End of the Line

“A woman like that is not a woman, quite I have been her kind.”
Anne Sexton

For my first appointment at the fertility specialist’s office I wear all grey except for my boots; these are shiny, cherry red. The four-inch heel makes me look tall and lean, as does the loose grey wrap I’m wearing. The other women here are all with men—their husbands, I assume—but I’m alone, and the only one, it appears, who knows how to pull herself together. It is only when I see the other women in their sensible shoes and faded Disney sweatshirts, their bulging purses and doughy, vulnerable faces that I think about what I’m wearing. Then I see what I’ve done, how I’ve dressed all steely and hard as if it can protect me.

 *     *     *

To get to the specialist’s waiting area, I’ve had to pass through a women’s clinic.  Its waiting room is raucous with young mothers in tight jeans, their newborns wailing in pink and blue. A two-year-old in a silver parka flails on the floor, while her mother, grim-faced, flips through a dog-eared magazine. There are no fathers here. Behind their desks, the receptionists don’t smile. I wonder if they have children, if the crying and noise gets to them.

The next room is the ultrasound and imaging waiting room. Women in various states of pregnancy sit in the pink chairs, their bellies propped before them. Pregnant women have always looked smug to me, satisfied, but this is perhaps unfair. Some of the women look past due; they have dark circles under their eyes. They are probably up every hour to pee at night. One woman paces, her hand cupping her belly.

At the end of this room, there are glass doors I must pass through, and then I am in the waiting room of the fertility clinic. A reverse trip from baby to pregnancy to what?  To hope, perhaps. To the glimmer of an eye? No, nothing glimmers. There are no sparks.  Here, tucked away from the bustle and business of life, sit the infertile ones, the sad, the lonely.

It is quiet and dimly-lit in the waiting room. Plexiglass partitions prevent the overhearing of arriving patients’ names or needs. A sign indicates privacy is a priority.  The other patients don’t look up as I take a seat near a low table where pamphlets from special fertility pharmacies are fanned out. There are no children here. There are no children.

But wait, I want to cry out, I have a child, a healthy beautiful seven-year-old daughter, the child I always imagined I’d have—affectionate, verbal, funny and creative.  The quiet in the waiting room, in fact, calls to mind the atmosphere I strived for while she napped as an infant. So what am I doing here, wearing kick-ass boots, in this western New York fertility clinic?

 *     *     *

If you tell people you are trying to get pregnant, you open yourself up to a vein of advice both ancient and technological. Try sex in the morning when sperm counts are higher, someone says. Or take up belly dancing, eat the nut of the Ginkgo Biloba or swallow Robitussin at ovulation, stand on your head after sex, wear jade or malachite, bloodstone to ward off miscarriage. What I need is acupuncture, a full moon or to give away all my baby stuff—that always does it. “Clomid,” an acquaintance says. “Two of my friends took it, and now both are expecting twins!”

 *     *     *

My name is called, and I’m led back to a nurse’s station, weighed, my blood pressure measured, before being directed to a room with an examining table, some chairs and a desk. I wait for Dr. Lewis, lucky to have this appointment. When I first called the clinic in September, the receptionist told me there weren’t any appointments.

“Ever?” I asked.

The receptionist laughed. “No, just not until the new year,” she said, “and we don’t have January on our computers yet.”

I don’t mention that I’m not getting any younger, that three months—a trimester!—is an incredibly long time to wait when one has already waited so long. The receptionist tells me to call back in a couple of weeks, and when I do, an appointment has opened up.

 *     *     *

“Nice boots,” Dr. Lewis says, as she enters the room.

I like her immediately. She smiles as we shake hands, and then sits to examine my chart. What story will she make from all those pages and reports? The facts are these: One healthy pregnancy. A miscarriage five years later. Another a year later. As a short story writer, I want an ending to this story. I think this is why I’m here—I want an ending. I’ve been suspended in this plot for several years now, and I crave the gentle slide into denouement. I even believe, at this point, that any ending is better than this limbo, this suspension, this—dare I say it?—aborted action.

I think this is why I’m here—I want an ending.

I imagine I’m sheepish when I answer Dr. Lewis’s question about the five years in between Maude’s birth and my first miscarriage—the waning years of my fertility, it will turn out.

“I thought I was done,” I say, and then clarifying, “I thought one child was enough.” This never sounds right to me—I sound cold or stupid or greedy, or all three.  “Then,” I push on because she is waiting, “we found ourselves pregnant.”

“Ah,” she says, “I see.”

How genuine is my desire to have another child, someone might ask, if I didn’t even intend to have one? Dr. Lewis doesn’t ask me this. Her manner suggests she’s heard it all before. She is in the business of giving women what they want regardless of their previous hemming and hawing. Because here’s the thing, I hadn’t planned another child, but neither had I entirely ruled it out. I watched how friends had a second child or a third, saw how tired they were, how chaotic their lives. I loved my daughter so much, loved how she would join me and my husband in bed in the morning—my little family all under the same covers, all breathing in the same sleep-filled air. What more could I ask for?

Dr. Lewis explains how we will proceed—tests, blood work, the interpreting of the results, likely a prescription for Clomid or an injectable alternative. “At what point,” I blurt, “would you tell someone to give it up?”

She smiles at me kindly. Perhaps I sound desperate, hysterical, but I believe I’m asking in the abstract. Does anyone ever say “enough’s enough already”? And it seems like a logical question to me, too, rather like asking about departure and arrival times were one taking a trip.

“That would depend on the results of the tests,” she says, “but if in a year, you still haven’t conceived, I’d think it would be time to reconsider.”

I nod. How can I explain myself, my lingering ambivalence and skepticism? Perhaps it’s all defense. Here I am, after all, for all intents and purposes already aboard.  Voting with my feet, as they say. She tells me to make a follow-up appointment and then sends in a nurse.

The nurse leads me to another room with a conference table and asks me to wait while she gets the materials. On the wall across from me, there is a large faux Impressionist print of a round table draped with a pale blue cloth. A bowl of lemons sits on the table, and a cobalt blue pitcher. Behind the table a window is open to the sea. A chair is pushed back welcomingly. It’s pretty enough, but eerie too—I can’t help but notice the absence of people. Imagine the same scene rendered by Mary Cassatt or Degas, a rosy-cheeked infant and calm Madonna nestled in that chair.

“I’ve got homework for you,” the nurse says, entering the room with a big binder.  The cover has a close-up of a baby’s face. The spine says Fertility and Reproductive Science Center Patient Manual.  Homework?

Seeing my look of distress, she takes the photo of the baby out of the plastic front of the binder, turns it around so it is blank. “There,” she says. “Better?”

“I’m okay with babies,” I say. “I have a child.”

“It’s hard for some of them,” she says, “so I just flip it around.”

She’s efficient and fast-talking, so I’m glad I’ve got a pen to take notes. There are certain days of my cycle for certain tests. On the pages that describe these tests, she’s attached post-its labeled in loopy, girlish handwriting. There is a test for my husband to take and this is complicated too, because he must make an appointment with the lab and then bring in his specimen. She gives me a specimen cup—a small plastic cup with a lid.

I’m tired suddenly, overwhelmed, and I wish she’d just say, “Your husband has to jerk off and fill this up with his sperm.” Why not call a spade a spade? I get that in this place of fraught conception babies are off-limits, but is sex too, and the sticky realities of the body? And who is served by this sterile language? In its hollowness and half-truthfulness, it reminds me of the clichés that surround new motherhood. Bundle of joy, for instance, a phrase that made me want to argue. I loved my infant daughter, found her presence miraculous. Still, joy is only part of the story.

When I leave, my big binder in my arms, the waiting room is inhabited by more quiet couples. I pass through the other waiting rooms and into the hospital lobby, and then out into the cold October late afternoon.

 *     *     *

Serophene is the brand name for the drug called clomiphene citrate or Clomid.  Clomid is the first stop for many of the infertile. I know so many people who have taken Clomid, you’d think it was candy at Halloween. It works by stimulating the ovaries to produce an egg—or in the case of all the Clomid multiples—eggs. It is said to make you bitchy and emotional—a kind of hormone-induced craziness. It has other unpleasant side effects too:  my sister-in-law knows a woman who took Clomid for several years in the late eighties, before it was understood that extended use could cause ovarian tumors. She has twin daughters—15 years old—and she is dying of ovarian cancer.

 *     *     *

My second trip to the fertility clinic is five days before Christmas, almost a year since my last miscarriage. I take my husband this time, because I am learning the rules of this place and because I expect bad news. I’ve spoken with the nurse twice regarding my tests, but I can’t get any details out of her, nor will the doctor speak with me on the phone. “She likes to speak with patients in person,” the nurse repeats, as if I’m slow as well as infertile. Again, there has been a long wait between the phone calls and an available appointment. I know this clinic serves much of western New York, but still. Why are there so many women who want babies and can’t have them? A pamphlet I leaf through says six million Americans confront infertility.

When we are all seated in the examining room, Dr. Lewis tells me that the blood work shows that I have diminished ovarian reserves. The phrase calls to mind something military, a regiment after a losing battle. What it means, though, is that my eggs are damaged because they are old. Later I will think about my eggs as my awkward adolescent self, hopeful and waiting, as kickball teams were chosen. “Pick me!  Pick me!”

Poor little eggs, I find myself thinking, poor old gals.

“Your best bet for pregnancy is with a donor egg,” Dr. Lewis says.

Together, my husband and I say no, and then look at each other in surprise. We haven’t discussed how far we are willing to go, but we are in agreement that this is too far. End of the line! Let us off! In response to my husband’s questions, Dr. Lewis talks numbers for a while—chances of pregnancy if we don’t try treatment: 5%, chance of pregnancy with Clomid: 6-7%. I’m not really listening anymore. I have the ending to my story.

“Your best bet for pregnancy is with a donor egg,” Dr. Lewis says.

“I’m happy to answer questions for you as they come up,” Dr. Lewis says.

“I’m done,” I say, as we leave the office.

“Okay,” my husband says. He puts his arm around me as we pass through the hospital lobby festooned with decorations. Christmas carols play softly. Outside it has started to snow.

 *     *     *

Earlier this week, in Skidmore, Missouri, a town near the one where I grew up, a young pregnant woman is found dead in her kitchen. She’s been strangled, her belly cut open and the eight-month fetus kidnapped. A witness at the murder scene said it looked like her stomach had exploded. It will turn out that the murderer, Lisa Montgomery, had been feigning a pregnancy. She will claim to have given birth while shopping.  She names the baby Abigail, which means “gives joy.”  Montgomery dresses her in pink and shows her off at a restaurant, the Whistle Stop Café, in her Kansas town, before being tracked down by police and the FBI.

The nation is momentarily obsessed and outraged. Montgomery is called a female Hannibal Lector, a womb-raider and worse. A Christian blogger wishes her a long, torturous stay in hell. As horrific as this crime is, it isn’t a first. The women—and it is always women—who perform this crime are desperate for a baby and to fulfill a childbearing fantasy. They also hope the baby will cement a relationship between themselves and their partner, who usually knows nothing of their plans.

Winter in that part of the Midwest doesn’t mean the clean whiteness of fresh snow, as it does here in New York. Winter in places like Skidmore means dried brown yards, bare trees against a stark, colorless sky. The light is bright, but not warm or golden. More like the intense lighting used for mug shots, the sharp light reveals all the blemishes and bruises of these sad towns—listing porches, chipping paint, buckling sidewalks, boarded up storefront windows on Main Street, grit and dirt and grime. Lisa Montgomery worked two or three shitty jobs and pretended she was pregnant. She also raised rat terriers, which is how she met her victim. She couldn’t afford the fertility treatments available to women like myself, nor would she have access to a foreign adoption, which would require travel and money. A domestic adoption costs plenty, too, and couples wait up to five years for a child.

None of this, of course, excuses Montgomery’s brutality and violence. Her motives are harder to comprehend when one learns she already has four children—though nearly grown—from a previous marriage. Still I can’t help feeling that Lisa Montgomery didn’t act alone. I lay some blame on a culture that persists on viewing motherhood as a woman’s greatest calling, on Baby Gap and Babies R Us and on all the mail-order catalogues specializing in quaint nursery furnishings: Pottery Barn Kids, The Land of Nod, Company Kids. And on People magazine and their covers with celebrity moms, proclaiming the joys of motherhood. “Of all the roles I’ve had,” says one star, “motherhood is the most rewarding.”

At the crime scene in Skidmore, the local sheriff said, “Someone was wanting a baby awful bad.” What amazes me about Lisa Montgomery’s story is that she knew how to perform a C-section without harming the infant. By this point in my journey, the desire and desperation—that huge wanting—doesn’t surprise me at all.

 *     *     *

I spend the next month telling friends and family that I won’t be having any more children. At the same time, I start having fantasies about boarding a plane to China or Guatemala or Korea and adopting a baby girl. In theory, it seems easy and perfect—no morning sickness, no refraining from coffee or wine, no need to buy maternity clothes, a kind of reproductive outsourcing. I think about the ads I’ve seen in the campus paper, couples looking for knocked-up college girls who might give them their baby for adoption. All medical expenses paid, a loving home, the ads promise. I think about finding one of those students and making the same promises, and more, anything–I will promise them the moon. And yet, when I set out to research adoption, I don’t get very far.  I’m travel-weary, unready for this endeavor with its attendant uncertainty and waiting and expense. In Barnes and Noble, and then later at the public library, I can only stand before the bookshelves noting the many hopeful titles and bright spines.

At first I resist the impulse to pack up all the baby equipment from my basement.  There are plenty of other things I might do—work on my novel or my collection of stories, plan my classes for the upcoming semester. But nothing is as compelling as clearing out that stuff, making way for the future. I give away boxes and bags of baby clothes, puzzles, games, books, tucking away only a few of our favorites.

*     *     *

Despite the good doctor’s statistics, I will get pregnant two more times. Each time, I feel a certain smugness and surprise. And each time, the pregnancy ends in miscarriage. The calendar is littered now with a jumble of birthdays gone wrong, due dates I failed to meet. And there will be no answers from the doctors, no explanations.  There is no ending to this story it turns out, just as there is no baby at the end of my pregnancies, something I—foolish girl!–should have understood. Instead of a baby, this is what I have in the end: a list of unused names (Clara, Ruby, Gabriel), a pair of buttery fleece booties with the tags still on. And this: an ache that hits not when I hold other women’s babies, breathe in their milky new smell, but instead when a recipe fails, keys are lost, a carefully planned trip gets cancelled.

photo(8)Rachel Hall’s short stories and essays have been published in numerous literary journals and anthologies including The Gettysburg Review, New Letters, Water~Stone and It’s A Girl!: Women Writers on Raising Daughters (Seal Press). In addition, she has received awards and honors from publications such as Lilith and Glimmer Train, and from the Bread Loaf Writer’s Conference, Saltonstall Foundation for the Arts and Ragdale. She lives in Rochester, NY with her family and teaches at the State University of New York at Geneseo.