Fertility Facts

1. We are told to start our stories at the beginning, but what if we cannot? Even when the moment of conception is precisely known, there is always a moment just before.

2. Well, then, you might suggest, start before the beginning.

3. Senior year of high school, psychology class: My teacher explains research methods and types of survey questions, including one called a binary choice. Most perceived binaries are constructs, hiding shades of gray. But some choices are discrete, she says. “For example, are you pregnant? That’s a yes or no question. You can’t be sort of pregnant.” Later, we learn about the Stanford Prison Experiment, eating disorders, and Maslow’s hierarchy of needs. Our final project, I remember, was to write an autobiography of our psychological development, in which I pasted photographs from my childhood and wrote out “bucket list” items that I wanted to accomplish before I die.

4. Anyway, this is not a story about psychology class. This is a story about pregnancy.

5. “The embryo is the size of an apple seed,” I tell my mother on the phone. I am lying atop a pile of clean, unfolded laundry, bathing in sunlight. This piece of unfathomable information is one of many I’ve compiled lately in a personal series I call “Fertility Facts.”

6. Did you know your cervical fluid becomes viscous just before ovulation to mimic the quality of semen and carry sperm to the cervix?

7. Did you know the number of weeks pregnant you are starts not with the moment of conception, but on the first day of your previous period, two weeks earlier? Start before the beginning, some male doctor decided long ago.

8. At five weeks pregnant, or more accurately, three weeks after conception, the apple seed-sized embryo is shaped like a small C, according to my fertility app. It has the nubs of arms and eyes. It even may have a “heartbeat,” or “cardiac activity,” depending on what side of the abortion debate you’re on, although the app says it’s not detectable by most ultrasounds, regardless of your terminology.

9. The state of Tennessee, officially, is on team “heartbeat,” as well as on team “unborn child.” In 2020, the legislature passed a law outlawing abortions “upon a pregnant woman whose unborn child has a fetal heartbeat.”

10. In 2021, the Sixth Circuit ruled that the so-called “heartbeat bill” was unconstitutional because of the protections granted by Roe v. Wade. A few months later, it vacated its ruling and agreed to re-hear it. (Whiplash.) Before that could happen, though, the U.S. Supreme Court vacated Roe v. Wade, so the whole back-and-forth became moot.

11. I recite my Fertility Facts to my mother as if these actions are happening around my body rather than inside of it. Sometimes we repeat our personal mantras or goals or prayers in order to make them true. But this is a case of repeating truths in order to make them personal.

12. How my body is capable of such things, and has been capable of such things since the moment I got my period at 13 years old, I cannot begin to grasp.

13. When I hang up, I go to the bathroom. The toilet paper is stained red. I stare at it with distant fascination. This truth is not yet personal, either.

14. I try talking to my stomach as I wait for a blood test. “Come on, baby. You can do it,” I say gamely. The action feels reassuring but potentially futile, like talking to God. I do not know if what I’m talking to exists.

15. Did you know your pregnancy hormone levels are supposed to double every 48 hours following implantation? If my levels increase two days from now, I am told, I will be pregnant. If my levels decrease, I will not be pregnant.

16. But what am I now?

17. Even in the best of circumstances, pregnancy is a nine-month-long act of creation, whose gray areas have spawned generations of debates over non-existence and existence. Yet pregnancy that may or may not be a pregnancy is a certain kind of purgatory.

18. Perhaps the Eighth Amendment to the Irish constitution was an attempt to smooth out such messy matters. In 1983, the Irish populace voted two-to-one to enshrine the “right to life of the unborn” as equal to the “right to life of the mother” — implementing a near-total abortion ban.

19. But what is a “mother,” I want to ask. I barely had time to think of myself as more than a body with a productive uterus before the pregnancy failed.

20. Thirty-five years later, the same country voted two-to-one for a new constitutional amendment to reverse course. Abortion is now legal in Ireland, though limited by a patchwork of seemingly arbitrary regulations. A win for gray areas.

21. In Tennessee, the pendulum swung even faster. It was less than 15 years between the time when a judge determined that abortion was protected by the state constitution, and when voters added an amendment to undo that.

22. The fact that, in both cases, voters chose to codify abortion law in their respective governments’ constitutions — the holiest of secular texts — shows just how absolute, how binary, the state of pregnancy is thought to be.

23. Whether actual holy texts allow abortion, however, depends on who you ask. Progressive rabbis are quick to point out that the writers of the Talmud considered “fetuses” as part of a different category than “babies.” Traditional rabbis find a clear abortion ban spelled out as early as Genesis, though termination is allowed when the fetus endangers the life of the mother.

24. But what is considered “endangerment?” Chabad, an ultra-Orthodox sect of Judaism, answers it this way: “As this is a very sensitive and nuanced area, a qualified rabbi — together with medical experts — must be consulted.”

25. On the Friday night, Shabbat, after my first pregnancy ends, I leave the dinner table to go to the bathroom. After I finish peeing, a gush of liquid drops into the toilet, and I peer over to find a small sac of blood. Is this the embryo? I’ve read on anti-abortion websites that you might see a miniature baby in your toilet after taking abortifacient medication — essentially, inducing the kind of miscarriage I already had. Their hope is that the trauma of such an encounter will make you wish you hadn’t ended your pregnancy.

26. I kneel in front of the toilet bowl and dip my finger in, trying to catch it like a fish, but the sac floats away under the U-bend.

27. The writers of the Talmud were quite clear about when fetal tissue becomes worthy of any consideration at all. For the first 40 days after conception, they write, the fetus is “merely water.”

28. Perhaps this is why I find little solace when my mother tells me she’s lit a yahrzeit candle, a mourning candle, for the apple seed. It was the foundation of life, but it did not, to me, represent life itself.

29. A few weeks into my second pregnancy, the blood comes faster, with more force. My partner is out of town; I ask a friend to hold me as I cry. This time I don’t bother talking to the embryo as I wait for the hormone test results, which confirm what I already know.

30. One other thing my psychology teacher failed to tell us: Even when the pregnancy has ended (binary = 0), it takes a while to be done. The amount of blood that my body expels in the following days is no mere water.

31. Nor did she mention the sudden drop-off in pregnancy hormones following a miscarriage, which creates a state of mind similar to postpartum depression. “Insult to injury,” a friend’s wife tells me.

32. Then again, insult and injury often go hand in hand.

33. Take the case of Savita Halappanavar. In 2012, she checked into a hospital in western Ireland with severe back pain. She was 17 weeks pregnant. The doctors determined that her cervix was dilating too early and the fetus wouldn’t survive for much longer. But when she asked for medication to induce the miscarriage, doctors told her they couldn’t help her. “Under Irish law, if there’s no evidence of risk to the life of the mother, our hands are tied so long as there’s a fetal heart [beat],” one doctor told investigators later.

34. Within a few days, the fetal heartbeat stopped. Savita delivered the fetus and placenta on her own. She also developed an infection while waiting and died of sepsis.

35. Savita’s death became a rallying cry for abortion rights in Ireland and was, arguably, the single most important factor leading to the repeal of Ireland’s constitutional abortion ban. But when I learn the details of her case, and how her distress came from a miscarriage, I feel a sense of familiarity. The ending of a pregnancy, regardless of how it’s induced, is always a messy business.

36. That sense of other people trying to comfort you without really helping, without giving you what you say you need.

37. Irish history is littered with such stories. In 1992, a 14-year-old girl was raped by a family friend. Her parents attempted to take her to England for an abortion, but they were stopped by the government. Finally, the courts acquiesced, not because the girl was raped but because she was suicidal. That, they decided, counts as endangerment to the life of the mother.

38. Before the girl can get an abortion in England, however, she had a miscarriage instead.

39. The story ends so neatly that I wonder if something wasn’t hidden between the lines. Maybe someone finally listened to what she needed.

40. I need someone to hold me as I cry. Not just someone — everyone. If I could line up everyone I know and have them hold me in silence for 10 minutes apiece, that would be enough.

41. Instead, I receive a lineup of platitudes:

You have such a busy year anyway.

Just focus on making love, not making another baby.

It will all work out at the right time.

You know, before at-home tests, you wouldn’t have even known you were pregnant that early.

Two miscarriages? My friend had eight! And now she has three beautiful children.

42. And my personal foe: When you miscarry that early, it’s usually because the embryo wasn’t viable to begin with.

43. But who, I want to ask, created those flawed embryos I had to destroy? At times this thought is almost too painful to bear.

44. “Is there a chance you might be pregnant?” the X-ray technician asks me, as if she’s reciting a script. “Yes,” I say. She looks up at me sharply. “Well, are you?” I must confess a non-binary: “I don’t know,” I say.

45. I do know this now: The double line of an at-home pregnancy test cannot predict the future.

46. One friend had morning sickness for weeks, only to find that her first routine ultrasound failed to amplify a fetal heartbeat. It seemed her body hadn’t yet realized it was no longer pregnant — the ultimate purgatory.

47. Am I one of the lucky ones? My body determined that the embryos were no longer growing, or that for some reason they no longer should grow, and it took care of them efficiently and effectively, through no merit of my own.

48. Even now, my body buzzes with latent potential. That it is capable of such profound creation. That it is capable of such complete destruction.

49. I am awed by the former. But I am prouder, at times, of the latter.

How Grief Works

how voraciously I will hunt in every minutiae of life a hint of my dearly departed