Gradually, Life Returns to Normal (a.k.a. Grief Isn’t Linear)

It’s been eight weeks now since my pregnancy ended and we lost our baby, but it feels as though it’s been much longer. A lot has happened in these eight weeks, and at the same time not much has changed – in a sense, it’s as though life returned to what it was like pre-pregnancy. At the same time, we did go through more than half a pregnancy, so it’s not like things can just go back to the way they were before.

Taking time off

I was on sick leave for 6 weeks after the delivery in order to recover. It was like maternity leave, on the one hand, because it was after a delivery, but I didn’t have a baby to take care of, so it really didn’t feel like maternity leave. At first, I was surprised at my obstetrician’s suggestion to take sick leave (because the law doesn’t allow maternity leave until 24 weeks of gestation, and my pregnancy ended at 21 weeks). “Do I even need sick leave?” I asked. “Yes,” she insisted. “No work for 6-8 weeks.”

“Wow,” I thought, “Okay, apparently, this is a big deal.” And I’m glad I took time off. I was so exhausted those first two weeks, physically and emotionally. I look at my calendar for those days, and what do I see? “December 30 (2 days after delivery): Buy groceries.” Jacob, William, and I went and bought groceries together, and it was my first time out of the house (except for going to the hospital) in more than two weeks. It felt like such an event, and at the same time I was in a haze because of fatigue, shock, grief, etc. What a big deal it is sometimes to go out and buy groceries!

During those first weeks, I did simple things such as do some gentle movement, go for a short walk (started with 15 minutes), take a nap, talk to a friend. When I cooked a meal, I lay on the couch to rest afterwards. I also did things on my laptop such as making the annual family photo album (every year, I make an album with our favorite pictures for that year, and it’s super fun!) and the yearly review. The point is that it helped me to keep myself somewhat busy with pleasant activities and taking care of William, but I also took lots of time to take care of myself and to rest.

Beginning to work a tiny bit

After 3 weeks off, I felt I wanted to do a little bit of work again. I knew I didn’t have to, but I wanted to be making progress towards my PhD. I was still relatively tired, but I had more energy and was able to concentrate better. So I blocked out 2 hours per day (10:00-12:00) 4x per week to work on the chapter I had been writing. It seems like a very small amount of time (8 hours per week), but I was able to make some progress.

Most importantly, writing my chapter gave me the feeling that I was accomplishing something, and that’s what really mattered to me at that point. In a situation where I could control almost nothing, this was one area where I could actively focus my efforts, and that felt good.

I also made sure to do all the other things: do gentle movement, walk, nap, meditate, cook, and take care of the family. And sleep. Lots of sleep.

Returning to work

Two weeks ago, on February 14, I returned to work. It felt exciting! I had 3 months to finish my PhD, so I was (and still am) in go go go mode. Not feeling stressed, to be honest, but more in a “Let’s do this!” mindset.

Interestingly, my daily schedule remains similar to what it was before: I work (mostly write) in the mornings 4x week and avoid distractions at that time. Then, I have lunch and do some admin and tasks that require less focus. Afterwards, I cook or exercise, followed by a little walk on the way to picking up William from daycare. The self-care is still there, although I rarely take a nap anymore.

(Fun fact: It’s difficult for me to fall asleep for a nap, so I tricked myself into napping by listening to a meditation while lying in bed and falling asleep in this way. I did it every day for 50 days!!! Seriously! I got a 50-day streak in my meditation app, but since I don’t nap anymore, I’ve lost my streak… 😦 )

My amazing 50-day streak in the Headspace app.

I’m also feeling more social again, meeting up with friends and looking forward to chatting with colleagues as well. And I’m really into watching movies!! I’m re-watching all the Harry Potter movies, then all the Matrix movies and all the X-Men movies since Jacob loves those as well. (Tangent: Maybe I’ll re-watch the Lord of the Ring movies as well because I really don’t remember what happened there. My recollection is the following: hobbits partying, Gandalf shows up, they meet some elves and some dwarves, they walk a lot, then they go fight some other people, oh, and Smeagol shows up at some point, then there’s a massive fight with lots of people, and then Frodo is standing near some fire and looking at the ring… Yeah, I think there’s more to this classic epic, and I need to discover it properly.)

Grief as a part of everyday life

What I’ve been saying so far is that life appears to have returned to normal rather quickly for me, almost too quickly. There’s fun and joy in my days, there’s purpose in my work and taking care of William, and there’s also everyday, routine stuff that need to get done. But I’d be lying if I said that was all of it.

Take this example: I’m walking down the sidewalk, and I see a pregnant woman with a big belly. I look away. Good for her, I think. I do the mental math in my head: at this point, I should have been in the 7th month, and I would have had a big belly like her. But I don’t. Keep walking. Just keep walking.

A couple of friends and I got pregnant around the same time. My due date was May 9, and theirs are in May or June. I can’t imagine what it will be like to visit them and their babies once they are born. I try not to think about that. I also try not to distance myself from those friends. They are dear friends that I care about, so I try to stay open and meet up with them. I am happy for them and their babies, and I am sad for myself and my baby. The two feelings can co-exist.

I went to the dentist for a dental clean yesterday. I noticed the dental hygienist was a bit confused, looking at my belly. “It says here you are pregnant at 29 weeks…?” “Oh,” I say, “We lost the baby at 21 weeks.” She says she is very sorry and how hard it must be. “Yes, it is very hard,” I say. “But I’m glad we already have one child, otherwise it would have been even harder.” “That’s true,” she says. “But it’s still a very big loss, and it’s very sad.” I only nod. I am grateful that she acknowledged how sad it is and that I didn’t in fact need to soften the situation or make it more comfortable for her. We just allowed it to be sad.

Last Tuesday, on the famous Twos-Day (22-2-22), we had the cremation ceremony for our baby boy. It was done together with other babies who passed away before 24 weeks of pregnancy. We, the parents, got together and walked to a beautiful place next to the crematorium and spread their ashes. There were three rocks with lovely butterflies on them to symbolize the children who didn’t make it. We got to stay there for a bit and think about our babies who would never join us in this world, whom we’d never get to watch grow up, and whose personalities we’d never get to know.

This experience hit me harder than I had anticipated. It uncovered more sadness than I knew was there. It was the last time we had contact, in some way, with our baby boy, and now he really was gone, forever.

Beautiful butterflies symbolizing the lovely children that didn’t make it into this world.
At Crematorium Jonkerbos

Moving between everyday life and grief

My therapist, Linda Lansink, gave me this wonderful analogy. Imagine the infinity sign, the number eight lying on its side. Sometimes you’re living in one circle, which is everyday life, joy, fun, etc., and sometimes you’re in the other circle, which is your grief. It is healthy to be transitioning smoothly between the two circles, so normal life and grief become integrated. It can become an issue if you get stuck in one of the circles: either you are only living normal life, denying the painful experience the space it needs, or you become stuck in the grief, unable to live and enjoy life.

Life feels like the infinity sign right now, transitioning between sadness and joy, between the normalcy of life and the exceptionality of our loss. It’s strange how something as jarring as the loss of a tiny baby becomes part of life, integrated with the narratives of our lives. But that’s how it is.

The infinity sign, symbolizing
living with both joy and grief.
Source: Wikipedia

Brain rewiring: Getting used to our pregnancy loss

For those first ten days or so after we lost our baby halfway through the pregnancy, I was in a phase I called ‘brain rewiring.’ A huge change had taken place in our lives, and my mind was struggling to get used to it.

Integrating two narratives

On the one hand, I could remember in vivid detail how I’d given birth to our tiny baby and then we’d had to say goodbye. On the other hand, I kept forgetting that I was no longer pregnant.

At one moment, I was having an intense conversation with a friend about the current state of the pandemic, totally engulfed in big thoughts about the state of the world and no thought about my personal experience. A couple of hours later, I felt such pain and grief that I threw myself on the couch and cried, all thoughts of the global pandemic forgotten.

I kept having thoughts such as, “Since I am no longer pregnant, I can drink wine again,” but they only brought me sadness. I didn’t want to be able to drink wine; I just wanted to be pregnant again.

In fact, I didn’t want to be pregnant anew, but rather I wanted to still be pregnant. I wanted to go back in time and make it as though the events of the past two weeks hadn’t happened. And then I was faced with the stone-heavy realization that that wasn’t possible. In that moment, my heart fell through the floor.

During those nights, I dreamed about a baby and a pregnancy and all sorts of related (or unrelated) things. In the dreams, I carried the sadness of losing our baby, but upon waking, for the first second or so, I thought, “Oh, it was just a dream, thank God! My baby is still here…” And then I’d remember that he wasn’t here and that it was in fact all true. That fact hit me like a train, crushing me. It felt impossible to accept or bear that truth.

Slowly, my brain started integrating the new truth about our life. At the beginning of the process, there was our life on the one side and this terrible, tragic thing that happened to us on the other side. At the end of the process, this tragic event was integrated into the narrative of our life, our world. It had become a part of us.

What is “brain rewiring” anyway?

I first coined the term “brain rewiring” during a heavy break-up way back in college. The change was so painful and difficult that, once again, I was struggling to integrate the world I had known with the world I lived in now. It took a few weeks before the knowledge of the break-up and how that affected all aspects of my life was integrated within me and no longer shocked me with its harshness.

By calling it “brain rewiring,” I took the subjective aspect out of it. It wasn’t that “I couldn’t accept the break-up yet,” but rather “my brain needed time to create new neural pathways to reflect the change.” As you may have guessed, I was a psychology and neuroscience major in college back then. Who would have guessed I’d do a PhD in neuroscience after that?!

The “brain rewiring” stage has been the most painful one for me (so far) during this grieving process. I believe that’s because I was constantly being faced with the shock of what happened and the magnitude of the loss. Beyond that shock, there is pain and sadness that’s about the actual loss and about our baby boy, but the shock makes it impossible to find acceptance for those emotions.

Once I moved through the “brain rewiring” stage, I felt sadness, but it wasn’t anymore the raw pain that hits you head-on. It became more of a quiet sadness rather than a train crushing me. I’m not saying that quiet sadness is good, but it felt more bearable to me.

Thank you, brain

There is something amazing about the “brain rewiring” stage: it seems to me that the brain must be working overtime then. It must take so much work to update so many beliefs, expectations, and memories and to integrate this colossal event into my sense of self. For that, I feel a sense of gratitude towards my brain. Thank you, dear brain, for working so hard to make sense of this, to accept it, and to weave it into the narrative of who we are. I know it’s hard, and I thank you for all you do. (Yes, I speak to my brain. It speaks back sometimes. You can make what you want out of this.)

Photo: Prints of our baby’s hands and feet. They are tiny.

How we lost our baby at 21 weeks of pregnancy

This is the most difficult blog post I have written so far. I wondered whether I should keep quiet about our loss and keep our pain private. But there is a tendency to share the good stuff and hide away the bad stuff, especially when it comes to pregnancy loss, and I thought I’d break out of that pattern. This will be the sad story of how we lost our baby boy halfway through my pregnancy. (If you find the topic of pregnancy loss triggering, please don’t read any further.)

All good

We got happily pregnant in August and were looking forward to the birth of our second baby. I was nauseous during the first trimester, just like with William. I got through those tough first few months of queasiness and fatigue, emerging on the other side with energy and excitement: the second trimester truly is the honeymoon period of pregnancy for me.

At 19.5 weeks, on December 15, we had our 20-week ultrasound. It was excellent! The baby was developing well, all organs were doing well, and basically everything looked good. We were having a little boy! We made jokes about it because we had had a bet: I’d said that it’d be a girl, and my husband (Jacob) had said it’d be a boy. Well, he’d been right, and we were going to have one more healthy little boy.

Everything changed

At 20 weeks exactly, on December 20, I rolled over in bed upon waking up, and I felt my membranes rupture, or my “waters break.” I wasn’t sure because it wasn’t as dramatic as the big rupture during William’s labor, but it still felt similar. It was way too early for the membranes to rupture (this was at 20 weeks of pregnancy, and the usual duration of pregnancy is 40 weeks), so I called my obstetrician. We were called into the hospital to get checked out and, yes, my membranes had ruptured.

We weren’t sure how bad this was; we were mostly anxious. Then, two gynecologists came to speak to us in the examination room. You know things are bad two gynecologist come to speak to you at the same time. They were very, very kind, and they explained that this was a truly unfortunate situation.

Apparently, my membranes had ruptured, which meant that amniotic fluid was leaking out. There were two ways this could develop: either enough amniotic fluid could stay with the baby, in which case the pregnancy could continue alright, or the amniotic fluid leaking could trigger early labor, in which case the baby would be born too early and most likely would pass away. They couldn’t give us probabilities on the two outcomes; we’d just have to wait and see.

“But what caused this?”, we asked. Did I do something wrong? Did I cycle too far? Did I walk too much? Did I pick up William when I shouldn’t have? Did I do the wrong exercise? “There’s nothing you did wrong,” they said. “You couldn’t have done anything to prevent this.” Apparently, it was a structural issue of how the membranes form on the placenta, something called circumvallate placenta (we found this out after the delivery). “Building a human is very delicate work, and it can go wrong. This is like a glitch in the system where something just doesn’t go the way it should.”

In a way, it was reassuring to know we hadn’t done anything wrong. In another way, it was terrifying to think that something can just go wrong so late in pregnancy. I knew that miscarriages are common in the first weeks of pregnancy, that sometimes the baby just doesn’t form well, doesn’t embed well into the uterine wall or whatever, and that’s why early miscarriages are common. But at 20 weeks of pregnancy? After the 20-week ultrasound had assured us everything was fine and we were having a boy? Glitches weren’t supposed to happen at this stage.

Things going downhill

In the beginning, we didn’t allow ourselves to think it would be so bad. Sure, a little bit of amniotic fluid was leaking, but the placenta makes amniotic fluid, so it’s fine, it’ll replenish it, the baby will be fine. Things will go well for us, we’re not going to lose this baby. It’s just a little scare. I’ll go home and rest, I’ll take it easy for the next few months, and everything will be okay.

Gradually, over the next week, things started getting worse. My symptoms got more severe, with more amniotic fluid leaking, more bleeding, and contractions starting. I can’t describe the painful uncertainty of those 8 days. It was like living in limbo, not knowing whether the pregnancy would continue for another day or not, whether our baby would live another day or not.

We were in the hospital every other day for check ups or midnight visits, depending on my symptoms. With every increase in symptoms (stronger contractions, more bleeding), we thought this was it. We were going to lose our baby now. And then we’d go to the hospital, where the doctors would try to give us hope. There may be a tiny chance left that things go well. And we’d go home, hoping against hope, waiting.

Here, I have to give a shout out to our friends Sue, Petra, and Marjo who took care of William. One of my biggest worries was who would take care of William while we’re at the hospital, and since we had 5 evening/night visits to the hospital in 8 days, this was an actual concern. Sue, Petra, and Marjo were on call during evenings and nights, so we always had someone to take care of William if we needed to rush to the hospital. I can never thank them enough for what they did for us and the peace of mind they allowed us regarding William while everything regarding our new baby was falling apart.

This was it

On Monday evening (December 27th), we went to the hospital again because of increasing symptoms but were told we could go home because labor had not begun. On Tuesday morning, we had a regular check up at the hospital and were told the same thing. Then, in the afternoon, Jacob went to work, William was napping, and I was watching a movie on the couch when labor finally began. It was a strange realization: “It has begun. We need to go.” Quite simple, even practical. I called an ambulance, called Jacob back from work, and Sue and Petra to share the afternoon and evening with William. It was happening.

We went to the hospital, and I delivered our little baby boy. He had passed away by the time he was born, but we still got to hold him afterwards. He was beautiful, a perfect little baby. It was so unfair that he couldn’t make it. I wanted more than anything in the world to put him back in my belly, add amniotic fluid, and seal those membranes. We held him for a long, long time, trying to get ready to say goodbye. It was heartbreaking to lose him, and it was impossibly hard to leave him there at the hospital.

At the same time, I kept thinking about William. Was he doing okay without us? Had he eaten dinner well tonight? Were we going to make it in time for his bedtime? It was strange that things such as bedtime still existed while we held our lifeless baby in our arms, but William was at home, and he needed to eat and sleep.

We left the hospital and went home. I felt empty inside, figuratively and literally: my belly truly was empty, our baby had stayed behind, we had left him at the hospital, and we were walking away from him. The sadness was swallowing me whole.

The world continues to turn

And then, we got home, and William saw us. “Mama!” he exclaimed. I held him close. He was okay. He was alive. Petra had taken excellent care of him, and he had eaten all of his dinner. He took me by the hand to build a puzzle. We built a puzzle with cows, sheep, and chickens. Then, we changed his nappy, put him in his sleeping bag, read him a goodnight book, and put him to sleep. I was beyond grateful for this simple evening routine, and I didn’t want to let go of his little hand.

Jacob and I ate a late dinner, sitting at the table across from each other. I have no idea what we said to each other. What do you say when you’ve just lost a baby together? But we stayed by each other’s side the entire time, and he supported me in an incredible way. We cried together, and we held each other. Not much more to do or say.

I didn’t sleep much that night. I kept re-watching the events of the afternoon and evening, unable to stop the tape, like it was a video playing right behind my eyelids. The ambulance. The doctors. The nurses. Our baby. The anesthesiologist. The operating room. Jacob. Our baby.

It never stopped.

What do I even do with myself?

The next day was unreal. The feeling of loss, ever-present, and still difficult to believe. I kept forgetting I wasn’t pregnant anymore. It felt like nothing had changed and everything had changed, at the same time. Life was continuing, things were as usual, the world still kept turning, conversations still worked the same way, William still liked to build puzzles. And yet, the world had turned on its axis, something was very different, very wrong. I was off balance. The world was off balance. I didn’t know how to put one foot in front of the other, and yet I kept doing it, on autopilot. I was exhausted beyond belief.

Those first few days must have been the hardest of my life. That inexplicable, guttural sense of loss. The mind trying, and failing, to reconcile what has happened with the world I knew and lived in. Standing in the kitchen, preparing lunch, and suddenly, I’d remember: we lost our baby. He is no longer in my belly. He is gone, forever gone. An abyss opens up beneath my feet, and I fall in, head first, never hitting bottom. Falling, falling, falling.

One foot in front of the other

Fortunately, it got better over time. The first few weeks were heavy, and I had very little energy. Slowly, my energy started returning, and my interest in life began to come back as well. I am beyond grateful for William for the joy and love he brought us. Every time he saw Jacob and me holding each other, feeling sad, he came over to give us hugs and kisses. He didn’t understand that we’d had a loss, but he understood we were sad and knew to comfort us.

Gradually, we were able to have hope again. Hope that life may slowly become “normal” again, even hope for another pregnancy. Our doctors informed us that the condition of circumvallate placenta is rare and doesn’t carry increased risk for a following pregnancy. They told us we have “a bright obstetric future,” although I can’t help but find that ironic. Nobody can guarantee that we won’t suffer a devastating loss again. It’s great to know that it’s not more likely to happen, but we also don’t delude ourselves that things will simply be fine next time.

This is the price we had to pay, in addition to losing our baby boy: we know how quickly things can go from good to bad. We have hope and lots of love but no illusions of safety, certainty, or guarantees. And yet, we continue, putting one foot in front of the other. Fortunately, the human mind capitalizes on hope. It’s a survival mechanism.