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Thousands of Canadian women receive grim diagnoses of life-limiting fetal anomalies each year, and yet terminating a pregnancy for medical reasons is rarely discussed

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A photo of Emma Gilchrist, taken three days before her pregnancy termination, sits on her bedroom dresser.Taylor Roades/The Globe and Mail

Emma Gilchrist is the co-founder and editor-in-chief of The Narwhal.

Looking back on that hot, humid day in Sayulita, Mexico, I wonder if the moment that sealed my fate was when I wandered down a dingy side street at the market.

I was 18 weeks pregnant and my back was killing me, but I persevered in looking at colourful stalls with a friend from Canada. After months of averting my gaze from cute baby things, I fell for a blue felt mobile – my first baby-related purchase. The street vendor told me it was handmade, but I later found a manufacturing sticker on it. With my mobile stuffed in a yellow plastic bag, I found some shade at a café and ordered a mango-coconut-milk smoothie, patting myself on the back for being a responsible mother and nourishing the little girl who’d been growing inside of me for the past five months.

On a vacation to Mexico, Gilchrist went to a market in Sayulita, shown in a photo by her friend Kathryn Juricic, and bought a blue mobile, shown at her home in Victoria.

One week later, I was back home on Vancouver Island, lying on a medical exam table, as a technician spread gel on my belly for an anatomy ultrasound.

When the tech ran her wand over my stomach she found a strong heartbeat and a growing, kicking baby girl. My husband and I went for Thai food afterward, photos of our yawning little one safely tucked away.

The next morning, I bundled up for a winter bike ride to the office and posted a silly photo on Instagram of me wearing my bike helmet under the hood of a puffy jacket. That photo is the last evidence of “before.” Before the hushed voices, before the invasive procedures, before a fault line cracked open, severing me from my previous life.

Just a couple hours later, I was sitting in my fishbowl office when I answered a call from our midwife. I wasn’t surprised to hear from her, figuring it was a routine follow up. When she asked if my husband was with me, it struck me as unnecessary.

But then came strange words that didn’t belong in my life.

“Liver and stomach of baby seen outside abdominal wall.”

“Two-vessel umbilical cord.”

“Maternal fetal medicine specialist.”

I could barely breathe.

After I hung up, I headed for the exit, eyes glued to the ground, got back on my bike and rode home, heart pounding, tears blurring my vision.

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Gilchrist, who is adopted, says that while she was hesitant to have children, deep down she craved a biological family especially 'because I'd never grown up with one.'

I was born in the 80s to a young single mother who placed me for adoption. “She has not seen nor named her baby, stating she chooses not to build an emotional bond with the child,” reads the report by the social worker.

I spent the first month of my life in foster care before being adopted. I will never know who fed me my first bottle or changed my first diaper or rocked me to sleep when I cried. To this day, when I see a newborn baby, instead of joy or fascination, a primal wound opens up inside of me.

Maybe that’s why, when I saw the double pink lines on the pregnancy test, I didn’t start planning the baby’s room immediately or find myself cooing over baby carriages. Instead, I worried about how I’d balance an intense career with motherhood, and when I’d get the chance to take a girls’ surf trip again.

But deep down, I did crave a biological family of my own, especially because I’d never grown up with one.

I had the sense that having a baby would be both painful and deeply healing. It terrified and intrigued me in equal measure. And, at 36, I felt I’d delayed motherhood pretty much as long as I could, so I decided to go off the Pill and joked with my friends about “letting Jesus take the wheel.” He took it and got me pregnant at the first opportunity. My husband and I immediately started referring to our growing spawn as “Piggy.”

My path was clear.

Our midwives walked us through a dizzying array of genetic testing options and at around 10 weeks, we opted to pay $99 privately for a non-invasive prenatal screening blood test (known as NIPS) that assessed the fetal DNA for risk of chromosomal abnormalities. The results came back negative, meaning my pregnancy was not at increased risk for any of the conditions tested – but in a video on the testing company’s website, a cardiganed woman calmly noted the test doesn’t screen for all genetic conditions.

With the negative results in hand and the first trimester behind us, we started telling our families and friends about Piggy. Our elderly parents were overjoyed, buoyed by the promise of a grandchild. At the magazine where I work, two other editors were due within five weeks of me, so we bundled our pregnancy announcements into one grand reveal and shared our news with the rest of the team when I was about 15 weeks along.

I was determined not to let pregnancy stop me from doing the things I loved. With the approval of my midwives, I kept lifting weights and going on surf trips, joking that Piggy would be born with a love of waves.

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A photo by Mexican surfer and photographer Esteban Vel shows Gilchrist on the water 19 weeks into her pregnancy, five days before the ultrasound that would show the baby was in trouble.

One of the crazy things that happens when you’re struck with a piece of news that stops your world is that the rest of the world keeps turning. Two days after the phone call from the midwife, my day job as an editor exploded. One of my magazine’s photojournalists was wrongfully jailed in northern B.C., drawing international media attention. I spent the weekend strategizing with lawyers, doing media interviews and launching a letter-writing campaign to get her out of jail.

It was a welcome distraction from the quicksand of anxiety that threatened to drag me in as I waited a full week to see a specialist.

I tried not to think about worst-case scenarios, but when I was alone I was often gripped by a palpable physical panic. I’d start hyperventilating on my walk to work. Or I’d get up at four in the morning, unable to lie in bed, viscerally aware of Piggy inside of me. I abandoned my mission to get on daycare waiting lists and cancelled my coming appointment with the pelvic floor physiotherapist.

On the morning of our trip to the hospital to see the specialist, I wrote in my journal: “I’ve been noticing the sunrises more lately and they’ve been beautiful. Maybe it’s my early rising or the time of year – or maybe it’s my deep suffering sharpening my observations.”

“What we want more than anything is a clear answer – unviable or viable with minor complications. It’s a very strange landscape of hope. Like almost hoping for no hope while also hoping for a miracle.”

Once I was back under the ultrasound wand, the specialist confirmed our baby had a severe abdominal wall defect called omphalocele. During typical fetal development, the baby’s intestines extend outside the baby’s abdomen into the umbilical cord, then return back into the abdomen by about 11 weeks of gestation. If this process doesn’t happen, an omphalocele occurs and some of the baby’s organs are contained in a sac outside of the abdomen. Our baby had the most severe case, called a “giant omphalocele,” meaning the liver and intestines were outside of the abdominal wall.

The doctor also discovered more problems: Piggy’s spine had a sharp bend due to a wedge vertebrae and her kidneys weren’t draining. Given the combination of anomalies, he said the issue was almost certainly caused by a sporadic genetic mutation, meaning it happened at random, not due to any family history. This mutation likely occurred in the genetic code in the first three weeks after I learned of my pregnancy, but the issues could not be detected by ultrasound until around 14 weeks.

The doctor looked into our panic-stricken faces and told us three truths. The first: “There’s almost certainly nothing you could have done.” The second: “Most couples in your situation would choose to terminate.” And the third: “This is very hard on couples.”

In that instant, I became part of a group of thousands of Canadian women who find themselves on the receiving end of grim diagnoses of life-limiting fetal anomalies each year. Yet at first I couldn’t find any of those other women. In the coming months, I learned that most of us are silent, shamed into living our worst nightmares in the shadows.

While other forms of baby loss, such as miscarriage and stillbirth, have received media attention in recent years, terminating a pregnancy for medical reasons is rarely discussed – despite the fact that improved screening methods and higher parental age have increased the likelihood of dire fetal diagnoses.

It is rarely discussed for one simple reason: Terminating a pregnancy is abortion. Indeed, Canada doesn’t even reliably track data about how many people terminate a pregnancy for medical reasons, due to fears of intimidation, harassment and violence toward abortion providers.

Due to this silencing, on that day at the hospital, I didn’t even know a phrase existed to describe what I was going through. I’d never heard of it happening to anyone before. And I wasn’t directed to any pamphlets, websites, podcasts or support groups. I was alone.

Back at the hospital, we were ushered into a medical genetics office with fancy leather couches reserved for people receiving horrible news. As a geneticist walked us through our prognosis, I was grateful to be wearing a mask so she couldn’t see me biting my lip, fighting back my feelings. I was more or less holding it together, until, voice cracking, I asked the question that was gnawing at me: “Why?”

I went to the gym and saw a nutritionist. I didn’t drink alcohol during the pregnancy. We had no family history of genetic anomalies. Sure, I wasn’t a spring chicken, but we had those negative screening results. Why was this happening?

I learned that most fetal anomalies have no known cause – they’re just typos in the genetic code, random acts of nature. Chromosomal errors are responsible for the majority of miscarriages – which happen in about one in six pregnancies – and that’s what probably should have happened in my case. The fact my body held on was testament to what a “healthy environment” my womb was, the geneticist said, adding: “It wasn’t anything you did that caused the problem.” I scribbled her words in my notebook and returned to them over and over again, like a prayer for absolution.

In cases of giant omphalocele, when the majority of the liver is outside the abdomen, babies often have underdeveloped lungs and a small abdomen, which cause further complications after birth. More than half of all babies born with omphalocele have other anomalies, too, including brain, spine, heart, gastrointestinal issues or genitourinary problems. And up to one-third can also have a heart defect. But we couldn’t know for certain how our baby’s other organs were impacted at this stage of the pregnancy.

The geneticist walked us through our “best-case scenario.” If the baby survived to term, I’d travel from my home on Vancouver Island to Vancouver for a planned cesarean section. If the baby survived birth, we wouldn’t be able to hold her because she would be rushed into the first of many surgeries to begin the process of moving her intestines and liver to the inside of her abdominal wall. If she survived the first surgery, she would live in a neonatal intensive care unit for months, if not longer, as she endured further surgeries. She would likely have liver and kidney problems and would almost certainly be fed by a tube for months, if not years. We’d need to move to Vancouver indefinitely to be close to the specialized care she’d need. At least one of us would likely need to quit our job. And if our baby survived we’d likely lack the financial and emotional bandwidth to have any other children. I sat on the cushy leather couch, listening to this fortune-telling doctor, and repeated the words “best-case scenario” in my head.

It felt like a bomb had gone off and I was waiting for the shrapnel to hit. Since I was already in the war zone, I decided on the spot to have an amniocentesis done – a procedure in which a long needle is inserted through the abdomen to draw a sample of amniotic fluid to test cells for genetic anomalies. We were searching in the faint hope that the early screening test we’d done was wrong and our baby had a known condition. That way we could make a decision with more certainty. I closed my eyes and imagined I was floating on a surfboard in Mexico as a 10-centimetre needle pierced my abdomen.

When the results came back, there was still no diagnosis. I learned that giant omphalocele happens in about 0.01 per cent of births. One in 10,000. I had been struck by lightning.

“Why?” became my sad mantra. I’d run a hot bath, turn up my sad music so loud my husband couldn’t hear me and then cry-wheeze that word to the universe.

The prognosis wasn’t black and white like we’d hoped for, but I came to learn that these things very rarely are. Parents in our situation almost always have to make a choice that doesn’t really feel like a choice. Our doctors made it clear our diagnosis was on the more severe end of the spectrum. Our decision – wretched as it was – seemed clear.

“Rationally, I know this is the best choice – the only choice really,” I wrote in my journal. “But I hate that there is a choice at all. I wish the heart had stopped and it was case closed. I’m good with things that are outside of my control. I don’t want a choice.”

The day after the hospital tests, I did the only thing I felt I could do: I called our genetic counsellor and told her we were going to terminate the pregnancy. One of my friends described it as “an act of mercy.” I clung to her words. I later heard another mom on a podcast describe her similar predicament this way: “I could choose life or I could choose peace.”

In an instant, our world shifted from deliberating over what room to turn into a nursery to a universe of much grimmer decisions: Did we want footprints of Piggy? Should we authorize an autopsy? Did we want her ashes returned to us? Should we give her a name on the death certificate? And perhaps the worst: How was I going to get this baby out of me? I was given another unspeakable choice: I could induce labour and give birth or be put under and have what’s called a “dilation and evacuation,” a fancy term for a surgical abortion.

We were told the “upside” of inducing labour is you get to hold your dead baby. In the wide-eyed horror of the moment, this didn’t feel like an upside to us, so we opted for a surgical termination.

Another particularly thorny choice was: Should we share the truth with friends, family and colleagues or gloss over what really happened? Our genetic counsellor warned us to be careful about who we shared the whole story with, and advised us to use the vague line: “We lost the baby.”

As we waited another week for the procedure, I prepped a message to be sent out at work once I’d emerged safely from surgery: “Emma encountered some serious complications with her pregnancy and unfortunately lost her baby.” It was a half-truth, but it was all I could muster.

By the time of my termination, I was 21 weeks and three days pregnant.

At 21 weeks, babies are about the length of a banana and weigh nearly a pound. Their eyelids, which have been sealed together, are beginning to separate. Their pancreases are beginning to make enzymes that will break down food for digestion. And, in those final days, I started to feel Piggy kicking. I spared my husband that last fact. I’d feel her especially while I was lying in bed, so I’d get up early and spend time Googling all the things I was too afraid to search while the sun was up. What exactly did the procedure for a surgical termination involve? What were the best names for a stillborn baby? Based on the set of anomalies doctors had identified, what kind of rare diseases might Piggy have? I found a paper about a baby boy born at full term with very similar anomalies. He died 95 minutes after birth.

A surgical termination at my stage of pregnancy was a two-day process, beginning with a visit to an abortion clinic. The day before my appointment, a nurse called me to go over the procedure. I was in the middle of my work day as she walked through the details of the “feticide” – a process required for terminations past 21 weeks. When the nurse told me I needed to call a pharmacy and pay $84.66 out of my own pocket for a drug that would stop my baby’s heart, tears and snot streamed down my face. A colleague ran to get me a box of Kleenex as I squeaked out questions: Will the heart stop instantly or will it take time? (She has to check and call me back.) Can I please have some Ativan before the appointment? (No.) Would the baby feel anything? (No.)

Three atmospheric rivers hit the West Coast in the last week of my pregnancy. As we drove to the clinic at 8 a.m., it was still dark outside and raining so hard it felt like the Earth was trying to drown our sorrows. Due to COVID-19 precautions, I had to leave my husband outside in the truck. We were running late, so I gave him a quick peck, hopped out into the rain and walked into the clinic alone. The stark waiting room was empty. In the bathroom, free condoms were on offer and a poster about STIs was taped to the back of the door.

I was called into the appointment room where two doctors were waiting. One of them looked at my chart and said she was sorry. I told her we’d decided to name our daughter Grace and she wrote it down on the registration of stillbirth.

I was told to undress from the waist down and lie on a table, legs in industrial-strength stirrups. At first, I felt strangely calm; I was resigned to my fate. Then the doctor put a clamp on my cervix and injected a numbing agent. She told me that next she would make an injection into my amniotic fluid with the drug that would stop Grace’s heart. I started sobbing hard, sobbing recklessly. My stomach heaved up and down so much I feared they wouldn’t be able to place the needle properly. I conjured all the love I’d ever known. “You are so loved,” I told her. “You are so loved, you are so loved.”

Next, the doctor inserted six sticks of a seaweed called laminaria in my cervix. They would gradually absorb water over the next 24 hours, painfully forcing open my cervix. When it was over, the doctor had to tell me twice to get off the table because I was in such a daze.

When I stood up, blood trickled down my legs. The doctor gave me a pill that would cause the lining of my uterus to break down, handed me a stack of giant maxi pads and gave me her cellphone number on a yellow sticky note, telling me to call right away if my water broke. Over the next 24 hours, Grace gradually stopped moving. I became a walking tomb.

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Gilchrist wears a 'G' necklace in remembrance of Grace.

The day of my termination just so happened to be my husband’s birthday. While I was admitted for day surgery at the hospital, he was once again shunned due to COVID precautions. He went on a mission for pads and ibuprofen and then busied himself with washing our sheets. As much as we didn’t want to be, we were on different journeys now.

As I lay in a hospital bed awaiting surgery, a nurse asked me whether I was having an IUD inserted – a free service offered to women ending unwanted pregnancies in B.C. An 18-year-old girl lay across from me, whimpering. I felt like I was somewhere I wasn’t meant to be – swimming outside the boundaries.

I told myself I just needed to survive this day, and then things would get easier. I’m glad I didn’t know the truth. Because the truth is the woman who walked into that hospital never walked out again.

The procedure was simple enough. First, I was given a drug called misoprostol, which softens the cervix and causes the uterus to contract. Then, I was hooked up to an IV and given all the drugs I didn’t have access to for the previous day’s horror show: Ativan, morphine, general anaesthetic. I wanted all of it. I wanted oblivion. The last thing I remember is shimmying onto the operation table. Then black.

The moment I regained consciousness, I started asking every nurse within earshot if she’d seen my baby. I desperately wanted to know if I was going to see the doctor again, if I could ask her about my baby. But I never found anyone who’d been in the room. One kind nurse told me she’d put my card in my bag. In a drugged stupor, I asked her “What card?”

She pulled out a sealed plastic bag with paper inside and showed me Grace’s footprints. “They’re so tiny,” I whispered.

Seven hours after arriving at the hospital, I was back home, without my baby. I slept all afternoon. Flowers arrived from friends and family. That night, my husband and I cried together on the couch, having the horrible realization that his birthday will now always be both the birth and death day of our first child. And then we watched the Downton Abbey movie.

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Gilchrist holds Grace's footprints. When she got them from a nurse, she remembers remarking on how small they were.

Grief unravels day by day: At first, I’m relieved and riding a high of oxytocin, my body tricked into thinking it’s had a baby. I feel broody, affectionate, can almost conjure Grace cuddling with me in bed. I tuck her footprints in the drawer of my bedside table and feel like there’s a string running between that piece of paper and my heart. I always know exactly how far away she is.

But my body doesn’t know my baby is dead, so a couple days later I wake with my breasts throbbing. They get harder and harder, filling with milk until they feel like they’re going to pop. My midwives tell me to drink sage tea and put frozen cabbage leaves in my bra and advise me not to express any milk, because then my body will create more. After three days of agony, the balloons on my chest start to deflate, and I spend the afternoon sobbing in bed, overcome by hormones. I become attached to my hot water bottle, grasping it tight nearly 24 hours a day. Later I learn of a condition called “empty arms syndrome,” a physical ache to hold lost babies, and think “of course.”

“Some things are too traumatic for the body to accept all at once,” our bereavement counsellor tells us a few weeks after the procedure. “We have to take them in bit by bit.”

On Christmas Day, we escape the festive season by hopping on a plane to Mexico for a trip we’d planned long ago for what was meant to be the end of my second trimester. The last time I was in this place, I was pregnant with Grace. Everything reminds me of her: the place I took my first “bump” photo on the beach, the tacos I could barely even look at due to my nausea, the way I loved surfing with her in my belly.

A couple days into our trip, I wait until we’re in bed with the lights off and then, between sobs, ask my husband if he still feels sad. I’ve been barely getting through the days, choking back tears at every memory, and he seems fine. He says he’s been wondering if it’s been hard for me to be back where I was in my last happy moments of pregnancy, but he was afraid to bring it up. I tell him I feel like I’m trapped on the other side of a frosted glass window – watching everyone go on with their regular lives on the other side. I tell him how lonely it is.

“He wants to support me, but he’s not there with me,” I write in my journal. I learn later that men who lose babies often feel the need to be “the strong one,” and to play a supportive role, rather than feeling their own grief. On a not unrelated note: I also learn that married couples who lose babies have massively higher rates of divorce.

I go around and around in my head about the decision we made, skipping the beach in favour of lying in bed on my phone for hours reading about survival rates for various rare conditions, questioning whether we did the right thing. One survivor of a giant omphalocele is studying to become an astrophysicist. Another is proud of the scar on his belly. Another loves dancing. For about a week, the words “She would have lived” run through my mind on repeat every waking moment. I regret not seeing her, holding her.

I learn the phrase “the burden of choice” while listening to a new podcast I find from an organization in the United Kingdom.

“It adds a whole other layer of trauma,” our counsellor tells us. She also tells us how every new grief tugs on the thread of old griefs: being left in that hospital as a baby, putting down my 23-year-old cat, discovering my biological dad isn’t who I thought it was. All of my familial losses are rubbed freshly raw.

Christmas passes us by. Then New Year’s. As we watch fireworks from our apartment’s rooftop on New Year’s Eve, our friends back home welcome a healthy baby boy.

For two months after losing our baby, we exist in a sea of uncertainty, unsure whether Grace’s problems were caused by an inherited genetic condition. If so, we could have a one in four chance of it happening again. We agree to whole-exome sequencing, a type of genetic testing that looks at genetic information from Grace and compares it with samples from my husband and me in an attempt to identify single-gene disorders.

In early February, our results come back. We hop on a phone call with our geneticist and learn the testing didn’t identify a cause of the anomalies. The whole morbid affair is chalked up to an “embryonic mistake.” We have about a 1-per-cent chance of it happening again. My husband is relieved, comforted by the fact no lurking medical issues were found within his DNA. I’m frustrated that we have no answers. “Not getting a diagnosis means I will question that decision forever,” I write in my journal. I’m also haunted by the results of the autopsy, which didn’t give us any new information, aside from the casual detail that our baby was “in fragments.”

A few nights after that phone call, I have a dream of Grace. She’s dark-haired and chubby and lying in bed between us, giggling. The doctors had been wrong – she’s fine, and meeting every milestone.

I flounder in endless questioning about what Grace’s death could possibly mean, about who I am now, after.

Why was I faced with the “decision” to kill my own baby? Have I been a bad person? Did I deserve this? It’s the same old question people always ask: Why does the tornado touch down on the primary school? Why does the truck cross the centre line?

I come to realize that I’ve been carrying around pieces of a deeply flawed belief system my whole life: I have believed that good things come to good people; you pay your dues and there’s a return some day; there’s a moral order to the universe.

My friends would describe me as dutiful, responsible, reliable. I’d weathered my fair share of struggle, but subconsciously believed most things could be overcome with enough hard work and determination. I thought the universe worked kind of like a bank account – that what you put in equalled what you got out. And I spent my 20s and 30s racking up the balance: working hard in the non-profit sector, trying to be a good daughter, a good friend, a good boss, a good wife, a good person. I was careful not to withdraw more than I thought I deserved.

When my pregnancy was going well, I felt like maybe this was the moment for my moral bank account to pay dividends. But after that ill-fated ultrasound, I wrote in my journal: “I had begun thinking over the last week or so that maybe I was destined for good luck from here on out – an easy pregnancy, a healthy, easy baby, a good marriage – and I feel foolish now for hoping.”

My mind whirred with the what-ifs: What if it was that margarita I drank before I knew I was pregnant? What if I wasn’t consistent enough with my folic acid? What if it was that time I sat in the sauna for a minute in Week 9? What if it was punishment for not wanting it enough?

I learn that my way of thinking has a name: the just-world fallacy. We’re socialized from a young age to believe that if we follow the rules, work hard, and do what we’re supposed to do, then we’ll be successful; life will be accommodating. We think we have mastery over nature. The dark underbelly of “good things come to good people,” of course, is “bad things come to bad people” – which means when people have bad luck, we blame them. This is irrational nonsense, but it’s easier to believe we have some control over things than to believe that randomness, chaos, dictates so much of our lives.

Ten days after conceiving Grace, I went on a girls trip to Pender Island. One morning, I woke up early and set out on a walk in search of croissants. At the far end of a lake, a man called me over to watch a turtle burying her eggs. I stood there, awed by nature. Six days later, I learned I was pregnant. It all seemed so perfect. But seeing that turtle laying her eggs was no more a sign of anything than Grace’s scrambled genetic code was a sign of anything.

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Gilchrist writes in her journal, which she uses to collect her emotions about Grace's death.

Our geneticist warned us that “pregnancy is contagious,” but she didn’t need to. Two of my best friends are pregnant at the time of Grace’s death and, despite all of our best efforts, I quickly begin to feel that a growing trench divides us: their greatest joy is now my greatest pain. Their choices are of a different variety: disposable diapers or cloth? To sleep train or not to sleep train? When to start their babies on solid foods? I normally pride myself on being a perceptive and present friend, but now I feel robbed of that ability. I was in a club and now I’m not, and nobody knows how to navigate my hasty departure. Every woman who waltzes in and out of her 20-week ultrasound in blissful ignorance enrages me. Everyone who momsplains postpartum hormones to me makes me want to scream at the top of my lungs: “I had a baby, too.”

I realize that, should I be so lucky as to get pregnant again, I’m unlikely to have a pregnancy that isn’t riddled with anxiety. This feels like another loss.

I exist on an alternate plane of existence, disconnected from pretty much everyone I knew before. My friends go on dates, complete their PhD theses, decorate their nurseries. I don’t understand how life is supposed to carry on. I like to do my crying in private: the first moments after I wake up, as I do my makeup (not a good time to cry), in the bath, on my yoga mat, on my walk to work.

“There are gaps in the mesh of the everyday world, and sometimes they open up and you fall through them into Somewhere Else,” writes Katherine May in her book, Wintering. “Somewhere Else runs at a different pace to the here and now, where everyone else carries on.”

When I look in the mirror and see melasma freckles on my cheeks – a darkening of the skin caused by pregnancy hormones – I gently stroke my face and whisper Grace. I’ve never loved myself so much.

My due date – April 10 – looms large, like a poorly stacked pile of bricks, ready to topple. I can’t wait to be on the other side of it, out of the impact zone. I book two weeks off work and go on a solo retreat to Tofino, staying in a beautiful hand-built cabin in the woods. There’s a little deck looking onto the forest, and the sun shines down through the trees, leaving dappled light. Grace is in every sunbeam, in the moss on the forest floor, in the stars above the outdoor shower. I can see my breath in the cold mornings, and she’s there, too.

The fact Grace didn’t get to live outside of my womb makes me want to grab life with both hands, seize every moment, live my fullest truth, love with my whole heart.

I come to learn that what I’m experiencing is known as “post-traumatic growth” – the transformative self-improvement some people undergo after a traumatic life event. It’s typically seen in five key areas: embracing new opportunities, improved personal relationships, a heightened sense of gratitude toward life, greater spiritual connection, and increased emotional strength and resilience.

Sauntering along the beach at sunset one night, I whisper under my breath: “Grace, I gave you my spirit. And you gave me yours.” Loving her, and losing her, has made me more me somehow.

Someone on Instagram sends me a study on how fetal cells migrate into the mother during pregnancy and can persist for decades. These cells are found in the mother’s blood, bone marrow, skin, and liver. Grace is quite literally in my body. It’s beyond metaphor. I am changed.

My life feels a bit like a forest after a wildfire. All the trees are scorched, but the mushrooms and wildflowers spring up with new life.

Desperate to understand what is happening to me, I start calling up psychologists, grilling them for details about “ambiguous loss” and grief – all with my journalist hat on. But the real questions were always very simple: “What’s happened to me? When will this end?”

“If you just bounce back, you’re not going to grow,” one of them tells me. “It’s almost a prerequisite of growth that you have a fair amount of suffering.”

The spring after Grace's death, Gilchrist couldn't bring herself to plant a garden. Planters lie empty on the patio.
A card reading ‘remembering Grace’ remains in a potted plant given as a sympathy gift.

The spring Grace should have arrived, we don’t plant a garden. The pots on our patio sit barren. It’s like we both can’t bear to nurture anything. While my friends have their babies and Mother’s Day comes and goes, I live what I come to call “the opposite life” – an alternative to the life I was meant to live as a mother.

When I should have been entering my third trimester, I’m surfing and drinking margaritas in Mexico.

When I should be in my final month of pregnancy, I’m going to the gym four days a week and splurging on new clothes since my old ones still don’t fit.

When I should be prepping to have a baby any day, I’m wearing a bikini on a rainy Victoria beach, going for a cold-water ocean dip with new friends.

The day a “certificate of remembrance” arrives in the mail, marking my daughter’s death, I go out dancing at a country bar. Grace would have been two months old. The next day I hold the certificate in my hands, tears streaming down my face, and mutter: “It really happened.”

No amount of margaritas or fitness classes or ocean plunges can erase my loss.

I wait anxiously for a phone call about our daughter’s ashes, even checking my voice mail from Mexico, worried they might be discarded if I miss the message. But the call never comes. Eventually I call the women’s clinic and they tell me they’re at the cemetery. When we go and pick them up, I learn they’ve been sitting there for six months, uncollected. A nice woman named Susan with a perfect manicure gives me a tiny wooden box and asks me to sign a ledger, as though I’m signing out a library book.

I can’t help but think of all my friends holding babies at home, while I’m holding a cremation certificate and my baby’s ashes in a wooden box. Their children will take their first steps, go to their first music festivals, start kindergarten, constantly reminding us of what we lost. I find a study that shows women two to seven years after terminating a pregnancy for medical reasons show just as high a degree of trauma as women 14 days after terminating, which confirms something I already knew in my heart: This loss will reverberate for all of my days.

Six months after Grace was taken from my body, I write in my journal: “I never imagined it would be this hard, this disruptive, this unmooring. I feel like I’m living in the middle of an inferno no one else can see. And I don’t know if I’m going to make it out.”

I’m no longer the person I was before, but am equally unsure of who I’ll be on the other side of this fjord of grief. When well-meaning people ask if we’re going to get pregnant again, I just say: “We’re not there.”

Around the same time, Roe v. Wade is overturned in the U.S. and I watch the news blankly. All I feel is numb.

Grace’s ashes sit in a box above the fireplace.
The mobile from Mexico hangs on an ironing board.

As I write this, the blue mobile I bought in Mexico still dangles off the edge of the ironing board in our spare bedroom, in the exact spot I put it when I first returned home. A cupboard sits full of baby gifts people gave us too early.

I wander outside with a cup of tea and notice plants sprouting up in our pots even though we didn’t put them there. The world continues on despite it all: seeds germinating, some making it up through the soil, some never pushing through, turning back to dirt before they’re ever known to the world. There it is again, staring me in the face. Nature: insistent, oblivious, beautiful, cruel.

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  • The Pregnancy and Infant Loss Support Centre in Calgary runs an online support group for parents who have terminated a pregnancy for medical reasons, online chat support and free one-on-one counselling, available to anyone.
  • Families in Ontario can access support through the Pregnancy and Infant Loss Network, including an online support group for parents who’ve terminated a pregnancy and one-to-one peer support.
  • Antenatal Results and Choices based in the U.K. provides support for parents before, during and after antenatal screening, including a helpline and fact sheets.
  • The Time to Talk TFMR podcast explores all aspects of pregnancy termination, including post-traumatic growth and impacts on couples, and includes interviews with maternal fetal medicine specialists, psychologists and bereavement midwives.
  • TFMR Mamas supports parents around the world through a website, podcast, Instagram account and Zoom support groups.
  • TFMR Psychologist collects data via surveys from parents, offers trainings for counsellors and therapists and has an international therapist directory.

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