how love smells

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I washed my hands in the restroom of a doctors’ office the other day and smelled it instantly. It lingered on my hands even after they were dry. The smell of that particular kind of medical antimicrobial soap, I will know it forever.

In a flash, for a moment, it is 7 years ago and I am back at the big sink outside the NICU, the one whose water flow is controlled by foot pedals. Or the sink inside, right next to my daughter’s tiny bed. The one only nurses are supposed to use, but which they let me use as well. That same soap. That same smell.

For a while it unsettled me to encounter it. Just over a year after my baby died in that hospital, I found myself at the sink in the bathroom of another children’s hospital in a city 2500 miles away. I had just interviewed for a job managing a research project in their NICU, and before returning to my car in the parking garage, there I was washing my hands and that smell… I almost collapsed as I watched the tears flow down my face in my reflection. In a daze I found my car, and I sat privately and cried, doubting that I was ready to be working in such a hauntingly familiar environment. Wondering if my desire to create meaning from the loss of my baby girl would be overpowered by the raw emotion of having so recently lost her. I didn’t get the job, and perhaps it was for the best. I would have been so good at it though. Good for the right reasons.

Then one day that same smell surprised me – in the moment that it went from being unsettling to comforting. It was February 2011 and I had come to the hospital to deliver the twins who had stopped growing mid-pregnancy inside me. They gave me – the grieving-mother-to-be – the largest room, the nicest room, and also the room furthest away from the other mothers (those giving birth to living children) in Labor & Delivery. I went to wash my hands at the big hospital sink and there it was… that smell. With tears in my eyes I said to my husband, “It’s the same soap.” And I just stood there and smelled it. I washed my hands at that sink many times that night, and the smell remained the strangest kind of comfort throughout.

The smell doesn’t haunt me now. Whenever I am in a medical office, I smell the soap to see if it is the same one. When I encounter it, I take the time to smell it, and I travel back for a moment and return to a time and place where my daughter is still alive. Where the possibility of her survival still exists. Where my entire purpose each day after washing my hands up to the elbows is to sit by her side and love her.

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I keep my baby daughter’s things in a wooden chest in our home. It’s amazing what accumulates from such a short life. Not just things she touched but things that came afterwards. Like the little shrine I made in her memory for Dia de los Muertos that first fall, with three friends who had also lost their babies. Like pictures her sister drew as she navigated her own grief. Like the shirt I wore at Tikva’s blessing way when I was still pregnant, the sweater that kept me warm throughout the second half of my pregnancy, and the nightgown I wore when I delivered her.

The tiny blanket that lay over her during those weeks is in a jar, along with the hat that covered her head when we took her outside to breathe her final breaths. The stuffed lamb and the stuffed duck that lay against her fragile body are in another jar. I open those jars sometimes and take a deep inhale. The smell is the same, a little musty but so familiar. Perhaps it’s not exactly her smell, and whatever it is has replaced the familiar in my memory because I would open those jars to smell it so frequently in the months immediately after she died. Like the soap, it brings me a tiny bit closer across the divide between the living and the dead.

****

It’s been more than 7 years since she lived and died. That’s a long time. And yet there have been times during those years when her loss feels especially present. There is no rhyme or reason to why and when that happens, it usually catches me by surprise. The loss of her is very present for me right now. It’s not a stabbing pain, more like a dull gnawing to remind me. I said to my older daughter the other day, “What do you think life would be like right now if Tikva had lived?” She replied that we probably wouldn’t have my son, her brother. She’s right. We always wanted two children and Tikva would have been the second. So this little being who came and went so fast and will forever remain a baby, she will eventually come to represent something to the little boy who came afterwards, her brother.

After Tikva died, on one of the nights of our shiva, as friends and family filled our home with love and food to share in our mourning, three amazing women came through our door. Two of them had been the midwives we’d worked with during my first pregnancy with my older daughter, and it had been years since we’d seen each other. The third was an acquaintance from many years before whom I’d gotten reacquainted with when I donated some of my breast milk for her baby. I had freezers filled with my pumped milk from the two months of Tikva’s life, more milk than she was able to drink through her feeding tube, and I wanted it to go to babies who needed it. This woman who came to our shiva with our midwives was one of them. It’s hard to explain the connection you have with someone who was able to nourish her baby with the milk you pumped for your own baby who is no longer living.

She walked into our home carrying a basket of warm muffins wrapped in a beautiful napkin, and I hugged her with tears in my eyes. She did not take her basket and napkin with her when she left, and they have followed us in the 7 years since. This little basket that is perfect for small corn tortillas, and this beautiful single cloth napkin.

And you know what? It is my son’s favorite napkin. He calls it “My Napkin” and it is the only one he will use, even when it is filthy and needs washing. He throws a fit if anyone else picks it up.

And I love that. I love how it is all connected – this baby who came and went too fast, this mother I reconnected with whose baby drank my milk, this napkin that has followed us from that time and which didn’t end up in the trunk of Tikva’s things, but instead fell into the hands of my son, the one who came into our lives as the culmination of everything that began when Tikva left us.

The connection between them all is love. It’s that same connection I feel when I smell that hospital soap. It’s in the musty smell inside the jars in Tikva’s trunk. It’s the connection to love – my love, the ones I love, the love from others. The smell and the feel of love.

 

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the way we birth

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When I was preparing to give birth for the first time more than 11 years ago, I made a birth plan with my husband and our midwives. I deeply believed in my birth plan. I was going to have my baby naturally and at home. I was going to eat and drink if and when I wanted to. I was going to walk around my apartment freely, unencumbered by an IV. I was going to trust my body and my baby to know how to do this. I was going to breathe, as I’d learned in our homebirth class, for as long as it took. I was going to avoid bright hospital lights and cold floors, doctors I didn’t have a relationship with. I trusted myself, I trusted my baby, I trusted my partner, and I trusted my midwives.

And none of that trust changed. But the plan did.

I did labor at home – for 32 hours. In between contractions, which were all in my lower back, I took occasional bites of bagel with jam and drank juice diluted with water. I sat on the exercise ball in the shower with scalding water aimed at my back for so long that I had scars afterwards. An acupuncturist friend came around hour 28 and put 16 needles into my lower back for the pain. I got to 8 centimeters but no further, for hours.

Then I looked at my husband and our midwives and said with 100% conviction and clarity, “I want to go to the hospital.” It was noon on a Tuesday.

I left the dark cocoon of our bedroom for the first time since the previous day at 5:30am to get into the car. It hurt. And the outside world – going about its business as usual all around me – felt surreal, like it was moving full speed while I was in slow motion. My sister dropped us off, my husband got a wheelchair that I didn’t use because it hurt too much to sit and I’d already been sitting for 20 painful minutes. I walked into the room and lay down on the hospital bed. I got an IV and a monitor was wrapped around my belly.

When the anesthesiologist walked in, it was as if an angel had just entered. “You’ve been laboring for how long?” “32 hours,” I replied. “Let’s get you that epidural. We’ll skip your blood work and get on with it.” All these years later, I can’t begin to describe the sensation when the medicine began to take away the pain I had been in for a day and a half. All I remember is relief, and the colorful woven hat that the anesthesiologist wore on his head.

Finally able to relax, I dilated to 10 centimeters and the doctor said I could push whenever I felt ready. Then she stepped back and let me do the work, guided still by my midwives. My daughter came out an hour later, pink and beautiful, head covered in black hair, right hand coming out “fight the power” style immediately after her head. She was pregnant herself, the doctor, 32 weeks with her first. She was a third year resident so less experienced than my midwives, who had between them attended so many births. She watched the whole thing, respecting the relationship I had developed with my midwives during my pregnancy, and the work I had done already at home.

My daughter almost did a flip off the little metal table as they checked her Apgar scores. They gave her tens, clearly this one was just fine. Four hours after she was born, the three of us were back home in the bed where I had labored. Parents. A radiantly healthy energetic baby who hated swaddles and slings and anything constricting from the second she was born. We were a family of three.

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With everything I’ve experience related to birth since then, I can’t help but view my first daughter’s birth through rose colored glasses. It wasn’t what I had planned, but it had turned out so well. Immediately following her birth, however, I gave myself a tremendous amount of grief that I had given up” and stopped laboring at home, that I had chosen to have an epidural and go to the hospital. I told myself that if I had just kept going, I could have had the homebirth I had planned.

I held this disappointment for two and a half years, until I took an 8-week midwifery course with one of the world’s most renowned homebirth midwives. I sat with her during one of our lunch breaks and told her my daughter’s birth story, and I asked her if she could tell me what had happened – why I hadn’t been able to progress past 8 centimeters no matter what I did, no matter how much time went by and how many contractions I endured, no matter what my midwives tried or what position they guided me to labor in. And her eyes got wide and her body got really still and then she popped out, “Deep transverse arrest!” “Deep transverse arrest?” “Deep transverse arrest! Go home and research that this week and you can teach the class about it when we meet again.” And I did.

A deep transverse arrest is when the baby’s head is engaged a little off in the pelvis so that its head doesn’t hit the cervix quite right. This means that the cervix, which relies on the pressure of the baby’s head along with the mother’s contractions to open fully, can’t open fully. My daughter’s head was turned just slightly, and her right hand was next to her left cheek for most of my labor (causing the painful back labor). Her head was engaged enough to get me to 8 centimeters, but no further. And with each contraction, instead of relaxing to open and create space for her to move, I literally contracted and tightened and she got more wedged in.

“You were right to go to the hospital and have an epidural, because then you could relax and make space for her slightly turned head to shift into the right position. Your body knew what it needed and you listened,” she told me, this decades-long experienced homebirth midwife. In that moment, all of my doubts and disappointment in myself dissolved and I felt peace.

****

It amazes me how much we are capable of torturing ourselves as mothers about the ways in which we failed to follow our birth plans, our supposed hopes and dreams for the beginnings of our babies’ lives. It amazes me how deeply my ego was invested in the outcome of my plan – and how much of it all is just that: ego. The idea that we can actually plan how our children’s births will go, that we have any control.

I planned two homebirths and had none. A few years after my daughter was born, I miscarried another pregnancy at 10 weeks. A few years after that, I was pregnant again with Tikva, and again I planned to birth at home. And again the universe laughed. Tikva was diagnosed in utero at 21 weeks with a life threatening birth defect. She would not only be born in the hospital, but she would be born in the operating room, so that a team of neonatologists, obstetricians, anesthesiologists and nurses could be prepared for anything she needed. So that she could be put on a ventilator within minutes of her birth because she wouldn’t be able to breathe on her own.

An hour into my labor, I asked for an epidural. My labor was short – just a few hours long – and for weeks after Tikva was born I second-guessed myself again, thinking I had not needed that epidural, could have birthed her without it. But this is the thing: In that moment, I was terrified. I was about to release from the safety and warmth of my body a baby I knew would not be able to breathe or eat on her own. Inside me, she had been safe – I breathed for her and ate for her and could hold and protect her; outside, she was not. She could live for just a few minutes after her birth, or she could live a whole lifetime – none of us had any idea what was ahead, and I was scared. And I was stressed. And I did not want to be distracted by the pain of labor. And I didn’t think this through in actual thoughts, I just knew. And I fell instantly in love with that anesthesiologist too, an amazing third year resident who was so gentle and precise, and who gave me just enough medicine so that I was still able to feel the moment when Tikva came out.

The second she was out and the cord was cut, she was whisked away through a window in the wall into another room where she was put on a ventilator and given paralytic medication so she wouldn’t destabilize herself. I would really see her about an hour or two later for the first time, intubated, feeding tube in her nose, IV in her arm. My beautiful girl.

And then, our real story together began. 58 days long and every day since she breathed her last challenging breath almost 7 years ago. For those few months we were a family of four.

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Three years later I was pregnant with twins. Twins! Twins that came to us with help and with work. Twins who were all promise, all hope, all healing – for their mother, their father and their sister. Twins who would bring a beautiful whirlwind of baby energy into our home. Twins who would be closely monitored to ensure a safe pregnancy, ultrasounds and amnio and bloodwork and frequent appointments. Ten weeks in, one of them stopped growing. At 18 weeks – on Valentine’s Day – I no longer felt the other one move. A few days later, I went to the hospital to be induced and 24 hours later I delivered my very small babies-to-be. And a few hours later, after holding the one who had grown enough that he was fully formed, only just the size of my hand, we left the hospital without our babies. These beings I had also labored to birth, whose ashes I would sprinkle on the same beach where I had walked during the very beginning of my very first labor so many years before.

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I birthed my son in my heart, and another woman that I will forever be grateful to conceived and nurtured and birthed him from her body. He came out 6 weeks early by C-section. He was tiny and he was perfect. He always breathed on his own and he learned to take a bottle in a few weeks and we brought him home. He never breastfed, but I nourished him with my love and formula till he was ready for food. Two years later, he eats like a teenager and is so heavy I can barely carry him.

And we have been, once again since his birth two years ago, a family of four, surrounded by the beloved spirits of the babies we lost.

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This is the thing: You may be able to set an intention for how you’d like things to go, and you may be lucky when it all goes “right,” but it’s all just so random and out of our hands. I thought I was responsible for how healthy and strong my first daughter was, that it was all because of how well I had taken care of myself during pregnancy. But then that means I was also responsible for how fragile and sick my second daughter had been. I have no idea why her diaphragm didn’t form correctly, and neither do the doctors. I have no idea why my twins didn’t make it, or why I miscarried all those years ago and again before we adopted our son. What I know now, though, is that when it does work out well, and that healthy baby is born – it’s an incredible amazing miracle of life. And that miracle is as arbitrary as when things go another way.

I cry tears of joy and relief every time I learn about a baby who has been born healthy. If I know a friend is in labor, I take a deep breath and I exhale when I hear that all went well.

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There’s a way we talk in our culture about birth after it’s happened, and I think that way is skewed. I’ve heard it from men who have witnessed and supported their partners’ labors, referring to the women as warriors because they labored naturally, at home in a birthing tub, without pain medication or medical intervention, and gave birth to a healthy 9 pound baby that immediately knew how to suckle and nurse. I’ve also heard it from women who have been through labor – talking, like I did, about the ways in which they felt they had failed – because they hadn’t been able to do it naturally, because they had needed help, or because their babies had died. So we are warriors if it goes one way, and we are failures if it goes another. Or we are warriors in the eyes of everyone but our own critical selves.

But this is the thing: We are all warriors. We are warriors when we birth, however we birth. We are warriors when we need help to birth. We are warriors whether or not we nurse. We are warriors whether we wear our babies or sleep with our babies; whether or not they sleep through the night. We are warriors when our babies are conceived with assistance. We are warriors when we are not able to conceive or carry a baby to term. We are warriors when someone else carries our babies for us. We are warriors when we miscarry. We are warriors when our babies are born still. We are warriors when we mother by caring for our babies’ graves. We are warriors when we choose not to have babies and we love in other ways. We are warriors when we are allies for other women. We are warriors in how we nurture the world.

We are warriors because, in some way, we choose to love. Whatever that love looks like. However it is birthed.

Happy Mother’s Day to all of the warriors out there. I hope you know who you are.

almost

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I wrote something on one of my earlier blogs about lemonade. It wasn’t really about lemonade; lemonade was just a metaphor. I wrote it almost four years ago about something that happened exactly four years ago today. I wrote it about the day I birthed twins who had stopped growing, one at 10 weeks and the other at 18 weeks. So I went searching for that post today to reread it, the first time I have reread it in at least three years. I didn’t wake up aware of this strange anniversary; I realized it a few hours into my day. I realized I felt neutral about it, not triggered, not emotional. I realized that four years feels like longer. It feels far away and yet I can bring myself right back to that hospital room where drugs administered through an IV slowly convinced my hesitant, mid-pregnant body that it was time to release my babies.

A lot of hope left me that day. Hope for the promise they brought after the loss of Tikva two and a half years before. Hope for siblings for my older daughter, who had waited for so long to be a big sister. I wrote that post with both sadness and bitterness, holding a white flag of surrender.

And yet hope came back.

I can’t say exactly how or when, but it came back, slowly, over time. We chose a different path to growing our family, to bringing into our fold another child to love and hold and help to become himself. There was a point when I let go of the need for that child to come from my body, and with that release came a calm I hadn’t felt since I learned about Tikva’s condition when I was 21 weeks pregnant with her seven years ago. And here I am, four years since I delivered two almost babies who had died, with a feisty, smiley almost-two-year-old kicking soccer balls and throwing footballs to his big sister, laughing as they tackle each other on the rug.

On February 22, 2011, I wrote:

You don’t get to love the way you think you’re prepared to, but you do get to love the way you discover you can.

Somehow even then I knew I needed to understand this, or at least come to believe it. And I was right.

I wonder what life would be like if three-and-a-half-year-old twins were running around the house right now. Or if Tikva had lived, and a six-and-a-half-year-old was playing with her older sister. I think of how I wouldn’t have gotten pregnant with the twins if Tikva had lived; how we wouldn’t have adopted our son if any of them had lived.

I think a lot about parallel universes that might exist side by side with the one I exist in; other roads I was on that did not continue because my life took one detour, and then another. What it would be like if… And if those realities are perhaps still happening somewhere in time.

I’m remembering those little ones today, my almost babies who got away. How much I wanted them and loved them for the time I carried them and held them. How different it is to mother them than it is to mother my living children. How I will love them always.

 

essence

I’ve been listening to podcasts a lot lately, mostly about the mind and our thoughts and how we work, and about science. The thinker in me, the cells in my brain love the stimulation. This morning as I made my tea and started my day, I listened to this one from Radiolab called Fetal Consequences. I can’t really stay away from a title like that, even if I know it might stir something up. And it did, but not in a bad way. More in an, “Okay, whoa!” kind of way.

The science, according to the show, is this: Fetal cells and maternal cells do not stay separate during gestation. In fact, fetal cells intermingle with maternal cells, and they remain in the mother’s body for decades, possibly an entire lifetime, after a baby is no longer in a mother’s womb. Even fetal cells from miscarriages, stillbirths, abortions. Even fetal cells from babies who are no longer here. Scientists studying what the role of these cells is in a mother’s body believe they can both help and hurt. Help in that they have been found in areas of women’s bodies who have an illness, say in the liver of someone with hepatitis. Hurt in that they may also contribute to auto immune conditions like arthritis.

I’ve been pregnant five times and I have one living biological child, my daughter, and my son grew in another womb. So my heart leaped at the thought that my babies’ cells remain inside me. I love that I carry a piece of those I’ve lost inside me and always will. It’s like when I learned years ago that all of our eggs are already in our tiny ovaries when we are growing inside our mothers’ wombs, so that for nine months of pregnancy we get to carry not only our children but also our grandchildren inside us.

For the part about how these cells might do harm? I’m not sure what to think, and the science is not conclusive about any of this. But I do have an auto immune condition, and I’ve always been intrigued to think that, in me, it happens to be located in that second chakra place close to my womb. It’s an emotional place for me, still marked by the faint vertical line that appeared on my lower belly during my last pregnancy, the line I was happy to see never quite faded completely after that pregnancy ended. A reminder that I carried them all, even if they are not all still here.

I wonder about my son’s birth mother, and what she carries of him, literally and emotionally, almost two years since his birth. What she may carry for the rest of her life. How he will remain in her.

How he has so quickly made his beautiful way into my heart, if not my cells.

I know there is still healing that remains. And I know that there is a way in which we never completely heal from the loss of a child. And that’s okay. In six and a half years since losing my daughter, and the losses before and since, I’ve learned not to force myself to be anywhere but where I am. I’ve learned that grief is cyclical and not linear, that it can be repetitive while it propels us forward even when it can feel like we are moving backwards. I’ve learned that I carry each of them inside me always, their essence, their spirit.

And now their cells.