by Jody Keisner

I look past the doctor sitting across the desk and focus on the floor-to-ceiling bookshelves behind her. My eyes skim over the medical books and land on the framed picture of her two young sons, both of them tan and dressed in preppy pastel shirts. They look about two years apart and have the doctor’s thick brown hair and dark eyes. She’s talking about saline infusion sonograms. Saline? I think. The stuff that I rinse my contacts with at night? I should pay attention to what she’s saying, but instead I picture her boys riding bicycles down a suburban neighborhood street, past trees and children playing on lawns. The older one calls over his shoulder to his brother, Come on! Faster! I imagine the younger one pumping his legs, his feet becoming a blur going round and round with each spin of the wheel. Now the younger one stands up on his bike, giving everything he has to catch up. Maybe this moment will mean something to the boys later in life, maybe it won’t, but the camaraderie they’re experiencing means something now. Then I picture my daughter, Lily, a few years from now, the same age as the oldest boy, pedaling down our street alone.

“…if your uterus is healthy enough to support a pregnancy.” The doctor looks at me intently. She’s noticed my drifting.

Because of a mix-up with the date of the appointment, Jon is at his job as a drywall installer, and I feel like I need to explain this so she will know that we are in this together, though we aren’t sure that we are. “My husband really wanted to be here,” I say.

She nods. “Do you have any questions, Jody?”

I do have questions, loads, but not the kind she can help me with. Do I want to pursue more medical intervention? Do I even want another baby? Or are we already complete, my family of three? I should know the answers, considering I’m sitting across the desk from a fertility specialist. Correction: infertility specialist. Given my age, 39, and Jon’s, 42, and my history of infertility, our chances of conceiving without medical intervention are around 1-5%, she says. I didn’t know our chances were so grim. She hands me a fertility menu: artificial insemination, in vitro fertilization, zygote intrafallopian transfer, donor eggs and embryos. The long list of interventions and the high price tags overwhelms me. So many options, each increasing in degrees of separation from what Jon and I are supposed to be able to do in the bedroom. Must I decide the future outcome of my family right now? Is it even my decision? Perhaps nature has already decided and science won’t be able to circumvent its choice. I set the fertility menu on her desk.

“The saline sonogram will tell you more about my uterus than the X-ray dye-test? And it will hurt less?” I ask.

She nods again. “It will cause less discomfort than the hysterosalpingogram.”

Why does it matter to me if it hurts less? Before I had Lily, I would have undergone any test. I would have allowed any number of transvaginal wands to probe me. I would have increased my risk of developing ovarian cancer which, according to unpopular research, I did every time I subjected my body to aggressive fertility drugs. I would have put up with any amount of “discomfort,” as all of the doctors that I saw preferred to call it, even while I lay on the metal examination table writhing from the uterine cramping caused by the catheter and iodine dye used during the hysterosalpingogram. Then, my ink-filled fallopian tubes, lit up uterus, and the black void on the computer screen resembled a Rorschach test. The first word that sprung to my mind when I looked at the screen was “hurt” so I willed into its place “baby.” But now, thinking of all the testing and hour-long drives from my job to the fertility clinic, I feel tired. My pain matters.

“Intrauterine insemination will increase your chances of conceiving each month by 3-5%,” the doctor says.

My eyes start to well. These are still terrible odds. I discreetly wipe my face and remind myself that I’m not in the same place that I was before Lily was conceived, throwing negative pregnancy tests in the trash month after month, only to have the resulting pregnancy one year later end in miscarriage. Then I felt hopeless and desperate, seeing each pregnant woman in the grocery store as a threat: I was the negative statistic, the infertile one, the one who couldn’t make things grow. I pleaded with Jon to consider international adoption, to consider anything short of snatching a baby from a discount store parking lot so that I could be a mother.

But now I am a mother. I have Lily, delightful, pretends-to-be-a-robin-at-storytime-and-flaps-her-arms-around-her-bedroom-Lily. So why am I sitting here in this office? My friends and family wonder the same thing. “You are so blessed, Jody,” my mother tells me. “You should be happy that you have that little girl. She’s a miracle.” My mother had suffered three miscarriages before adopting me and then surprised herself when she gave birth to my sister a year later.

A colleague of mine, a woman in a same-sex marriage who had struggled to bring a baby into her union and now embraced a child-free life, said, “Why do you need another? You have one perfect child.” I didn’t disagree. Lily is healthy in every way. She’s a happy child, too, who snuggles and offers up hugs like sticks of gums. My pregnancy with her, two months after the miscarriage, felt nothing short of miraculous. Is it selfish of us to want another one? Parents of larger families seem to think it’s selfish of us not to. It doesn’t help that we live in Nebraska, one of the most enthusiastic baby-having states in the nation.

“When are you going to give Lily a brother or sister?” asked my friend, Laura, herself a mother of two. Our three children were on a playdate.

I didn’t know what to say, so I shrugged and said, “We’ll see what the universe has in store for us.”

“Brandon and Caroline are best friends,” Laura said, smiling at her offspring, who at the moment, were engaged in a heated tug-of-war over a naked doll. Lily sat close by, sucking on the index and middle finger of her right hand, entranced by the unfolding drama. Brandon gave one final yank and pulled the doll, minus one arm, away from Caroline. She used the severed limb to whack him on the head. “Well, when they aren’t fighting,” Laura added.

I can’t remember a time when my sister and I didn’t fight as children, and we aren’t especially close now. There are no guarantees.

“It’s about time you started thinking about your next one,” a father of three young boys said at a work picnic. He had casually asked me my age earlier in the evening. He glanced at Lily who was being chased around an evergreen bush by his youngest son and then at his watch. Was he looking at my biological clock, and if so, could I have a peek? He couldn’t have known that Jon and I been actively “trying” for the past seven months, that we’d already exhausted the final three rounds of fertility drugs that my gynecologist would willingly prescribe before considering them a failure. Us a failure. After that, my gynecologist recommended the infertility specialist. Like many fertility challenged couples, we had once mistakenly assumed that pregnancy was a biological given. Jon and I were both good students. If my gynecologist advised us to have sex every other day for our ten “fertile” days each month, told me to eat unappealing high fertility foods like kale and told Jon to give up his nightly beer, we did exactly those things, expecting nothing less than the hoped-for outcome. We had never considered the possibility of no outcome.

But this time is different. We haven’t failed; we have Lily, with her charming daily inspection of the ladybugs in our hosta garden. But after months of unsuccessful attempts to conceive baby number two, we began to have doubts. We found reasons to move on with our life, as is. “Adding another baby will change the family dynamic,” I said one evening. Jon agreed, “Our marriage feels like it’s a priority again.” We are learning how to make time for each other. We’re content. Our house no longer feels topsy-turvy with the round-the-clock demands of a baby, who is the most inconsiderate kind of roommate a person can have.

Besides the added stress to our family dynamic, there are the usual suspects: the financial strain that having another baby will bring to a middle class family like ours, and less time for a career I love. “I can’t think of anything more important than being a mother,” a mother of three children said to me after I had confessed my work-related worry. Sometimes I fear the divide between mother and academic is too wide to cross. I want time for my research and writing endeavors; I want time to advance my career. It all matters, regardless of how idyllic the frolicking family of four on the cereal commercial looks.

Most concerning, I know that breastfeeding and bonding with a new child will mean less time for Lily. “You have enough love for Lily and for a new baby. You do,” one mother told me. I’m not so sure. My love for Lily is fulfilling and also…so consuming.

In the month leading up to my appointment with the infertility specialist, I struggled to tune out well-meaning voices so that I could figure out what I really wanted. I had been certain that I wanted another baby, but now I was unsure. I began to look for signs from a Higher Power. “God, please give me a sign. I want clarity. Is Lily meant to be an only child?” When my prayer went unanswered, or perhaps I neglected to listen, I considered seeing a psychic a friend recommended. Ultimately, I couldn’t manage to find the time in my jam-packed schedule. Was that, in itself, a sign? My interpretation of “signs” changed from one minute to the next. Collecting a pair of Lily’s socks from the laundry basket, thinking of her stubby toes, this little piggy goes wee-wee-wee, I ached for another baby. This sign said yes. Then, in another moment, Jon and I both weary from a full workday, arguing with each other over who would make dinner while the other tended to Lily’s diaper and bath, Lily stomped her foot and screeched, “I WANT MY GOLDFISH CRACKERS!” Then she crumpled onto the kitchen floor and sobbed. When I reached for her, she flailed her legs, kicking me in the nose. Maybe this is a sign saying no, I thought.

One evening after Jon and I had read Lily stories, sang songs, and kissed her night-night—a ritual that usually left me feeling peaceful—I went outside for my walk and instead paced the few blocks on my street. My pacing soothed me in the way it mimicked the pacing my mind was doing, too. My neighbors probably thought Jon and I were having marital woes, but we weren’t. We were having only-child woes, worried we weren’t yet a real family. We weren’t child-free nor were we child-full. During our early courtship, six years ago, Jon and I had agreed that two was our number, and I struggled to reconcile that early shape of our American Dream with our current reality. The only sound I heard came from the summer cicadas, buzzing so loudly that I entered a kind of trance. Did I want another child in case something happened to Lily? It was then that I realized that maybe I didn’t want another baby as much as I wanted to clone Lily in case the unthinkable happened. It’s silly: there is no back-up Lily. Nothing could ease the despair of losing her. Once I vocalized it, Jon admitted he shared my worry, too. “If something happened to her, I wouldn’t be Dad anymore.” Being so vulnerable terrified me, but I knew having another child would only increase my vulnerability, not lessen it.

Then how to explain the fact that I’m sitting here in this doctor’s office, seeking more invasive medical intervention to help get me pregnant? The myth of the only child syndrome doesn’t worry me: extroverted Lily isn’t socially inept. Toddlers are supposed to be spoiled, and developmentally they’re all selfish. Most of the only children that I’ve known have grown into thoughtful, intelligent adults.

I’m concerned about the other consequences of Lily growing up an only child. Will her childhood be lonely, spent longing for a sibling to torment? Will holiday celebrations with only the three of us feel too small, somehow unfinished? Will she feel overburdened as Jon and I grow elderly? Will Lily be alone after we die? Perhaps the answer to all of these questions is “yes.” The bigger question: Can I live with that?

I have so many questions and none of them have to do with the semen analysis the doctor is requesting for Jon or the blood work she’s ordering for me. Earth to Jody. I focus back in on the doctor across from me. I look at her skin, clear and smooth, unlike mine which has been blotchy ever since my pregnancy with Lily, over three years ago. I like the doctor. She’s straightforward but upbeat. She’s someone I could imagine myself spending time with outside of this situation we’ve found ourselves in. But I know that we won’t.

“Do you have any questions?” the doctor asks again.

For the first time today, I know what I want. I want to leave. I want to see Lily. I want to touch her and smell her hair. I want to spend the rest of the day focused on the family that we already are instead of pursuing the family that we may never be.

“I don’t have any questions,” I say, and at least in the moment, it’s true. “Thank you.”

I practically run to my car. It’s a mild late-summer day, ideal for a walk to our neighborhood park, the same place where Lily slid and swung and climbed for the very first time, holding our hands and squealing. Weather permitting, we’ve walked there every week since she’s been born. More than once, I’ve hit the top of my head on one of the climbing structures, a painful reminder that the park has been built for very young children. As a new mother, I cut my teeth at this park. It both saddens and delights me to know that Lily will outgrow it soon.

Jody Keisner’s work has appeared in Literary Mama, Women’s Studies, Studies in the Humanities, and elsewhere. She teaches courses in creative nonfiction at the University of Nebraska at Omaha.