Heart-Shaped Box

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I have a bicornuate uterus. A septum divides the two sides of my womb. This “Müllerian anomaly” is a birth defect that affects less than 1% of the female population. I had no idea it affected me until I experienced complications early in my pregnancy with my oldest son.

I remember exactly where I was when I first thought I was losing the pregnancy: then a high school history teacher, I had rushed to the bathroom between classes when I saw red blood—bright and accusatory—on the toilet paper and in the bowl. I ran to my friend, tearfully explaining both that I was pregnant and that I was scared I was about to not be. He covered my next class as I talked to my doctor on the phone and made plans to meet my husband in her office as soon as possible.

An hour later we heard our son’s heartbeat and saw the first pictures of him. No bigger than a sesame seed, he nevertheless impressed us just as much as the other striking thing we noticed on that ultrasound screen: instead of the pear that, we learned, a uterus is supposed to be shaped like, mine was shaped like a heart. There was our sesame seed, growing inside a heart inside of me. I’m not sure I’d ever seen anything so beautiful.

Having a bicornuate uterus, the doctor explained, is associated with an increased risk of miscarriage because the zygote (here I was wishing I taught biology instead of history) can only implant itself in certain parts of the womb in order to have sufficient space and blood flow to grow.

Had our sesame seed implanted in a good place? It was too early to tell, she said, but it looked okay for now. And what about all that blood in the bathroom? Not necessarily a bad sign, she assured us.

We’d have to wait and see.

As I learned more about my bicornuate uterus from my doctor and from ill-conceived Internet searches (note to self: never turn to the Web when looking for reassurance), I learned that I was at risk for preterm labor, that my pregnancy would likely be irrevocably breech and my plans for a natural delivery were shot, and that he was four times more likely to be born with a congenital deformity. I spent the first few months and much of my last trimester on bed rest, my stomach jutting out at an increasingly odd angle, my son having settled himself completely on the right side of my womb. I bled on and off throughout my pregnancy, each event no less scary than the first had been, but countless ultrasounds suggested that, despite the evidence to the contrary, the pregnancy was proceeding well.

Plans for my delivery went the way the rest of the pregnancy had. Scheduled for a c-section at 38 weeks, I went into labor the week before, mistaking the telltale fullness of contractions for indigestion before understanding that yet another plan in this chaotic pregnancy was unraveling. But despite the fact that I hadn’t yet packed my bag with everything you’re supposed to, that I hadn’t yet finished the requisite chapters of What to Expect When You’re Expecting, that I had spent the previous eight months more scared than I’d ever been, I gave birth to a healthy son that Labor Day morning.

My pregnancies with my second son and my daughter were hardly less dramatic. I experienced the same bleeding with both. With my son, I had such bad sciatica that I could barely walk—a challenge for any pregnant woman, let alone one with a one-year-old to take care of. But my pregnancy with my daughter was the most challenging of all. When I was 32 weeks pregnant, I experienced a placental abruption and had to spend the rest of my pregnancy in the hospital with a fetal monitor strapped to my belly. But both children—like their brother before them—were born healthy. For as much time as I’d spent with doctors during my pregnancies, I was able to bring all three of my babies home right away. The doctors, it seemed, had done their jobs, just as my abnormal, heart-shaped uterus had done its own.

Despite all the worry it caused during my pregnancies, there’s some poetry, I think, to having grown my babies in a space shaped like a heart. And there are many ways in which having difficult pregnancies was the perfect preparation for the much harder work that came afterward. What better way, after all, to steel myself for the sleepless nights, sick days, and collapsed Lego towers that come with parenting?

What better training for what to expect when you’re expecting then the unexpected that defined so much of my pregnancies?

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