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pregnancy loss. The blood: its color, its meaning. A flood of grief. That at-least-your-body-is-working mantra. Remembering the blood that indicated the beginning of the end. A glaring reminder that I was no longer pregnant. Starting again, maybe. Anticipation. Hope that there will be future pregnancies that last. Not knowing. No control. A surreal state of being. Loss of an identity you once knew and thought of as ironclad. Menstruation can mean so many different things to women around the globe, and for those of us who have miscarried, that first period post-loss can trigger unimaginable memories … and maybe even a little bit of hope.

That hope hurled me back into that space—the physical act of potentially getting pregnant again, the mental strength that must accompany a post-loss pregnancy, and the emotional toll that the magnitude of such a thing would take on my ailing mind. I was still reeling from the trauma I’d just lived through, but tucked in somewhere deep was a trust that this would not happen again. It just couldn’t. And so, we proceeded.

I could choose to wait out the months or years it might take to emotionally recover, or I could choose to try to conceive again. I couldn’t have both. I was forty by then, and Jason had just turned forty-one, so we were well aware time wasn’t something we had to waste. And so I (re)embraced my recently established desire for a larger family and went through the motions, because on some level, I knew I wanted to. I wanted to, even though I also didn’t want to. The fear of getting pregnant again was just as intimidating as not being able to get pregnant again.

And it was there that I found myself once again immersed in another aspect of a struggle I’d heard time and again, from patients within the confines of my office and online among other loss moms. Countless women had recounted to me their fears of sexual engagement, of conceiving again, of not conceiving again, reckoning with their altered sexual identities and sometimes suppressing their own desires altogether. And here I was, again able to empathize in a way that was only possible after experiencing such a thing firsthand.

10

“We are not going down on this note.”

“My friend Jasmine keeps pressing me—she won’t stop asking if I’ve started thinking about trying again,” Ella told me. She sat across from me, legs and arms crossed, head leaning on the back of the firm, brown leather couch. She plucked a Kleenex from the nearby box. “It’s just weird that something so private—so individual—is asked so nonchalantly. Like somehow my sex life is a public matter now,” she said, on edge. It was uncanny to be having this conversation with her, when people had been asking me the very same thing.

“You felt pressured to share something you weren’t quite ready to talk about,” I remarked.

“Yeah, it was awkward. But I told her that I had,” she replied. “I didn’t tell her that we’re already trying, though. I just said something about how we’ll get to it when the time feels right.” Ella continued, “She has two kids, and has some fairy-tale story—like, she got pregnant with both on the first try or something. No miscarriages, no pregnancy fears, no nausea, even, so she just doesn’t get it. I don’t know … I just wasn’t in the mood to talk about it with her. Wrong audience, or something—you know?”

“I understand,” I said. “And trying again—how do you feel about the prospect of that? Are you feeling ready?”

“You know, I really do, actually,” Ella replied. “I finally got my period, and I’m just so ready to get back into a good place again. Less bogged down. I’m tired of feeling like my loss is what defines me. I just want to be pregnant again.”

“That makes sense. Feeling reduced to a loss is not a good feeling. You are more than your loss. So much more, of course,” I empathized.

“Thank you. I think so. My life is about so much more than grief. It’s got to be. And I think being pregnant again will bring some much-needed hope to our household. I’m curious, though, how easy it’ll be this time around. Or how hard. I’m in this private women’s group on Facebook, and I asked how long it took each of them to get pregnant again after they’d miscarried.”

“What were the responses like?” I asked, admittedly at least partially curious for personal reasons.

“They were varied, but most people got pregnant again within a few cycles, give or take. One woman said it took her nine months. This frightened me to no end. It had better not take me that long. I don’t think I could handle that: The ongoing, unrelenting disappointment. The reiteration of loss through negative pregnancy tests. That grief. Getting my period again and again would feel like loss after loss, I think.”

“I can understand why hearing that would spike your fear,” I said. “It can be tempting to compare time frames, but everyone’s situation is unique, and it can sometimes hurt more than help when we survey what other people have gone through.”

Silently, I hoped that it wouldn’t take long for Ella, and by proxy, myself. I also considered how challenging it can be to not have access to answers. To simply not know. And while Ella never asked me how long I imagined she would have to try before getting pregnant again, so many women do. “Do you think I’ll get pregnant again?” they’ll ask in angst, and it takes everything in me not to automatically respond with a guarantee about a future I cannot adequately predict. I want this for these women if and when they want it for themselves. And because hope is vital, I hold it almost always, at least for those who need it. And because uncertainty is such a tough place to live—within our psyches, and within our bodies—I want to shout yes from rooftops: you will get

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