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Sarah’s Box

By Lisa C. Friedman

WO Sarah's Box ArtShe lives in a box. Actually, she is the contents of a box. The box is wrapped in a blanket that was a gift from my sister. It was supposed to keep a newborn warm, but now it’s muted pinks, greens and blues warm the box. I look inside once a year, on the anniversary of her birth/death. I have, like a fanatic, kept every scrap of her. Her first ultrasound. Locks of her hair. A card with her foot and hand prints. The doll’s dress that she briefly wore. (She weighed 3.5 lbs, too small even for the preemie wardrobe.) Condolence letters. The autopsy report, detailing her tiny dimensions and the final, inconclusive results.

The contents are about the potential for life. They also mark the end of hopes and dreams. They are the reality of my child, born dead at 32 weeks. No separate birth and death dates mark her headstone; just one date, March 11, 2006.

When you’re pregnant, the countdown to birth starts almost immediately. It is a long but steadily quickening race to the finish.

The first trimester, from the approximate date of inception through week 12. Nervous excitement, and thankfully no nausea, just a strong craving for grapefruit soda. A first ultrasound brings the baby to life. We see and hear her heart beat inside me. My waistline slowly expands, forcing the inevitable shift into maternity clothes. A pregnancy still fresh and special, it is a secret between me and my husband.

The second trimester, weeks 13 to 26. At age 39, the dreaded amniocentesis. The needle draws its fluid and does no harm. Good results, so check that one off. Tell our 3-year-old that she is going to be a big sister. Also tell our family and friends the happy news. Let my employer know that I plan to keep working after the baby comes.

The last trimester, weeks 27 to birth, typically anywhere from 38 to 42 weeks. The end is near. Sleep is getting more difficult. My back aches. But the excitement is growing because soon we will meet our new child.

It is Friday afternoon and it seems as though I haven’t felt the baby move all day. To relieve my anxiety before the weekend, I make an appointment for a quick visit to my obstetrician. I call a friend on the drive over. I say, “I’m sure it will be fine. She’s probably just been sleeping a lot.” And then I add, “But if there’s no heartbeat, come visit me at the asylum.”

My husband, not one to miss a chance to hear and see the baby, meets me at the doctor’s office.

I know very quickly that something is wrong. The doctor is taking a long time to find a heartbeat. My own is quickening and I can sense my husband getting uncomfortable. I ask, “Is something wrong? You can’t find a heartbeat?”

“I’m sorry,” he says in his slight English lilt. “No, there isn’t one.”

The tears want to come but I force them back. He puts down the doppler and looks at us. I am aware that he is really trying his best to be caring, to sound caring.

“This is a tragedy,” he says. “I am so sorry.”

I ask, “But this—has this happened before?”

He says that it is very rare.

Then why me? Why me? Why us?

“We can go to the hospital this afternoon. I think it would be best to take care of this as soon as possible. I would also recommend an autopsy so that we can understand what happened,” he says.

“But I don’t have to go through labor, right? You can do a C-section, right?”

“No,” he says. “A vaginal birth. A C-section is an unnecessary risk to you. The baby is small so it won’t take long. Just call my office and let me know what you decide to do. Take as long as you want in here.”

He leaves. The meltdown can come now. Still in my gown, lying on the examination table, I start sobbing. My big belly bounces with me. The dead baby bounces along inside. My husband leans his head into mine and cries.

But we need to pull ourselves together. I don’t want to go to the hospital now. I want to see my 3-year-old.

On the way home, I ask my husband to stop at the city recreation department—today is the first day to turn in summer camp registration forms. Looking back, I can now see my need for control—to make something turn out right. My 3-year-old daughter would get into the zoo camp.

I’m sure I’ve done something wrong. Was it my ambivalence about having a second child that cursed me? Having suffered severe postpartum depression after my first, I wasn’t sure about having another child. We waited more than two years before even trying.

I must have done something wrong. Was it something concrete? Not taking my prenatal vitamins every day? Drinking too much bubbly water? Sleeping on my back?

We tell our daughter. I hold it together while my husband falls apart on the floor of our closet. She climbs on top of him and puts her face close to his ear and giggles.  

But she will come to ask many questions over time, wanting answers we don’t have or ones we are unwilling to give someone so young.

“But I want to see her. What is she doing now?”

“Why can’t you just open her eyes?”

“If she’s buried, do her eyes have dirt in them?”

“If heaven is above the clouds, why can’t you turn the clouds upside down to see her?”

“It’s better to have boy babies. They don’t die.”

As promised, the labor is fast. The Pitocin kicks in, and I only have to push once and she slides out. Our last faint hopes disappear with her silent arrival. There is no flush of first life; her skin is gray, body limp. Eyes are closed. I count ten fingers and ten toes. A head of dark hair. But she is broken.

Once finished with the task of labor, the doctor sits down to do paperwork. Why doesn’t he leave? I am holding my dead baby you idiot! I want to shout. We wait while he completes the hospital forms. Then he says he is sorry again and will get back to us with the autopsy results.  

I want to feel that she is beautiful. I want to feel like holding her forever. Maybe I’m numb. Or maybe death is ugly.

We cry more. But then we don’t know what to do. No rush to breastfeed, change diapers and make happy phone calls. No flowers, no gifts, no breath, no life.

We name her Sarah. I want a name that has endured.

The nurse is wonderful and caring. At some point, she takes the baby and puts her in a dress, makes an imprint of her feet and hands, and cuts a few locks of hair.

We leave the hospital with our box.

Irrational thoughts come and go. I can diet quickly and lose the baby weight. I can sleep through the night. I don’t need to breastfeed.

But my milk comes in and fills my breasts, my skin is so stretched I want to cry out. I moan into my pillow instead. I’m advised not to pump off the milk because then more will come in. I take lots of Advil. My husband wraps an ace bandage tightly around my breasts to keep them from moving.

It is early morning and everyone is asleep. My mother has flown out from the East Coast to help. I wake her up to tell her about the birth and the baby. I want her to know that it was a real baby—I held her. She was complete. My mother cries with me. In her day, the baby would have been whisked away. A friend’s mother who experienced a similar loss never even saw her baby.

My father does not come. He is a doctor, a researcher published many times over, renowned in his field.

But he doesn’t come. When we talk on the phone, he goes into science mode. He even calls my doctor to try to get some answers. Thankfully, my OB shows discretion and says he can’t talk without my permission.

I tell my father, “I don’t need you to be a doctor. I need you to be my dad.” He doesn’t know what to say. I am angry and sad. He simply can’t do it.

My sister and I had due dates a week apart. Ever the older sister, I try to be strong and supportive. Pregnant with her first child, she can’t let my loss in. I am resentful and pissed.

She gives birth to a healthy baby girl six weeks later. It will take me several years, including the birth of a healthy second baby girl of my own, to really acknowledge my niece—to embrace her and not see the shadow of what we lost.

The cemetery. The rabbi meets us there and fittingly, it is a cold, rainy day. He is wearing a worn yellow slicker. His voice is warm and gentle. The heavy-set man from the funeral home carries the tiny casket. We put a teddy bear inside and a note. We say goodbye.

Word gets around quickly. I am too raw and sensitive to face people. I despise the ones who don’t say anything, too afraid and uncomfortable to acknowledge what happened. Others say things so thoughtless and stupid like, “Don’t you wish the hospital would have just taken care of it?” I don’t even ask what that means.

Then there are the friends who give the pitch-perfect response like the one who wraps me in a hug and says, “What the fuck?” Every reaction either passes the test or feels like an assault.

I have always felt in some way that my worry would protect me from really bad things ever happening. But then it didn’t. There was no heartbeat.

I have a second daughter now. She was born on March 6, 2007, just shy of one year after Sarah. Born with a rare spinal abnormality, she had to have surgery at seven months. Told repeatedly that it was a simple procedure for a skilled neurosurgeon, I was not convinced. I felt sure she would react negatively to the anesthesia and not wake up or that an infection would come and she would be gone. The surgery went fine and she is a perfectly healthy 6-year-old.

But once tragedy hits, it never really leaves. The scars run deep.

I watch my younger daughter as she sleeps, with her favorite stuffed animals—horse and bear-bear—standing guard on either side of her. Then I imagine another trip to the cemetery. The panic subsides and she is once again a peaceful, happy, sleeping child and I am her mother again and not some crazed lunatic.

My older daughter’s anxiety can make us laugh at times. If someone feels unwell, she jumps on it, “Is she going to barf?”

Too often, her worry can escalate to, “Is she going to die?”

I’m not so prickly now. I no longer feel the need to announce my loss. Seeing a very pregnant woman sometimes, not always, makes me sad.

And guilt, a friend of grief, has often come to visit. Maybe I’ve made too much of my story. My neighbor had a stillborn baby at 40 weeks, much worse. A friend lost her daughter at 17 months, unimaginable. Stories of dead children are everywhere.

But as a friend tells me, “This is not a tragedy horse race.”

Sarah’s box sits at the top of my closet and I open it once a year.

Lisa C. Friedman lives with her family in Northern California. 

Want to read more thought-provoking essays? Subscribe to Brain, Child: The Magazine for Thinking Mothers and see why we’ve been receiving awards for literary excellence since 2000.

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