snapshots: parenting after loss

 
I know I haven't written here in many months. In fact, I haven't visited at all in many months. During my pregnancy with Naama, returning to this place became too much, this special and sacred place where over the past few years I opened up my heart and received so much from you in return. For anyone following along, I hope you will forgive me for my absence. I still can't quite explain why I couldn't write or come here for so long, other than being quiet was what I needed most during the spring and summer.

Naama was born on June 26, 2013 at 37 weeks gestation. Her name means pleasant and calm. She came into the world with a full head of black hair weighing 2700 grams (just shy of 6 pounds) and measuring 20 inches long. She has made my wildest dreams come true.

I don't go over all the details in my head constantly anymore. The details of what happened to me, to us, is too painful to take in all at once. But not infrequently, I catch a glimpse of something and I am transported back to that cruel, rainy winter and everything that transpired then and in the years that preceded it and during the months that followed.

Sometimes I am walking down the windowed staircase of the medical school research building to my research lab and I catch sight of the old inpatient building that is now defunct. I look across at the windows (shutters now drawn) and balconies of the third floor -- the women's ward -- where Aminadav and Naava were born and died in the final months of the building's use, before all the inpatient wards were relocated to the new tower. 

And I am back.

I remember my view from the hospital room, a nice view, really, with the Judean hills off in the distance. The grayness and bleakness of that drab winter, which was particularly cold and rainy. Early mornings being sent down with an orderly in my wheelchair for ultrasounds -- during the first hospitalization, hopeful -- just a bleeding spot in the placenta -- and then more bleak, the ones where I asked the technician to turn off the big screen and only Y could bear to look at the small monitor: two hearts beating, two beautiful, healthy babies, except one immobilized by no fluid left and the death sentence that awaited my two precious bubs.

I remember lots of the little details, and perhaps they are the ones that hurt most: the moment of shock and horror of my water breaking all over the bedroom floor while on bed rest after being discharged from my first hospitalization following my partial abruption. Knocking frantically on my next door neighbor's door, the one with the balloon animal-covered van who ran children's birthday parties, whose popcorn cart infringed slightly on our storage space in the basement. "It can still be, it can still be!" she exclaimed, mostly to herself.

Leaving the hospital through the mall once it was all over, walking past the baby store with my deflated belly and empty arms with the realization that Y and I were leaving the hospital as two and that was it, having gone from a family of two to four and back to two again. It would never be all four of us again.

Y telling me on the way to the car: Just so you know, we're not going back to my car, it's a rental because my car is in the shop because I swerved off the road and totaled it three weeks ago in the rain on my way home and I didn't tell you because I didn't want you to worry. 

I remember going home for three weeks and then going back to the hospital and my massive hemorrhage and the new worries about my platelets. It seemed like I couldn't keep myself out of the hospital.

My mother came from Massachusetts to Israel to stay with us and I wanted her in the apartment but not in the same room. I sat on the computer by myself and discovered a Glow in the Woods and searched every variation of "abruption" "PPROM" and "twins"  on PubMed again and again, searching desperately, pleadingly, for a way to save my dead babies. If only I could figure out the magic formula retrospectively, maybe I could bring them back. Maybe I would get a do-over and they would live.

Then, finally, is the second half of my story: redemption. When Naama was born, right after her Apgars, the nurse placed her immediately on my chest. I remember looking down at her in shock, stunned -- was this really my baby with her mop of thick black hair? Mine? Alive? Even when I was in labor, the sublime reality of it all seemed thousands of miles away in time and space.

But the photograph Y took in that moment captures something else -- a tiny hand reaching up, up, tightly clasping the round "N" and "A" discs on my necklace. Reaching out into the big world and embracing her big brother and big sister.

Does she know? I often wonder.

Usually I am not prone to those type questions, but I like to believe that my beautiful, vibrant, living daughter is connected to her older brother and sister in ways we don't necessarily understand. I do know that she would not exist had they survived. This is the complicated reality of parenting after loss. I could never had all my children alive, for Naama's existence is a direct consequence of Aminadav and Naava's death. To pretend anything else would be dishonest, though the reality is impossible reconcile.

When Naama was three days old, I read her her first book, Goodnight Moon:

Goodnight room, goodnight moon, goodnight cow jumping over the moon.
Goodnight light and the red balloon. Goodnight bears, goodnight chairs,
goodnight kittens, and goodnight mittens. Goodnight clocks and goodnight socks. Goodnight little house and goodnight mouse. Goodnight comb
and goodnight brush. Goodnight nobody, goodnight mush and goodnight to the old lady whispering "hush."  

Goodnight stars, goodnight air, good night noises everywhere --
 

This part came out in a choked whisper. Hadn't I recited those same lines for Aminadav and Naava in my head when they left us? Many parts of this parenting gig have left me in tears of both gratitude and the knowledge of what was lost, especially in those first few days, when the details of another labor, another birth story, came flooding back. It all felt very familiar. And I suppose that in some parallel universe, I had done all of this before. It was all for the first time just as none of it was for the first time.

One of the most helpless things about losing children at birth is the inability to parent them. It is a biological cruelty that when you are left empty-handed, you are still flooded with the same maternal hormones that catapult the rest of us into the nurturing and caretaking of mommy land. And so all of these rituals of newborn care, the tedium of the feeding and rocking and diaper changing, took on new meaning for me, all of the things I couldn't do for my sweet twins. In her memoir "An Exact Figment of a Replica of My Imagination" Elizabeth McCracken writes about her son Gus, born after the stillbirth of her first son Pudding, and captures the notion of the parallel universe far more eloquently than I ever could:

Sometimes I look at Gus, and it all feels very familiar. Not him. He was a skinny just-born, with cheekbones and an incensed cry: he looked like an old man who’d been outfitted with hands and feet a size too big and he wanted to know to which knucklehead he should address his complaint. Now he is fat and looks like a retired advertising executive. He is gorgeous and inscrutable. I tell you, I’ve never seen his like. But taking care of him, changing him, nursing him, I felt as though I’d done it before, as though it were true: time did split in half, and in some back alley of the universe I took care of Pudding, when he was a tiny baby, and this reminds me of that. There’s a strange museum/ gift shop/ antique store/ tourist trap in Schuylerville, New York, the next town over. In front is a reconstruction of colonial Fort George done in wood cutouts — a soldier in stocks, Revolutionary soldiers in profile, all cut with a jigsaw and painted in bright colors. In front is a sign that says: An exact replica of a figment of my imagination, and that is what this life feels like some days. It’s a happy life, but someone is missing. It’s a happy life, and someone is missing. It’s a happy life —

I think she has it just right: "it's a happy life, but someone is missing. It's a happy life, and someone is missing. It's a happy life --"

a new spring

photo credit: Gazelle Valley Park, gvp.co.il

As an update to my previous post, at this past week's appointment I got to speak with the other MFM in more depth about the steroid shots. There are two MFMs who run the prevention of prematurity clinic, so I volley back in forth between them during my clinic visits. I think they are both really competent, and I appreciate having the two different perspectives.

In short, we've decided we will definitely do the shots at 28 weeks unless something changes in the mean time, in which case we would do them immediately. As Emily pointed out in her comment to my last post, Dr. W. said they work most effectively on more mature lung tissue, so from a lung maturation standpoint, they don't function optimally at 24-26 weeks. However, in this age group, they do decrease the likelihood of intraventricular hemorrhage (IVH), which in addition to the respiratory issues, is a major obstacle for micropreemies.

In the absence of any indication that I am going to deliver in the near future, she felt pretty strongly that it is best to optimize the lung maturation benefit we will get out of them and get good coverage during the 28-32 week window, which she sees as a more likely scenario than something catastrophic happening over the next few weeks. So I feel better having some resolution on that and I feel comfortable with our choice of waiting a few more weeks.

Baby girl is a bit of a chunker, which is great :) Last week her estimated weight was 1 lb. 9 oz., about a week ahead. Her other measurements put her in the 65% percentile for her gestational age. I am happy she is measuring a little big. I did my 1-hr GTT last week. I am a bit nervous about the results, because I didn't know I was doing the test and I had a couple of glasses of cranberry juice with breakfast before I drank the glucola.

I have a bad cold which is annoying, but it is nothing more than a nuisance. It felt really good passing V-day, but I will feel even better next week once we G-d willing pass 26 weeks and I am holding out for 28 weeks even more so. The outlook would still be quite bleak if our little girl was born this week, but still, reaching the point when there would at least be an attempt to intervene feels significant. I am hoping for this pregnancy to stay boring for quite a while longer!

I am also looking forward to March being over. February and March 2012 were two terrible months for us punctuated by complications, hospitalizations, and of course the loss of Aminadav and Naava. Since then, it has always felt to me like February and March were out to get us. Just one more week and we can kiss my dreaded season goodbye.

As the days get longer and warmer and we enter the spring holiday season, I remember the emptiness and hollowness of last spring. Most of all, I remember my empty empty arms after a winter spent gestating two vital little lives. This spring, I still carry that emptiness and hurt in my heart everywhere I go, but I feel thumps and spins and all sorts of acrobatics on the inside that I can't help but admit make feel hopeful and vital again. I guess you could say that finally I am expecting.

dusting off the cobwebs

Its been a while. Quite a while. Since I last posted, we passed a lot of significant milestones. All of these milestones were pretty hard, and they actually made me feel less like writing. Instead, they made me want to crawl into my own little cocoon and burrow there for a while.

The Big Dates

The first big date was 19w2d, which was my PPROM milestone with the twins. It happened to coincide with the weekend before my SIL's wedding, so it was also a hectic family time. I spent a lot of time crying in the shower and crying in bed that weekend. Hitting my PPROM milestone was harder than I anticipated and made me sadder than I thought it would.

I was also incredibly fearful. I knew there were no ominous warning signs that my water was about to break, but it still felt like maybe there was something karmic or evil about that particular gestational age that would rob me of this little one, too.

My FIL made a toast at dinner in which he listed month by month all of the babies born in our extended family over the past year and he omitted Aminadav and Naava. Given my already fragile emotional state, this really made me feel like crap even though I know he meant no harm by it. I didn't think it was worth it to call him out on it, especially not on my SIL's wedding weekend when the attention should deservedly be focused on her, but it did really upset me and the timing was just very poor.

Y's grandmother noticed the omission and also commented that she always remembers them. We shared a little cry and that made me feel much better.

Later in the week, I reached the gestational age where I lost Aminadav and Naava. Getting to that point was surprisingly less emotionally charged and sad for me than my PPROM milestone. I felt a small weight lift from my shoulders as the day ended.

And just a few days after that was the Hebrew anniversary (yahrzeit) of Aminadav and Naava's death. I knew that being essentially on the same calendar with this pregnancy as I was with their pregnancy, all of these significant dates would come one after the other.

Their yahrzeit falls on the Jewish holiday of Purim, a particularly joyous holiday, ironically. Y and I decided not to celebrate. Instead, I lit their yahrzeit (memorial) candle and we went out snowshoeing in a nature reserve.  I wanted to do something solitary in nature, so this felt right to me. In the evening, we went out to dinner. I spent a lot of time crying on their yahrzeit and the crying was very therapeutic for me and actually made me feel better, as I find sitting in the depth of my pain on occasion often does.

Then about 10 days after that was the one year anniversary of their birth/death on the English calendar. That date was actually much easier and lighter for me than their yahrzeit. I focused on my appreciation for the blessing of their brief existence instead of on all of the hurt, pain, and what-ifs and should-haves.

The Babe and Me

Thank goodness this pregnancy continues relatively uneventfully. My only major complaint is that I have frequent contractions and cramping/pressure, which coupled with my anxiety makes me really nutty. I go in weekly for a tv u/s to measure cervical length and take a quick look at the babe. My cervix continues to hold stable, usually measuring between 3-3.7cm. This is obviously a big relief.

At 21 weeks, I had my anatomy scan. Everything looked good and we were told for the 4th time that baby is a girl :) The only notable finding was an echogenic focus on the heart, but we are told that with improving ultrasound technology, this finding is becoming increasingly common and is very unlikely to have any significance in light of our first trimester screening and quad screen results.

Baby girl was super active during the anatomy scan, which was pretty cool to see. I have an anterior placenta again this time around, so movement was a little muted at first, but during the past few weeks I have been feeling consistent movement including some really good jabs and kicks that are visible from the outside, which is pretty cool. I started progesterone on the same day as the anatomy scan.

I had a detailed placenta scan at 22 weeks, which showed my placenta looks great. This is also a big relief since it seems placental issues are what began the series of disasters that ultimately resulted in the loss of the twins.

I've made one trip to L&D, which was actually a positive experience, but hopefully we won't have reason to repeat it for many more weeks. I was having menstrual-like cramping and lower back pain for a few days that wasn't going away and I was scared of PTL. My MFM happened to be on call that night and she was very reassuring. We were in and out within an hour with the knowledge that even if I was contracting, my cervix was stable.

I met with the hematologist again a couple of weeks ago. The current plan is that I can get an epidural as long as I take clotting drugs prophylactically beforehand (the concern with an epidural with a bleeding disorder is a subdural hematoma). I will see her again in May.

I am really fearful and anxious these days. I am so scared my body will screw up. I know these next few weeks until 28 weeks are really critical. I relive my water breaking all of the time - it was such a strong sensory experience. 

I know that right now I am very "lucky." Lucky in that I had a relatively easy journey (relative to my previous history, anyway) conceiving this pregnancy after losing the twins and lucky in that so far, I have had a pretty good go of it this time around. (It feels a little ominous and foreboding to write that.) I have experienced enough to realize that this journey has everything to do with dumb luck and little to do with deserving.

I exist in this really weird place where I am constantly trying to mentally prepare myself for losing this dream little girl while in the same moment I can look at cute baby clothes and read carseat safety reviews. Stuck between preparing for the future I have dreamed about for so long and preparing for the death that I pray won't happen. 

                                                   23 weeks

a quick week 16 update

I was just updating the "our journey" tab of my blog and it made me so sad to think, when will I ever update the "Aminadav and Naava" tab? I can't believe we are quickly approaching a year since they were born and died. A little trite to say, but it certainly doesn't feel like a year since I lost them and yet my pregnancy with them and the happiness of that time feels like it was so long ago.

I have been thinking lately what I might want to do to acknowledge the one year anniversary of their birth and their death and I am still stumped. I just don't know. Unfortunately, early March is not such a nice time of the year for a special hike or outdoors activity. And of course the creeping thought has occurred to me: Will I still be pregnant with this baby on March 7? G-d I hope so.

I haven't even wrapped my head around what exactly this one year anniversary is - to be born and die on the same day - a birthday and a death day - what is that exactly? A celebration? A somber remembrance? I am not really sure. I guess it is up to us to make up the rules of this day.

In happier news, I had my weekly clinic appointment and the MFM was thrilled with the way my cervix looks. It is measuring around 3.4mm, so I actually gained a bit of length over the past two weeks' measurements, and she said it is curved (not stretched taut) and has a glandular pattern, which is also apparently a good prognostic marker. I am happy to be boring and hope to stay boring for a long time.

We also found out that baby appears to be a GIRL! I am equally thrilled with either prospect, but I was pretty convinced that this babe is a boy, so it was a bit of a surprise :) I had my quad screen drawn this week as well as a bunch of platelet function tests.

My only complaint is that I continue to have weird cramping and what I think are probably sporadic Braxton-Hicks contractions, but painful ones. The various pains definitely put me on edge. I just have no idea what's normal and since I had some pretty significant cramping both before my partial abruption and before my water broke, I never know whether any given 2am cramps are just insignificant, normal pregnancy pains, or whether they are the harbinger of a new disaster.

Does anyone have some ideas of what we might do to acknowledge the one year anniversary of Aminadav and Naava's birth and death? Unfortunately, since we are currently in Canada and they are buried in Israel, visiting the cemetery isn't an option.

quiet

I know I have slipped back into my cocoon the last week or so. There is not so much to say about my pregnancy. It is basically a black box until our first ultrasound on Thursday (7 weeks).

The days are passing very slowly and I constantly worry that my symptoms are too mild. But I suppose it boils down to something pretty simple -- either there will be a heartbeat(s) on Thursday or there won't be.

It is a little haunting how this pregnancy came almost exactly a year after my pregnancy with the twins. The two due dates are just 15 days apart. I can't help but be transformed back to last November -- every little detail of where we were, of how my pregnancy with the twins began to unfold.  But it is strangely comforting, too. I feel Naava and Aminadav's presence more strongly now. It is a sweet, bright presence that brings me nostalgia and warmth.


Israel has obviously been weighing heavily on my mind. Seeing on the news what it going on back home and not being there -- it is all very strange. Also, now living outside of Israel and seeing the way (some) of the outside world views the conflict is truly distressing and frightening to me. Those who question the right of Israel to exist and defend herself disturb me greatly.

Here's to a quieter, calmer week for everyone.

on gravesites, due dates, and the after

Last week was Aminadav and Naava's due date (by 40 week standards, though I knew with twins I was never going to make it that far even under the best of circumstances). I found myself becoming increasingly miserable as the due date approached. It meant another degree of finality was closing in surrounding their death -- almost as if the possibility of their existence slightly existed in some alternate universe until that date came around and slammed shut any possibility. As if they existed in some suspended in-between until now, certainly not here, but the possibility not entirely gone, either. The difference between gone and really gone. I know it's wacky and illogical, but it is the best way that I can describe it.

I felt like we were supposed to do something special to commemorate the day but I wasn't sure what, and so I was left grasping for something that felt very elusive while feeling like I was failing extraordinarily to honor them properly. Should I buy a bundle of sunflowers -- too cheery? Light a candle -- tacky or a little macabre? Nothing was really speaking to me.

The day before I was positively wallowing in dread watching the calendar inch closer and closer to what never was and never will be. In order to cross between the research lab and the main hospital building to go to the coffee shop, I go through the traffic circle entrance of the hospital out back, where parents load their newborns into the car to take home.

That afternoon as I walked into the hospital, there was a family parked in the traffic circle with their two kids and newborn daughter. The father was videotaping the mom carrying her to the car narrating, "And here is her first time in the car! Here she is coming home!" Watching the happy new parents load their newborn into the car struck a raw chord. I couldn't hold back my tears thinking of my poor babies who never got to come home with us. I wasn't jealous, just so sad for Aminadav and Naava and sad for us, especially knowing that the babies coming home healthy now are their compatriots.

One thing that has grated on my conscious constantly is being physically so far away from Aminadav and Naava, with them buried in Israel and us here, and also not having a special place to go to that acknowledges them. One thing I have not written about at all here -- perhaps because until now it was too painful -- is the reality of what happens to babies lost during late pregnancy or shortly after birth in Israel.

While the notion of a proper burial applies, there is a long-held belief that parents of young babies should not participate in the burial and should not know where the baby is buried. Different chevrot kadisha (ritual burial committees) enforce this policy with varying degrees of strictness and leniency, but in the hospital they don't really present the different options to you -- you just sort of get stuck with whatever chevra kadisha serves that particular hospital.

At first, when we signed their bodies away to the chevra kadisha, I was pretty naive and I was just happy that my babies would get a proper burial and not be considered medical waste or some similarly horrible fate. I wasn't thinking about it so clearly at the time, but I didn't realize I might never find out where they are buried.

In the months after we lost Aminadav and Naava I began to wonder more and more where they were buried and began to develop a desire to find out and visit the place. In the process, I learned more & more about what this might entail. Not shockingly, I am not alone, and you can find many similarly-minded posts on the Israeli pregnancy loss forums, of women months and sometimes years later, trying to figure out where their babies are buried.

I learned that oftentimes it is difficult to just get in touch with the correct chevra kadisha and if you do, getting any information at all can be extremely difficult if the person you are in contact with thinks he is protecting you by refusing to give any information. If you are lucky enough to find someone willing to help locate the body, the records are sometimes kept shoddily, and especially if time has elapsed, it is sometimes impossible to find a record of the body. I also found out that the babies are generally buried together in mass graves that are either unmarked or poorly marked.

I know this reality may sound shocking and horrible to many, but this is the situation we are dealt in Israel. Of course now I would like to spread awareness among women in similar circumstances -- that at least there is a choice in which chevra kadisha comes for the body and that some are much more willing to involve the parents in the burial itself and the details surrounding it, but this was not information at hand for us when it was relevant.

I had a very strong desire to find out where Aminadav and Naava were buried before we left for Toronto, but I had an oversimplified fantasy of how we would find out before I started fact-finding and reading the forums. I have a wonderful book on pregnancy loss in Hebrew - כחלֹום יעוף - Like a Fleeting Dream, which to my knowledge is the only Hebrew language book on pregnancy loss written for religious couples. The book has a listing of phone numbers for the chevrot kadisha serving various Israeli hospitals. I thought we would just call the listed number, they would look up our babies in their records, and we would have our answer.

Of course it wasn't simple at all. After a long and convoluted goose chase, Y did succeed in tracking down the cell phone number of the man who took their bodies. However, he only finally succeeded getting his cell phone number the night before we left Israel, which made visiting them impossible. Also, I was really adamant that we try to track down the information before leaving because I figured that as more time passed, the chances of getting the information would just become increasingly slim.

Sure enough, the man remembered our babies as "the twins from Purim" (Purim is the Jewish holiday on which our babies died -- ironically, it is a particularly joyous holiday.) However, he would not agree to tell us where the babies are buried, at least not outright.  Instead, he spoke in riddles, I assume because he had a moral opposition to telling us, but at the same time had some empathy for our situation. We understood from what he told us what city and what cemetery the twins are buried in but not the location of the plot.

For then, that was all the information we had, and it gave me some peace at least knowing the location of the cemetery, but not enough. I thought if I could just go there, maybe I could find a kind person who works there who could tell us where they bury the small babies and since we know they were buried fairly recently, maybe we could deduce which plot.

But we were leaving Israel and it wasn't going to happen this way, at least not maybe until we got back. My babies are in some unmarked mass grave with the chance of ever identifying the spot dwindling with each passing month, I am moving 6000 miles away for the year, and I can't even visit their spot, I thought. Here I go failing them again. And again. First it was my body, now it is practically almost willful.

So on the eve of their due date, here I was more than 6000 miles away, with a vague general idea of where they are, and no way to properly visit or honor them. Thankfully, there is another part of the story:

Two acquaintances back in Jerusalem also lost babies this past year and subsequently became good friends (yes, it is both sad and ridiculous that we only became good friends after losing our babies, because they are two wonderful women). One of them delivered her baby stillborn during her 22nd week of pregnancy at the same hospital in the same room where I delivered Aminadav and Naava about 3 weeks later. Recently, she also got the urge to track down her baby.

She had a similarly difficult time tracking down the information (though it seemed very likely that her baby was in the same cemetery, perhaps even the same plot as the twins since it was at the same hospital only a few weeks apart). Indeed, she eventually traced her baby to the same cemetery. She and my other babylost friend, N, went on a pilgrimage together to the cemetery in an attempt to find the grave. It happened to be on Aminadav and Naava's due date.

Just like in my fantasy,  the staffer, a kind older man (Sephardi and very gentle as decribed by my friends) pointed them in the right direction and led them to three plots with small babies. Based on deductive reasoning, they figured out which of the three plots they think has E's baby, and they think Aminadav and Naava are in the same plot, too. They recited some tehillim (psalms) and placed stones on the grave for E's baby and for Aminadav and Naava, a Jewish tradition that signifies someone has visited the grave. The elderly Sephardi cemetery staffer and my friends recited the names of all of our lost babies and prayed for them together.

So, over the course of their due date, not only was the site of their grave discovered, but Aminadav and Naava got their first visit, not from me directly but from my messengers. Their names were recited, stones were placed, and my sweet babies were remembered by Y and me in Canada, and by two very special friends in Israel, N and E, who I am very blessed to have in my life. E reported that after the visit, she felt "this powerful urge to nap -- not in a tired way, but in a peaceful, relaxed way that I haven't felt in a long time."

I cried all morning, but not the sorrowful tears I cried the night before -- instead, these were more tears of relief. Relief that I felt right was finally done by my babies. Like E, I found some new peace, too. Thank G-d my friends decided to visit the cemetery on their due date. Thank G-d they found the grave. Thank G-d for these small blessings -- they amount to a big deal in my life.

I'm back

That was quite the unintended lengthy hiatus. Moving across the ocean was a much bigger project that I foresaw. The good news is that after a few weeks at my inlaws we finally moved into our new apartment and we are now more or less settled (we FINALLY got internet set up on Friday). Y started his fellowship and I got my work visa and began work in the new lab.

I am doing okay but life isn't easy -- I still have many hard days, some incredibly hard days, and mostly a lot of in-between days. I wonder whether life would be a little more palatable with some pharmaceutical help, but truthfully, I am so distraught over the weight I haven't loss since giving birth that I am not sure I can handle adding antidepressant weight gain to the mix.

I never stop thinking about Aminadav and Naava. I imagine all the time what life would be like if they were here with us now and what they might look like and be like.

I get teary when I go through old pictures of Y or even myself from when we were both babies and toddlers. We were both really cute little kids -- I think both of us piqued in our looks around 3 or 4 :) I know the twins were really beautiful when they were born and I am sure they would just be so so cute now. Thinking about that never fails to make me cry.

And now here we in July, the month they were due. I suppose at some point the passage of time will make everything easier -- the memories gentler, the reality of life as it is less harsh, but for now I can't help but think time is strengthening the blow.

For some time after they were born but before they were actually due, the reality of our lives and theirs seemed somehow suspended in time, like we existed in some strange in-between where the twins were of course not here with us but they weren't yet supposed to be here with us.

I don't feel like that anymore -- I feel like our universe diverged into two roads, one the promising and happy path we were on and one the sharp and unexpected reality that came to be. I see all the new babies around now and think about how they were Naava and Aminadav's compatriots. How miraculous in some sense that they are here now -- so healthy and robust -- but I guess it is not so shocking after all, I mean isn't that what is supposed to happen? Supposed to happen for whom, though? Surely not for me.

I think that is what is so terrifying about moving forward with attempting to conceive -- the belief that I am somehow cursed, the belief that I am somehow different and every attempt at a live child will end in some permutation of something that is, well, not a live child.

To be fair this line of thinking is clearly not so illogical under my particular circumstances -- 6 IUIs, 5 IVF transfers, 3 pregnancies, 2 beautiful babies that my body wasn't able to support long enough, and 0 living children. It could be so much worse and I know I have many fellow comrades in the pity pool, but it is already an objectively abysmal set of statistics.

Y's grandparents met some woman with allegedly psychic powers who said I would never carry a pregnancy successfully unless I speak with her (she doesn't want money, she just needs to tell me a message). Despite their pleading, I can't bring myself to call her. I just can't. I guess to me it signifies 1) acquiescing that I am cursed 2) puts at least the illusion of personal control to change my situation back in my hands. The latter is a demon I have been working so, so hard to rid myself of -- the notion that any of this is in my control. If I say that yes, I do have control, the avalanche of self-blame that subscribing to this type of logic allows is limitless.

Also, just as a final update to my last saga, I thankfully ended up miscarrying naturally at 5w2d, bringing an uneventful end to my extremely short-lived pregnancy. I don't have any plans on the immediate horizon, but I do hope to set up a consultation at a clinic here in Toronto over the next few weeks. Realistically, it will take a couple of months to get in and then likely another couple months of repeating testing and making arrangements before I cycle again.

In the mean time, we are giving it a go the old-fashioned way…I have never had a naturally conceived pregnancy, but we have all of the right body parts, so I assume it is technically possible.

I would say that the loss of the twins is finally putting some strain on our relationship, not in a serious way, but it is something that wasn't there before that I feel now. Whenever I get really mopey and melancholy and ask Y whether he wishes things were different, he says of course, but he doesn't dwell on what was handed to us vs. what could have been the same way I do.

He even accidentally referred to the twins as "it" once a few weeks ago. He apologized and said he didn't mean it, but I couldn't look at him or speak to him for a little while after that.

When the babies came, we were truly one and together in a way I could never imagine beforehand nor articulate in a way that would do it justice now -- I am not big on soul-talk, but the best I can describe it is that our souls met somewhere above us and became one. It was a level of emotional intimacy that I had never experienced before nor will probably ever experience again.

Of course the flip side of such extreme intimacy is that it unsustainable and can pretty much only go in one direction after that. So I guess there is a bit of a rift now -- a sense that I still have so much intense sadness that can be overwhelming for Y. And whenever I feel bitterness I can't help but think it bad or dirty to feel that way, even though I know it is pretty normal. I know Y doesn't share the intensity of longing (not jealousy, I don't begrudge others for their good fortune) that I sometimes feel for what other people have.

The secondary issue is that I am feeling increasingly ready to accept adoption as a way of moving forward. This is in an abstract sense, because there are so many logistical issues that we would need to deal with. I would love to be pregnant again but having a child to love and to raise is more important to me than being pregnant again (of course with no guarantee that any pregnancy will result in a healthy living child).

Y doesn't feel even remotely similarly about adoption. Having a biological connection to the child is paramount to him -- he says he doesn't see what the point is if the child isn't his own. There is pretty much nothing to talk about there. There is no evidence to suggest that donor egg would be particularly helpful to us and while surrogacy may be helpful, with such a high price tag and in the absence of any super compelling reason why its our only option, that is off the table, too. In short, I think we will just continue to power on as we have before.

I just miss my sweet twins so so very much.

missing parts

Last week I had my last painting class of the year at the museum. Painting is something I do for fun and just for myself -- I am not very good at it. Back in February, right before my first hospitalization, we were working on a self-portrait project. The assignment was to take a xeroxed photograph of our faces and then break it into 25 parts, painting each panel separately and then finally pasting it all together to see the whole face.

The idea is to see each aspect of the face abstractly - in other words not to see an eye as an eye, for example, but just a random collection of darks and lights with a particular contour. It was a 3- or 4-week long project, and half-way through, I had the partial placental abruption of Aminadav's placenta.

When I came back to class after the twins had been born and died, I had a vague recollection that I had left the self-portrait project incomplete but I had no desire to go back to it. It just served as another reminder of where I was, what I was doing, and what my happiness and anticipation was like in the weeks and days preceding the darkness that was to come.

For our last class, we were supposed to discuss 3 or 4 pieces that we felt were most representative of our work and our progress throughout the year. My half-complete tiled self-portrait was long forgotten by me, but my teacher apparently found it at the bottom of a drawer filled with projects from the winter, and when I walked into the classroom, I was met with the half-complete painting tacked on the wall.

I really didn't want to spend any time looking at the self-portrait, which I had not seen nor really thought about since I was pregnant with the twins. I could not, however, ignore the obvious irony of my own missing parts in the painting.

In the other painting, something other than my xeroxed face was suddenly and unexpectedly left wholly incomplete.

right where i am: 2 months and 3 weeks

This entry is for Angie's annual Right Where I Am project where she asks baby loss bloggers to describe where they are in their grief. Thanks, Angie, for both facilitating this project and the prompt -- I know it certainly helped me and took me to an unexpected place.

Today we are packing up our apartment in Jerusalem into boxes that will be put into storage for a year. In about 2 weeks, we will move to Toronto for Y to complete his fellowship. Y's parents are in town and they are helping us pack. Both of them (and Y) are much better at packing than I am. They are doing us a big favor by spending their vacation time in Israel helping us to pack, especially because I am so spatially challenged, easily distracted, and also inefficient.

Y's mom really wants me to acknowledge what a good job she is doing and how much she has helped us. But my stubborn 5-year-old version of myself is at war -- I will not thank her or acknowledge her help. Instead I will mope aimlessly in the corner. Both of my feet are planted firmly on the ground and I push hard against Y, against his parents who are helping to facilitate this move. Enablers. Co-conspirators.

I offer Y's mom a slice of leftover pizza, ask her if she'd like me to heat it up. She'll have it cold, she says. Like her son, she is ok with eating pizza cold. I marvel over how this is done, I tell her. Personally, I think cold, congealed pizza is disgusting. "I eat pizza cold because I am a mother," she tells me. Is this lady for real? Of course the only appropriate response is "Oh, well, mothers of dead babies like their pizza warm."

But instead I just bite my lip and stutter "I really don't think that has anything at all to do with being a mom." I hate myself for not saying what I want to say, but I'd hate myself for saying it, too. I hate myself for all that is left unsaid between us -- for the dirty feeling I get each time I realize that she doesn't consider my children real babies nor me a mother, not even a sort of in-between half-mother. One day I will tell her everything that she does not want to know.

I will tell her the truth, that these were her grandchildren, too. That Aminadav had Y's big head and that Naava was born alive. That they were not some sort of sad, macerated, bloody miscarriage mess. In fact, there was nothing sad about them except for their death. That these were real babies. Real, beautiful babies. Perfectly formed, just too small.

But for today I will not thank her for packing up my apartment and I do not budge. I do not want to budge. I don't kick or scream or make noise, I just give in to inertia and refuse to move. Actually, it is less of a refusal, more of a giving in. I am paralyzed, my feet planted firmly into the floor, through the floor, into the ground. Doesn't anyone understand? I have roots here.

Roots -- isn't that what I sought in this land, this scorching dry holy land that sucks you in until you belong to it more than it belongs to you? I came here, to Israel, as a new immigrant 6 years ago, seeking out the metaphorical roots. But now I belong to the land -- rooted.

These are the strongest, most real roots; so solid I could not extricate myself from them with any amount of effort or denial. Because here comes the simple truth: my babies are in the ground here. They are part of it and belong to it and I am part of them and so we all belong to this land.

Leaving this place, packing these boxes with our books and pots and pans, is leaving my children behind. So on this day, 2 months and 3 weeks since Aminadav and Naava came and went and returned to the land, my land, I hope you can understand why I can't interrupt my moping to thank anyone for enabling me to leave this place.

When they were gone it was so easy to go back to the life we had before. Except for their absence everything about our lives was identical -- a perfect replica of everything we had left behind. I went back to the lab, to a life of pipetting and aliquoting and enumerating. Y went back to the operating room, to the familiar routines of cutting and splicing and suturing back up. We both found a lot of comfort in the oldness and predictability of our lives from before. I returned to work full-time within a week of their deaths.

But here's the thing: I never imagined the future without the twins. I never imagined Toronto without the twins. While it was easy to slip back into the past without the twins, when it comes to the future I am still stuck on the future of my parallel universe -- our future with arms more than full. In the last few weeks, I have been preoccupied by the thought of how if they were to come now they would most likely be here safe and healthy.

I still wonder what it is like to have arms that are more than full.

Until now, until our living room was filled with bubble wrap and packing tape and IV boxes full of kitchen utensils I conveniently blocked out the part when everything changes and the twins aren't here, the moment when the future arrives and the twins aren't coming with us. This is right where I am: 2 months and 3 weeks later.

our trip

The world is so beautiful, but it is also an empty place. Everywhere I go, I wonder what it would be like if Aminadav and Naava were there with us. Being outside, the midday sun blinding my eyes- it is all really nice, but of course mostly I wish that I was still on bed rest, watching the days lengthen and the seasons change from a hospital bed.

on helplessness

The past week has been hard and sad. For the past month I have felt like I was in a very fragile place but doing a pretty good job keeping it together. But needing this surgery, the invasiveness of having no control over my body (again) and everything surrounding it really brought me to a low place. I think it is also the holidays and being surrounded by babies and children and families, too.

When I lost N&A, I was really worried about the bitter and jealousy returning. There was a stretch of time during our infertility struggles when I felt very jealous and bitter of others' good fortune. The jealousy and bitterness was something that came from a very dark place and honestly made me feel pretty crappy about myself. It was something that felt destructive and I made a very conscious effort to work through it. I like to believe I mostly succeeded on this front.

In the aftermath of their birth & death, I was relieved that the bitterness and jealousy didn't return, or at least not in the way that I feared. I didn't want any baby in some abstract sense; I wanted them - my specific babies. Other babies felt irrelevant.

Passover was the first time I was subjected to babies and young children in large doses since our loss. It was much harder than I expected, not because I was jealous, but because it was such a visceral reminder of everything I can't do for my babies. A screaming baby in need of soothing is enough to get me wailing. Because the baby can be soothed. Because there is something her mother can do for her.

I never got to do anything, really, for my babies. It is the most helpless feeling I can imagine, I think, to give birth to a living baby to whom neither you nor medical science can help. To give birth to a living baby who by virtue of leaving your body is destined to die. Perhaps giving birth to Aminadav was in fact doing him a kind of favor because of his suffering - but again, I always come back to it - when I gave birth to Naava I killed her.

I never even held Naava. Sometimes I wonder if I lack basic maternal instincts. One day a couple of weeks after their death, our cleaning lady pulled me close and said "Maybe your soul wasn't ready yet to accept them."

During more rational hours, this seems like a hideous proposition - after all those failed fertility treatments, our first miscarriage, all that longing - my soul wasn't ready yet to be their mother? But why didn't I know instinctively to hold my babies, especially my living one? No one encouraged me or told me to. I was in shock. It all happened to so quickly. I will know better for next time. These are my alibis. But why didn't I just intuitively understand to do it?

I wasn't able to do anything physical for my babies in this world. I love(d) them and think of them constantly. Winter is over and the days are becoming long and hot. I do not think it will rain again. G-d willing we will somehow bring a living child into this world (though that seems to become increasingly daunting to think about with every new complication). But nothing is going to bring these babies back; no amount of magical thinking or new medical knowledge or regrets realized & examined.

they were here

When Naava and Aminadav were born, I was scared that they might look fetus and alien-like or somehow grotesque. I was afraid that when I looked down, what they actually looked like could never match up to my vision of them, what I dreamed they might look like.

Instead it was the other way around – they were so exquisitely and perfectly formed, my son and daughter, so beautiful and so human, beyond my wildest imagination. They were just miniature. I will never forget those tiny ears. Those tiny ears and their perfect intricate folds.

I remembered them from months before as embryos - blastocysts that looked like the surface of the moon magnified on a microscope screen. "Hey, I remember you!" I wanted to tell them, in awe of how much they had grown. The nurse placed them in a little box side-by-side, so that Naava was curled behind her brother. Yoel filled out the cards with their names for the chevra kadisha, the ritual burial committee, to pick up with their bodies.

I was wheeled down to the operating room for an emergency D&C since Aminadav's placenta didn't come out, and Yoel followed behind the gurney. That was the first and only time we spent with our babies.

1000 Oceans

Thank you to Mo for posting the Tori Amos song 1000 Oceans. I have been listening to it on repeat over and over the past couple of days and really connect with it right now.

Maybe because 1000 oceans feels like how far away I am from Aminadav and Naava, the two little souls that we came so close to spending our lives with. Maybe because it feels like 1000 oceans is what separates me from a totally different life in a parallel universe, the universe we were living in until last Sunday.

When I suffered my first (much earlier) loss, I spent a lot of time afterwards reliving over and over again in my head those happy last few days before the ultrasound that showed our baby had no heartbeat. How I felt like such a fool knowing I walked around so smug, so expecting of a baby, that unknown to me, had stopped developing.

These days I spend a lot of time reliving over and over again my last few days with Naava and Aminadav before my water broke and all hell broke loose. Our last few days as a family of four. I don't think so much about those initial awful moments when my water broke (more accurately exploded), the complete terror I felt and my shrieks and screams, over and over again, to Y on the phone, to myself, to the neighbor who called the ambulance. By then our fate had already been sealed. Those are not the moments on repeat.

Instead I think of those last few days on bed rest, how much time Y and I spent together in those last evenings, lying on our bed watching sitcoms once he moved the television set into the bedroom with our cat, Harriet, at the foot of the bed. (Harriet is usually not allowed in our bedroom nor are we typically the watch tv in bed type of couple - these are the types of allowances we made during this time.)

How the four of us would lie happily in the bed together in the evenings, Y and I both stroking my swelling belly out of habit. I was already having complications at that point but we were still happy and so blissfully and innocently in love with each other and with our sweet babes.

The hyperemesis, the bleeding, the bed rest - it all seemed part of a rite of passage during a difficult multiples pregnancy following infertility - challenges and some physical suffering for what would be a great reward. But not this - not this awful, horrible thing that came next. There was no rite of passage and there were no rules. No illusions of stay in your bed and you'll be safe, no bargains to be haggled, and no reward.

I think of our last Shabbat together, which was right before my water broke. I was so desperately bored and listless. I think of the fool again. There she is. There she is on the couch so bored, oblivious that these are her final hours with her babies. Always the fool. Always obliviously unaware to what happens next. It's never a happy ending. We've played out almost every possible variation on reproductive misery over the past few years; the only outcome that seems to have evaded us is the one that is most statistically likely - The Happy Ending.

I replay over and over again our final days with Naava and Aminadav, how as anxious and worried as we might have been, we still fundamentally believed that they would stay with us. I look back on my life in a parallel universe, a slice of time and a trajectory that existed such a very short time ago, but that life is now 1000 oceans away.

Aminadav and Naava

Aminadav and Naava were born on March 7 at 10:30 pm. They were perfect and beautiful in every way but born too soon and too small to survive. Aminadav's water broke on the morning of March 4, believed to be the result of the partial abruption of his placenta, which occurred three weeks earlier. Both of my sweet babies were alive until the end, even my poor Aminadav who was lying across the top of my cervix unable to move with no amniotic fluid at all. Aminadav came out blue - clearly he was suffering those last few days - but my beautiful Naava was healthy and pink.

There is a Midrash in the rabbinic retelling of the Exodus from Egypt where Nachson ben Aminadav jumps into the water of the Red Sea first before the instruction is given, showing his courage and bravery and prompting G-d to split the Red Sea so the rest of the Jews could pass safely across the water to freedom from slavery. Naava means beautiful. Aminadav and Naava - our son and daughter. I wish we got to spend the rest of our lives getting to know our first- and second-born and letting them know how much we love them.