Editor’s Note: The following essay contains a detailed description of pregnancy loss.
On March 17, 2020, my twin pregnancy became a singleton. The little girl I didn’t know I wanted was never meant for this world, and my husband and I grieved her light. But this is not about that day. I wish that days like that didn’t happen to women like me all over the United States—healthy professional women, women who, despite their successes in life, all belong to another group with a commonality that sometimes eclipses everything else that helps define us. We are women over the age of 35 who have suffered unimaginable losses trying to do something that comes so naturally and freely to so many others.
Losing a pregnancy is not a rarity among women my age. It is not an occasional tragedy or something that happened to a colleague or distant cousin whom we vaguely know and not-so-secretly pity. It is there in our unnoticed doctor’s visits during lunch, our unspoken multiple IVF cycles, and our unannounced first- and second-semester pregnancies that end suddenly and without explanation. It is a reminder that, unlike men, we don’t have the luxury of time. Our dreams of an amazing career and a beautiful family can be zero-sum, and these choices are often made too late. For some of us, however, there is an added burden. For some of us, the journey to motherhood comes at a higher cost. We are more likely to experience complications during pregnancy than any of our contemporaries. We suffer miscarriages at a higher rate. Most alarmingly, we die in larger numbers following complications from childbirth. We are Black women. The risks we take by giving birth in America make pregnancy more dangerous for us here than any other developed country in the world, regardless of our socioeconomics. And our respite from that terrifying reality? She is a symptom of what makes us stronger and kills us at the same time. She gives us the strength to bear the burdens that we should not have to carry. She is a manifestation of our inner strength, pride and resolve. She is our magic. But this is not about a day my Black girl magic lifted me up. This is about the day I broke her.
Broken magic is like a betrayal of love or a crumbling foundation. It is all-consuming. There is no putting on the face or holding up the walls; they collapse in on you. And that happened to me in the bathroom, naked and exposed, on what has now become the worst day of my life. March 17, 2020, was not that day. March 17 was the day that I lost a pregnancy, but I still carried her inside of me. Not in an emotional way, but an actual physical manifestation that my doctors told me would resorb into my body. There was also the possibility, they said, that when I delivered my baby boy, there could be “additional tissue” that delivered as well. “Not to worry,” they said. “It will be unrecognizable.” On March 17, she was still there. And so, I carried her on.
Weeks passed and my husband and I focused on our boy with a newfound energy. We laughed over names, deliberated over housing, and played my son music that we love, courtesy of COVID-19 celebrity quarantines and Instagram live. But this is not about COVID-19, either, at least not directly. One morning in May, I woke up soaked in fluid from waist to thigh, but my bladder was still full. I was alarmed, though I felt no pain. I phoned the on-call doctor, and after a trip to the office and a quick exam, he said that I had urinated on myself. I did not think so, but after all, I’m not a doctor. I explained to him that I did not believe it was urine, but he dismissed my concerns outright. My husband, more gracious than most, could not let it slide without a few plastic sheet jokes.
The next day, the pain started. I consulted Dr. Google and landed on round ligament pain. When my husband asked me about it, I told him that it was a common side effect of pregnancy. He is supportive but not pushy, and he let it lie. The frequency of the pain increased, and the severity of the pain intensified that night. I did a follow-up with my pregnancy phone app and added Braxton-Hicks (a womb’s practice contractions) to my diagnosis. I was wrong.
I took a shower the next morning, and an arm and a hand came out of me. I may not have even noticed it, except for the contrast of the grayish-pink flesh on the hard white tub. I picked it up and felt a small bone. I counted five digits attached at the end. Trying to remain calm, I called my husband. He is a homicide detective and had gone to work despite the COVID-19 shelter in place. He raced home and took me to the doctor, with a hand in my purse.
‘Then the pain came again. It was the physical pain of my body forcing itself open and finally letting her go. It was the logical pain of not being believed or validated by patronizing doctors. It was the emotional pain that I had never fully grieved the loss I’d suffered.’
This doctor was a maternal fetal medicine specialist who was treating me because my age and multiple gestations made the pregnancy high-risk. She was smart, sharp and no-nonsense. She wasn’t the nicest, but neither am I. She wasn’t the most reassuring, but neither am I. There was a difference between us, though. She didn’t have magic. She didn’t know my magic was all that was keeping me together in that room. My magic told me to stay calm when this petite blonde doubted my story. My magic told me not to yell when she barely looked at the hand. My magic told me not to argue when she said that women did not pass parts of a “demised fetus,” and she wasn’t sure what that was. It is a hand, I thought. You can feel the bone and count the fingers. I asked her what I should do, whether this would continue, and to explain best- and worst-case scenarios. She provided no answers and no wisdom. She only repeated, “Don’t worry. Your son is fine. Whatever that is, you will be fine.”
Still, I sought answers. After hours consulting Dr. Google, I finally gave up and called my assigned obstetrician, who answered my questions with the same calm and practiced condescension reserved for a child speaking of aliens in the closet. I wrapped up in my husband’s arms, called a few friends and built up my magic’s reserve. Then, I broke her.
The day after the fetal medicine specialist pronounced me “fine,” the pain came in waves. I still tried to find solace in my doctor’s lack of concern. I repeated to myself, “No blood, no discharge, no worries.” I stayed up most of the night with my husband by my side. Eventually, I persuaded him to take a nap and then go to work. He reluctantly kissed me goodbye, and I ate some Cheerios. Around 10:30 in the morning, I went to the bathroom and felt a desire to push. I did.
I felt something hanging, like it was still attached somewhere inside of me. I reached down to wipe it away with toilet paper and felt the hardness of bone. Then the pain came again. It was the physical pain of my body forcing itself open and finally letting her go. It was the logical pain of not being believed or validated by patronizing doctors. It was the emotional pain that I had never fully grieved the loss I’d suffered on March 17. Here, alone in the bathroom, bent over the sink and dialing my husband’s cellphone number through tears that rarely came, my magic broke. May 23, 2020, was the worst day of my life.
My husband immediately came home and took me to the hospital. The pain continued and he half-carried me down the hall to labor and delivery. I could still feel something dangling from me, sitting inside a panty liner I had hurriedly placed between my legs. I thought of the on-call doctor who told me my “urination” was normal. I thought of the specialist who told me she didn’t know what I had expelled from my body, but it was “nothing to worry about.” I thought of the obstetrician who told me that the specialist was an esteemed colleague and friend. None of them believed me. None of them considered that if I was right, my health or the health of my son could be at risk. None of them treated me with the concern and respect that I deserved.
‘I sat alone in the darkness of my room, shedding silent tears, when my nurse came in. She didn’t say a word, but she sat with me for a while. She said everybody has to allow themselves vulnerability. She didn’t have my magic, but she saw me.’
At the hospital, the doctor had me undress from the waist down. The smell of necrosis filled the air. She removed the tissue that was now sitting in my underwear. She, like the others before her and after, had never seen anything like this. But this doctor was different. She was a woman of color. And there was no doubt now. Somehow and for some reason, after my demised fetus stayed inside me for two months, my body delivered her. This doctor blocked the remaining tissue from my view. She was compassionate and direct. And although she had never seen a situation like this before, she insisted that I stay in the hospital while they try to figure it out.
Now concerned that my cervix could still be open and subjecting me to infection, early labor of my son and a whole host of other problems, the medical staff immediately admitted me to the hospital. I had partially “delivered” but was no longer in labor. And so they sent my husband away because of COVID-19 protocols. My magic was gone, my love was banished, and I was all alone.
At the hospital, I had compassionate and experienced nurses. I also continued to face the same condescension and passive aggression that some treaters without my type of magic deploy against people like me. They marveled at my story and proclaimed never to have seen anything like it in their various numbers of years in medicine. The curiosity was mixed with disbelief. They also subtly reassured me that, despite ignoring my concerns, all my treaters would have followed the same course had they actually known what was happening.
I started putting my magic back together with nourishment from my mom, other family and friends. My husband called every day from home, and we grieved together. We also grieved apart, dealing with our own demons and sadness. But that is not the end of the story.
I was on medication for the lung and brain development of my son just in case I went into early labor, but the levels in my blood became toxic to me. They stopped treatment, but I received most of the course and the complete benefit for my son. Then the contractions started again. My temperature was over 102. An ultrasound revealed that my amniotic fluid was low and my cervix was too thin. Then the shivers started. My temperature jumped to 104.6. The doctor said in a severely calm voice, “We have to deliver this baby now.” Through chattering teeth, I pleaded for my husband. The nurse called him, and he arrived in time for my C-section, which my doctor described as “violent.” I developed sepsis and remained at the hospital for a few days, including some time in the intensive care unit. I wish I could say that my doctors learned their lesson, but they did not.
I was discharged less than a week post-delivery. My son remained in the NICU. When I left the hospital, I had a low-grade fever and a burning sensation during urination. I was on narcotics for pain and could barely walk. The obstetrician who performed the emergency C-section to save me and my son told me that I looked good and would be fine. He ordered me to follow up with a nephrologist, because he thought I might have developed a urinary tract infection. He told me that was just out of an abundance of caution, because he would prescribe antibiotics to treat it.
I saw the nephrologist on my 39th birthday, June 4, 2020. I had continued to have an average body temperature of 100 degrees in the five days since my discharge. COVID-19 alarms aren’t usually sounded regarding fever until it reaches 100.4, so I had continued to go to the hospital every day to see my son. During my nephrology visit, the low-grade fever spiked to over 102. This doctor was familiar with my chart and immediately admitted me to the hospital. She did not have my kind of magic, but she saw mine. She saw me suffering through fatigue to be there for my son. She saw me weaning off my pain medication too early in order to be alert for him. She heard me when I told her I didn’t feel good. So I celebrated my birthday alone in the emergency room. My fever climbed to 104, but my husband was not allowed in. I no longer got to see my son. I sat alone in the darkness of my room, shedding silent tears, when my nurse came in. She didn’t say a word, but she sat with me for a while. She said everybody has to allow themselves vulnerability. She didn’t have my magic, but she saw me too.
‘Regardless of my education, occupation and insurance, all the doctors initially responsible for facilitating the birth of my son—save the women of color—did not see me or hear me when I needed them.’
Ultimately, I suffered a partially collapsed lung, and kidney and liver damage. No one ever told me why all this had happened. Even now, I don’t remember the surgery, the birth of my son or my stay in the ICU. “They thought you were going to die,” my husband said later. The doctor who delivered my son was the same one who told me that I had urinated on myself the week before. When he walked into my hospital room right before my temperature spiked, I smiled at him and asked if he still thought it was pee. He had the grace to look contrite and admit that he’d guessed wrong. He was the only person who ever conceded he was wrong. I never again saw the specialist who told me everything would be OK. I switched obstetricians to the doctor who initially admitted me to the hospital.
Despite the pandemic or the dangers of pregnancy, if I had died, it wouldn’t have been either of those that killed me. What happened to me was the result of a truth some of us have known for so long and others are just starting to see. Some of my friends understand disparate treatment but don’t believe that it happens in their neighborhoods, or to their friends who work hard and are successful like them. Some of my colleagues believe discrimination and racism require the same explicit malevolence, and that bias is an inconvenience, not a matter of life or death. But these folks are starting to see. Regardless of my education, occupation and insurance, all the doctors initially responsible for facilitating the birth of my son—save the women of color—did not see me or hear me when I needed them. They saw a Black girl and decided she was insignificant. They decided my concerns were exaggerated, that I was lying or even if I wasn’t, as far as they were concerned, I was fine. Maybe it wasn’t because I am Black—but I doubt it. That is how implicit bias works. We are not all similarly situated in life, and we are not seen the same way. The same intelligence that makes me thoughtful makes me intimidating. The same directness that makes me articulate makes me threatening. The same persistence that makes me effective makes me overbearing. This bias almost cost me and my son our lives. After all was said and done, some of my treaters came with whitewashed apologies. Others did not. And I continued to have complications from the sepsis and kidney damage. By my second hospitalization, my doctors had learned that I am an attorney with experience interpreting medical records, and my treatment course was decidedly more thorough. Maybe it was also because my magic was back, stronger than ever.
People ask what magic is, how she works and why she’s necessary. She is the essence of our strength. She channels our resolve into action and shields us from judgment, microaggressions and discrimination. She has protected us for generations and carries us still. She saved my life.
Herbrina Sanders, ’02, is a former federal prosecutor who currently sits as special master with the United States Court of Federal Claims. Email her at email@example.com.