Multiple Choice for Expecting Parents

I was 20 years old. The space shuttle had just blown up, killing all its passengers on national TV, and I’d been bleeding for almost a month. I didn’t feel well.

I got my mother to take me to a clinic in town. While she paged through old magazines in the waiting room, I went through the gamut of tests. The doctor told me that I’d tested positive for pregnancy. I started to cry.

“I don’t know if you’re happy, or sad,” he said, almost as if he expected a reply.

I had a year and a half of college left. I’d just returned from a semester in Avignon, where I’d fallen in love with a Greek student. Dealing with birth control in a foreign country seemed daunting. With Mediterranean machismo, Dimitris had warned me about his particularly potent seed; he’d already impregnated his Greek girlfriend twice. But I was living my life like an art house movie, taking risks in Europe that I would have taken nowhere else. I was a fool. I wasn’t ready to be a mother, and I couldn’t imagine Dimitris as a parent, either.

Late at night, I sat on the porch steps, smoking cigarettes and imagining what that baby would look like. I hated the idea of abortion, but the other options were even more terrifying. If I ever got pregnant again, I decided, married or not, I would give birth.

My mother made an appointment for me with an obstetrician. He told me that if I lost much more blood, I would need a transfusion. He recommended a D&C. He never suggested the possibility of saving the life inside me, and thus the decision was taken out of my hands. He wouldn’t verify that I was actually pregnant; the tests were inconclusive. Even so, the procedure went down on my medical records as a “partial abortion.”

Thirteen years later, I’m lying on a table with my feet in stirrups and an IV dripping into my vein. It’s winter and darkness has already fallen outside. Three days before, in this same room, five eggs were extracted from my ovaries with a needle. They were placed in a petri dish with my husband’s sperm. Four have been successfully fertilized. The doctor is about to implant the eggs in my womb.

Somewhere between my semester in France and marriage in Japan at the age of 27, an infection wreaked havoc on my reproductive system. After a series of tests, I found out that my fallopian tubes were blocked, and in vitro fertilization was my only hope of getting pregnant. So here I am, on my back, legs splayed.

The doctor asks me how many of the four zygotes I want to have implanted in my uterus.

I think about the odds. With one egg, I have a 10 percent chance of getting pregnant. With four eggs, the odds go up to 40 percent. According to the chart downstairs, only one of 12 women who attempted in vitro fertilization in October became pregnant. On average, only 30 percent conceive.

“All of them,” I say.

In a few weeks, we find out that three embryos have taken root. The doctor explains that one or two of the embryos may disappear within 10 weeks. Sometimes the body cannot handle multiple embryos. In the event that all three survive, the doctor tells us, we will have to make a decision. We can choose to decrease the number of fetuses in a procedure known as “selective reduction.”

In the following weeks, I consider our options. I would like to have two children; twins would be perfect. The thought of three newborns at once is overwhelming. My husband, Yoshi, a high school teacher and baseball coach, works 12 hours a day, seven days a week. In Japan, the high school baseball season is year-round, and games are scheduled almost every Saturday and Sunday. I cannot ask him to find more accommodating work, because he loves his job and it is not easy to change careers in Japan.

When I visit the doctor at eight weeks, all three are still there, growing and squirming in my womb. I love them all equally. I cannot bear the thought of giving one up. Of having one killed.

The doctor explains the risks. The more babies, the greater the chance of miscarriage or premature birth. Having twins is riskier than giving birth to one infant. It gets worse with triplets. I am already 33 years old. If this pregnancy fails, I will be at an advanced maternal age, and other complications may arise in future pregnancies. I believe this is my one big chance to have a baby.

On the other side of the world, a Nigerian woman has become famous for giving birth to octuplets, the first ever. Like me, she has used fertility drugs to increase her chances of getting pregnant. I read that, like me, she was once expecting triplets. She miscarried all three.

I tell my husband that I want to go ahead with the reduction. “We have to remember the third baby,” he says. He supports and respects the gravity of my decision. “We should have a funeral.” What he has in mind is a private chanting session. My husband is a Buddhist. I agree, thinking that this will help to relieve my guilt and sadness.

The Japanese believe that the soul of an aborted child will return to be conceived again. Would-have-been mothers place offerings in front of bibbed statues in hopes of helping the spirits of their lost children to a better place. In my own country, right-to-lifers carry signs condemning abortion. The fanatics might even carry guns. I was raised a Methodist, and although I am currently spiritually confused, the teachings of the church stick with me. I am full of guilt. It is wrong to “play God,” I think, to tamper with nature. I don’t have the right to make a baby in a laboratory. Another part of me desires a child more than salvation.

The day before I am to be admitted to the hospital, I am alone, sprawled on the sofa, thinking about strollers, when I feel a warm wetness between my legs. I go to the bathroom expecting milky white discharge, but my panties are blotched with red. Blood pours from my body into the toilet bowl.

My first thought is that the fetuses, somehow knowing that I am planning the demise of one, are exacting their revenge. Or I am being punished by God for wanting to abort. At the hospital, the doctor examines me and assures me that although I am in the throes of a threatened miscarriage, I would almost certainly not lose all of the babies. I am put on bed rest. The selective reduction is postponed.

I find myself hoping that I will indeed miscarry one of the fetuses. I want to avoid the burden of guilt, as I somehow did after my unwanted first pregnancy. I would prefer to avoid responsibility for the difficult choice I have made. But the bleeding decreases. The torn placenta begins to reattach to the wall of my uterus. The operation is rescheduled.

Once again I am on my back, awaiting a needle. This time, the needle will pierce my abdominal wall and the heart of one of my unborn children. The doctor will inject a chemical to stop the heartbeat. In time, the fetus will shrink and be reabsorbed into my body. The doctor appears, wearing blue scrubs. Although I believe that it would be best to destroy the fetus situated lowest in my womb, the one that had been tearing away on its own, I cannot choose which one will be “selectively reduced.” The doctor tells me that he must target the fetus that is easiest to access.

My body is covered with a sterilized blue cloth, my abdomen is swabbed with disinfectant, and the doctor jabs a needle into my skin, to the right of my navel. The first shot is a dose of local anesthesia. The second one is poison. The pain of the needles is enough to distract me from the purpose of the operation.

Then, in my sixth month of pregnancy, I am surprised by bleeding once again.

“Threatened premature labor,” the doctor says and sends me to bed for the duration. In the hospital, I brush my teeth while I’m on my back. I eat my meals at a 45-degree angle. For 10 days, my feet do not touch the floor. Even so, my belly tightens with contractions, and blood stains the sheets.

I am transferred by ambulance to another, bigger hospital–one with lots of incubators and a neonatal intensive care unit. Three days later, I lie on the operating table awaiting an emergency C-section. From across the room, the neonatal specialist says, in his best English, “Twenty-six-week baby very high risk. I will do my best.”

The anesthesia kicks in, my belly is sliced open, and I feel fluid wash over my stomach. The doctor reaches in and lifts out my tiny, mewling son. My daughter, the one who has lived beneath my heart for almost seven months, is delivered soon after.

By some miracle, my one-pound, eight-ounce daughter and my two-pound son are born without any serious problems. They are put into incubators and they begin to grow. I start buying baby clothes.

Later, I think about my son, Jio, the baby situated lowest in my womb, the one I might have lost if I had miscarried in the fourth month of gestation–Jio, who even at 12 weeks commands my deepest love. If my early wish had come true, I would have lost him, and it would have been a tragedy. But I also wonder about that other child, the third baby that faded into nothing. Would I not have loved him or her as much as I love my son and daughter?

In all of the commotion of the past few months, we somehow never got around to having a funeral. Yoshi and I heap adoration on our surviving twins, while the spirit of the third hovers, a reminder. And so I carry my guilt. In quiet moments, I pray for forgiveness, while out of love for my newborn children, I find it impossible to repent.

From Brain, Child: The Magazine for Thinking Mothers (Spring 2000). Subscriptions: $18/yr. (4 issues) from Box 714, Lexington, VA 24450.

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