Adventures of a Misbehaving Uterus

Confession:  I have cried nearly every day since the presidential debate last week. 

Why? Because I feel so overcome with frustration and powerlessness when it comes to reproductive rights and procreative liberties.

Politics is never a good choice for my mental health.  Perhaps I should choose not to read the news stories.  Perhaps I should silent certain accounts on social media.  Perhaps I should; but I don’t. 

I don’t because I don’t want to be silent on this issue.  I don’t want to ignore it. 

I am enraged at the way abortion is talked about by politicians and political pundits on the right.  And I am devastated at the impact abortion bans are having on the pregnancy loss community, and women and mothers more broadly.  I cannot let it go. 

Last night I saw Esther Perel speak.  She said that political polarization doesn’t happen just because people hold different opinions.  Polarization happens when people become so convinced that their opinion is correct that they are no longer able to hold space for a different opinion. 

Today I read the story about Amber Thurman, a 28-year-old single mother who died of septic shock because a hospital in Georgia waited too long to perform a D&C after a failed medicated abortion.  Then I read an Instagram comment on that story from someone who said that Amber’s death was really her own fault because if she hadn’t taken the abortion pills to begin with, she wouldn’t have become septic.  As if Amber deserved to die and leave her 6-year-old son motherless because she chose to end a pregnancy.  

Second confession: I may have a polarized point of view because I don’t know how to hold space for opinions like that.

My dad to me I should stop “seeking out these stories.”  Should I?  Should I insulate myself from stories like these to protect my feelings?  Or should I search for more and try and amplify them?  

When I was younger (in high school and college), before I had any desire or plans to start a family, I considered myself pro-choice, with limitations. The idea of limitations around “fetal viability” seemed so rational, so middle-of-the-road.  The same way I imagine someone might say they are pro-life, with limitations.  Exceptions to protect the life of the mother, are so compassionate, so middle-of-the-road.

I now believe that my position was ill-informed and naïve.  It was based on my own self-interest, a lack of understanding of how to access care within the healthcare system, and a complete ignorance about the risks and complications that can arise during pregnancy.

In the debate, former President Trump said that some states allow abortions in the 9^th month and even after birth.  When you hear that, or a term like “late-term abortion,” it sounds terrible. If you picture a healthy woman in her third trimester walking into a clinic where she and a doctor voluntarily end the life of her healthy growing baby, you’d be outraged.  What sane person wouldn’t be?

But that’s just not what’s happening. In most instances, a conversation about a later abortion or comfort care after birth is not about whether a baby should live, but about how a baby will die and who should be allowed to make end of life decisions for that child.

I listen to stories like this one from Callie in Georgia and want to scream. Callie was carrying twins but one of the babies had many lethal organ defects.  To protect her own health and save the life of her other baby, Callie needed to have a “selective reduction” (a type of abortion), but it wasn’t legal in Georgia so she had to travel to New York for the procedure.  The delay in getting treatment caused complications that eventually led to pre-term labor (of her other baby) and sepsis (for her). 

Allie Phillips of Tennessee had to travel to a clinic in New York for similar reasons.

A woman I met through my nonprofit work found out her baby stopped progressing in her second trimester.  She lived in Texas and had to travel to New Mexico because she couldn’t find a doctor in her state who would perform a D&E procedure (her preferred method to manage her loss) even though her baby was already dead.

I see so many comments on social media or in the comments section of news articles that claim stories like these are hyperbole or that they are irrelevant because they meet the exceptions under the law.  If that were the case, these women would have been properly cared for.  The laws are insufficient.

I am aware that I might be too close to this issue to have objectivity.  When I read stories about women who have made the choice to end wanted pregnancies, I do cry for them, but I also cry for me. Because I know what it feels like to want a pregnancy so badly and have it end in a way that is outside of your control, and I don’t want that for anyone else.  I want to find Callie, and Allie, and all the other women and hold them close and tell them, “This sucks. I’m so sorry, and it’s not fair. What on earth can we do to make this terrible, awful thing just a bit easier for you?  What can we do to give you back a tiny shred of autonomy in a situation that is your worst nightmare?”

But I can’t do that.  So here I sit, sending a blog screaming into the void.

Live Action (which I hesitate to even link to) is a nonprofit organization leading the pro-life campaign.  It is well funded, and it is spreading lies.

Live Action claims that removal of a fallopian tube due to an ectopic pregnancy is not an abortion because it does not ‘directly kill the child.’ 

They claim that the induced labor and delivery of pre-viable baby (in the case of premature water breaking) is not an abortion because it doesn’t ‘target the baby’s body.’ 

They claim that “necessary medical treatments that are carried out to save the life of the mother, even if such treatment results in the loss of life of her unborn child” are not abortion. 

They claim this because they say that abortion is the “direct, intentional killing of an unborn child.”

They purposely frame it this way to play to people’s sensitivities and sensibilities – threading a delicate needle through all the situations in which you might find grace or compassion for those terminating a pregnancy.  They are trying to make abortion a dirty word.

But these ARE abortions. Medically.

The removal of an ectopic pregnancy is a type of abortion. A selective reduction in the case of multiples to protect the life of the other baby(ies) is a type of abortion. Induced labor after pre-viable premature rupture of membranes is a type of abortion.  The decision to terminate a pregnancy for medical reasons after the discovery of a lethal fetal anomaly is a type of abortion. 

It is impossible to anticipate every scenario which might necessitate an exception to a law.  Doing so allows us to lose sight of the very real, very difficult conversations about maternal mortality and perinatal and infant death.  Pregnancies go wrong. Unexpected complications occur. Not all babies will live. It is a terrible, difficult reality. Sometimes a conversation about abortion is a necessary part of healthcare. And healthcare is a necessary part of LIFE.

I recently listened to “The Retrievals,” a Serial podcast that tells the story of a situation at Yale’s fertility clinic where hundreds of women underwent egg retrievals with limited to no pain medication because a nurse was diverting fentanyl.  I have quite a bit to say in response to the podcast, but thought I’d better start by picking up the thread of my own story and talking about our egg retrieval.

Our doctor in Seattle recommended we try in vitro fertilization (IVF) after our 4th miscarriage. Her hypothesis was that poor eggs or sperm had led to embryos with chromosomal abnormalities, thus causing our losses.  By testing embryos prior to implantation we could potentially prevent that type of loss. I can’t say I necessarily believed this, but at that point, I was willing to try anything, so I agreed. 

Much has been written about the IVF process, so I doubt I have anything unique to add.  But it’s an important part of our journey that needs to be told.  There are several steps in the IVF process.  This post will only focus on the first step, the egg retrieval, which, for me, was AWFUL.

Ok, so, mini-biology lesson… Picture my little misbehaving uterus.  She has two “arms.”  Those arms are her fallopian tubes and on the end of them are her ovaries.  Ovaries contain follicles – small fluid filled sacs containing immature eggs.  Usually just one of these eggs matures over the course of a menstrual cycle.  Once mature, the follicle breaks open and sends the egg down the fallopian tube to be potentially fertilized.  But, for IVF doctors want lots of eggs to mature, and they don’t want any of the follicles to break open otherwise they can’t go in to surgically retrieve the eggs. 

The process starts with birth control.  Birth control serves to “quiet” the system and prevent any follicle from maturing on its own. (I still find this ironic since the only reason I subjected myself to IVF in the first place was to get pregnant.) Then, once the ovaries are quiet, they need to be woken up – LOUDLY. 

I had to give myself a daily injection of stimulation hormones to help the eggs mature, and wow, did mine mature. I’m what they would call a “good responder.” On the day of my egg retrieval, the nurse told me my ovaries were the size of small grapefruits.  Read that again… grapefruits!! 

What did that feel like? B L O A T. Everywhere I went, I felt like a slug dragging my bag of eggs behind me like a slimy ball and chain.

I was also taking medicine to prevent my ovaries from releasing those grapefruits full of eggs – another daily injection – and my slug-self had to visit the fertility clinic every other day for a blood draw and transvaginal ultrasound. 

Every woman’s body responds slightly differently to the stimulation medications, so doctors have no way to predict exactly when an individual will be ready for retrieval other than monitoring egg development via hormone levels and ultrasounds. It’s not an overstatement when women say IVF feels like a second job. It was a LOT of appointments. I got on a first name basis with the phlebotomist and the front desk staff. 

I don’t have many precise memories about this part of my journey. Honestly, a draft of this post has been written for about two years. I think I’ve avoided finishing it because I still feel pretty negatively about about my IVF experience. I remember being overwhelmed by the sheer number of medicines my body was being asked to consume.  I remember growing tired of the regular drive into the city for appointments. I remember being supremely uncomfortable. But mostly I remember feeling resigned.  I was trudging diligently along, like the little engine that could, doing anything the doctors told me if it promised to bring me a baby at the end.   

When you haven’t gone through it, IVF seems so simple.  Science! Wham! Bam! Baby! 

In reality, IVF is a constant effort of physical endurance and expectation management.  Everything has to happen around your cycle.  If you have an important meeting, a work trip, an important personal event which can’t be moved, it’s not like you can reschedule your egg retrieval or your embryo transfer to the following day or week. You wait another month.  We started the IVF process in February.  Our retrieval was in May.  Our first transfer wasn’t until September.  It is a long, expensive process with huge personal implications no matter the outcome.

On May 1st, 2018 I presented myself to the clinic to have my eggs harvested. Does that sound clinical? It should. An egg retrieval is a surgical procedure.  I was fully sedated for it. I was in stirrups, strapped to a table, with a needle going through my vaginal wall and into my ovaries, meanwhile, my husband was several doors down producing his “sample.” (The juxtaposition of this visual image still confounds me.)

My retrieval itself was incredibly successful; they collected something like 25 eggs.  I was overjoyed.  Unfortunately, the feeling was short-lived.

After the procedure, I developed what’s called Ovarian Hyper Stimulation Syndrome (OHSS).  My ovaries swelled, and fluid that had surrounded my eggs leaked into my body and had to be reabsorbed. It was the most discomfort I’ve ever felt.  I was bloated, nauseous, and couldn’t lay down because I developed plural effusion and became short of breath.  None of my clothes fit and I wanted to absolutely crawl out of my skin. 

To combat OHSS, I was told to increase my protein intake and drink electrolyte fluids.  For days I pretty much subsisted on protein shakes and Gatorade – it was disgusting.

I still probably should have been happier. A lot depends on a ‘good’ retrieval, and I had a great one. Not every egg that gets collected is usable, you see.  In fact, most of them are not.  After my eggs were retrieved, they were evaluated.  Immature eggs were immediately discarded.  The mature eggs were then individually fertilized through a process called Intracytoplasmic Sperm Injection (ICSI).  It’s a more science-y alternative to putting the eggs and sperm in a petri dish and just letting them go at it.  Any eggs that weren’t successfully fertilized were discarded. Then we waited to see if the fertilized embryos survived.  Embryos that stopped growing before five days were discarded.  Then, on day five, they extracted a small number of cells from each embryo to evaluate the number of chromosomes.  Abnormal (‘aneuploid’) embryos were discarded, and the rest were frozen.  Seven of them to be exact, which we lovingly referred to as our “seven dwarfs.” 

This is a fantastic number of embryos.  Many women endure rounds of egg retrievals and don’t wind up with any usable embryos.  This is why people call themselves “IVF Warriors.”  It takes real Xena Warrior Princess balls to step into that hormonal sh*t storm more than once. I should have been excited, but I wasn’t. When our doctor told me we had seven genetically normal embryos, I believe my immediate response was, “So, I guess egg quality wasn’t the problem then, huh?”  

My doctor was surprised; she was delivering good news, something fertility doctors don’t always get to do.  But I didn’t see it that way. In retrospect, my response demonstrates how distorted my thinking had become because of recurrent pregnancy loss.  Good news, like positive pregnancy tests had become terrifying. Promising test results became areas of anxiety.

I want to be clear, it’s not that I wasn’t grateful for my embryos – I was.  But by this point, I’d had four miscarriages even though, to quote my doctor, “nothing in my test results gave any indication that I couldn’t successfully carry a pregnancy to term.”  I wanted embryo quality to be the reason because then IVF would be the solution.  Instead, it felt like just another thing we were going to try. 

The biggest irony in all this is that the day of our egg retrieval is the day my daughter’s embryo was created – her date of ‘scientific conception.’ It should be a day I mark and celebrate. Yet it lives in my mind as a physically painful lull amidst an emotionally painful storm. It was a period where there was a lot going on, but nothing was happening.  I was impatiently waiting for what would come next. And what came next were two more losses. To be continued…

I had considered writing about abortion laws and their potential impact on infertility and miscarriage management long before last night’s news about the draft Supreme Court opinion overturning Roe v. Wade, but I’ve been afraid to open myself up to potential anger and criticisms. I don’t want to debate when life begins or the merits of pro-life vs. pro-choice, that’s not what this blog is about.  However, those debates and resultant legislation have real and potentially serious implications for the infertility and pregnancy loss communities, and I think it’s important to discuss how. That’s what this post will focus on.  If this is a non-starter for you, stop reading now. For the rest of you, I’ve broken this down into three areas.  There are others, but these are the ones I’ve spent the most time exploring and which I feel would have directly impacted my own fertility journey.  First is the issue of “personhood,” second is the legislation restricting access to the “abortion pill,” and the third is the question of fetal harm and maternal responsibility.

**Please remember that I’m not a lawyer nor a constitutional scholar. This is simply a summary of my own research and personal opinion on the subject.

• Personhood legislation could limit assisted reproduction

Several states have already introduced legislation stating that human life begins at the moment of conception/fertilization (“personhood legislation”).  If passed, these types of laws could severely limit reproductive research as well as assisted reproduction procedures like IVF.  As stated in RESOLVE: The National Infertility Association’s policy position (I encourage you to read the whole thing), “with personhood legislation, the legality of pro-pregnancy fertility treatments would be called into question: if microscopic fertilized eggs/embryos are full humans, anything that puts an embryo at risk could be a criminal violation.”

Were a personhood law to pass in my state, it would mean that my remaining frozen embryos were PERSONS, persons with rights. I have four embryos remaining – 400 cells.

Currently, the decision about what to do with them lies with me.  I can use them to try and become pregnant, I can have them destroyed, I can donate them to science, or I can donate them to another couple or individual. But if my embryos were considered persons, my options become limited. I could try for more children.  Although, given my pregnancy history and current maternal age, one might argue that a transfer into my uterus would be reckless endangerment.  Or I could donate them to another couple, essentially giving my embryos up for potential adoption. I find neither of these appealing.

Personhood legislation could also limit scientific research.  Already no federal funds can be used for research involving the creation or destruction of embryos. Personhood legislation could further restrict privately funded research as well, limiting potential advancements in both reproductive research and embryonic stem cell research.

• Restrictions on medicated abortions impact miscarriage management

Movies and TV shows often depict miscarriages as happening all at once – a woman wakes up and her bedsheets are soaked with blood.  Sometimes it happens like this.  But often, a woman finds out her pregnancy is no longer progressing before her body starts to physically miscarry. In these situations, there are generally three choices: (1) wait for the body to naturally pass the pregnancy, or “expectant management”; (2) undergo a surgical procedure called a dilation and curettage (D&C) to scrape the uterine lining and remove the pregnancy tissue; or (3) induce a miscarriage using medication. 

Over the course of my six miscarriages, I have personally selected and experienced each of the above options.  They all have pros and cons, and they all generally suck.  Expectant management is unpredictable; you can wait for weeks for your body to pass the pregnancy and often you still need to have follow-up treatment to remove “retained tissue.” Medical management is more predictable but can also result in an incomplete loss and require retreatment.  Surgical management is predictable and complete, but it is invasive and (for me) resulted in post-operative uterine scarring, twice. I should also note that these are the options for managing early losses, later pregnancy losses are handled differently.

The American College of Obstetricians and Gynecologists (ACOG) recommends a combination of two drugs to medically manage an early miscarriage – an oral dose of a drug called mifepristone followed by a vaginal dose of a drug called misoprostol. However, this is the same drug regimen that would be used to induce an abortion in the first trimester.

Several states have now introduced legislation limiting the availability and use of mifepristone, calling it the “abortion pill.” And while, it is possible for a miscarriage to be managed with misoprostol alone, the combination therapy is more effective, there is a lower possibility of retained pregnancy tissue, and thus a reduced need for further treatment (see the NEJM study here). What this means is that after already suffering the trauma of early pregnancy loss, women are now receiving less effective medical treatment for their miscarriage because of abortion laws that restrict doctors’ ability to prescribe mifepristone. 

• Fetal protection laws risk criminalizing pregnancy loss

Fetal protection laws are similar but different to personhood.  Fetal harm legislation already exists in many states, and while it is usually used when a pregnant person is the victim of a crime, it also has been used to prosecute pregnant women whose actions contributed to their pregnancy loss.

As stated in a Kaiser Family Foundation (KFF) policy brief, “by granting full rights to a fertilized egg, embryo or fetus, or by failing to provide sufficient exemptions to pregnant women in fetal harm laws, the rights and protections of the pregnant individual may inevitably decrease. Because the pregnant person and their developing pregnancy can be regarded by the law as two separate entities, if a person experiences a pregnancy loss and they are thought to be at fault in any way, they could be charged with a crime using fetal protection legislation.”

If you read that and groaned because you think it’s ridiculous, think again.  That same KFF brief references this analysis which identifies numerous cases in which women who experienced miscarriage or stillbirth were charged with crimes because state prosecutors believed them to be responsible for their pregnancy losses.

You may examine those cases and find the prosecutors’ arguments reasonable.  But what does that say about me? I transferred two pre-screened, top-notch embryos, and I lost them. At this point, neither my doctors, nor I believe I was responsible for my losses, but what if I was?  What if down the road, it’s found that I have a genetic predisposition for miscarriage (this, by the way is not outside the realm of possibility).  If I intentionally got pregnant with the knowledge that I would likely miscarry, would that constitute fetal endangerment? If I did miscarry, would it be considered feticide? Where do my rights end and the fetus’s begin? If I skied or hiked while pregnant and had an accidental fall which resulted in loss, could I be held responsible or deemed criminally negligent?

I recognize I’m being hyperbolic, but there is a slippery slope here, and laws like these can have serious unintended consequences.  My father told me that overturning Roe would never happen and was simply a fear tactic used by the left to increase voter engagement leading up to elections, but here we are.  You tell me what’s hyperbole. And, even if you are pro-life, even if you support all the aforementioned legal restrictions, I still think it’s important to recognize how such laws might affect the entire spectrum of family planning not just whether or not a woman has the right to choose.

I’ll close by saying that one might imagine after everything I’ve gone through in my efforts to have a child, I’d be offended by those who elect to terminate their pregnancies.  In fact, it’s exactly the opposite. After enduring the physical and psychological trauma pregnancy loss and considering the virtues and vices of unanticipated (and often undesirable) fertility treatments, I feel more than ever that all women should have all family planning options available to them.

I’m sorry I haven’t posted for a while.  I’m sorry because I have so much I still want to say (so much I still need to work through), but I haven’t made the time to write.  Or maybe I’ve avoided it.

As many of you were aware, my husband and I had been going through the gestational surrogacy process. I am now pleased to report that we are the proud parents of an 8-month-old baby girl.

I am overflowing with words on the experience of her birth, the surrogacy journey, and the transition to parenthood.   But I’m also not done sharing or working through everything it took to get us here. 

I don’t intend for this to turn in to a mommy-blog, but I also cannot avoid my current context or keep it from influencing my outlook on the future or reflections on the past. Moreover, recurrent pregnancy loss undoubtedly affected my parenting experience, and I think it’s important to discuss that.     

I know there may be some readers who are still struggling through infertility and loss.  If you need to stop reading, please do.  You won’t hurt my feelings at all.  I know your pain well. 

My sensitivity to past my triggers is acute, so much so in fact, that I almost didn’t post a birth announcement on my social media feeds.  When I was going through my losses, I found birth posts distressing, and I didn’t want to cause similar unease for others.  In the end I did announce her birth on Instagram and Facebook.  Having been open about our journey and our decision to pursue gestational surrogacy, I decided it was more disingenuous to hide the truth.  But as it stands, I haven’t posted anything about my daughter since her birth announcement. 

I’m not entirely sure why.  There still is sensitivity around not wanting to share images that will cause others pain.  But I also feel a strange desire to protect my former self and former identity – as if by not transitioning my social feed, I’m keeping that version of myself in some sort of pre-parent time capsule. 

For years, having a baby was the primary objective of my life – the goal around which all other goals were organized – and grief was the primary theme.  Grief was my filter for life; it became the explanation and justification for everything. 

This experience altered me. In some unexpected ways it served me.  It made me humbler. More compassionate. It motivated me to leave a job that was unfulfilling and fueled me to start Recurrent Pregnancy Loss Association. I found a community. I found my voice.  I know I need to change my filter, but it’s not quite as simple as changing my outlook, it’s changing my perception of myself.  Perhaps this is akin to a someone getting remarried?  They transition from “divorcee” or “widow” to “bride” and “wife.” But it’s not like the past gets washed away.

I think part of me is afraid to release my pain.  I don’t have anything from my pregnancies.  I didn’t keep ultrasound images or pregnancy tests.  I don’t have burial plots or keepsakes.  If I completely let go of my grief, I worry there will be no record of what I went through.  No proof.  At least no proof that anyone but me would recognize.

This yearning to hold on is elicited (for me) by the final stanza of E. E. Cummings’ poem I Carry Your Heart with Me.

here is the deepest secret nobody knows
(here is the root of the root and the bud of the bud
and the sky of the sky of a tree called life;which grows
higher than soul can hope or mind can hide)
and this is the wonder that's keeping the stars apart

i carry your heart(i carry it in my heart)

Because in the end, who will remember my pregnancies but me? Even if they were only imaginings, they were mine. For Christmas last year I bought myself a gift – a necklace. It has six, intertwined golden rings surrounding a peridot – our daughter’s birth stone. The six rings are for my six pregnancies. I carry them with me (I carry them in my heart)… and around my neck.

My maternal grandfather, my Papa, died yesterday.  He was 100 years old, so it was not entirely surprising, but it is still a loss.  The loss of our family patriarch, the loss of one of my life-long role models, the end of an era for me and my cousins.  I find myself in a very philosophical place today, pondering life’s big questions and the very nature of grief.  

But let me start with him.  Two words come to mind when I think of my grandpa: family and faith.  He was an accomplished businessman—starting, growing, and selling his own company.  He was a veteran, and a golfer, and a fisherman.  But his two great loves were my grandma and God.  His proudest legacy was the family they built, and his happiest moments were when we were all together. 

While death at age 100 is not shocking, his passing yesterday was unexpected.  In the morning he woke up, ate breakfast, got dressed… and then died.  My grandmother, his wife, passed away two years ago.  Her health had been declining for several months, so her death was anticipated if not welcomed.  In some ways it was a relief for us to see an end to her pain.  My grandpa’s death was not a relief, but there was a sense of rectitude and rightness to it.  I was happy to imagine his soul reunited with my grandma in some other space and place. 

I spoke with cousin of mine who was conceptualizing the loss in a very similar way as I, but said he wasn’t feeling grief over Papa’s passing.  His phrasing struck me because I did think I was grieving.  I began to wonder how each of us was defining the word “grief.”

I am not anguished by my grandfather’s passing.  I am not angry about the circumstances.  I am not shocked, nor am I wishing for a different outcome.  I have had tears in my eyes and a lump in my throat, but I don’t feel broken open.  I am upset, but I am not sad, at least not in the traditional sense.  I feel nostalgic.  I feel the Earth has lost something in his passing.  I wish I could relive many of our family reunions and holiday celebrations.  I miss that foundational stage of my life when my grandparents became my role models.  I’m grieving memory—the memory of the grandfather of my youth—but I don’t feel robbed of a future.  Perhaps that is the gift of long life.  There isn’t a sense of injustice or things left undone.

The loss of unrealized things is the grief of pregnancy loss.  It’s the opposite of what I’m experiencing now, and yet in some its ways similar.   Nostalgic memories and unfulfilled futures are both just thoughts in our heads.  We can’t get to either one, and both leave us wanting.   

Months after my grandma passed, my mom shared that there was a part of her that felt like she wasn’t allowed to grieve because her mother had lived a wonderful life until 99, as if age negated the fact that my mom missed her mother.  My mom is remarkable.  She is a person you want around in times of crisis.  She is a bit unflappable, she’s compassionate, and on top of that, she’s an ordained minister.  She is very comfortable with death.  She has a very clear idea about where we go after all of this.  She organized and officiated her own mother’s funeral.  She showed gratitude, and grace, and strength, but she didn’t feel she had permission to be in “grief.”  I think she and my cousin were both thinking of grief as sadness and tears.  My mom grappled with whether sadness was acceptable, my cousin was equated its absence with a lack of grief entirely.  But both their experiences were an effort to come to terms with loss.

My definition of grief has broadened over the past years (perhaps too much).  Grief always recognizes itself in others, and now I see it in so many ways.  For me learning to grieve has been learning the human condition.  We are all of us, all the time, managing feelings of loss or disappointment.  We are constantly reckoning our feelings of anger, or guilt, confusion, or lack of control, with feelings of joy and acceptance.  We worry when our feelings about a situation don’t square with what we think we should feel, and that makes us feel alone.  The irony, of course, is that we are all together in this collective confusion.

Last night I received what I believe was a message from my grandfather. It’s a long story, but one that lead me to Second Corinthians, Chapter 12, Verse 9 (sorry to get biblical, but I did say my grandpa had an extremely strong faith).  In the chapter, Paul describes a thorn in his side that torments him, and his repeated pleas for God to remove the pain, but God answers “My grace is sufficient for you, for My power is made perfect in weakness.”  God doesn’t remove the pain but gives Paul the grace to bear it.  It is a beautiful metaphor for the experience of grief and other human sufferings.  We are all pricked by different thorns in different ways at different times, it cannot be avoided. But we are given the power and grace to move through it.

There is a movement in pregnancy loss community about “redefining motherhood” and challenging the standard ideas about when someone becomes a mother. 

Does motherhood start at birth?  What if your child is stillborn or passes shortly after birth?  Are those women still mothers?  Is motherhood defined by the act of raising your child, or birthing them, or conceiving them?  If it’s the later, how long does someone need to be pregnant before they are considered a mother? Is it a kick?  A heartbeat? Does an early miscarriage count?

I won’t pretend to know the answers to these questions.  I don’t believe one answer exists. 

Many women who have experienced pregnancy loss feel they are already mothers.  There are hundreds, if not thousands, of social media accounts recognizing “loss moms” and “angel babies.”  Commemorative boxes and plaques can be purchased for named or unnamed and unborn babies.

I am incredibly supportive of this movement to redefine motherhood.  I want to acknowledge the pain and grief of pregnancy loss at any stage and honor each person’s self-expression and self-identification.  But I do not feel like a mother; that’s not how I see myself.

I recently participated in a vlog (video blog) conversation with Michelle Valiukenas, Co-Founder of the Colette Louise Tishdal Foundation, a nonprofit that provides financial assistance to families dealing with the impact of pregnancy loss.   The plan was to discuss the various ways to commemorate pregnancy losses.  In her introduction, Michelle said she is the mother of three: one living child and two in heaven.  In my introduction I said I’d had six pregnancies… because I simply don’t feel like I have six children.

Similarly, several years ago, after sharing that I’d lost multiple pregnancies, a colleague of mine assured me that I was “still a mother.”  I smiled politely but inside my head I was screaming, “NO, I’M NOT!”  I’m an awesome aunt, a supportive friend, a loving wife, a sister, a daughter, and a dedicated professional.  But I’m not a mother.  Not by my definition.  Not yet. So, I’d prefer the movement to redefine motherhood instead focus on broadening the definition, because I don’t feel like the new definition applies to me.  If fact, I find it pretty uncomfortable. 

I am sharing my feelings on this topic, because there is so much guilt and shame associated with pregnancy loss, the last thing I want anyone to feel is more guilt thinking they haven’t conceptualized their child correctly. 

I was very invested in each of my pregnancies.  My losses were devastating.  But I don’t feel like I lost children.  And while I have tried to find ways to honor my journey, I didn’t feel the need memorialize my specific losses. 

And that’s OK. 

We get to define ourselves in this life.  We get to choose our thoughts.  We grieve and process in our own imperfect ways.  So rather than trying to agree about when motherhood begins, rather than focusing on redefining the word, let’s work on broadening our definition.  Let’s simply “undefine” the word motherhood (thanks Katy Harrison).