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Vital Signs

Rachel Mann

You wake to the sound of the nurse entering your room to take your vitals. Because you are, despite the fog of your brief early-morning sleep, still alive. Not that you’re aware it is morning. There is no day or night for you now, not since the rush of bloody fluid between your legs. 

You are confined in a hidden wing of the maternity ward, down the hall from where the live babies are born. With a tight expression and few words, the nurse takes your temperature and blood pressure. Later, your husband tells you there’s a sign on the door reminding the staff of the solemnity of this room. You feel like an outsider, a foreigner, and not just because you’re an American living in London. You’re not supposed to be here, in the maternity ward—not yet. 

There will be no happy cries, no rigorous infant howls. You know this because life, in the form of blood and fluid, has been leaking out of you for days. Your body is turning from an incubator to a tomb. There is nothing you can do to stop it. You can no more help your own flesh and blood from leaking out of you than you can stop your monthly bleeding from doing the same. Blood and fluid will go where they must. 

It’s been less than twenty-two weeks. At intake, both of your hearts are beating. But the baby’s vitals are unstable. A fetus ejected from the womb now, just past halfway gestated, will not survive. Even if there is some way to keep it in for another couple weeks—to squeeze your legs, say, or to bargain with your God, who seems to have abandoned you—even then, the child will suffer. If it lives for a day or a week, it will suffer. If it lives for longer, it will suffer more. 

You are bleeding. But, vitally, you are alive. Your temperature is elevated. Your uterus is contracting unevenly, as if frightened and confused. If the infection is allowed to spread, you could die. You are not a doctor. You don’t know the exact risks. You suspect the doctors don’t either. But you know you can’t die. You have two little girls at home. You beseech: 

Make this end. Please.

You must sign a consent form. You do, without hesitation. In Jewish tradition, your life trumps the fetus’s. The doctor orders Pitocin, the same drug they give to a woman in labor, which is what you are. 

The squeezing of your midsection intensifies. You can hardly bear it, though it is not nearly as intense as it will become. You know it will get worse, because you have given birth twice before. That you will have to endure the pain of childbirth without the joy that follows is almost too grotesque to fathom. There is no way for you to leave this hospital room without meeting your doomed offspring—ejecting it from your body, crying over it, holding it, stroking for a few brief moments its downy hair, red just like your own, before it will be put in a box and consigned to the earth. Will you survive this violence? You still have a pulse. Your vitals, at this moment, say you are very much alive.

Your uterus contracts again and you remember the other times—how despite the pain, there was laughter, too. A yellow onesie sitting inside the empty newborn car seat in the corner of the room. Joy and anticipation. The promise of new life. 

You didn’t dare tempt the evil eye with too many purchases before the birth. Your Jewish mother taught you well: no baby shower, no gifts. Just one outfit, one car seat, and a secondhand crib: only the necessities. There’s no onesie in this hospital room. 

It’s not that you need a third child. No one needs a third child. One child, definitely. Two, at the very least—a child deserves a sibling. Your two girls came almost too close together, just a year and a half apart. You luxuriated in your babies. You swaddled them and breastfed them and tied them to your chest with stretchy fabric. The third child is not a necessity, no. The drive has already been fulfilled. In fact, your husband didn’t especially want a third child. 

“Wouldn’t it be better for the girls to start growing up so we can do more things together?” 

“What things?” 

“Museums, plays, travel, skiing, biking. Things that babies can’t do. Who wants to start all over again with diapers and sleep training and night waking?” 

“I do.”

You wanted to. You knew, with your two girls growing up as fast as they were, that there is nothing like the smell of a warm baby on your chest. You wanted it, just once more, before you became the mom who manages moods and buys tampons and cautions about boys and drinking. You know that mothering a baby is a fleeting experience, and that three is a good number, and—

Maybe we’ll have a boy.

You said this out loud to your husband, when you were trying to convince him. You didn’t actually care about the sex of the baby. You always preferred not to know. That’s why, at your other births, it was a yellow onesie in the car seat. Just hoping for a healthy baby, you would say to anyone who asked. You tried to convince him, but you didn’t have to try too hard. 

“I want what you want,” he said. 

But you can tell he has reservations. He likes the way your life is. He doesn’t feel the need that you feel. Later, you will wonder if that was why. You will regret this thought, but you cannot stop yourself from having it: Maybe this child wasn’t wanted enough

One thing you will feel, as fiercely as the contractions squeezing you now like a juicer, is that it will always be a different kind of loss for him. He might say, if he spoke about it, that he didn’t know this child. How can he mourn a person he didn’t even know? But before your babies were born, they were part of your own body. You knew them when an elbow or a hand jutted out of your midsection, or when they kicked you in the groin at the end of a long day. You knew them when their bodies took up so much of yours that you felt that your stomach was up in your throat and your vulva hanging low between your legs. His only introduction was a grainy white image on a black screen, at the twenty-week scan. 

The girls are staying with a sitter. When he says he is going home to check on them, you let him go. You believe any pain he feels is not for his unborn child. His pain is for you, for your situation, and for the little girls at home, whom you have forbidden to visit you at the hospital. You can hardly think of them, your living children, even though it’s for them that you need to stay alive. You can’t tell them their sibling is dead. You will have to tell them, of course. But not yet. 

Soon, you’ll have to tell everyone. You’ll have to get rid of the crib. You could kick yourself for buying that crib, for inviting the evil eye into your home, your womb. You gave away the girls’ crib years ago, long before you moved to England. So when only weeks ago you saw a simple, stained-oak crib listed on a mothers’ group at a bargain price, you jumped at it. Why wait? What was this, the nineteenth century? Of course you’d need the crib. The remaining weeks would fly by, and before you knew it, the baby would be sleeping in it. 

You heaved the crib up the steps of your rented terraced house and placed the wooden slats beside the bed in the guest room—the room that would be the baby’s. Maybe it was the lugging, the overexertion, that sent the marble down the track. Maybe the crib really did kill the baby. Maybe you killed the baby, by buying the baby a crib. 

Alone in the hospital room, you replay the last few weeks in your mind, searching for signs. It started with a little pink spot on your cotton underwear. A shade darker when you checked again an hour later. This had never happened to you before. You knew this could happen—was common, even. But never to you. This was new.

Maybe it was the rough doctor you saw at the public hospital where the midwife instructed you to go. The exam felt like knives in your vagina. You told him he was hurting you, but he did not apologize. He informed you that there was blood coming from your cervix, as if you didn’t know. He suggested a colposcopy, a term unfamiliar to you. You later looked it up: a cervical diagnostic test after a suspicious pap smear. He sent you home, bleeding more than before. That was three weeks ago. 

Or maybe it was the baby itself. Maybe it thought: I don’t like that crib. I don’t like that room. I don’t want to leave this warm place. Maybe it thought it wasn’t a good idea to enter a world where there were already two loved children. How many times can a parent split their love? Or maybe the fetus thought its father would be disappointed because, as it turned out, it wasn’t a boy. 

Time stretches, then races. Your husband returns from checking on the girls. He has showered and changed. You remain where he left you, in the hospital room at the end of the hall. The pain is escalating. It’s worse than either of your two prior births, which you managed with breathing and moving and dancing. You had a doula, a woman who looked in your eyes and told you it was all going to be okay. When you thought maybe your body would split apart, that you would be the first woman in the world to explode during childbirth, the doula knew it would be okay because she’d witnessed hundreds of births. She knew the rhythms of your breath better than you knew them. She recognized the historical and biological patterns. And when your babies were born, each weighing almost eight pounds, you did not split apart. In fact, you were up and walking within an hour. Within the second, you were home for dinner. You were living proof that a body can do this miraculous thing, this lifegiving, godlike act. This time, there is no doula. There is no one looking in your eyes and telling you it is going to be okay. This time, the baby weighs barely over two pounds, yet the pain is exponentially worse. You want the drugs they used back in the forties and fifties—the ones where you fall asleep, and then can’t remember anything after. 

The nurse suggests gas and air. She puts a cup over your mouth and commands you to breathe. The air is cold; the cup is distracting. You squeeze your husband’s hand as the doctor shouts at you to push. You don’t want to push. You don’t want to do anything. 

When you have already endured more than you think possible, more than a court would deem torture, at last it is over. And yet somehow, you still have a pulse; you are still alive. 

You hold the tiny body, wrapped by the nurse in a baby blanket, for twenty minutes. You can only see her tiny face, her downy scalp. You are too afraid to unwrap her and really look. You’ve never held a corpse before. 

You refuse to allow her to be dumped with medical waste. You call the rabbi, and he collects the body from the hospital in a box the size of a takeout meal, to be buried in the Jewish cemetery. There’s no shiva, no official mourning, for a baby that dies before thirty days of life. You insist on witnessing the internment in an unmarked grave for those souls, who, according to tradition, haven’t yet existed at all.

You give the crib to an organization collecting items for refugee families. You make the arrangements immediately, as soon as you get home. You drink tea with milk and honey, chew a piece of toast. You sleep without dreaming and wake up swollen, sweating, bleeding, breasts aching. Your milk comes in and you cry in the shower, expressing the sweet liquid down the drain in a swirl of hot water. Your parents fly in to help. Your daughters cling to you. You tell them you are fine. They run off to play, and their laughter sounds like it’s miles away.

The day after you get home, a postpartum nurse rings the doorbell, sent by the National Health Service. She’s come to check on the new mother, to offer breastfeeding support. Your mother, furious at the mix-up, sends the nurse away. 

You would have invited her in. You would have asked the nurse if this is what it means to be alive, now. Though your arms are empty, your breasts are full. Though your lungs move breath, you struggle to speak. Though your chest is pounding, you can’t feel your heart. 

You would have asked her to take your vitals.