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Mental Health Days

Sakena Jwan Washington

My second miscarriage was caused by Trisomy 18, a chromosomal abnormality that my doctors attributed to “advanced maternal age.” This was before a team of sociologists released a study declaring Pittsburgh, the place I call home, to be the worst city for Black women. Fetal deaths are two times as likely among Pittsburgh’s Black women compared to white women. So unless I could have gotten my hands on a time machine and a moving truck, this wasn’t something I could fix overnight. At forty-one, I didn’t feel that old, but each time I saw those words on a pathology report, I imagined my eggs with little canes complaining about the weather in my ovaries. It didn’t seem too late to be a mother, but every time I considered my age, I remembered how much time I’d wasted with men whose blizzard of red flags I muscled through in denial.

In my late twenties, I ignored the memo that nearly everyone I knew from high school was dating husband material. That tip was on full display in the quarterly alumnae magazine of the private all-girls school I attended in Pittsburgh, in which scores of women posed with their college sweethearts.  Many of these women pursued college degrees at highly selective schools and went on to become doctors, engineers, and executives. But I don’t remember their career updates as much as I do their wedding photos. 

In my thirties, when baby announcements cluttered that same magazine, I was too busy chasing my dreams as a creative writer in Los Angeles, dealing with annoying bouts of vertigo, and pursuing pseudo-relationships that might one day lead to my very own class update in the alumnae pages. By the time I found Rick, when I was forty, time was against us. 

I was eight weeks pregnant when my husband and I took a trip to Savannah, Georgia to celebrate our third anniversary. I was on my fifth consecutive pregnancy in eighteen months. 

The sun was beating down during our walking tour of the city. The shade of the Spanish moss couldn’t compete with the overwhelming humidity, as our passionate tour guide offered up the history of every park and square in Savannah. I’d been having slight cramps since the tour started, but I told myself that my abdominal ligaments must be stretching, (I knew so much about fetal development by that point in my life, I could have taught the course on it.) We were at least a mile in when we stopped at a local coffee shop.

After a ten-minute wait to enter the single stall, I realized that what I’d assumed was thigh sweat was actually the beginning of a miscarriage. I didn’t want to stop the tour or alarm my husband, so I stuffed my underwear with as much toilet paper as I could cram in. 

Rick knew right away that something was wrong. I tried to play it cool, but he could tell that it was serious. “Do you want to head back?” he asked.

I refused and kept walking. I didn’t want to ruin this trip too. 

For almost three years, every moment that should have brought joy was experienced through the lens of grief. When I wasn’t depressed, I was jealous, and when I wasn’t jealous, I was angry. I cried in bed, on buses, on my couch, or sprawled out on ultrasound exam chairs. My emotions lived inside me like a raging storm. They were loud and deafening, but I couldn’t find the words to describe how broken I felt to my close friends and family, the very people who could have given me the space I needed to heal. My therapist was the only one who knew the depths of my shame and blame—the shame of my infertility and the blame of waiting too long to become pregnant.

If I’d learned anything from all the healthy pregnancies in my orbit it was this—the more nonchalant you were, the more likely you were to deliver a baby. The women who snuck a glass of wine, or ate sushi, or casually forgot which ultrasound it was when you heard the heartbeat (week 10), or how soon you could screen for abnormalities (week 12), never had anything to worry about. These women, the ones taking naps instead of harassing their PCP for a quick blood test to see if their hCG was doubling or tracking mobile ultrasound units like a vigilante, always made it to week 40. Most of these women were younger and white—it’s true—but I fixated instead on how my eagerness to get and stay pregnant jinxed the whole process. 

This time around, I decided to play it cool and just keep enjoying our walking tour of lovely Savannah. When we arrived at our final stop, a stately building with Corinthian columns and a story that quickly escaped my memory, our tour guide offered to take our photo. I posed next to Rick, smiling under the Savannah sun like death hadn’t found us, yet again. 

As soon as we landed in Pittsburgh, we dropped our bags and drove to the emergency room, the cramps steadily worsening. As they placed me in a wheelchair, a dark red spot formed on my sweatpants like a Rorschach print in real time. The doctor pressed the ultrasound probe into my abdomen, hunting for any sign of life. But the fetus was gone. My elevated hormones were the only proof that I’d ever been pregnant. 

I gave myself twelve hours to get it together before I returned to the office where I’d spent the previous four months building websites and writing content for a local university. I wanted to ask my boss for a week to lie in bed and cry, but something told me those kinds of requests weren’t honored. So, I said nothing. I arrived at work with bags of Byrd’s Famous cookies, a Savannah treat, to share with my coworkers. “How was the trip?” each of them asked, with the upbeat curiosity of a collegial work environment. 

“It was great,” I blurted.

Ten days later, I walked into our daily meeting and my teammates erupted into the “Happy Birthday” song. I was forty-two, and all I could think about was the loss of another year. I forced a smile as our boss passed around a box of cupcakes.

She wiped the crumbs with a napkin and then took a beat. “By the way,” she added, “I’m pregnant.” 

As the words came out of her mouth, I braced myself for impact. Pregnancy announcements always felt like a punch to the gut with a hot poker simultaneously tearing my heart out. With practiced pain, I delivered an Oscar-worthy performance of smiles and congratulations, and then escaped to the bathroom and sobbed until my eyes were bloodshot. I sat on the toilet dry heaving, cursing my body.

My phone pinged with a Slack notification from my boss—the meeting had started. I splashed cold water on my face and rushed to her office. “Is everything okay?” she asked. 

I wanted to say, I feel like dying. I want to crawl under my desk and never see daylight again. Instead, I told her I had allergies. 


A year later and for the first time in two years, I wasn’t pregnant or trying to get pregnant. When I finally saw a specialist about my recurrent bouts of vertigo, I learned that I’d been having vestibular migraines. Upon hearing my entire reproductive history, the doctor told me that these types of migraines are triggered by hormone fluctuations. 

“Don’t worry,” I assured him, “we’ve stopped trying.”

For me, trying had come in many forms. First there was having sex on day 10 of my cycle, a calculation my gynecologist arrived at after scribbling on his desk blotter. Day 10 worked like magic: I got pregnant every single time. I didn’t need to stand on my head after sex or consult the phases of the moon. It just happened. 

Friends, family, even my therapist, assured me that getting pregnant was half the battle, though I seemed to keep losing the other half. I tried IVF as a means to tease out a more viable-appearing egg, but that failed— twice. There were high dose supplements like vitamin D and CoQ10—a magical cocktail that might give my eggs a homeopathic boost. But nothing could get me to week 40. I could get pregnant, but I just couldn’t stay pregnant. 

I was far more comfortable talking about vestibular migraines than I was explaining the nuances of miscarriage. Migraines never called into question my mental health, my age, or the state of my reproductive organs. They didn’t make me feel fundamentally defective, as my recurring miscarriages so painfully did. 

After a series of vertigo attacks in the office, my boss asked me in to talk. I sat across from her desk as she looked at me with concern. “I think you should take a mental health day tomorrow,” she said.

I eyed her warily. A mental health day?

“You seem like you are under a lot of stress.” 

The next day, instead of frantically chasing a bus, I stayed in bed and went back to sleep for eight more hours. No internet, no TV, no texting with friends—just sleep. When I woke up, I thought about all the ways I’d always fought through my depression. I thought about all the times I showed up—to happy hours and baby showers to eight-hour workdays and jury duty—when I should have stayed home.

During those three years of trauma, I never once went to any of my previous bosses and asked for a “mental health day” unless it was in jest. I worried that if I told them how much I cried, how many meals I skipped, and how little I desired to wake up every day, that it would call into question my work ethic just as my career was taking off. Severe depression isn’t exactly the career benchmark for promotion and distinguished service.  

My grief over the promise of someone who didn’t have a name, but only a silly nickname, a due date, and a barely measurable heartbeat seemed too intangible for anyone to understand. There seemed to be a hierarchy of loss, with first trimester losses notably low on the scale. It was the same way that people react when you tell them your aunt died, rather than your parents or siblings, and they respond, “Were you guys close?” instead of just offering their condolences.

My body seemed to have its own way of stretching out the mourning process, of not letting go, even after an ultrasound had confirmed that our embryo stopped growing. For two of my miscarriages, it took a D&C to fully remove the tissue. Without the procedure, who knows how long my body would have stayed in denial? 

A week after our third miscarriage, Rick suggested we play tennis to get us out of the house. I resisted at first because I was angry that the clouds could part so soon for him, that he could move forward again. But I agreed to join him. As I got dressed, I felt something push out of me like a small, squishy organ. I went to the bathroom and discovered a crime scene in my underwear. Afterward, I cried into Rick’s arms, “My body is a graveyard.” 


I want to tell myself that I’ve learned so much from this period in my life. I want to say that I’m better about telling employers, family, and friends what I need, even when it’s inconvenient for them. I want to say that I’m more honest about telling people that I’m not okay, instead of smiling through my pain. I want to tell women and girls that I don’t just talk about self-care, I live it. And that if something like this happened again, I would demand, even beg for all the mental health days I needed to feel whole again. 

But it’s not true. Three months into my new job and a global pandemic, I got pregnant for the sixth time. It was a surprise to both of us. And like the times before, it ended in another miscarriage. I reported to work the next day. While the world was battling COVID-19 and the reckoning of Black men and women murdered across the country, I was safe and relatively healthy with a recent promotion and a healthy paycheck. I looked around me and everyone was trudging through twelve-hour workdays, layoffs, isolation, exhaustion, sickness, burnout, low morale, fear, and anxiety. So, who was I to ask for a mental health day?