Published on July 13th, 2021 | by Jessica Zucker


The discordant refrain of what-if what-if what-if?

My labor with Noa started gradually and progressed steadily. It rained that day, and I insisted on heading out on a hike in the hills in the early morning drizzle, with the hope of somehow getting things moving. By afternoon, contractions began, and as they quickened, my husband and I headed to the hospital.

Once we got settled in the hospital room, I recall hearing Jason talking with my doctor and the nurses, and moving about the room; I chimed in too. But the closer I got to the final stage of labor—transition—the more I required quiet and deep concentration. The intensity of the contractions demanded singular focus, most especially in those final hours.

I’d opted to forego pain relief. I had delivered Liev with the help of an epidural, but after experiencing the torment of delivering alone in my own home and the unmedicated D&C that followed, it became deeply important to me to bring this baby into the world while I was fully present, feeling it all. Soon after getting pregnant this time around, I realized how poetic and powerful it would be if I had the chance to give birth without numbing, without taking the edge off. I hadn’t really had an option as I labored through my miscarriage, but this time I’d have a choice, and I planned to embrace the pain willingly. There would be no fear of imminent loss this time. I wanted to feel my body go through this, and to bring about a new ending to the story I’d never intended to write at all. I wanted this birth— which I hoped would be a live one—to provide me with something reparative: the start of a lifelong relationship.

I spoke little, aware of the fact that if I left the steady confines of my mind, the physical pain might overwhelm me and propel me into another laboring direction altogether. The intensity of an unmedicated birth required stillness—I was in an internal, meditative state where I sat in silence on the birth ball. I stayed calm and quiet, inwardly facing the pain of childbirth with the knowledge that it was serving an important purpose—that each contraction was bringing me ever closer to meeting this baby of mine.

Pain is something we typically want no part of, be it physical or emotional, as it often signals that something is wrong, that something should be quelled. But not in this case. I went into labor with the mantra that in labor, pain is purposeful. Pain was a dance between my daughter’s body and mine, a necessary conduit to her entry into the world. I stayed the course, and did what I could to shut out the uncertainty—the question of whether or not she’d make it, if she’d be okay. Loss, after all, has that way about it: colors are muted, sepia tones wash over what would otherwise be a bright(er) landscape. As the hours passed, I continued in my necessary retreat inward, focused on my breath. This pain is purposeful, on loop. Breathe. In and out. This pain is purposeful. It is normal. Everything is okay, I’d silently encourage. I can do this, I’d reassure myself. We can do this.

And finally, there she was. My daughter. Just after nine o’clock in the evening, midway through a strong push, sweet Noa Raye came into the world, curious and calm, and mere hours after a rainbow so fortuitously glowed outside the window of my hospital room. My rainbow baby. Here. Safely. The little being who’d spent the preceding nine months growing, thriving, and kicking about inside my body. I’d spent those months in varying degrees of unrelenting fear, but within moments of catching her and bringing her to my chest, the energy swirling inside me began to shift. I exhaled. Not all the way, of course. What I’d lived through to get here was as poignant and real as ever before.

Immediately following her arrival, Noa snuggled up on my chest and began suckling. I was in awe of her. I lay back on the hospital bed, my girl cozy in my arms, and drank in this surreal moment: her vernix-covered body, the sound of her breath as I fondled her little toes, and the fact that I’d actually made it to the other side of pregnancy.

About thirty minutes after Noa’s arrival, the nurse brought her from my arms over to the counter to be weighed and measured. Suddenly, I was propelled back into a state of fear. I couldn’t hear Noa. “Is everything okay?” I asked, panicked as the nurse weighed her. “I can’t hear her. Why can’t I hear her? Is she okay?”

Even though Noa had made it earthside, my angst pressed on. In fact, it instantaneously morphed into something else altogether.

“She’s just taking it all in,” the nurse said lovingly. “She’s just looking around. Calm as can be.”

Gobsmacked by these feelings, I was truly taken aback that I was not in the all clear of these exhausting concerns, but I gently reminded myself to breathe. She’s here, on loop, she made it. These compassionate thoughts rivaled the discordant refrain of what-if what-if what-if that I had expected would be quieted upon her arrival.

I was suddenly face-to-face with the realization that yes, she’d made it through pregnancy and into the world safely—But how will I know if she’ll last?! It was unnerving to witness myself transferring the fear from pregnancy to newborn in real time: Maybe she was safer on the inside, I pondered. Perhaps the pregnancy worry was a waste after all, and what I should have been even more concerned about was her staying alive upon delivery.

I didn’t see this coming: the next dimension of trauma. What I’d have to see through experience was the fact that what I’d thought was the finish line was actually the start of another marathon altogether.

I’d heard stories about sudden infant death syndrome and rare, fatal diseases of babies within the four walls that make up my office, but only now did those narratives make their way into my bloodstream via cortisol, into my now-deepening well of worry.

Photo by Jenna Norman on Unsplash

As time went on and Noa grew little by little, the way I thought about my loss and the fragility of mortality morphed. With this darling daughter of mine earthside, I couldn’t help but study her in deep awe, marveling about the fact that this beautiful person wouldn’t have joined our family had my first daughter made it. Such a mind-bending, existential road I had found myself on.

Navigating motherhood in the wake of Noa’s birth was, for a time, excruciatingly uncomfortable. It was as if a piercing alarm bell had gone off and was ringing at a pitch no one could ignore: the sound was a constant reminder about the vulnerability of life. No amount of thick skin could be located. It was all just too raw. Anything can happen at any time, I’d think. Where had my capacity for denial gone? It was one thing to parent Liev after my loss, but now with two little ones underfoot and a world of angst brewing inside, I struggled to maintain a sense of calm.

In those years when Liev was our only child, I was free of this great worry, but now, with two lives to raise and protect (and the loss under my belt), I found myself deluged by hypervigilance—deeply porous and more anxious than I’d ever been before. The cacophonous symphony of what- ifs was a constant, and fear-based thoughts popped in at inopportune times. Autopilot and denial eventually kicked in to help me master my days as a mother of two, but it took a while before I could quell the sound of those alarm bells that were ringing all too often, robbing me of the poise I’d had when I was a mother to one and no other. Post-loss motherhood: a whole different ball game.

Photo by Alex Jackman on Unsplash

As time moved forward and my feet steadied on the ground, I finally had the chance to fully relax—to unclench my teeth, release the morsels of antagonistic anxiety, and marvel at Noa’s existence in a state of peace. I fell hard in love with her, and Liev was taking his newfound role as big brother in stride. I was feeling much more like myself and was well into the swing of my clinical practice again. I was back in the saddle. But on occasion, something seemingly mundane would flip a switch, and I’d find myself thrust right back into that post-trauma, distressed state of mind. Seeing this in my patients was one thing—I knew how to reassure them that what they were feeling was, in fact, normal—but when it was me, knee-deep in flashbacks or flooded by anxiety, I had a difficult time deciphering up from down, left from right, what was real and what my anxiety was manifesting.

Our grief doesn’t dissipate overnight, nor are our feelings about what we’ve lost replaced by the overwhelming love of those resting safely in our arms. Life doesn’t replace death. It doesn’t need to, and it simply can’t. And since the existence of one child does not negate the loss of another, why does culture—with its wonted way of focusing on happy endings—demand that we turn our backs on our grief to serve our well-being? We needn’t succumb to this insidious unspoken pressure.

And so was the case with me. Noa’s arrival was a monumental turning point, but the months that preceded her birth were sullied by an awareness that anything could go wrong at any time, and my resulting worry that surely something would, even after she entered the world. Noa’s birth was pivotal and deeply healing in that sense, as was the subsequent opportunity to reflect on the fact that we’d made it through every single one of those harrowing weeks of her development, and that I’d done so without having to relive the horrors of what had happened to me such a short time ago. There’d been no blood, no early labor, no unassisted home birth, no traumatic loss. Instead, only the good, the predictable, and the expected transpired in that pregnancy and there in that hospital room. Noa’s birth was physically intense, of course, but I had welcomed the opportunity to feel every twinge of pain. I’d gotten the reparative birth experience I’d yearned for and trusted my body through it. This pain is purposeful. I had the chance to be present in mind and body with a positive outcome, the way I was when the outcome was bleak, with no choice in the matter. An outcome so confounding it is still hard to find the perfect words to sum up. This time was different.

One of the most insufferable and surprising parts of grief is that one moment we can’t stand to feel our sadness for another second, and the next we are scared of ever losing the intensity of that feeling. That somehow the passage of time, and the eventual lessening of the sting, is an affront to the memory of the one we lost. This thought pattern is common among the bereaved, but the dichotomy is even more intense after a pregnancy loss, because there are so few who knew the lost one—sometimes, of course, the pregnancy isn’t even known until after the loss occurs. To let go of grief can feel like letting go of memory, and if we alone bear the burden of those memories, that can be a terrifying thought. So then why not allow grief to stay, even as time moves forward and joy returns? The pain is purposeful. I learned that I didn’t have to choose.

In acknowledging that death is as big a part of life as birth, we recognize that sometimes intense gratitude and unconditional love commingle with fear, overwhelm, and angst. And in so doing, we let go of that strident, fantastical notion embedded in our culture that the birth of one baby somehow erases the complex feelings of having lost another. Replacement isn’t a thing when it comes to pregnancy and human beings. We find, then, that it’s imperative to extinguish the idea that the existence of good negates
all that which has been painful in the past. Trauma is like tar, sticking to our innards, affecting so many things, from the way we physically move through our environment to the way we psychologically process the world. We must hold both. Even if we don’t feel capable of managing both, we can and we will.

Moving into this headspace ever so subtly changed the way I practiced as a therapist. I relished the three-month maternity leave: to bond with Noa, to foster a connection between my children as siblings, and to familiarize myself with my reformed mind, now mothering two. In that still-inchoate time—milky and sleep deprived as I was—I knew that steadying my anxious tremor was paramount to a successful return to the workforce. Clearly visible in my rearview mirror was the hasty return I had made after my miscarriage, and I wasn’t about to do that again. So I made sure not to rush. And I made sure to sink into this new life of mine—as a family of four—with the deep imprint of what had come before and the grief that was born of it.

Photo by Jan Canty on Unsplash

When I made my way back to work, I felt well—a much-welcomed and marked distinction from the way I walked back in after my loss. Interactions with my patients felt measured, and I was back to being focused on their stories without a recent and similar narrative of my own hovering in the background.

Compared to the return following my miscarriage—that abbreviated moment where I hardly even took in what had happened—this time, in hearing their stories and sharing their grief, I felt sturdy. I felt encouraged and validated by the way my experience had changed me. My loss quite lit- erally helped bolster my ability to understand and relate to my patients in ways previously relegated strictly to the theoretical. After Noa was born, sitting with my patients—no longer pregnant, with no plans to be again—I was able to sink into my work with aplomb. And, I noted, the fact that new patients meeting me for the first time would not have to encounter my burgeoning belly (or the chaos of my loss) no longer rendered me as a potential trigger for those walk- ing through my door. This brought enormous relief. A new chapter was underway.

Reprinted with permission from I Had a Miscarriage: A Memoir, a Movement by Jessica Zucker. Used with the permission of the Feminist Press. Copyright © 2021 by Jessica Zucker.

Feature image by JJ Jordan on Unsplash

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About the Author

Jessica Zucker is a Los Angeles-based psychologist specializing in reproductive and maternal mental health. Jessica’s writing has appeared in The New York Times, The Washington Post, The Guardian, New York Magazine, and Vogue, among others. Dr. Zucker is the creator of the #IHadaMiscarriage campaign. Her first book I HAD A MISCARRIAGE: A Memoir, a Movement is now available (Feminist Press + Penguin Random House Audio).

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