But none of that happened.
The now-infamous three-mile run felt normal. There was no niggling pain, no tightening in her abdomen, nothing to suggest that the harmonious birth she’d planned for was about to go horribly awry. When she returned from her run, Jeff had already left for work. Gwen normally went into the office but had arranged to work from home a few days a week during her pregnancy.
She stripped off her damp clothes and admired her belly in the mirror. From behind, she did not look pregnant at all. It was only from the side or front that it was obvious. She was one of those pregnant women who look like they just have a basketball under their shirt. In other words, she was one of those pregnant women that other women hate. She chalked it up to doing all the things she was supposed to do. She took her vitamins and ate super-clean food. She exercised. She’d started meditating to practice bringing her body to a calm state. She was the epitome of a healthy mother-to-be, could envision herself as the smiling cover model on a pregnancy magazine.
When she reached into the shower to turn on the hot water, she felt a sudden twinge of pain. Her first thought was Braxton Hicks, those contractions the uterus does leading up to delivery. It seemed too soon for those types of contractions, but if anyone’s body was going to start practicing early, it would be hers. She took deep breaths, inhaling and exhaling like she’d seen Lamaze teachers instruct in YouTube videos. But the pain continued. Then she felt liquid running down her leg. Some of it was clear and some of it was red, and all her meditation learnings went out the proverbial window.
She called Jeff and Jeff called her doula, because of course she had a doula. The doula’s name was Essence, because of course her name was Essence. Jeff had her on speaker, and she said, in a singsong voice, “Oh, my dear, this sounds like quite the emergency. You need to go to the hospital.” She then informed them that she would be unable to attend “the arrival” because she was at the Esalen Institute in Big Sur.
Jeff called the OB’s office, and they said Gwen’s doctor was on vacation but another doctor would meet them at the hospital. Gwen cried and cried because none of this was right. Jeff ushered her to the car, and she briefly grieved her lack of a hospital bag, complete with a plush robe and her favorite organic snacks. By fixating on this detail, she could be in complete denial of the possibility that she and her baby might die.
When she’d hired Essence and Essence had asked about her ideal birth plan, Gwen had tried to sound easygoing because she didn’t want to be one of those controlling women who demand Enya and twinkly lights and an inflatable tub. In reality, though, that was exactly the kind of woman she was. She had a playlist on her phone that she’d been secretly curating, and it did include a couple of Enya songs. She’d purchased a special chromotherapy lamp that was supposed to emit green light to relax her during labor. She had chosen her OB because he was the director of a birthing center that had tubs available.
Water births were very much recommended by @mother.nurture.official and the vast number of commenters on theirpage, many of whom had delivered their babies at home, away from medical equipment and liability-obsessed doctors, “as nature intended.” Gwen had suggested to Jeff that she birth at home, and he’d said, “Hell no” before reminding her of this time in law school when he sliced his finger while chopping vegetables and promptly passed out at the sight of blood.
Truthfully, Gwen was relieved by his refusal. As much as @mother.nurture.official encouraged her to “trust the magic” of her body, she was terrified to give birth without professional assistance. The twenty-thousand-square-foot birth center at Virginia Mason Hospital, which included a staff of midwives, seemed like the next-best option. She even commented on a Mother Nurture post about home birth:
This is such a beautiful thing. I am so sad that my husband insists on me birthing in a center, but am grateful to live in an area that has a center with such a progressive, mama-empowering mindset.
She tagged the birthing center in the post. Her comment got many likes and many replies applauding this respectful compromise she’d made—both supporting her husband and his “male prerogative” while also honoring most of her wishes. Even the Mother Nurture account itself replied:
Love your flexibility and openness. This will serve you well in motherhood! Best wishes with your delivery.
Gwen was adamant with Essence that she did not want an epidural or any medications. These were very much frowned upon by @mother.nurture.official and the like. There were complications that could arise, potential negative effects for the baby. Besides, women’s bodies had been birthing babies without interventions for centuries. Jeff had asked if Gwenwas sure about this. She was, after all, someone who had no qualms about popping a couple of ibuprofen at the hint of a headache. She told him she was sure, told him that even if she begged for something to relieve her pain, he was to refuse. Essence assured them that she would also help Gwen stay true to her wishes, even when “primal sensations” attempted to lead her astray.
Gwen was also adamant with Essence that she wanted to avoid a C-section at all costs. Essence waved a hand in the air, likeduh, and said, “Honey, that goes without saying.” They were both in agreement that C-sections were terrible, that they were violent interruptions of the natural birthing experience that women’s bodies were made for. Gwen had done the research. She knew women were four times as likely to die with a surgical birth. She knew that babies born via C-section were more likely to have respiratory distress and low Apgar scores. They were often lethargic from the anesthesia given to their mothers. Without traveling through the vaginal canal and absorbing all its healthy bacteria, they were more likely to have asthma, child-onset diabetes, and allergies. The Mother Nurture account had a whole post series about the rise of C-sections:
1 out of 3 deliveries is via C-section. Women’s bodies must be trusted instead of brutalized. Enough is enough.
A C-section sounded like a personal failure and a betrayal of all womankind. In the private confines of her mind, Gwen judged other women who had them. Were they not educated enough to raise objections with their doctors? Did they not know all the different labor positions to try? Had they grown impatient or panicked during the arduous process of laboring? What, exactly, had they donewrong? Gwen didn’t know, but she was quite sure she was doing everything right.
When they arrived at the hospital, she was taken upstairs immediately. She heard the wordsplacental abruptionand knew that was not good, but she felt somehow detached from the scene. She was losing blood as fast as she was losing her grip on reality. People were bustling about. A doctor she didn’t know said they were going to have to do an emergency C-section, and before she could remember that this was the thing she was supposed to avoid at all costs, they were wheeling her into a too-bright operating room and erecting a blue curtain that prevented her from seeing the lower half of her body and all the frantic efforts underway to save her and her baby.
Her arms were stretched away from her body, in a T, like those of Jesus on the cross. She shouldn’t have gone for that stupid run. She was dying for her own sins, that was it. Faster than she would have thought possible, she could not feel anything below her boobs. There was the smell of something burning—her flesh, she understood later. She felt pressure, jostling, tugging. Jeff was next to her, stroking her sweaty hair with his palm, telling her, “It’s going to be okay.” He looked terrified and pale, and Gwen would find out later that he lost consciousness shortly after she did.
There were all kinds of things Gwen would find out later. The doctor would explain to her that when the placenta detaches from the uterus, as hers had, this creates an internal wound that bleeds. The internal bleeding triggers a reaction of proteins in the blood, and they become abnormally reactive. This is the first stage of something called disseminated intravascular coagulation, or DIC. At this point, blood clots were traveling throughout Gwen’s body.
After delivery, the uterus usually contracts like a fist, which closes off the blood vessels that ruptured during the birth and stanches the bleeding—the female body is an amazing thing. But Gwen’s uterus did not contract fully, and the bleeding continued. This led to the second stage of DIC. The proteins that naturally cause clotting had all been used up during the first phase. With no coagulants left in her system,she experienced what they call catastrophic hemorrhaging. At that point, the only chance of saving her life was to remove the uterus and stop those particular vessels from bleeding. It was a Hail Mary.
Gwen spent eight days in the hospital, five of those in the ICU. Baby June was whisked away to the NICU due to being preterm, but was quickly transferred to the regular nursery when they determined she was completely healthy, albeit small.
Gwen lost her blood volume, twice. They had to give her ten units of blood. Even then, it was touch and go. There was nothing to do but wait and see if her body could recover and produce the coagulants needed to stop the deep internal bleeding.
For the first three days in the ICU, Gwen was not fully conscious. They’d hooked her up to a ventilator, a ribbed white hose arching out of her mouth and connecting to a machine that was breathing for her. Jeff would tell her that he couldn’t even see her face because of the white straps crisscrossing it. She was completely still, her skin chalk white, her lips colorless. Her body still looked pregnant. She was covered in tubes, her hands cuffed to the side rails of the bed, her legs wrapped in thick pneumatic pads that inflated and deflated to circulate her blood while she lay there. A bank of monitors showed jagged lines going up and down, various cursors blinking. The hospital staff let Jeff stay the night, which wasn’t something they usually allowed in the ICU. It was that dire.
On days two and three in the ICU, she was critical but stable. Jeff held her swollen hands, rubbed her swollen feet. They kept telling him there was nothing to do but wait. The risk was organ failure, but they were hopeful her body would start to recover before that became a reality necessitating further discussion.
On day four, she made the turn they’d all been hoping for. They took her off the ventilator, removing the hose from her mouth and thewhite straps from her face. It was then she opened her eyes and said to Jeff, in a raspy voice, “Hi.”
Jeff lost it then, burying his face in his hands and crying—not gentle, soft crying, but full-on blubbering. Jeff was usually so composed. This reaction, the massive bags under his eyes, told Gwen that whatever had happened was serious.
“Oh my god, I’m so glad you’re okay,” he said, his head hanging low against his heaving chest.
Had she ever seen him cry in the fourteen years they’d been together? She didn’t think so. Her usually stoic sweetheart, destroyed.
“What happened?” she asked, not sure she wanted to know. Maybe this amnesia, this obliviousness, was for the best.
“Where’s June?” she asked.
