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Chapter One

I don't cry. So it's unusual, as I lie next to my sleeping three-year-old daughter the night before my son is born, that I taste a tear at the corner of my lip. I watch her, remembering the adventures we've shared, first child and first-time mother, the learning we've done together. We're very good at our jobs. She's avoided colic and temper tantrums. I don't yell or slap, spoil or neglect. Still, like any woman who will admit the truth, I have found motherhood frustrating and suffocating. But I have never doubted my ability to do it well. Mothering is the first thing I have ever done with such confidence, the first thing that has ever come so naturally to me.

In other areas of my life--my work as a journalist; my role as a wife, friend, daughter; even my ability to keep my house clean enough--I am insecure. I spend most of my energy doubting and scolding myself, which leaves few reserves for accomplishing much in life. I live with a constant battle waging in my head, my own civil war. One side is constantly ambushing the other for the endless failures I perceive. Later I will realize that my twenty-four-hour self-assault is a symptom of low-level depression--dysthymia, they call it--that I've suffered all my life. But there is a lot I will learn after I'm through with PPD and still more that will change about me. Even the confidence I feel about motherhood will shift. Eventually, I will feel far more confident in most areas of my life, though far more vulnerable about my mothering skills.

But right now, hours before my son pushes through my body, I don't doubt that I will be as capable a mother of two as I have been of one. Still, I will miss this team. On dark winter afternoons, Carrie entertains herself on the carpet, building zoos with plastic jungle animals and wooden blocks, while I slouch in a chair reading the newspaper. On Sunday mornings, I draw big black circles filled with squiggly lines and she fills the spaces with color. We dig our fists into boxes of sugar-coated cereal when her father isn't around to see, and share an attraction to books that he doesn't. But tomorrow, a new player will be added to the roster. At best, he will take away the joy of our dyad. At worst, he will cause such conflict that neither of us will ever feel this content again.

I rub the back of my finger across Carrie's plump cheek and rest my chin on her hair. The tears surprise me. But there is one explanation for the magnitude of my sorrow. Sometimes, the body knows what comes next before anyone else.

The next morning, with my mother asleep on the pull-out couch and Carrie silent and peaceful in her bed, Dave and I drive through the dark to the hospital. When this pregnancy started, I disapproved of inducing labor with artificial hormones for anything but medical reasons. Those convenience births, planned to accommodate a babysitter's schedule or a husband's business trip or to reserve the most desired doctor in a large OB-GYN practice, seemed like cheating. They also clashed with my belief of birth as a natural, spiritual event. There was one way to do it, I believed, and that was to wait for God to crank open the cervix and spill out the baby. Birthdays were predestined events, not something to be altered according to the blank square in your doctor's appointment book.

I do not see it yet, but I am as rigid a woman as they come. I am also fairly self-righteous, passing silent judgment on others and myself about personal decisions like breastfeeding and taking antidepressants. PPD will break me of this rigidity. The disease will take a brittle woman, break her, and rebuild her with flexible materials. But now I am still entrenched in my unyielding little world, where every event is viewed through a black or white lens, every person hated or beloved, every decision right or wrong.

This one is wrong, I believe, as I get ready to have my baby's birth artificially induced. But I have to get him out. I still feel guilty about it, and weak for not being able to hold out until Mother Nature pushes the start button. But I can no longer bear waiting to see if this baby will come out healthy. Before this pregnancy, I'd lost two others. They were early miscarriages--one at eight weeks and one at five--but still losses of children I had already imagined grown and happy. I mourned the first one, the one who was supposed to be born in August, with weeks of tears. The second one, who could have had the same birthday as Carrie, I didn't bother to grieve. It hurt too much to say good-bye again to a baby I'd never hold. And I didn't have any energy left for facing a loss. My mother-in-law's impending death, which hovered over us until she finally died when Max was two, sapped all my emotional reserves.

Soon after the second fetus bled out of me, an infertility specialist determined that I lacked the progesterone necessary to carry babies to term. For the first twelve weeks of Max's existence, I inserted capsules filled with progesterone into my vagina twice a day so I wouldn't lose him, too. Once the threat of miscarriage had ended, I began worrying about a recurrence of my other pregnancy complication: early labor. During Carrie's stay in the womb, I developed preterm labor--the uterus contracting before the baby is ready for birth. After holding her off for a couple of weeks with drugs and bed rest, she was born three weeks early, scrawny, but healthy. Ten weeks ago, when I first felt lower-back cramps, I was put on the medical community's version of a short leash to prevent a more severe premature birth this time. My activities were restricted to standing only long enough to make a quick dinner and driving Carrie to preschool. I was not supposed to walk if I felt any cramps, but once a week I cheated and strolled every single aisle of a small drugstore.

Despite threatening to open early, my womb stayed still, during and after the restrictions. At thirty-eight weeks, I had false labor: real contractions five minutes apart that stopped the minute I crossed the threshold of the hospital's electronic door. I walked the halls from five to eight in the morning, begging my body to start contracting again so I wouldn't have to suffer the humiliation and disappointment of going home without a baby when everyone in my family was waiting by the phone to hear news of a birth.

Through all this waiting, I obsessed over infecting my baby with Group B strep, an infection in the birth canal that is harmless to the mother, but can cause meningitis and other deadly infections to the baby during birth. Even before official labor, if the amniotic sack has ruptured, the infection can seep up to the baby. I had been diagnosed with this malady, too, when I was carrying my daughter. Once a woman is diagnosed with it, she is always considered a carrier and is at high risk during each delivery. Whenever I felt moisture on my underwear during those last weeks of Max's womb life, I imagined the sack had a slow leak, and that the infection I carry was gradually killing him.

When Dr. Laly Haines offered to put me out of my misery and induce me one week before my due date, I surrendered my self-righteous position. Haines, a bubbly woman in her early thirties who always made me feel safe with her wisdom and her knack for treating me as if I were her long-lost best friend, entered the examining room one afternoon in February holding a black leather book. She told me the next day she had free, a day convenient for her, not me. It wasn't as if I picked a day that sounded good to me. I wasn't tempting the fates. She chose my son's birthday. The sixth. Today.

* * *

We arrive at the hospital at seven, sign some papers in the admissions office, then wait on a couch in the brand-new atriumed and glass-elevatored lobby. It takes twenty minutes before anyone comes to fetch us, precious minutes, during which we have the luxury of spending time alone in this public space. Dave sticks his fingers under his glasses to rub his tired eyes and I slump down so my huge belly, covered by my faded black-plaid flannel maternity shirt, sticks up like the top of a submarine. We watch the nurses clutching car keys and the interns balancing tall coffee cups as they come on and off their shifts. These characters distract us, and inspire us to play that "who are they and what are their lives like" game. She hates all the doctors, I say about one nurse, then goes home and ties up her husband. He was a dork in high school, Dave says of a doctor, and now he drives a BMW to make up for it. There is no pain, no scribbling of contraction times, only soft laughter and impatience.

We didn't get this the last time. Labor started naturally. One minute we were watching sitcoms on a Thursday night and the next moment I was hanging from the towel rods hissing with pain. I screamed on the way to the hospital, screamed in the admitting office, screamed when I thought I would pop out a baby before Dave finished parking the car. But this time, as our daughter awaits a sibling at home and our son lives his last moments of fish life inside my uterine aquarium, we are civilized, controlled.

We are, after all, veterans. We believe we know what's ahead of us and are sure we can handle it. Dave expects it to be as easy as I do.

"It'll be like the three of us plus a baby," he says. "Nothing different."

Finally, a nurse approaches. She asks if she can take me to the room first, then retrieve Dave. I don't like this separation, but I follow her into a gently lit hospital room with a clear plastic infant crib in one corner and a rocking chair in the other. She sits down on the single bed in the middle of the room and pats the space beside her white polyester thigh, inviting me to join her. I obey, wondering what this intimate positioning has to do with my appointment to have a baby. I want to get down to business: strip, tie on a gown, give blood samples, take laboratory-manufactured hormones, and shove out a son. I don't want to chat, which she seems to sense.

"We ask everyone to do this," she explains. "It'll just take a second."

She asks about my due date and my pregnancy history, facts she could easily glean from the file she's holding, then gets down to the real reason for the solo trip: "Do you ever feel afraid in your relationship that your husband will hurt you?"

"No," I answer, the real part of me shocked that she would think such a thing about my tender husband, the social activist in me glad that the hospital has set up this system to protect women who could answer the question affirmatively. They worry that the mother will leave with a baby and put both of them in danger, as if that is the only danger the pair could encounter. If the nurse had asked the opposite question, "Are you confident in your relationship that your husband will save you?" I would have said yes. I would have been right.

She brightens up, now that the uncomfortable question has been answered comfortably, and hands me a cotton frock.

"I'll go get your husband," she says. "And your labor and delivery nurse will be Barb today."

"It's not you?" I ask. I've been worried about what my nurse, the one professional who will spend most of the labor with me, will be like. It's been said that a good or bad nurse can make or break the birthing experience. This one seems kind. I'd like to keep her.

"No, I just do check-in," she says with a smile. "You can change in the bathroom."

Barb, who tells us that she is divorced and about to go on vacation to Florida, is as cold and bitter as the weather she's escaping. She is tall and thin, with bottle blond hair that is blunted at her cheekbones. Because I am being induced and because I will need antibiotics during labor to fight the strep B, she prepares an IV line for my hand. "I've never had one before," I tell her, "I'm nervous." She jams the needle and plastic tube into my skin without looking at me. After the fluids have started flowing and I am strapped to a fetal monitor, Dr. Haines comes in to break my water. She prods the sack with a white plastic stick that looks like a knitting needle, pushing and twisting at the tough membrane until finally I feel hot liquid gush over my thighs and rear. Like someone with bladder control problems, I don't feel it coming out or have the ability to stop it. It seems endless. It keeps coming and coming and I panic, realizing I have no say over what my body is doing.

Contractions, sharp and sudden, begin soon after Barb and the doctor leave. Barb stands at the nurse's station, talking, while I scream into a pillow and beg for painkillers.

"It's too soon," she says, annoyed, as she looks at the strip of paper regurgitated from the fetal monitor that indicates the closeness of contractions. "You have to wait longer."

When she leaves, I ask Dave if he can convince her to get Dr. Haines. My husband is a short, trim man with a self-described face of a rabbi. He has salt-and-pepper hair that gets saltier by the month and sea blue eyes that hide behind strong glasses. He is the type of person that everyone loves. His manner--sweet, genuine, funny, and devoid of bitterness--draws people to him. I don't think he has ever had or will ever have any enemies. I joke that he is a new soul, free of the baggage from a previous life that causes shadows and dark crevices in most of us. He is as strong, confident, and cool as I am flailing and emotional, which is probably why we get along so well. It also helps tremendously that he brings me water from downstairs in the middle of the night when I'm thirsty and listens to me worry whenever I ask for his ear, all without ever stepping on my independence. Sure, he has some flaws, such as not being honest about his anger, extreme sloppiness, and possibly being the slowest man on earth when it comes to getting dressed or preparing a meal. But for the most part, he's golden. It's this personality that makes it so easy for him to talk the steely nurse into getting my doctor without offending her.

Dr. Haines sticks a gloved finger inside me and orders Barb to shoot a syringe full of the narcotic Nubian into my IV line. I'm getting close.

I start to feel woozy and heavy and weak and before long I see everything twice. Double vision nauseates me, so I close my eyes, hold Dave's hand, and ask him to tell me when he sees a contraction starting on the monitor.

"Here comes one," he says, over and over, in a voice both excited and soothing.

"Oh, yeah," I slur. "It hurts. It hurts. Okay it's better now."

I don't scream anymore, because I can't feel the pain directly now. The contractions feel the same, but my brain doesn't register it as pain, or signal anything that reacts to pain to jump into action. The Nubian is like a cotton ball jammed into an eardrum: sounds come through, but not strong enough to elicit a response.

The drug lasts about ninety minutes. As it wears off, and the pain and my mind become clearer, Dr. Haines measures my stretched cervix and victoriously announces that it's time to push. Barb and Dave each grab one of my thighs and pull them toward my head so I am spread as wide as possible. Dr. Haines stands in front of my vagina as if she's about to conduct an orchestra and orders me to push. Suddenly that forgetfulness that Mother Nature created in mothers to further the species melts away. I remember everything about Carrie's birth, particularly the sensation of being turned inside out like a freshly washed sock while pushing her out of my body without the crutch of drugs. I realize I can't possibly go through that again. How can I get out of here? I think, trying to come up with a plan. How can I slip out so these three don't notice? They keep bossing me around, as impatient and unsympathetic as basketball coaches, so I obey. I push and push, pretending I'm trying as hard as I can, until out slides a little poop. I am so embarrassed that I shout, "Did I just take a shit?," and someone tells me yes, not to worry about it. Then I push with more spirit until I feel something tear. Not in the spot I'd expected, between my vagina and anus, but in the front of my body, near my urethra. I feel as if I am splitting, that something inside is tearing and that when the baby's head comes out, it will keep tearing right up the front of me, like a zipper.

Finally, the baby arrives, leaving only small, predictable sections of my bottom tattered. He is blue and motionless with part of the amniotic sack wrapped over him. Dave says he looks like a space creature. He is terrified because he thinks the baby is dead, though he doesn't tell me this until months later. It is the Resnick trademark to spare loved ones any ugliness. All of Dave's family members protect one another from the truth. I once called it lying, but now I see it as a form of love.

They take Max to an isolette and rough him up a little to get him to breathe, put drops in his eyes, then bring him back to me. There is no magic moment of bonding. Dave cries and Dr. Haines praises me for getting it over with so quickly, but all I can think is that I have go to the bathroom. There are photos of me holding Max and talking on the phone and smiling, but I don't remember making those calls or smiling those smiles.

It is said that a traumatic or dissatisfying birth experience is one of the factors that can lead to postpartum depression. I gave birth to Carrie with the assistance of a nurse-midwife, a hot shower to tame the pain, and a nearly dark hospital room in which to greet my new child. After the pain and fear subsided, I felt I had accomplished something courageous and breathtaking. Max's high-tech birth was defined by bright lights, IV tubes, straps that tethered me to the fetal monitor next to the bed, stupefying medication, and a heartless nurse. After he arrived, I felt as if I'd been through a harsh medical procedure. Had I experienced another noninduced, low-tech delivery, I wonder, would I have avoided PPD?

A few minutes after birthing Max, we load my overnight bag, coat, pocketbook, and me into a wheelchair. Max, wrapped in a stripped flannel blanket and wearing a matching striped cap, lies in my arms. I still feel woozy and unstable from the drugs, as if I am about to collapse. I worry that I'll let him roll off my lap onto the hallway or down the elevator shaft as we ride to another floor and our permanent room.

After a nurse bathes and diapers Max, and changes the pad and ice pack between my legs, Dave goes home to get Carrie. When he brings her back, there are presents to open. After peering quickly at the being who will later become her beloved playmate, she tears through the wrapping paper. My tiny girl suddenly looks huge to me. She wears a T-shirt that declares I'm the Big Sister over her pink turtleneck. Even her new Richard Scarry figurines seem sophisticated compared to the stuffed gray horse she gives to Max.

After some playing on the bed and reminding her father that she was promised ice cream when the baby was born, they leave. My first obsession starts. Though we knew we would name our son Max as soon as we learned his sex (Dave had made me promise to name our first boy after his grandfather the Russian fruit peddler during our second date, and had held me to it), it is up to me to pick a middle name. I know I want something that starts with J. From a long list, Justin, Jacob, Julian, and James have made the final cut. I love them all, but each has a drawback. Though four of his great-great-grandfathers were named Jacob, I find it too ethnic and predictable, especially next to Max. Dave hates the name Justin. Julian is the middle name of another boy named Max in our small town and James is one syllable too short. The birth certificate office needs the name before I leave the hospital in two days, so I spend every moment I am alone over the next few days obsessing about the decision. Order always gives me a sense of control when I am insecure or anxious, so for my entire hospitalization, I keep straightening my room, then returning to the list of names and trying each one out in my head. I throw out wrappers from pain pills and stool softeners, toss soiled newborn T-shirts in the hamper, change the pad on the diapering cart, push the flowers my mother sent to the center of the window sill, place my slippers next to the bed, climb under the sheets and recite: Max James, Max Justin, Max Julian, Max Jacob over and over until somebody calls or visits. It is so important and final, so crucial that the name be perfect. But I can't rest on one combination. I've often had trouble making important decisions, and I've been pondering this middle name question for months, but it's never possessed me like this. My mind runs in circles, day and night, until the birth certificate lady calls and in a panic I choose the safest middle name, Jacob.

Obsessing isn't the only postpartum symptom that's unique to this birth. After Carrie's arrival, there was celebration, visitors, a bouquet of pink balloons tied to a chair in the hospital room. This time there is on-and-off weeping. I blame it on the loneliness. Since Dave has to spend time at home with Carrie, and she's bored after a few minutes in the hospital, he only visits for a couple of hours each day. Except for mandatory blood pressure checks twice a shift, the nurses neglect me because I'm a second-timer. My best friend, Kelly, can't visit me because there's a big snowstorm predicted and her babysitter cancels. Dave tells me the storm will be so bad that he doesn't even know if he'll be able to pick us up after we're to be discharged.

Late in the afternoon, one day after Max's birth, I wander the circular hallway of the ward, looking for someone to talk to. We aren't allowed to carry our babies in the hallway, so I push him in his Plexiglas rolling crib. I peek into rooms filled with happy relatives and pass couples walking their babies together, the father with one arm around the mother and the other pushing the crib. No one seems to see us, though there are tears in my eyes and, I imagine, a beseeching look on my face. I walk to the dead end of a hallway, stand by a window, and watch the snow whip past me. It blows the coat off the back of a lone pedestrian down on the street, and covers the roads so thoroughly that curbs and fire hydrants can't be distinguished. I look at Max, who is sleeping, and I try to feel how special this should be, just me and my new, new baby against the world. But instead I feel homesick and more alone than I have in years.

As a little girl, I was always lonely. In second grade I wrote and illustrated my first book. The stick-figure girl on the cover was frowning. Inside, I told the story of a girl who is rejected by her entire family. Everyone is too busy to play with her until her father comes home and takes her to the park on his shoulders. My teacher entered the book in a contest, but it didn't win. When I was thirteen I started collecting poems that other girls published in Teen magazine. I pasted them into a book I made out of loose-leaf notebook paper and kitchen string. On one page I pasted a poem I'd written myself, in blue magic marker.

"I dream, and make all bad things good again. But when I come back to reality, nothing has changed. Except after I dream, I have more hope and courage to really make the bad things good again."

(Continues...)

Excerpted from Sleepless Days by Susan Kushner Resnick. Copyright © 2000 by Susan Kushner Resnick. Excerpted by permission. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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Sleepless Days

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