The sharp cramp beneath my swollen belly wakes me in the middle of the night. It feels like a tiny hand squeezing my small intestines. I try to walk it off, like my mother told me to do when I was a little girl and had eaten too many helpings of mashed potatoes. Thirty weeks pregnant, I pad around the upstairs in my bare feet, listening to the open-mouthed exhalations of my two daughters and husband as they sleep. The walking doesn't help. Deep breathing doesn't help. I brace myself against the stairwell banister and moan into the pain, my eyes closed. When I open them, the walls blur and my skin shivers under beads of sweat. I stumble into the bathroom with an intense urge to push. A splash of bloody liquid strikes the bathroom floor. A rug stained. A sudden relief. Before I scream for my husband to wake up, I pause for a moment, acutely aware of how much better I feel.
At the local emergency room, the on-call doctor confirms an amniotic rupture. She tells me that I may go into labor, and she arranges for my transfer to a larger hospital with a better-equipped neonatal intensive care unit. My ambulance attendants question me on the 20-minute ride: did I have any trauma before my water broke? Have I had any previous complications with this pregnancy or the others? No, I tell them. No. The male EMT smells like cigarettes and antiseptic. I feel like I might throw up. They take me to the labor and delivery ward on the second floor, where I am tested and monitored and hooked up to an IV. Ten hours later, I am given a room to myself on the maternity ward. Unlike the other tenants, I am not recovering from childbirth, nor am I trying to give birth. I am waiting to find out what my body will do next. I am waiting.
Properties of Flight
Not long ago, my daughter came home from school with an airplane she had built, crafted from balsa wood and foam and branded with her usual flourish of swirly neon pink marker. She told me that in science class they had learned about the four properties of flight–thrust, drag, gravity, and lift–and how they worked together to keep an object airborne. In the backyard, we took turns throwing her plane into the air. Sometimes it soared and landed smoothly, other times it crashed, nose first, into the ground.
I told her about Newton’s First Law of Motion–that an object remains at rest or continues to move at a constant velocity, unless acted upon by an external force. For a plane to maintain constant velocity, all opposing properties of flight must be equal, with no acceleration and no change in direction.
She held the plane, suspended by her small fingers, and tried to fly it in a straight line while I became a wind, a storm, a mountain in her path.
"Not fair," she said, veering off to my left to avoid a crash.
"I know," I said. "It isn't fair."
Now, I think about those arbitrary external forces, the ones that have acted on me, diverting me to this hospital bed. When, by what force, will I change direction, accelerate, and go home?
My condition has a name. It is called preterm premature rupture of membranes, or PPROM. The doctors tell me that most women go into labor within one week of their water breaking. They will be surprised when I don’t. They also tell me that my body will keep creating fluid for the baby, replenishing that which is lost like groundwater rising into a well. But the membrane itself cannot be repaired, so every time I stand, I drip and leak and seep onto the cold white floor.
In my room, I have a surplus of hospital gowns to choose from in my own personal supply closet. They come in varying sizes of huge and various shades of drab, with patterns of crisscrossing red lines that converge and diverge like dirt roads on a rural map. I put a clean one on every morning. Some days I intentionally drop food on myself, just so I can change into a different one. I am told not to wear underwear because it breeds infection, so all I have on my body is this gown, loosely tied up my backside.
I am allowed to walk within the confines of my room, but they tell me I must use a wheelchair to go anywhere else. They tell me that I will be here in this hospital, in my room, until I go into labor, or until the baby’s lungs have developed enough to sustain him outside of the womb at 34 weeks. If I make it that long, they will deliver him because the risks of staying inside will begin to outweigh the risks of the outside world.
The doctors and nurses tell me to try to hold onto the baby, to keep him inside of me and not go into labor, but they don’t tell me how. They tell me what might go wrong if the baby comes before he is ready to live outside my body, and I cry at the possibilities. They tell me to visit the NICU, because no matter what happens, he will be born premature.
My bed is pushed up against the only window in the room, which looks out over the parking lot, and the main entrance to the hospital, and the busy parkway just beyond that. I watch the sun rise over the tree line. I watch visitors come and go. I watch the doctors and nurses and hospital workers light up cigarettes in designated smoking zones. I watch helicopters bring in the injured and the dying from car accidents that I hear about on the news. I watch for my husband and daughters when I know they are coming, and I watch them walk to our car when they leave to go home. They always turn around and wave at my window. I wonder if they feel guilty about leaving me behind. I feel guilty for staying.
In the evenings, after visiting hours, I sneak across the hallway to a room where plastic juice cups are stacked in a refrigerator. I take three or four, enough to last me until the morning. I am told to drink lots of liquids and since I can’t have a glass of wine or a gin and tonic, I drink multitudes of tiny plastic cups of orange juice. They are best when they are partially frozen, and I have to use a spoon to shave the juicy slivers off the top. They taste almost like the homemade popsicles I made for my daughters just a month ago, when the days were hot and long, and we carried blankets and snacks up the grassy hill beside our house and took turns identifying shapes in the clouds.
Taking a ride in a wheelchair is the most exciting part of my day. But requesting a chair when you need one can take a very long time, and time during visiting hours has become my most precious commodity. So I've stashed a wheelchair under blankets in my room, hoping the nurses won’t notice and take it from me. Tonight my husband will stop by on his way home from work and he will wheel me out of the ward, into the elevator, and down to the Au Bon Pain on the first floor, where we will eat chocolate croissants and talk about the girls and our days as if this is normal. Because this is our life now.
Every morning my day nurse comes in to check my temperature and my blood pressure and to ask me the usual questions.
"Are you still bleeding?"
She marks my answers in a thick blue binder that has my last name written in black marker on its spine.
"What color is the blood?"
"Medium to dark red."
"So, it's old blood."
"I guess so," I tell her, uncertain if I am qualified to answer. What would happen if it was new blood? Maybe what looks dark red to me is really bright red. Color is just a visual perception, after all.
"Can you feel the baby move?"
"Do you feel any labor pains?"
"No. I don't think so." I am pretty certain this time.
"Good." She closes the binder and places it back in its cart. "I'll bring the monitor in for the baby after you eat breakfast."
Twice a day they strap a fetal monitor around my belly and turn on a printer. I am left alone for half an hour, sometimes more, to watch the long sheet of paper that translates the heart rate and the uterine contractions into squiggly lines unravel slowly onto the floor. And I listen to the beautiful revving of his heartbeat. A single engine Cessna, holding on the runway. Just waiting to take off.
After a few weeks, I lose track of time. The days collapse into one another. Interruptions are the routine. I am alone, but never by myself. The nurses come every three hours, even during the night. The night-float doctor comes before dawn; the rounding doctors in the late morning. Nursing assistants come to take my blood; housekeeping staff take my sheets and disinfect my room; the radiologist comes to see inside my womb; the patient advocate comes to see how he can make my stay better; the social worker comes to talk about my feelings; the television guy comes to take my money; the food service people come to take my orders and deliver my meals.
Thrust and Drag
"Wait. Don't tell me." My night nurse says, as she listens to his heartbeat for the first time. "It's a boy. Boys are usually slower than girls."
"Yes. You're right. It's a boy," I say.
A boy. My boy. I like to talk about him. I like to think of him as a baby, outside of my body. I like to wonder what he will look like. Pointy chin like my second daughter? Dark hair like my first? Blue eyes like my husband? I like to pretend that he will not have to go to the NICU, that he will go to the nursery at the end of the hall with the other babies, and I will walk down there to visit him and hold him and bring him back to my room to nurse him. And family and friends will visit us, with congratulatory hugs and adulatory gifts. But I know this won’t happen.
My midwife, the woman who delivered my second daughter, the woman who was supposed to deliver the baby I am carrying now, calls me.
"I'm so sorry this happened. Do you have to stay there?" She asks me this, as if I have a choice. Like I might still have some control over my body and my life right now. And then I realize that I do have a choice. I can go home if I want to. I don’t have to stay in this room. I am not attached to anything. I am not ill. I am not in pain. I haven’t been infected. I haven’t gone into labor. I can walk out of here right now. But I don’t. I am scared.
One afternoon, I get a roommate. She is 16 and having labor pains, but her water is intact. Her mother is with her in the room because she is a minor and they traveled a long way from their home upstate, where they don’t have hospitals with level IV NICUs. She likes to talk. She makes fun of the food. She calls her friends and laughs like this is an amusing situation. She talks about her upcoming baby shower, her baby-daddy-boyfriend, her small vagina. She seems unafraid of what might happen, of what is going to happen. I am afraid for her. Her mother sits, dejected, or maybe just tired, in a chair between our beds and talks to me because I am there, because my gray hairs reveal my age, because I might understand her situation. She did not want this for her youngest child. She doesn’t know what went wrong. She has tried her best to raise her, and now, she is done. At this moment, I am both mother and child. I say something vaguely encouraging and ask her to pull the curtain so I can try to sleep. Someone comes to give her daughter medication to try to stop her contractions, and someone else comes to give her a steroid shot for the baby's lungs in case her contractions don’t stop. I never know the outcome. They are gone in the morning.
Gravity and Lift
I keep the blinds on my window slightly open when I go to sleep, so I know when morning comes. Sunlight is my only prompt to start another day. This morning is particularly bright. I adjust my bed so I am sitting and use the arm rail to pull myself upright. When my body is vertical, gravitational forces expel an unusual amount of fluid onto the floor. Flecks of red spatter onto the tops of my bare feet. I sit on the edge of the bed and consider cleaning it up, but instead I push the call button for the nurse. Within minutes I am being wheeled out of my room, through the security doors and across the hall to the labor and delivery ward. A young doctor examines me. She is the same one who examined me when I first arrived, however many weeks ago.
"Let's see what’s going on, okay?" Her brown eyes are fatigued and her long, dark hair is pulled back into a low ponytail.
Speculum inserted, spotlight steadied, she searches for something deep inside of me. She apologizes when I wince. I sense that she does not have children of her own. Perhaps she never will.
"Everything seems fine. It was probably just a clot that worked its way free. I don’t see any new bleeding, but we need to keep you over here for a few hours to monitor the baby. Try to get some rest." She adjusts the straps on my belly and gently touches my arm before drawing the curtains around my bed.
I start to close my eyes when an alarm sounds in the speaker box above my bed. Over an intercom, a female voice says, "Code blue." There is a rush of movement and someone closes the door to my room. I know that code blue means–someone needs resuscitation, and in the labor and delivery ward, that someone is either a mother or a newborn. I don’t want to know which. Down another hallway a laboring woman is screaming.
After several hours, I am wheeled back to my room on the maternity ward, back to the quiet hum of the routine of waiting. Light streams through my window and I stretch my arm out to capture its warmth. I try to sleep, but instead I watch the people outside, and I spot an old man who appears to be going much too fast in a motorized wheelchair. He drives through the parking lot, weaving around cars and away from a man in street clothes who seems to be yelling at him. The old man goes out the main entrance and veers right onto the sidewalk that wraps around the block. His faded hospital gown, just like mine, flaps against his colorless legs. Two men in white uniforms run after him, arms raised, as if to say, "Stop, wait, come back," but they stay a few feet behind, perhaps afraid of what he might do once caught. I wonder, as the three move out of sight, how they will stop him. I wonder how they will bring him back.
With a smile, I whisper, "Go, old man. Fly, fly away."