Chapter 1
September 30
My contractions have begun, but everything is wrong: the wrong day, wrong month, wrong person clutching my hand.
The pain in my lower abdomen eases to a dull shredding. I open my eyes and flinch at the yellow leaves flashing across the ambulance’s back glass in the fading evening light. Those citrine hues are the first colors to appear in the New England fall and the last thing I should see on the day I go into labor.
The driver speeds down Blackstone Boulevard, where I collapsed after a rush of blood coated my thighs. Blinking back tears, I concentrate on the thin blur of telephone wires cutting through the trees along the road. Each tree is trimmed into a deep V to keep the power lines safe. No longer full and round, they’ve grown into broken hearts. I count four split hearts before I’m seized by another contraction.
A minute, maybe more, passes before the cramp disappears like a twig snapping, and I fully exhale. The pain is so much worse than the Braxton-Hicks practice contractions I’ve had the past few weeks. I grasp for some guidance from the books and classes and articles, but my mind cannot get beyond the terrible truth of what being on this gurney means.
More wetness spreads beneath my thighs, dampening the backs of my knees. The EMT loses all color in his face as he lets go of my hand. His jittery stare creeps along my navy-and-white nautical dress until it reaches below my pregnant stomach. The stripes are now maroon to the point of shiny black. Our terrified gazes lock, and then he yells to the driver. The wail of sirens begins.
We’re in trouble, baby girl.
Both my hands grab the metal handles, squeezing until I regain control of my breath. Finally, my mind shifts, but it’s not an act. There is fight and there is flight, and I’ve done them both plenty. But there’s a third choice for those of us who have experienced enough terror: focus.
The pain is on the left side of my abdomen. If the blood loss is from there, I have to do something. With a moan, I pull myself over, applying as much pressure as I can stand.
Panic returns, and my nostrils burn as tears descend my cheeks, pooling along the tight oxygen mask. This child, small and beautiful and mine, is almost in my arms. I picture her from last week’s ultrasound and cry harder.
The EMT’s chin wobbles as another contraction begins. He grabs my hand again.
“I’m okay.” I repeat the words until I’m coughing, which doesn’t make them believable.
This cramp pulls me to a primitive place. The EMT’s murmured assurances barely register. My senses narrow onto the sharp pain. My muscles tighten as if in revolt, desperate to escape my body.
I feel the road change from the bumpy potholes and uneven city streets to smooth highway. I take a long, exhausted exhale in relief. Almost there, almost there, almost there. Women & Infants Hospital of Rhode Island, baby girl. We’re almost there.
We stop at last, but it’s seventy-eight breaths before the driver with a gut who loaded me into this ambulance can be bothered to help the panicked EMT get me out. They finally lower the gurney onto the ground as another contraction begins. I let out a deep guttural holler, then take short breaths from fear as much as pain. The gurney wheels squeak, and my noises continue as I see stars starting to appear above me in the evening sky.
They hurry me through the ER’s sliding doors. In my own area, I’m surrounded by beige curtains and beige cabinets and blinking beige machines. A man in blue scrubs enters, though his face is beige, and he’s got a scruffy dark beard.
“Devony Burges, I’m Dr. Keller. You have to slow your breathing.”
No one outside southeastern Kansas calls me anything other than Devon. I hate the name my mother gave me, but correcting him isn’t possible.
“Can you hear me, Devony?”
I slow my gasping to a shuddering trot under the oxygen mask. A burst of light passes across my left eye, then right, then left again.
“Are you with me?” he asks, pulling the penlight back for my response.
I grab his hand and gather up all I’ve got. “I’m twenty-eight weeks and a day. I don’t . . . have any allergies. I’m O negative.” I grit my teeth through another contraction, but it’s gone soon. “I’ve been walking all day . . . the contractions got worse . . . I thought my water broke, but all I saw was blood.” I pause as my voice catches. “There’s terrible pain . . . my lower back.”
He nods tightly once and joins the activity around me. The nurses cut away my dress and underwear, slipping my arms into a thin gown. The blood bag cart clinks against the gurney, and the pinch of the IV is a tickle compared to the pain within my body.
The nurse drops my purse in a plastic bag. The edge of a yellow day planner slides out as she ties it shut. I start to say the planner isn’t mine, but there’s another contraction, and all I can focus on is the overhead light behind the doctor’s head.
“Can you tell me what happened?” he asks.
He’s asking the wrong question. I count down from one hundred, and finally the contraction’s grip dulls, and I have a few glorious moments of only burning back pain. I relax my closed eyes and think. When I was in my first trimester, I made a list of probable complications that could occur during labor. Seventeen of them seemed worth categorizing and diagramming and obsessing over. They’re tucked away in a tidy spreadsheet on my computer. In the ambulance, I was too scared to mentally cull through the symptoms to determine what’s happening. That’s the problem with logic. It doesn’t stand a chance against terror.
I must be brave for my daughter. I visualize my spreadsheet, and every line item spins around like a slot machine. The variables of my day align with different columns until number seven stops: detached placenta. The system my body grew in my uterus to feed my baby and give her oxygen has stopped working.
“All day my back hurt,” I begin. “I was . . . walking and then bleeding. It’s my placenta.”
Dr. Keller sticks out his stubble-covered jaw as he presses on my stomach. “Have you noticed increased urination prior to today?”
I shake my head no because I pee all the time lately. “First trimester, I bled some. Not . . . for a while.”
He pauses his hands along my stomach. “Have you felt the baby move?”
Everyone stills. Even my breath goes somewhere else.
“No,” I manage to gasp as another contraction begins. I groan and press my trembling hands along my stomach. I picture the cord, amniotic fluid, and my baby fighting to stay with me, mere centimeters below my touch.
The ultrasound machine appears, and familiar goo is plopped onto my bare stomach. The seconds are minutes.
“Please, please, please,” I moan to no one and everyone.
The liquid silence of my womb continues. My head rears back, mouth falls open with a silent scream lodged deep in my chest. This is the real pain.
There’s a murmur, distant like a record scratch in another room over and over and over.
Her heart is beating.
My body shakes as I cry hard. This is the only sound in the world that matters. That will ever matter.
Dr. Keller prints the ultrasound images. “You’re correct. The placenta has pulled away. We have to stop the bleeding and deliver your baby. The heartbeat is weaker than I’d like, so a C-section is our only option.”
I try to temper my sobbing, holding my breath to make childlike gasps.