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  • Eternally Grateful
  • Samantha Knowlton

A full–term stillbirth is a delivery complication beyond comprehension. That I was 49 and my baby girl was ten years in the [End Page 202] creating added to my challenge. There had been nothing to suggest that my baby girl was anything but healthy. She grew steadily, moved constantly and her heart beat was vigorous. Until it wasn’t. There was no preparation.

After undergoing numerous rounds of IVF and experiencing several miscarriages, I was no stranger to disappointment. Each time a pregnancy surpassed the limits of the prior pregnancy, I would allow myself to experience an iota of cautious optimism. And as Emma Grace continued to grow, so too did my optimism, until I eventually forgot that there had been reason to be apprehensive.

As a physician, I had embraced, and even, at times, enjoyed the IVF process. There was something comforting about being immersed in the familiar realm of science during a time of such uncertainty. The technological sophistication seemed to hold the promise of success. Patience, persistence and personal assets were all that were required. Or so I thought. With each failed cycle, my protocol was modified before I tried again. I started my fertility journey using my eggs and my husband’s sperm. By the time Emma Grace was conceived, I was divorced and ten years older, necessitating that I buy both sperm and eggs from cryobanks. My pregnancy was one of the first conceptions arising from a frozen egg and I prided myself on being at the forefront of such an amazing scientific advance.

At long last, I had not only overcome the hurdle of implantation, but my body was humming along with the work of gestation. I eluded morning sickness and was thankful that I remained healthy and strong. I loved being pregnant. The hormones elevated my mood making it among the happiest times in my life. I was filled with optimism and excitement for the future. I started to plan the nursery. I began to interview nannies and visit day care centers. I told my patients that I was pregnant and arranged for maternity coverage of my practice. I was daunted by the length of the baby–preparedness checklist, but my partner, Tom, a father of four, reassured me that all I really needed was a few pairs of diapers.

About a month before my due date I had a premonition that something terrible was about to happen. At first, I imagined that one of my elderly parents was going to get ill. Then, I considered the possibility that I might get sick or worse yet die during delivery. It never once occurred to me that something might happen to my baby girl. To cope with my anxiety, I resorted to my default strategy of mastery by organizational control. Given my fear of postpartum depression, I wrote an advance directive for my mental health. I specified the name of my psychiatrist, what medications I would and would not take and where I wanted to be hospitalized, should that be necessary. I rewrote my will with my daughter in mind, including her guardianship arrangements. Reassured that everything was now in order, that I had done all that I could to control the outcome, I relaxed into the tail end of my pregnancy.

I saw my obstetrician five days before my due date, which fell on Memorial Day. He said that both the baby and I were healthy. There were no signs of impending labor. He gave me through the weekend, but said that if my baby girl didn’t arrive of her own accord by Monday, I should check into the hospital for induction. He mentioned that at my age the risk of stillbirth increased the longer one waited. Since we had just agreed not to wait even a day past my due date, I didn’t give that possibility another thought. Despite my numerous losses, I had exercised so many choices along the way, from the choice of my egg and sperm donors to the selection of embryos, that I had been deluded into thinking that I had some measure of control over the outcome of this pregnancy...


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pp. 202-205
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