a mother. When finally I got married, I felt certain that would be next. To let go of that idea—turn toward a different kind of life, a version I hadn’t yet imagined—was painful. Dr. P had been right—“for people accustomed to doing whatever they set out to do in life, this can be hard to accept.” There were other options, of course, but I couldn’t yet think about them. My emotions were too raw. I was sad, and depleted. And angry. I was furious. My hair was falling out, common when you stop taking hormones. Jake and I decided to table the subject for a while, give ourselves the summer to recover. We went to Maine for a few weeks, to his parents’ summer house on an island near Portland. There were babies everywhere. Meanwhile, I threw myself into the new novel. It was difficult to write, but that difficulty felt like a good thing—something I could handle, pin to the ground. Quickly, the original idea began expanding. Other characters were appearing. The teacher’s teenage daughter, who struggled with anxiety. The teacher’s ex-husband and his new girlfriend; they were doing IVF. We began talking tentatively about adoption. That January, on winter break, I spent five days alone at the Jersey shore. I went to work on the new novel. Off-season, Sea Isle felt deserted. I took walks along the ocean in a freezing wind. I got up at 5 in the morning and wrote until dinner, sometimes later—the kind of work I always found energizing, but it was making me feel queasy, exhausted. It’s a testament to just how effectively I’d removed myself from the possibility of getting pregnant that I didn’t wonder at this (I chalked it up to pressure) or at the fact that coffee suddenly seemed repulsive, or that at night I was so ravenous I found myself ordering enormous sandwiches from the one open deli, or that the texture of my lip balm made me gag. When I came home and stepped inside our house, filled with the smell of pine, I felt a sweeping sickness. The Christmas tree must be rotten, I decided. Jake shrugged and dragged it to the curb. The next morning, I woke early. I tried to remember the last time I’d had my period. Five weeks ago? Six? I had stopped paying attention. After the months of constant scrutiny, it was too upsetting to pay attention. Because it no longer mattered—though the fact that I had truly no clue gave me pause. I went into the bathroom and reopened the top drawer. I waited, staring at the blue test strip. I checked the indications on the wrapper, sure I’d taken a green one by mistake. I took a second blue one, thinking the first might have been defective. I woke Jake, confused. Even after three blue tests, I didn’t believe it, not until that afternoon, when I went back to the fertility center and saw one of my old nurses, who took blood and confirmed, amused, that I was already seven weeks. If the story were fiction, I would dismiss the ending as unrealistic. A deus ex machina. Contrived, overly convenient. Offensive, even, in its narrative tidiness, an insult to all the women who don’t get pregnant, don’t get the happy ending promised by the signs and clichés. Our baby was due in September. My novel about the family would be released in May. That spring, giving readings, my belly was growing. People talked about the book, then wanted to chat about the baby. At a Q&A that summer, I was asked what I was working on next and I described the novel-in-progress. The teacher, the shooting. “A hard book to write,” I acknowledged. A woman raised her hand—I would think of her often, later—and asked, “Why are you writing it then?” 3. Unlike having a baby, writing a book does not rely on the mercy of luck or science. It is an exercise in discipline. An act of will. I’d expected that, with a newborn, the process would be harder in the obvious ways—lack of time, lack of sleep and focus—but I hadn’t accounted for the unique difficulty of writing a book on a topic like this. I hadn’t fully anticipated—couldn’t have, I’m sure—the intense emotional terrain that came with having a newborn. The acute feelings of tenderness, fear and protectiveness. The love so distilled it almost hurt. The susceptibility to sentimental commercials, inability to handle any story in which something happened to a child. The towering sense of responsibility, having this little being in my care. Suddenly my own health, and the health of the world, mattered differently; this was the world into which I’d brought my son. To dip into the novel—submerge in such an alarming scenario, imagining the aftermath of a shooting—felt almost impossible to bear. What time I managed at the computer was brief, unfocused. The anxieties of my characters merged with my own in an edgy haze. Instead of the steadying effect I’d been counting on, invariably I emerged from my desk feeling more frayed. That November, the three of us went to our local elementary school to vote in the primary, Theo nestled in a Bjorn against my chest. As we stood in line, he started to wail. The older woman in line behind me smiled and advised me to breathe deeply. She had seven children, she told me. I drew several long inhales, and Theo gradually stopped crying, little body lifting with my breath. In June, after my semester ended—and Jake’s school year, as a counselor—the three of us headed to Maine. It was still off-season on the island, sleepy and uncrowded. An escape. The evening we arrived, I printed out my hundred pages—roughly a third of the novel, or so I was imagining—and stacked them on the porch. In the mornings, I rose before dawn and started working. When Theo woke up, I nursed him. Then Jake took him for a walk or to the beach. Alone in the house, it was quiet and secluded, ideal for writing. But I had trouble sinking below the surface. I read and reread pages. Tinkered with sentences, trying to get traction. Distracted, I checked my phone. A mass shooting at a church in South Carolina. Nine people had died. As I returned to the pages, I felt a rising despair. Around my son, I tried to stay calm. Stay present. Delight in the simple joy he found in seagulls, shadows, the moon. In the middle of the night, his sleepy weight in my arms, the stillness of the island was so absolute I could faintly hear the ocean. The low moan of the foghorn was a comfort in the dark. But alone, by day, I began to worry that the novel simply wasn’t working. I felt guilty for the hours I wasn’t spending with Theo. Concerned that my anxiety—about the book, about the world—might be filtering down to him. I grew reckless with the manuscript, chopping scenes and sentences. I deleted the IVF storyline entirely—after the way things had turned out for us I somehow felt I didn’t have a right to tell it anymore. I began to wonder if pressing for a book contract had been a mistake—I’d imagined it would be grounding and motivating, affirmation that I was still a writer. Instead it felt like pressure, proof of my failure to make progress, only emphasizing the disconnect between who I’d been and who I was. One morning, sitting on the deserted beach with a fluttering stack of pages, it struck me that my main character no longer felt right. She had a different name, I realized—was a different person. I set about reimagining her completely, starting from page one.  Over the next school year, the novel slowly found its shape. Completing it was ultimately something I had control over. I wrote early every morning while Theo was still asleep. I bought a giant six-dollar bulletin board to chart the different storylines. Heading into campus on the subway, I edited pages, scrolled through headlines. Mass shootings in Oregon, California. I felt sick about the direction the country was heading, the world my son was growing up in. But the world of the novel was no relief. Instead of offering an alternate reality, fiction felt like a more concentrated version. I spent hours researching the psychology of shooters. I recalled an anecdote my parents used to tell about how, as a kid typing stories in my room, I’d come flying down the stairs and stop short on the landing—“I scared myself writing,” I’d say. The following June, we returned to Maine. I’d missed my first deadline, unsurprisingly. The new goal was August. Each day, I worked from dawn until early afternoon. After lunch, the three of us were often the only people on the beach. Meanwhile, 49 people were killed in a mass shooting in Florida. Donald Trump was named the Republican presidential nominee. The poem “Good Bones” by Maggie Smith went viral. “The world is at least half terrible, and that’s a conservative estimate, though I keep this from my children.” It felt truthful and awful but also comforting and I reread it many times. 4. It is now another September, a little over three years since I walked into the maternity ward telling myself that if I had a book contract, my book would get written. That the contract would provide some sense of security, reassurance that my self as a writer was still intact. It was not so simple, of course. The world feels increasingly unstable. My mother self, writer self—the two are inextricable. The book, though, is done. I’d like to tell myself that in writing about something so pressing and frightening, I found an outlet for my own fears, emerged feeling more empowered. It sounds, I think, like a plausible ending. Convenient, but satisfying. Reassuring. If I heard that story, I might believe that it was true. Theo, now 3 years old, refers to me as Mommy, Mama, Mom. Except for when I’m writing, when he calls me by my first name. “Ellie?” he says, little hand rattling the doorknob of my study. Even at 3, he intuits that when I’m at my desk, I’m inhabiting a different role. “Ellie?” he calls. “Ellie? Are you there?” “Right here,” I answer, opening the door, scooping him up. Image: Flickr/jcooper971
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