December 23, 2015, I came home from work to see Logan and Travis playing in our living room. I greeted my boys with hugs and kisses and played for a few minutes before telling Travis I wanted to take a pregnancy test. I went to the bathroom and left the test sitting on the counter then went back to playing with the guys while I waited for the results. Logan was so close to walking and we laughed and cheered as he clumsily took a few steps before plopping down. We were having so much fun at least 30 minutes passed before I remembered the test. I went to the bathroom to throw it away then stopped dead in my tracks when I saw the positive test line. I was pregnant. My head swirled with so many emotions before quickly settling on excitement. I grabbed my phone and recorded Travis’ reaction as I told him we were having another baby. The last thing I said on the video was, “Merry Christmas.” The world was filled with hope and excitement for the future. Our family was growing. I watched Logan playing and couldn’t help but picture what our family would like next winter as a family of four.

December 23, 2016, there was no fourth. I wasn’t spending my day dreaming about the excitement of watching my kids open presents, instead, I was coming up with my plan for surviving everyone else’s joy. The previous days I cringed opening holiday cards from my friends. Their smiling faces looked right at me, most holding newborn babies, captioned with some phrase about god’s love or blessings, and they all seemed to say, “this should have been you.” We didn’t bother sending a holiday card this year. Neither of us could bring ourselves to do it.

This year, like last year, I spent December 23rd at work, but this year I wasn’t full of holiday cheer. This year I comforted a woman who was disappointed about needing a c-section and having her perfect birth plan thrown out the window. I empathized and told her I was sorry that things weren’t going to turn out exactly how she had hoped. I got choked up more than once while I told her I understood how difficult it would be for her to have a different birth experience than the one she had wanted while I thought about how I would have let someone pull my baby out of my ear if it would have meant she would have lived. My eyes burned listening to her plan to reject medical interventions which would protect her and her baby from infection and death as images of my own c-section flashed through my head and our choice to also decline interventions for our baby, like CPR. I maintained my professionalism and composure for the entire 30 minutes I spent with this person when all I wanted to do was scream at her. I wanted to tell her that sometimes life doesn’t work out like we plan. I wanted to shake her and point out her belly which was holding a full-term fetus that thanks to modern medicine, would more likely than not be a healthy, living baby that would be smiling on her holiday card next year. I wanted to tell her to shut up and give up on her “perfect plans” because, in the end, it was all about having a healthy baby and she was at least getting that. I wanted to tell her about Ava and tell her how petty and ridiculous she was being, but I didn’t. I stayed cool, calm, professional, and empathetic. This wasn’t something remarkable for me anymore, because somehow I’ve been doing this for months.

For the past four months, I have held it together talking to the people just like her. Or worse, the people who didn’t mean to get pregnant and are so ambivalent about the outcome of their pregnancy that they can’t be bothered to show up for prenatal care or to even stop using drugs. I’ve not only kept a straight face, but I’ve offered understanding and compassion to the people who ignored their crying infants or shushed them harshly in front of me when all I wanted to do was pick up their babies and comfort them and tell them they are loved and wanted. I’ve given a kind smile when the 100th woman has told me with a proud smile, “I’m going to have a natural childbirth.” I’ve even feigned sincere excitement when I reveal fetal gender to excited patients when the real point of my phone call was to inform them that their genetic screening tests were normal, but no one seems to really care about that part, they just want to know what color to paint the nursery. I’ve kept my anger, and jealousy, and contempt and sadness brewing inside of me for four months and have only allowed my exterior to show kindness, compassion, and excitement for my patients. I’ve become a sort of robot at work where I disconnect from my emotions and be the caregiver that my patients need me to be until eventually, my anger sizzles out, but this December 23 was different.

December 23, 2016, I got into my car after work and made it about three minutes from my office before I lost it. Completely. It caught me off guard. Tears started to come slowly and by the time I was merging on the interstate they were flowing freely. I decided not to fight it. I decided to embrace my emotions and let myself feel. I decided to finally let them out. I cried. I sobbed. I ugly cried, my face contorted into strange and uncomfortable shapes underneath a film of tears and snot. By the time I reached my exit I had a hard time seeing. I couldn’t stop crying and I didn’t want to. Instead of forcing my tears to stop and going right home I pulled into my neighborhood and stopped in an empty parking and really let it fly. I cried, I screamed, I swore. I stomped my feet and hit the steering wheel. I buried my head in my hands, and I pulled my hair, then I looked up at the sky and called bullshit on everything. I sat there for about 15 minutes like a crazy person in my car and then calmly put the car in drive and turned the corner to my house.

When I got home Travis could immediately see I had been crying. I didn’t try to hide it, there was no use anyway, it was pretty obvious. I was a red, swollen, wet-faced mess. He gave me a hug and Logan quickly came running to do the same. It felt good not to hide my grief. It felt good to admit to them that I was feeling sad and in a way that made me feel better. I didn’t feel as sad when I didn’t have to pretend I wasn’t. I took a moment to go to the bathroom and splash water on my face. When I returned the scene was much like last December 23. The boys were playing together in the living room, except this time Logan was running around and talking instead of wobbling on chubby legs, and this year, there was no happy news to celebrate or life growing inside of me. Still, the moment felt similar as my heart swelled watching them together. Everything was different but so much remained the same. The love and joy were still there. Much like last year I settled into the moment and smiled as I watched my guys playing, wondering with hopeful anticipation what our lives will look like next December 23.