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Lifelines and Deadlines
“Are you sure you should go?” my mother asked. Yes, I was. Positive. A family friend had just lost her newborn. How could I not go, unless my presence at the funeral would disturb her too greatly? But I had been assured this was not so: the grieving mother would not be undone by the sight of the visibly pregnant, and would rather have more people, not fewer, with her to remember her own child’s brief life. So I went.
The child had died of SIDS. The coroner said there was nothing that could have prevented it. It was just one of those things. The grieving mother, though, believed the truth might be otherwise. Hers had not been an ideal pregnancy from the start. She had made choices that she now wished she could unmake. No one could wish to add to her grief by agreeing with her, at least not during a time when the grief was so fresh. But her regrets were understandable ones.
She had smoked during pregnancy, and drunk far more than even those who permit alcohol during pregnancy allow. Perhaps surprisingly, in light of the smoking and drinking, she had followed her doctor’s advice to discontinue her asthma and antidepressant prescriptions when she learned of the pregnancy – and she stayed off those prescriptions, faithfully, for the entire duration of the pregnancy, no matter how bad things got. Would she have smoked and drunk less had she not stopped her prescribed drugs? The likelihood that she would have bothered her.
There were other sources of regret in her past, too. She had fallen pregnant while engaged to her fiancé, but not married to him. In fact, their wedding plans had to be canceled because of their child’s funeral plans. Youthful misadventures, including a previous abortion, had left her with scars that may have affected her child’s growth in utero. For a while, she had openly wondered whether she should just abort again, though not even her closest relatives could tell whether it was really her talking at the time, or just the lack of meds. Nonetheless, once her baby was born, it was greatly loved. Doted on. Adored. And then … gone. Dead.
Mine hadn’t been an ideal pregnancy from the start, either. Tubal pregnancy symptoms are nonspecific, and while I suspected my symptoms had another cause, my OB disagreed with me strongly enough to order me to drive straight to an ER one afternoon for an emergency ultrasound. There, if the ultrasound revealed a tubal pregnancy, the pregnancy would be terminated. I remember sitting on an exam table, heels kicking the drape of crinkly paper as I stared at a green wall, wondering how much a termination would feel like taking a life.
Like the grieving mother, I had done what’s considered the responsible thing and curtailed prescription drug use upon learning of my pregnancy. Like the grieving mother, that included greatly reducing asthma treatment (I could not stop it entirely) and discontinuing an antidepressant. And, like the grieving mother, I found the effects unpleasant – unpleasant enough to do some drinking of my own, though my tipple of choice was coffee, non-decaf. Pregnant women are advised against caffeine consumption, too, of course, but compared to other migraine drugs, including the fairly “conception friendly” antidepressant I was nonetheless instructed to stop immediately upon learning of pregnancy, caffeine may the most pregnancy-safe anti-migraine drug out there, with a long history of mostly unproblematic use. And clearly, my attempts to “just tough it out” unmedicated weren’t working terribly well.
Even with the sweet, sweet caffeine back in my system, it took through the second trimester to recognize those ineffable — and shameful — urges to hurl myself (and my unborn child) off a cliff closely coincided with periods of reduced lung function, a riddle only solved by increasing my drug use, knowing that doing so came with some as-yet poorly-understood risks to my child.
So, like the grieving mother, I know what it’s like to find pregnancy intensely distressing. Unlike the grieving mother, I couldn’t picture myself living with an abortion — although, again like the grieving mother, abortion was briefly, but memorably, the choice before me during the tubal pregnancy scare. And unlike the grieving mother, I conceived under sociologically auspicious circumstances: I was already married; I had not known the sort of youthful misadventures that might impair reproductive health or attachment to a spouse; my husband and I had already been saving up for children; and so on. I had the luxury of blaming much of my distress on the unnatural state of my being alive in the first place, rather than on the “bad things” I’d done. The grieving mother had no such luxury.
I call it a luxury, but a moralist might counter that it was a luxury I had earned. After all, I had stuck more closely to the precepts of clean, chaste living in my youth than many young women do these days. Even those who doubt chastity’s spiritual benefits acknowledge it’s a straightforward, if now rather awkward, means to avoid some practical calamities as well. Modern technology can do much to prevent or repair the physical damage from sexual adventures. But a few unfortunates, even today, will, like my family friend, find their very bodies permanently scarred.
Unfortunates is a key word, though. Vast swathes of humanity, as long as they’re reasonably prudent, will suffer no tangible calamities from past vices. By contrast, for every risk I may have avoided inflicting on my child by avoiding traditional vices, it wasn’t hard to think of another risk I imposed on my child through the consequences of other, albeit less traditionally disapproved of, choices (like, for example, the choice of someone like me to marry and try for children in the first place).
Well, time passes and probabilities collapse into specific outcomes. The grieving mother’s beautiful, beautiful child, a porcelain doll come to life, was born in distress and sickly from the outset. My child entered the world uneventfully and in robust health, despite a risky pregnancy. Her child died. Mine has not. It might be tempting to ascribe these different outcomes to differing moral choices, but it’s probably more honest to say that both of us imposed about the same amount of risk on our children, just in different ways.
Once my own child was born, of course I went through all the motions of SIDS risk reduction. Of course I had her child’s death to motivate me. And of course I proved far from perfect at risk reduction, despite that extra motivation. Never fall asleep with your child? Never leave your child unattended, even briefly, with loose bedding or clothing? Yeah, that’s not gonna happen. Seeing that these things happen less is about all I run to. And there are some risk factors no child of mine can ever avoid, despite my having avoided several risk factors the grieving mother hadn’t.
SIDS is rare enough that even an increased risk of it is still small; nonetheless, as the grieving mother realized all too keenly, knowledge that you’ve increased the risk to your own child becomes devastating if the risk ever materializes. My child is past the six-month mark now, and so well past the peak of the lognormal distribution that characterizes SIDS death by age. During the time when my child’s SIDS risk was highest, what I feared most wasn’t his death, since I knew how unlikely it was, even at peak risk. What I feared most was my culpability, should the worst come to pass.
We rarely do all we can to prevent awful things from happening, and that’s not just because we’re irresponsible. Not being maximally risk-averse is also sensible. But then when the worst happens, we must find a way to live with the knowledge that we didn’t do all we could. No matter how good you’ve been, no matter how bad you’ve been, no parent is immune from this state of affairs. As a population, the good may earn better outcomes than the bad, but at the individual level, any number of things can render “virtue rewarded and vice punished” meaningless.
The grieving mother’s story has had a happier ending than it could have had. It’s a bit optimistic to expect an engagement to survive the death of a child, but hers did, and not too soon after the funeral, she and her fiancee married quietly at the registrar’s. It wasn’t the dream wedding she had planned, but it was marriage, and now that they’re married, they’re having more children. Life goes on, and perhaps her grief will find redemption in making different choices for the children she has now.
Infant mortality is now so low in the US that a child dying after birth has become an exceptional, rather than mundane, tragedy, which only heightens the sense of culpability when it happens. Yet what we’re responsible for is the risk we choose, not the sheer dumb luck that lets one person escape likely disaster while inflicting on another unlikely tragedy. Robert F. Scott, Antarctic explorer, wrote just before his death, “We took risks, we knew we took them; things have come out against us, and therefore we have no cause for complaint, but bow to the will of Providence, determined still to do our best to the last.” Being a mother means the risks might come out against your innocent child instead. While it’s no cause for complaint (it’s just how thing are, after all), it will cause guilt and grief. And no matter how disastrous our past choices, there’s no help for the past but to bow to the will of Providence, endeavoring to do the best we can from now on, even when the aftermath of past disaster can be neither escaped nor rectified, at least not in this life.
Published in Group Writing
This post was originally drafted for the April 2016 Group Writing Deadlines series. It was, however, not finished in time, put on hold till Mother’s Day 2016, and then not published for Mother’s Day, either, since it seemed too much of a downer. It’s just been sitting in my drafts folder until now.
Many thanks to anonymous for introducing me to Scott’s meditation on risks.
I wish I had more to add, but I am at a loss at the moment. I’ll just say this is beautiful.
That’s beautiful, Midge.
The gamut of issues that can go wrong just rushes in on any new mother worth her salt. Well written even if the topic just plain stinks. It’s real and it’s life and it’s good that you shared.
You’re a model of self-effacing modesty in a really difficult situation, Midge!
Some thoughts occur to me reading your reflections. It seems, however, that we now think our arts and sciences can conquer chance–that knowledge is power–that, consequently, we are morally responsible for terrible things. It is not the suffering of losing something, but a new form of guilt–partly the religious guilt of behaving badly, which resists our knowledge that our actions do not control the future, and partly a new scientific form of guilt–not having enough power to protect ourselves and our own from unpredictable or uncontrollable events.
Yes, I think you’re right.
Nicely done, MFR. And may I say, way to be a friend to someone who needed it.
A poignant tale.
Thank you.
This is amazing.
Midge,
A prayer for you. A prayer for your son. A prayer for your friend.
May the Lord bless each of you and hold you in His heart.
Remarkable, Midge. Thank you.
Thanks for writing this, Midge.
This is so familiar to me — my wife is stuck on anti-seizure meds, and we lost two pregnancies between our second and third children. The meds’ risks are low but non-zero, and the resulting guilt to go with the grief was overwhelming.
And she really is stuck on the meds — Grand Mal seizures popped up in every unmedicated period, both deliberate and accidental. Plus one hellish summer when she built up a tolerance for the safest med available (phenobarb) — five (5) GM seizures in three months.
Oh, I am so sorry.
I’ve heard these days, some folks tell anxious mothers to think of medicines necessary for the mother’s health and functioning as “like pre-natal vitamins” – necessary for the ultimate health of the baby, too, and so nothing to worry about. But that doesn’t get it quite right, either. As you say, the risks are low but non-zero.
Thanks for sharing such a personal and informative post. God bless.
Big, big sigh of relief.
Thank you, Midge, for this post. Prayers for your friend.
I don’t have children, and am in awe of people who do. When one of my nieces was a toddler, I was the primary person watching over her at the moment, though there were others in the room, I was standing directly behind the chair she was standing on, so it was my job to make sure she didn’t fall off of it. I failed. The chair was directly in front of a computer, and my eyes wandered to the computer for half a second-ok, maybe a second or two, but no longer, and she fell. I immediately started sobbing and ran from the room. Her parents were very kind and understanding, and assured me that the same sort of thing had happened to them; once, her mother got distracted for a few seconds and the baby ended up taking a tumble down the stairs.Days later, her mother was still shaking and in tears over it. It is just not possible for any human being to keep their child safe 100% of the time. Most parents are lucky, but sadly, a few aren’t. God Bless all parents: God Bless those who can live with such crushing responsibility.
A beautiful testament to motherhood and accompanying fears and challenges. Thanks, Midge.
I was trying to listen to a pod-cast and read your post at the same time until I realized I hadn’t heard a word of the podcast, so I quit listening, and just read. That was gripping. I have two boys, now twelve and ten, and they still terrify me with the crazy chances they take. I had both in my late thirties, by which time I was convinced that I would never never be able to. I am so grateful for them.
Ditto here, Midge. Brilliant and touching writing on your part. Things happen, no matter what you do to prevent them, and self-recrimination in these circumstances, however tempting to indulge in, is a road straight to despair. We must forgive ourselves too.
Very true. Sometimes we do everything correctly and things still go against us. But modern medicine gives such surety of actions and consequences that it does leave us with guilt when life happens.
I remember reading the final column by the editor of a healthy living magazine (I forget the particular one) – by the time it was published he had died of lung cancer at the age of 65. He never smoked, never worked with asbestos, and was a runner. Cancer got him anyway. His last column said, essentially, that doing everything right only improves your odds, it guarantees nothing. He encouraged his readers to take cheer and keep trying anyway, not everything bad is your own fault.
I lost one in the first trimester, lima bean stage, due to nothing I had done. It was just nature correcting a problem but was heartbreaking even though it hadn’t developed into human form. The nurses’ station listed the reason I was there as “spontaneous abortion.” That made me feel guilty even though this is quite common. For the rest of my life, I must answer the question “Pregnancies/Life Births” on doctors’ forms with 3/2, the same way a person who has had an abortion answers the question. However, I was finally able to have a second child and she is such a blessing and a great mother to a cute granddaughter.
I lived in fear of SIDS, and so do my daughters. Worrying about what you eat and drink, smoke, take, etc, does not end with birth if your baby has allergies and you breastfeed. Every meal is an opportunity to upset the baby’s digestive system if you let some allergen slip into your diet.
Creating new life and raising it to be a moral, responsible citizen is life’s greatest challenge. Not only is it hard work, but the possibility of great sadness when something goes wrong is always there. Too many young people pass on kids or limit themselves to one these days, especially the college-educated ones pursuing careers. Perhaps abortion has planted the idea that children are an inconvenience.
I’m puzzled why you would stop athsma meds. As an athsmatic myself I never quit my medication through my 5 pregnancies and for the 4th the Dr actually doubled my dose which helped me quite a bit. When I asked about it during my 1st pregnancy, that Dr simply said ”We like our mothers to breath.” I’m not sure I would have survived without it.
I cannot speak for why our family friend stopped her meds entirely. It is a mystery to me, especially how she managed to smoke more at the same time.
In my case, I was on such astronomically high doses of asthma meds before pregnancy that the reduction was merely to what’s considered the standard dose. I never quit taking asthma meds – they were just hoping I could cut back to something more “normal”. (I am back to something more normal now, but cutting back had to wait till after the kid was born.) The adage I eventually became quite familiar with is, a third of asthmatic women get better during pregnancy, a third stay the same, and a third get worse. If you think about it, a one-in-three chance of needing less asthma control during pregnancy could well be worth trying out: after all, it’s a time when it’s supposed to be extra-important to only put meds in your body if you really need them.
Mast cells and inflammatory, or immune, response play an important role in female fertility and pregnancy. It’s not obvious, for example, that the mast-cell stabilizers you use for your own personal comfort while not pregnant, are best for the baby if you are pregnant, assuming you can stand the discomfort of doing without. Similarly, steroid drugs are potent, and there’s some reason to believe exposure to even the minuscule amount in circulation from inhaled steroids creates some developmental risk for the child, making it best to minimize the amount if it can be done so without making the mother’s asthma appreciably worse.
Uncontrolled asthma is worst of all, but asthma controlled without being over-controlled is best.
Will I try cutting back if I get pregnant again? No. Or, if I try (since every pregnancy is different), I’ll be much quicker to stop trying if it makes me miserable. Or, to be more objective about it, since it’s pretty natural for pregnancy to feel rather miserable even when everything’s going great, if peak flow deteriorates.
I feel for you.
Up to 50% of fertilized eggs miscarry, although many before the woman even realizes she’s pregnant. And yes, I do think moral horror at elective abortion cannot help but influence how we feel about miscarriage and abortion induced for true emergencies (like tubal pregnancy).
Maybe it’s not just abortion creating the impression that children are hella inconvenient. It’s also all the precautions “good mothers” are supposed to take these days.
As you observe, the modern “good mom” is almost expected to live in fear, worrying about breastfeeding, food allergies, etc, etc. Because mothers can know more about what might go wrong, they’re obligated to feel more responsible for it. If an allergic kid dies from accidentally eating a strawberry, it’s not “just one of those things” anymore, but “someone should have prevented this”.
We’re “too concerned” about safety (rather than morality) nowadays in part because we really can do more about safety than our ancestors could.
Mary Eberstadt wrote food is the new sex. Sexual permissiveness isn’t the only cause of that attitude, though. The women of my grandparents’ generation just weren’t as obligated to avoid smoking, or drinking, or eating the wrong thing, or not enough of the right thing, during pregnancy and breastfeeding, or worrying so much about their children’s diets, because the risks were still considered vague and mysterious. Smoking, drinking, and eating junk food were all vaguely unhealthy, of course, but vaguely. Not “you could wreck everything” with insufficient folate or whatever.
Beautiful essay, Midge! The one of my four kids who has actually experienced seriously health problems (and, as her siblings ruefully point out, she got ALL of them) was conceived while her brother was only seven months old and still nursing, and —needless to say?—none of this was planned. So I do wonder whether this poor child was exposed to more intrauterine stress. Not just the deprivation of whatever nutrients her brother was sucking from me, but the fact that I was chasing two tiny kids around and fretting about money and —important—had not yet done nearly enough Cognitive Behavioral Therapy to be able to keep my own mood stable. So I was a little freaky.
Being “freaky” is a neurochemical phenomenon—-being unhappy, worried, miserable, horribly depressed all dump various chemical cocktails into your system too, and into the baby’s system as well, minus whatever the placental barrier manages to catch.
I was thrilled with the baby when she came along, of course, and I’m still thrilled with her, health issues and all.
Knowing what I know now, I fully intend to do whatever I can to make the pregnancies of my daughters and daughters-in-law as stress-free as possible, both because I love them AND because it’s one thing I can do. But I’ve lost a grandchild to a cord accident, so I no longer imagine that Science (or, Lord knows, I) can control for all the awful possibilities. Not-life is normal—it is life that is the miracle.
Smooch little Zeke for us!
I think this is why there is such an anti-vaccine movement among mothers of children with low-functioning autism. It is incredibly hard to accept that incredibly bad things happen at random for no reason.
This will come across as an odd question, but why exactly do people like the idea of reproducing. I never wanted children myself but everyone else is into it and I don’t know why.
Of all my friends, family, and acquaintances, I know only two people who feel as you do. Given the popularity of the practice in spite of the risks and costs of childbearing, I would ascribe the enthusiasm to natural drives you inexplicably lack.
Having 4 myself I can say that children are wonderful. I first knew I wanted to be a parent when my youngest sister was born. I was 14 and had no prior experience with infants, but watching her grow up into her own person, while seeing everything as new and special, I knew then that I wanted a family.