Sometimes loss is involuntary, sometimes voluntary, sometimes both. The story written below is an exceptional case where the emotionally nondescript loss of a child (simply because there are no words that can capture that loss) was realized as a result of a decision to terminate a pregnancy. Although this particular story also has its share of the more traditional veins of infertility discussed on our blog, the impossible decision of whether to continue a pregnancy, after experiencing difficulty in conceiving, or terminating the pregnancy in an effort to prevent undue suffering and hardship on the unborn child is something unique to our electronic pages. It is easy to say, “Every pregnancy should be taken full term” or “Life starts at conception” or “It is a woman’s right to choose;” however, the gravity of the decision itself must be something that requires nearly identical experience for true empathy. This contributor has captured the common thread that has been woven through the story of her life as it relates to having a family, keep moving forward toward your dream. With that I we will pass our blog over... I have two words available to me to describe what happened: “Miscarriage” and “abortion.” Neither one fits. I have always known something was wrong with my “plumbing.” My periods began at the age of 11, and not long afterwards, my cycles were marked by missed school days, black-out level pain, time in bed with a heating pad, mass consumption of OTC painkillers, and blinding headaches. Although my gynecologists (most of them male) would tell me that such suffering was “a woman’s lot in life,” part of me always knew that something was wrong, and I suspected conception may be elusive for me when the “right time” came. However, the “right time” would not come for quite some time. When I finally found “the one,” he was given a cancer diagnosis a few months after we were engaged, and we began attempts to conceive immediately afterwards. Gratefully, he went into remission two weeks before we walked down the aisle together, and I married my very best friend in the whole world when I was 29. We both knew we wanted to be parents. We spent the first few years of married, cancer-free life trying to time conception for a summer birth, as baby-making can be a complicated and career-compromising move for female academics. After the first few years of strictly timed conception, we decided to broaden our window for a winter birth. And then, when the completion of my dissertation seemed imminent, we began year-round conception efforts. After 2 more years of disappointment, we agreed that there was likely a problem, and after some initial testing proved inconclusive (though all signs pointed to me after a normal semen analysis), we would pursue the matter further once I secured a salaried job as a professor. Graduate school was a difficult slog for me, and in addition to the awful menstrual periods and massive mood swings that accompanied them, I developed migraine headaches that came 5 or 6 days a week. At the time, my neurologist prescribed Depakote (a prophylactic medication). Though we were both aware of the drug’s status as a Category C, my neurologist reassured me that if I did conceive, my headaches would likely cease, and we could rethink my drug regimen then. I was grateful to get a bit of a break from the near-constant pain, and I felt satisfied with my physician’s care. Thankfully, I was extended a contract for a tenure-track job as a professor during the year I’d planned to finish writing and defend my dissertation. I happily signed on the dotted line, and returned to the writing process with a renewed sense of security and excitement for our family’s future. We set our cross-country move date for early July, immediately after the closing on the sale of our home. When we arrived in our new city, and finished unpacking the first handful of boxes in our new home, my husband was called away for a business trip. After his departure, intense rains and major flooding began in the area. While our home was not flooded, the acreage behind our house filled with water, and began to look more like a small lake than grassy prairie. Many of the roads in and out of our rural neighborhood were blocked. I awoke the morning after my husband left to painfully swollen and stiff legs. Doctors at Urgent Care told me it was likely “in my head” and “stress from the move.” The swelling went down after a few days, and my husband returned home. I can recall casually remarking that I had not had a headache for what seemed like weeks, which prompted my husband to ask, “When did you last have a period?” I could not answer the question, but I knew I’d been woozy in the mornings, and constantly exhausted, for many weeks. We immediately went to the drug store. Two pinks lines. Screaming. Crying. Disbelief. I called the doctor for an appointment to confirm. A few days later, and I found myself in stirrups in my new gyno’s office, watching a tiny heartbeat flutter on the screen. I was told I was roughly 8 weeks. I wept tears of joy. I was afraid to negotiate the demands of my new job alongside a developing pregnancy (PREGNANT!), as I knew many young academics were expected to work 60+ hour weeks in the first year of their career. But when I heard that beating heart, and saw the little mass in my belly squirming on the screen, I felt it was meant to be, and we would figure it out, because that is what families do, and we were (and are!) deeply in love with one another. After the ultrasound, the doctor began to ask general questions about my health, and I can remember watching her eyes widen as I told her I was taking Depakote. She asked if I was aware that it was a Category X drug. I corrected her, and told her my neurologist had assured me it was Category C, and not problematic in the first weeks of pregnancy. She reasserted the drug had recently been reclassified to a Category X, and referred me out to a maternal fetal medicine specialist. Because the matter was deemed “very urgent,” I saw him within three days. He reiterated the gyno’s concerns, and went into more detail: Risks included lowered IQ, autism spectrum disorders, and heart defects that if present, would quite likely require multiple surgeries on a newborn body. My chest slowly filled with terror, and my stomach sank into my knees. He reassured me that all pregnancies involved “some risk,” and the ultimately, the matter was “in God’s hands.” As an agnostic, this was far from reassuring from me, and caused me to seek out a second consult with my gyno. She admitted the pharmaceutical exposure could mean lifelong cognitive and physical difficulty for my child were I to carry to term, and because I was through the bulk of the 1st trimester, the “damage had been done.” When I asked what she would do if she were in my place, she frankly told me that “certainly, I would consider terminating the pregnancy. But given your history of infertility, I can understand this being a difficult decision for you. Only you can decide what you feel is best.” I was absolutely crushed. My husband and I wept, held one another, and talked into the wee hours of the night. We resolved that we would make a decision about the pregnancy after consulting some additional medical literature and thinking the matter through over the course of the coming weekend. After researching and deliberating for roughly two days, I knew: Carrying this pregnancy to term would be a selfish decision. The medical literature pointed to a very high level of risk for Depakote-exposed fetuses. Many children born exposed had IQs between 60-80. Some infants perished under the stress of multiple heart surgeries. It seemed a selfishly cruel decision to force such circumstances upon a new life. At the moment, this would-be infant was a small quivering mass in my abdomen. We resolved to terminate. I can recall watching the beating heart on the ultrasound again at the abortion clinic. The doctor informed me I was measuring at roughly 11 ½ weeks (mind you, I had been only 8 just days before), and was lucky I came in when I had—though I was no longer a candidate for pharmaceutical abortion given state law, and would have to undergo a surgical procedure. When I returned for the procedure the next day, the physician who came in to speak with me about the process was another man entirely, whom I had never met. He was almost surely over the age of 80, with tremoring hands, a gruff voice, and a brusque demeanor. When I said I wanted the physician I consulted with to perform my procedure, he told me “there’s the door, and you may leave if you wish.” I thought better of the trauma of more waiting, mumbled my consent, and asked for the anesthesia to be administered as soon as possible. After what seemed like the blink of an eye, I awoke on a hospital bed, and was being wheeled down the hallway into a sheeted recovery cell. I was not fully conscious, yet I remember screaming: “I wanted this baby! I wanted this baby so badly! But I was lied to! I should not be here! You come here when you make babies you do not want! BUT I WANTED MY BABY!” I was left alone in my bed behind a 4-way curtain, and I continued to cry and mumble in my half-conscious state. The woman in the bed next to mine reached her hand from behind the sheet, and asked me to put my hand in hers. I did. She squeezed it tightly. I sobbed and wailed. She soothed me, and stroked the back of my hand with her soft thumb. I slowly came to my senses, and we left together, dodging the protestors shouting in our faces, holding grisly images, and shoving baby booties at us. I snarled at them, pointed, rose my voice above theirs. They stepped back. My husband offered my new friend a ride home when she tried to part ways for the bus stop. Her inner-city neighborhood looked like a Syrian snapshot from the nightly news. She grasped my hand again as she exited the car. I wept again. We went to the Waffle House for lunch. I went home and sobbed in bed until I slept. I started the first day of work still bleeding from my procedure. One of my three colleagues announced her own pregnancy, and I watched her belly swell through the first year of my new position. When her son arrived, I delighted in holding him and watching him grow. And I thought constantly about the little one I lost—so much, that I nearly lost my mind when my beloved dog passed six months later, and I realized that work and stress and obligation began so quickly, I never truly mourned the loss of my child. My life had not allowed the time for it. I walked through my days feeling like my mind was full of broken glass, and my heart would burn a hole through my chest. We resumed our conception efforts after roughly 8 months, but when another year of trying brought us no resolve, we sought help. 4 failed IUIs, 1 failed IVF, and yet another failed IUI set me on a relentless search for answers. I had a known endometrioma (identified via transvaginal ultrasound), but no diagnosis of endometriosis. My reproductive endocrinologist insisted surgery would diminish my ovarian reserve to the point where conception would likely become impossible. He insisted another, immediate round of IVF would bring success. I was skeptical, given my inexplicably low retrieval and fertilization rate. A second consult with an endo-specializing surgeon brought me the opinion that without surgical intervention, my egg quality would remain so poor that I would continue to suffer chemical pregnancy after chemical pregnancy (indeed, I’d had 3 or 4 by that point), and I would likely never experience a successful implantation without surgery. After deciding the next step would be either donor eggs or adoption (rendering my own eggs useless anyway), I elected to have my endometriosis removed via surgical excision. The surgeon found advanced disease over nearly all of my abdominal organs and pelvic muscular structures. I was a “Stage 4.” It took weeks to recover. My menstrual symptoms, mood swings, and headaches improved almost immediately after surgery. And despite my reproductive endocrinologist’s firm objections, I had another chemical pregnancy 3 months post-op, and conceived and carried to first heartbeat and beyond the following month. Currently, I am writing with a laptop precariously balanced on my growing belly, and am 4 months pregnant with my daughter. I am now 36, and filled with the most profound sense of gratitude. It is unlike anything I’ve ever known. When prompted, I simply say that I “miscarried” three years ago. However, that narrative doesn’t quite fit. Nor do the ugly connotations of the word “abortion,” which unfortunately, still carries a good amount of stigma and is terribly misunderstood, twisted by political pundits, and abhorred by religious conservatives. There is no language to describe the horrible decision one must make to terminate a pregnancy that was very much, desperately wanted, and loved in a profound way. I found no refuge in the infertility community, and learned the hard way that I had to keep my story to myself, else I risk the charge of not “valuing precious life.” However, 99% percent of the time, I know I made the right decision, and I made it precisely because I do value precious life. I have no regrets regarding my decision to terminate my pregnancy, though I mourn the loss deeply. I also have no words to speak of my experience that will not flatten me into a stereotype. There is no way for my husband and I to easily signal our pain and loss to others. Even if such language existed, it would likely be misinterpreted by political conviction, stereotypes regarding women who have ‘unwanted pregnancies,’ religious belief, or lack of empathy. I wanted that child very badly, but I also wanted to prevent a lifetime of suffering for a child-in-the-making. Although the experience was an awful one, it taught me that the world is a complex place that will continually violate any expectations humans have for a simple, black-and-white morality. I’ve also learned that much of my experience lies outside of simple narratives and reductive frameworks. I’ve learned the limits of “unconditional love,” and that I must exercise serious discretion with who I can trust with my experiences and decisions (there’s a select few!), and who it’s perhaps best to keep at arm’s length. I’ve learned the limits of “community.” I’ve learned about my own tenacity. More than anything, I’ve learned that I love this small, growing girl-child inside my belly more than words can possibly convey, and my greatest hope is that I will meet her as her mama in roughly 5 ½ more months.