It was the 18th week of my second pregnancy. I lay in a fake-leather recliner, holding my breath and my husband’s hand as a maternal fetal medicine specialist slid an ultrasound wand over my abdomen. This wasn’t your standard anatomy check. The doctor was trying to see if our baby had all four chambers of her heart. And if she would be spared the 12 surgeries, six months of hospital life, and countless moments of pain and panic that our first daughter endured during her early years.
Violet was born with a rare collection of life-threatening congenital heart defects, all of which were somehow missed on the half-dozen ultrasounds I had during my pregnancy with her. We didn’t know anything was wrong until her heart began shutting down when she was a month old. Violet is now a happy and healthy 4-year-old who begins every sentence with “Actually… ” But her heart condition is lifelong. The question that haunted every conversation Dan and I had about a second child was: What if it happens again?
The odds of that were small, but much bigger than if it hadn’t happened the first time. So my second pregnancy was immediately classified as high risk. I underwent every genetic test and screening because my doctor was determined not to miss so much as a prenatal pimple. And so, after searching the grainy images of our baby on the ultrasound monitor for about ten minutes, my doctor turned to me with a huge smile. “Her heart is developing normally,” he said. “This baby gets an A+. Good work, Mom!”
I cried, of course. Until that moment, I hadn’t trusted myself to build a healthy baby heart. After all, the only other time I tried, I’d failed pretty spectacularly. That’s how it felt the day they diagnosed Violet’s heart condition. And now, with his horrible compliment, this doctor had confirmed it: If this baby was getting an A+, then that must mean I had flunked my first pregnancy. Maybe I could be in the running for “Most Improved Mom.” But on the other hand, there were still 22 weeks to go. Final grades would be cumulative. Plenty of time to mess up again and let this child down as well.
I carried this sense of failure deep inside me for the first year of Violet’s life. I was sure that if I said it out loud, everyone would nod soberly and agree. Yes, we know, it was all your fault. When I finally did start to talk about it (to Dan, to my friends, to my therapist, to Violet’s doctors), they fell all over themselves to assure me that it wasn’t true. The causes of most congenital heart defects are unknown; Violet’s were likely the result of genetic mutations that no one could have predicted or prevented.
Indeed, almost all of the “big stuff” that can go wrong is caused by infinitesimally tiny tweaks in a cell’s DNA strands. These things have nothing to do with our performances as mothers or people. I get that now. And yet, that’s not how we think about it. Our culture grades pregnant women constantly: Are you just saying no to wine and sushi? Getting enough protein, leafy greens, prenatal yoga? Good work, Mom! We talk about “building a healthy baby” as if we’re actually assembling one like a Mr. Potato Head.
During my first pregnancy, I got prenatal massages and acupuncture. I counted protein grams. I only took pricey prescription prenatal vitamins (no generic drugstore pills for my kid!). I scrupulously avoided gas stations and nail salons in case I’d inhale toxic chemicals that could disrupt fetal development. I tracked my weight gain and bought organic crib sheets. Pregnancy is so scary and unknowable. I wanted to believe that if I did every single thing I was supposed to, if I ate enough kale and chose the best diapers, I could keep my daughter safe and healthy. Perfect even, forever.
The messages we get about the importance of prenatal core workouts and birth plans are ostensibly about empowering us as women—so that we’re ready to withstand the rigors of pregnancy, childbirth, and presumably, parenthood itself. But almost as soon as that line appears on the pregnancy test, those messages become an impossible set of standards. And there is no power there.
With Violet, I put myself through 26 hours of unmedicated labor, in part because I was convinced that an epidural would somehow be bad for her. Fast-forward to a conversation I had with her doctors after her second open-heart surgery, when we debated whether my 9-month-old needed a methadone drip to wean her off post-op fentanyl. I haven’t seen any hard science, but I’m fairly sure a few hours of epidural exposure would have nothing on those weeks of round-the-clock opiates. And yet, by then, I was the one pushing for extra doses, because it was so clear that my baby was in pain and should not be.
But if I’m being honest, the narcotic risk was only part of why I insisted on a “natural” childbirth in the first place. It was also because I wanted to prove something about how strong I was and how perfectly I could deliver a baby. I wanted an A+ delivery to match my A+ pregnancy. That wasn’t fair to my friends who had different kinds of birth experiences, whether by choice or necessity.
And it wasn’t fair to myself either, especially not in the final hours before I delivered, when I realized I did want the epidural after all. In the throes of active labor, I had to admit that I’d made a mistake, that apparently I wasn’t strong enough to trust my body’s wisdom and I’d like some effing pain relief, please. And it really sucked when it turned out that I’d gritted my teeth for too long, and now there was no time for a quick spinal injection before a brutal 90 minutes of pushing.
Here’s the worst thing about the doctor saying “This baby gets an A+” and all of the other ways we’re told that we have to achieve perfection through pregnancy: It means that when I didn’t, it wasn’t just me who failed. Somehow, the implication was that Violet herself didn’t ace the exam because she was born with a few missing heart parts. This is also the problem with parents saying they don’t care whether it’s a boy or a girl, as long as they “have a healthy baby,” because it suggests that any unhealthy baby is somehow less than.
The idea that Violet is lacking in any way is hilariously wrong. She is so completely herself: this weird, sweet, curious kid who insists on sleeping in socks when it’s 90 degrees out and who told me a long story about a whale that had his voice stolen by a jealous fox. She is not perfect (or else there would be fewer mysterious marker scribbles on my walls), but she is everything she needs to be.
Expecting perfection in pregnancy is impossible. Even if your baby isn’t born with a congenital defect, she is somehow imperfect—because she’s human. Of course, if I could remove the need for extensive surgeries and frequent cardiologist visits from my daughter’s life, I would. But the fact is, without whatever genetic alchemy led to her “defects,” she would be a different kid. And I could never wish for that.
Our new baby, Beatrix, was born in October. And I’m so grateful that she has four chambers in her heart so we won’t have to put her through so much. Yet even without heart surgery, I know that there will be heartache of some unknowable kind.
Accepting that, as scary as it sounds, meant easing up on myself for the rest of the pregnancy. I went to precisely one yoga class. I had the occasional half glass of wine. When I passed my glucose test, I was relieved, but I didn’t see it as a validation of virtuous eating habits, mostly because I’d had brownies for dinner the night before. I still took prenatals every day, but the drugstore brand was fine.
It wasn’t a perfect pregnancy, and I wasn’t trying to build the perfect baby. I’m just making people over here. And I give us all an A+ for effort.