I also want to share how the ambiguities of biological life are of great comfort to me. There is no single moment when life starts, just as there is no moment when life ends. In that ambiguity is so much space for empathy and healing. 🧵
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Molecules become cells become organs become people. At death, through that journey our matter returns.
At 0 days gestation, an embryo was created by IVF. At 5 days gestation, we learned it was well-formed and also that it had XY chromosomes. We called it a “boy” but it wasn’t yet a boy. It could grow up to be a boy, but there was no boy yet. Just cells holding our hopes.
After implantation, at 6 weeks gestation, we saw cells beating rhythmically on the ultrasound. They call that a “heartbeat” but it’s not a heartbeat yet. There is no heart. No valves, no chambers, no blood to pump. It can become a heart but it isn’t a heart yet.
We’d previously lost an embryo after this stage, but this isn’t that story.
At 14 weeks, the fetus looked perfect for its stage, but the amniotic fluid was a little low. Something to note. At 18 weeks, we got a very anomalous AFP test, which is usually a sign of serious fetal malformation, but there is no malformation to be found. Still low-ish fluid.
On the day we did the last ultrasound to rule out malformations, we saw our baby-to-be. His spine is formed, as far as they can tell (fluid still low). His head looks perfect. He has fingers and toes. He has the beginnings of a face. He’s moving. Legs a little stunted now…
At this point, I’m scared but hopeful. Something isn’t right but “he” is fine. Relevant to the story I want to tell, I now know I’m making a category error. I’m thinking of the fetus as independent of everything else, but it wasn’t. Not yet.
They check Marisa’s blood pressure. It’s through the roof. She’s admitted to the hospital. Thankfully I get to stay and her parents can take care of our dog Niko. She’s getting bad fast and the treatment to prevent seizures is miserable. It slows the cascade but it can’t stop it.
The doctors help us understand what’s going on. Give us time to hold out hope. Show me scientific papers so I can understand, in my way.
It’s very likely his lungs won’t develop properly over the next few weeks. It’s inevitable that as his growth needs accelerate, he’ll starve. It’s inevitable Marisa will experience seizure, organ damage, and death if the pregnancy continues another week or three.
We come to accept there is no viable path for our son-to-be to survive, and none for Marisa to stay healthy and alive if she keeps this going. The only cure is delivery.
But he isn’t a person yet. Can’t exist without the placenta and mothers’ blood to feed him. Marisa can’t continue existing with the placenta. The low fluid was a hint. Something wasn’t right with the placenta—an organ that belongs to neither of them—and it was killing them both.
And so she takes the pills to stop his heart (it’s a heart now), and we hope for the restoration of her life and begin to mourn the life he won’t have, both at the same time.
To spare herself the trauma of labor and stillbirth, Marisa chose to have a surgical procedure to remove the placenta and fetus. We’re grateful that was an option in Washington state.
But they asked if we wanted his ashes, and we said yes. We didn’t know it then, but with that decision, which requires a death certificate, he was legally born and legally died. Our son, Dominic Joseph, was born and died on October 8, 2021.
I am so grateful for the unexpected interaction of laws in our state that allowed our fetus to be both not-yet-a-person, and also our son who died before we got to meet him and is part of our family forever.
Nothing about birth or death is simple. Had the laws here not respected that, Marisa may not still be here. Had the laws not respected that, we may have no acknowledgement that Dominic ever was here.
He was both not yet a person and our son. Both are true. Our compassion for each other and our laws should hold space for that truth. It means so much to me and Marisa and I know we’re not alone.
unrolled thread: typefully.com/famulare_mike/gYAAV2E