My energy level was high. No nausea. No sickness. And my first pregnancy had been relatively smooth and uneventful. So I didn’t think anything of the fact that during the final day of a work trip to Paris toward the end of my first trimester, my pee seemed a bit darker than usual. As I boarded a Eurostar train back to London with a colleague and noticed a little light cramping, I thought I’d simply eaten too much crusty bread too quickly during lunch. Maybe the food hadn’t gone down well.
It wasn’t until halfway through the train ride that I began to notice I was breathing through my mouth as I do when I’m in pain. I felt ill. Maybe the train ride was making me feel nauseous.
But no. A trip to the toilet revealed blood. I was bleeding. Not large amounts, but enough to worry. We were an hour away from London. I was eleven weeks.
So, hands shaking, I stuffed a ball of toilet tissue in my pants and sent my husband a text. I would head to the emergency room as soon as my train arrived in London. He would drop our son off with local friends and meet me there. My husband had started a new job, and our private healthcare hadn’t yet kicked in. So I decided to go to a hospital in a low-income, densely populated corner of Southeast London because it was nearest to where I lived a few neighborhoods away. “Are you sure?” my husband asked. It wasn’t the hospital where we’d had our first son—a place I had selected because of its strong reputation for maternal care.
When we arrived, the hospital was surprisingly quiet, but the wait was excruciatingly long. The hospital was short on staff. A nurse sat me and my husband down in chairs near the doctor’s station. A few feet away from my chair, a veneer of dried blood stained a stretch of floor like some kind of morbid watercolor. No one seemed to notice. When I pointed it out, a nurse apologized and paged the cleaning staff. We moved to a different corner of the room.
Thirty minutes later, the blood still hadn’t been cleaned up. If I’d had the presence of mind, I would have taken that as a sign and left. But it was late and I felt too unwell. An hour later, I was called into a small room, only to be asked to wait longer. Three hours later, a doctor examined me but could not make a definitive call on whether or not the pregnancy was still viable. So he sent me home and asked me to return in a few hours once the early pregnancy unit opened at 9:00 a.m.
As my husband and I sat in a crowded waiting room that next morning, I tried not to cry as I read the literature taped to the walls—posters telling women where to go, who to see, and what number to call should they have a miscarriage.
I was surrounded by Black and brown women, including a teenager with a bulging belly sitting next to her mum. A woman in a burka struggling to keep three rambunctious children quiet. And a young Caribbean-sounding woman dressed in a work uniform sitting on her own.
As we waited, a midwife chastised another for showing up to work late. In another room, we could hear a woman sobbing loudly.
“Have you recently suffered a pregnancy loss?” a poster asked me from across the wall. It seemed irritatingly presumptuous.
But the words stuck and surfaced later that year when I had a second miscarriage.
“There were two. I’m so sorry,” a doctor told me.
Two. Twins. Two sacs. So small. Too small. No heartbeats. One gone at seven weeks. The other at ten.
I found out about my second miscarriage two days before Thanksgiving. After the trauma of the first loss, I had decided to go private for the early scans. If all looked okay, I would share the good news with our families by Christmas.
But things didn’t look okay. I’d walked into the hospital thinking I was literally full of life, but the scan instead revealed a graveyard. What was once growing and alive was now disintegrating tissue matter. The doctor explained my options and then supported my decision to book a surgical removal right away.
It was difficult for me to see the situation as anything other than a death. And one that took place inside of me, twice. Twins.
We were scheduled to host a Thanksgiving dinner of twelve friends and family, some of whom had traveled from the States and were staying with us. It seemed too late to cancel. And I didn’t want to answer anyone’s questions or talk about it or listen to comforting words. I needed the distraction. Better to just keep quiet for the moment and cry it out later.
It had dawned on me that I had spent a fair amount of 2017 trying to get pregnant, being pregnant, or losing pregnancies. And it had been a very bad year as a whole with Brexit and Trump-induced angst spreading a cloud of funereal unease. There was the unpredictable economy, damning environmental news, growing xenophobia, spike in hate crimes, and increasingly polarizing and vituperative political rhetoric. My family dog back in Virginia died. And Borough Market, a local haunt my husband and I felt a special connection to, made international news when a group of men drove their van through crowds of people before randomly stabbing victims in a terrorist attack. That night, I could hear the sirens of ambulances and fire trucks rushing through my neighborhood toward the scene of the crime. Weeks later, seventy-two people died in their homes when Grenfell Tower, a block of public housing flats in North Kensington, erupted in flames. And weeks after that, I lost a baby.
As far as years go, 2017 was a personal low. And waiting in a hospital room, trying to swallow back tears as a doctor explained to me what the procedure would involve, felt like my rock bottom.
The thought of drowning my depression in a plate full of pumpkin pie while surrounded by people who could divert my attention away from the source of it seemed like the way to go.
“Are you okay?” the doctor asked me the next day as I sat in a hospital gown listening to the anesthesiologist’s instructions. “I’ll be fine, just like every other woman who has gone through this. I know these things are very common,” I replied. “It doesn’t make it any less hard,” he said with a sad look on his face.
When I came to an hour later, I felt like I had just woken up from a long night’s sleep, wide-eyed and alert. Less woozy than I was during the abortion in New York but much more sad. Devastated. Distressed that my body was failing me.
That night I went home and peeled potatoes. The next day we held the dinner as planned.
After our family members returned to the States following Thanksgiving, I became prone to crying in a way I never had before. I worried my son—so perceptive, so attuned—could sense that something was wrong. My husband surely did.
I wondered if the unwavering resolve, the stoicism with which I’d handled the abortion all those years ago, had backfired. My usual optimism and pragmatism were failing me. I was disappointed. Angry. Unsettled. And unsure of myself. I began second-guessing my everyday decisions because the decision-making that led me to this point hadn’t worked. I thought about all the things I did during that year of loss: a promotion at work and business travel to Paris, Florence, and Tokyo, among other places. Those were things I had wanted, but did they come at a price? I wondered if the narrative I had always dismissed as archaic and had resented, the idea that a wife and mother always had to choose between work and family—she could never have both—might have credence.
While all of this was happening, a conversation was growing about the abysmally poor maternal health outcomes of Black women in the US. The American nonprofit media organizations ProPublica and NPR had published a report revealing that Black women are dying from pregnancy-related complications at a rate that rivals third world countries and that Black infants in America are twice as likely to die as White ones. Even more revealing is the fact that Black college-educated mothers who give birth at local hospitals are more likely to suffer serious pregnancy or childbirth-related complications compared to women of other races. The same goes for women with financial means. Black middle-class women are more likely to die from childbirth-related complications than White working-class women. Rich women are also not immune. Beyoncé Knowles gave an interview to Vogue revealing her own struggles with preeclampsia, which Black women have a higher risk of developing. And Serena Williams gave an interview to the same magazine about how she nearly died in childbirth because the medical staff ignored her requests for a CT scan.