The Grief And Relief Of Having A Hysterectomy In My 30s After Our Surrogate Had A Stillbirth
Surrogacy had left us damaged and doubtful of whether we had it in us to trust again.
vladans | Canva I twirl the loose curl dangling behind my ear and poke it back into the cap. The blue mesh feels like it’s slipping from my forehead from the weight of my hair. I stiffen as if to prevent it.
The morning light is barely warming the hallway. I don’t want to see any equipment or cold metal tools. I turn instead to the framed photos on the wall, my back to the other two patients whose names were called with mine.
I know this gesture reveals to them that I’m anxious, especially when I fill my chest with one long breath that I’m reluctant to exhale. But I don’t owe these strangers bravery.
My eyes dart from landscape to landscape of Nevada or Utah or whatever other arid place houses these arches and valleys of reddened rocks. I study the strata of the cliffs closest to my nose; incredible how a rock keeps the score, like a body familiar with grief.
I’d been in Mallorca when I’d gotten the call. I’d felt a world away from the voice at the surgical bookings desk, which meant my vacation was doing the trick. Moments before the call, I’d scooped out the hot sand under my beach towel to carve a crater for my belly.
It had been heavy and hard for months without reprieve, and I’d decided I was finally done hauling this ache. The timing of my decision was almost ironic.
After pursuing surrogacy with donor eggs for over a year, my husband Ethan and I were lost in the throes of mourning our son, weeks shy of the finish line.
Surrogacy had left us damaged and doubtful of whether we had it in us to trust again. If there was ever a time to keep a uterus as a backup plan, it was now, yet I was convinced I wanted it gone, yanked out of me like a rotted plant from a pot.
When you beg for a hysterectomy before crossing into menopause, doctors ask you at least a dozen times if you’re certain. When you tell people you don’t want to carry a pregnancy, they run through the script you’ve been hearing since your teens:
“Never say never! You’ll change your mind. You’ll regret it when you age and need someone to care for you. You’re robbing your parents of the joy of grandchildren. Your husband deserves better.”
Everyone seems to know something you don’t about your wants and woes, something you’ve failed to consider in your tediously researched pro-con lists and your most visceral instincts.
It must be so unnatural for them to meet a woman who is ambivalent about this glorified organ and so reckless with her ever-pending membership to the Motherhood Club.
Even on my way to the O.R. this morning, I had to drop off a urine sample at the hospital lab. The requisition accompanying the cup had only one box checked off: pregnancy test. The doctor’s job is to be more certain than you are.
My surgeon’s voice is cheerful when it sneaks up behind me. I try to let it steady me, but I’m too weak from hunger and fear. I focus on her floral cap, oddly reassured by the confidence conveyed by her whimsical scrubs.
“Are you nervous?” she squeezes my shoulder as I nod.
Even things you’re sure about are scary. As I crawled into bed last night, I surprised myself with the thought: “This is my last night with my uterus.”
Not “a”, but “my.” This strange attachment had never reared its head before. I’d always resented and berated my womb, knowing full well that — contrary to popular belief — it is not the sole driver of my disabling pain.
But, on top of this full-body illness that sprouts and thrives outside my uterus, my periods have floored me for twenty-six years — sometimes twice a month, often for twelve days on end.
They’ve had me canceling, vomiting, staining, fainting, failing. When you tally the agony, this surgery feels anything but elective. It feels searingly overdue. Yet, I’m fairly sure I wouldn’t feel as emotional about surrendering my gallbladder or appendix.
I’m right-handed. I’ve had my tonsils out. I have a titanium biopsy marker in my right breast. My withered right ovary is impossible to find on scans. I have a slightly curved spine. I have no cavities or dental implants. I am allergic to naproxen and lidocaine. These are facts about my body.
Now, suddenly, I’ll also be uterus-less — who will I be, without my periods marking my month like a metronome?
My gyne surgeon is soon joined by the colorectal surgeon, the urologist, and the anesthesiologist. We talk about removing parts of the colon, reconstructing parts of the bladder, and inspecting the liver and lungs.
Endometriosis is an untamed circus beast that keeps several ringmasters on their toes. It has no cage and knows no satiety.“Will you check my hemoglobin level again? I got my period last week and it was hemorrhagic as usual.”
I’d secretly been glad to see it once more, to say goodbye. I’ve always hated not knowing when a time was the last. As I’d gritted my teeth and plowed through my last pack of pads and tampons, I hoped I’d never forget the intensity of this mad-making pain, so that I may never dismiss someone venting to me about it.
“When you wake up, you’ll never have that problem again!” my surgeon beams.
“Goodbye, Uterus,” I murmur.
“Goodbye and good RID-DANCE!” she almost sings.
This is her third time operating on me in under six years. She’s had another kind of insider’s view of how deeply I’ve suffered.
I’m escorted into the operating room by the anesthesiologist. He’s asking me about my career, whether my allergies are true allergies or simply anxieties, and whether I scrubbed my brown skin with the antiseptic sponges they’d given me. He’s speaking to me in French while I’m speaking to him in English. He’s asking me to remove my underwear, lie back, and give him my arms and my glasses.
It occurs to me that I forgot to ask my surgeon about keeping my cervix or about how she’ll prevent more scar tissue from forming. These questions take up all the space in my mind until I grow restless
I ask to see her again before I go under, and when I ask a third time, the anesthesiologist has no choice but to comply. I ask to sit up and for him to hand me my glasses, so I can think and listen.
“You need your glasses to hear?” the anesthesiologist laughs. His tone says more than his words.
It reminds me that I am the demanding patient — the difficult woman — who is sitting up underwear-less in an O.R. bed waiting to ask the doctor questions that people who haven’t been forced to advocate for their survival don’t typically feel compelled to ask.
The assistants are swirling around me, wheeling monitors and metal poles like stagehands in blue robes to set up the production I’ll sleep through. I am the scene’s unmoving center. Two nurses are doing an inventory of the shiny blades arranged on a large metal tray.
In another corner, the urologist is briefing her fellows about my bladder and bowels and ovaries, their sentences only reaching me in fragments over the clinking tools and the anesthesiologist’s humming.
I hug myself to quell my shivering and I stare at my socks — the only item of mine they haven’t placed in the white plastic bag under my gurney.
By the time the surgeon is at my bedside, I am swallowing hard and part of me has already left my body.
“Okay?” she says when she answers what seems to be my last inquiry, the gentle pressure she is exerting on my shoulder telling me to please lie back now and let them get on with the show. These surgeries are long and complex, and they have other patients to see, and families to eventually go home to.
A squad is around me now, each of them fussing with one limb, probing for veins, positioning the padding. I surrender to their gentle tugs on all sides of me as they hook up the IV and do whatever else they are doing.
“Don’t be afraid,” I keep telling myself as I stare at yet another ceiling. “You’ve done this five times now. You know the drill. The next days will be hard, but the days after those will be better.”
But will they? There are often surprises after surgery. Nerves that forget how to fire, a neck and shoulders and elbows that move out of tune, a bladder that is too seized to pee.
I’m afraid of surprises. I’m afraid of this illness that too few understand. Maybe life is good enough now and I shouldn’t be rocking the boat. Isn’t pain better than the unexpected? What will being uterus-less solve, except not having periods?
Am I copping out and taking the easy road, the way people said I did with surrogacy when I opted out of the IVF hamster wheel?
I’m afraid that all this won’t be enough, that giving this disease my career, my confidence, and my uterus still won’t satisfy its hunger. I’m afraid of being hopeful of a turning point that isn’t one.
I’m afraid of thinking, “How much more can I possibly take?” and being shown an ugly answer. The most colossal unfairness is that being an expert in uncertainty still never makes it easier.
I must be squirming. My surgeon cups my hand as if to try and warm it. I blink to bring her into focus.
“Isn’t your surrogate due any day now? Didn’t you say your due date was in May?”
I clear my throat. “We had a stillbirth,” I tell her matter-of-factly, softly, still unbelievingly. What I don’t tell her is all the trauma of the aftermath, of physicians denying us information on what happened, as though we were strangers off the street instead of his parents.
Months of therapy and I’m only just barely beginning to chip through one layer of the glass cage I’m in.
“What?” Even without my glasses, I can see she looks shocked.
“Everything was going perfectly, but then his heart stopped…” And yet his heartbeat was so strong at every milestone, and yet he had the slenderest fingers. These are the times when the breath in my chest feels like water. The anesthesiologist is tinkering with something behind my head.
“I didn’t tell you because I wanted to focus on…”
“On this, on your health. I get it,” she says, then keeps silent, staring at the ground. She must understand it’s dangerous territory to be vulnerable about your emotional and mental health when trying to get care for your physical symptoms, especially after a long history of fighting to be heard. Tears are pooling in my ears and I don’t have hands to wipe them.
My uterus flashes to mind, as though sent straight from hers.
I think of this morning’s pregnancy test, of how everyone assumes every woman, at some point or another, will want to use this organ for its prescribed purpose.
For a second, I’m afraid she’ll persuade me to keep it, just in case. Maybe I’ll wake up and she’ll tell me she couldn’t go through with it, that she vetoed my signature on the consent form. With all the hemorrhaging, inflammation, and cancer risk, it would be an absurd just-in-case.
Besides, it’ll be easier to explain surrogacy now. It’ll be a more straightforward narrative, a logical choice of path, like for women with MRKH who are born without a uterus, gay men, single parents, or cancer survivors.
Surrogacy is hard to explain as a selfish person who opted out of pregnancy to spare whatever little resilience she had left. We’ve done things in reverse order. Maybe that means we had a head start, instead of a setback — some kind of twisted, costly practice run.
“What now?” People don’t like irreversible losses, so I tell her the positive bit.
“We matched with someone new…” I notice how tentative my voice is, and how I dampen my optimism to avoid projecting an arc that the story won’t be able to hold. It’s not always worth getting hearts to hope.
This one’s different, I want to say. She doesn’t make us question our place and our worth. The expert psychologist doesn’t see any red flags this time. She’s not abusive and secretive and cold. But this conflicted relief is too much to unpack in the seconds before I’m gassed, and I don’t want to fall asleep with her in my bones.
“You guys just can’t catch a freaking break…” My surgeon sounds like a friend.
The nurse interjects. “I’m just gonna put on this oxygen mask so you can breathe and relax, okay, dear? Then you can carry on your conversation.”
This lie makes me chuckle. “There’ll be no carrying on the conversation,” I manage to say just as the mask is lowered onto my nose and mouth.
I squeeze my surgeon’s hand to tell her thank you and please. Please remember I’m fragile. Please don’t do anything that adds a layer to my red-hot, hardening grief.
I use the last seconds to relax my spine, unclench my fists, and release my pelvic muscles to prevent injury. I call to mind everyone and everything I love, all that makes me want to stay.
I see us gathered for a family barbecue in my parents’ garden — my childhood home — our faces baking in the sun as we clink our glasses of rosé to good health. I see myself watering my flowers, giggling at inside jokes with my nephews, and stuffing my face with croissants.
I see Sage and I bonding over her pregnant belly. I see published writing, stimulating work, fluid income, and long walks with Ethan. I linger on the image of his knowing eyes and the wrinkles I’ve caused around them.
I see us laughing, soaking up Italy, chasing sunsets from sailboats and rooftops. I see myself floating on my back in the sea without an ounce of resistance, my scars blending in with the previous ones. This is the life I’ve built out of disability, and this is the life that’ll cradle me when I emerge on the other side.
It’s taking long to fall asleep. I can feel the curious impatience mounting in the room. The anesthesiologist starts humming again and my gyne surgeon whispers, “I’m going to take very good care of you.”
I see the blur of the red clock at 7:43 and I disappear into a haze of voices.
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My first thoughts when I wake up are that I’m shivering violently and that I’m alive.
A blurred figure buries me under the weight of blankets as though I’m a corpse. I mostly see the inside of my eyelids. I give it everything I’ve got to pry them open longer than a flutter when the colorectal surgeon appears by my side.
She tells me things about having liberated the intestines and how she checked every single centimeter of them for disease. Somehow, I feel like I know this already, like I was conscious all along. My ears are full of voices and my cells recorded all the motion, as though I’d been underwater near a busy shore.
“Thank you so much,” I repeat at least five times in a labored whisper. I want to know more about what they found, what they took, what they left, and how I’m free.
I squint at a different red clock that reads 3:38. Ethan and my family must be hungry for news.
“It’s like flying to Europe!” I’m not sure I’ve said this aloud until the nurse laughs. He rummages through the white plastic bag and puts my glasses on, missing my right ear. “Close enough,” I croak, and he laughs again. I worry my voice won’t return.
My body feels raw and hollow and not quite mine. I register that my bladder is burning, my butt is sore, and I am still underwear-less. My hands and feet are unpleasantly numb, and I worry the anesthesiologist gave me lidocaine after all. It takes me a while to think about my uterus.
I imagine it traveling like luggage through an airport terminal. It is somewhere outside and away from my body, on its way to pathology, transported the way they transported my son away from a body that wasn’t mine. I wrestle with the same discomfort I feel when I drop off a bag of clothes for Goodwill.
I’ve given away something that belonged to me and there’s a space where it used to hang. I doubt my uterus will serve anyone, though. Maybe they can study it as an example of a bad uterus. I’ll be sad if they say it was healthy.
I picture my ovaries strung up like a garden hose in winter. This illness has been altering my anatomy for decades.
I’m dozing on and off in an upright position while a physical therapist takes patients and their IV poles for walks across the recovery room. I watch their knees, hips, and spines and try to figure out which parts have been operated on.
“The others were able to do this and are already going home,” I hear the physical therapist tell the patient hooked onto her arm. The comparison doesn’t have the intended effect of motivating her.
“Why can’t I manage it, then?” I know that sorrow in her voice. I know how frustrating it is not to heal to the beat of another’s drum.
The blanket-dispensing nurse is gone, but I flag another one down for my three requests: to speak to my surgeon, to be given something for my blazing bladder, and to be helped up to pee.
I’m in the washroom struggling to start my stream when I hear my gyne surgeon speaking to the nurse about me. I shut off the tap and shakily scramble to my feet.
I don’t want to waste her time. I don’t want her to leave. It’s already past six and I’ve taken up her entire day. If endometriosis and adenomyosis were taken seriously, the few experts in the world wouldn’t be stretched so thin.
“How did that feel?” the nurse asks when I open the door. My surgeon has her jacket and backpack on.
“I’ll try again later,” I wince. “I didn’t want to keep her waiting.”
I’ve been hardwired to feel like a burden on the system.
“It should get better!” My surgeon is as cheerful as she was at seven this morning. I study her face for signs of fatigue and can’t find any.
The nurse and the other patients in the ward get a crash course in endometriosis as we discuss all the spaces she cut it from, and all its different colors and fenestrations and webbings. I dare to imagine that this new retreat might outlast the assault.
When she leaves, I go back to trying to pee. I spend several minutes hushing myself to the rhythm of the tap water and my hushing reminds me of the baby I don’t get to sway to sleep when I go home.
Finally, when I tilt to the right and raise my left butt cheek off the toilet, there’s a tiny trickle. It burns for ages. How long will this last? What have I done? Was it worth it?
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I am released in the evening to recover at home. At night, fever flushes my face and has me trembling with chills. The next morning, bumpy blues appear behind both knees and on one thigh. The pamphlets they gave me are vague at best. How high is a high fever? When is a bruise a clot?
By Day 3, I am faring surprisingly well and able to stand steadily enough to bake muffins for Ethan. It’s a new recipe and I’m unsure of the steps. The batter will be thick, the recipe warns.
I’m relieved by the clear heads-up on what to expect so that I won’t be tempted to ruminate about all the ways I messed this up so that I don’t have to passively sit back and just hope for a positive outcome.
I’ve lost my confidence in the simplest things since surrogacy — how much to water my flowers, how little to stir. I also like that this recipe doesn’t yell DO NOT OVERBAKE! in all caps like some others do. The stakes don’t seem as high. I can relax.
I still double over when my bladder becomes full, and I have to hurry to relieve it, even if my physical therapist suggests waiting ten minutes to see if the urge disappears.
My bladder — like my breath and my heart and my mind — has to be lovingly and patiently retrained. While I recover, I’ve propped the garbage tin on a stool, and I pick things off the floor with a standing dustpan.
A disabling chronic illness is a thief of many joys, but it also gifts you with resourcefulness.
There are three minutes left on the oven timer. I doubt that’s enough time to pee, but I try. I tilt to the right to lift my left butt cheek off the toilet. Will I have to pee this way for the rest of my life now? Is this yet another accommodation I’ll have to accept? I bury my face in my palm and melt into laughter at the absurdity of it all.
I laugh knowing that even the most weathered landscapes can still be beautiful.
Kristina Kasparian is a writer, consultant, and health activist with a PhD in neurolinguistics. Her writing on identity, wellness, and social justice has been published by Roxane Gay, Longreads, Catapult, Newsweek, Fodor’s, the Globe & Mail, and several literary journals. She is currently at work on a literary non-fiction project on these same themes.