"I bet anything she's pregnant," said Mark as we left a get together with friends in the years long before recovery.  Having been through a pregnancy recently ourselves at that point, we knew what to look for: the change in eating habits, the hand unconsciously and lovingly resting over a still flat stomach...

"Totally," I agreed, "But they must not be telling people the news yet."

"You remember that time they said that they didn't think it was possible to tell when someone was at the beginning of a pregnancy?"

"And we did think it was!  Oh, I do!  I really want to tell them 'I told you so,' but we ought to let them share the news in their own time.  But if we do wait, they'll never believe we knew."

"We ought to write it down!  Then we can prove that we knew."

"I know what we should do!  We'll write it down and seal it in an envelope and mail it to ourselves.  That way it will have the postmark with the date on it.  I've heard people do that as a cheap and easy way to copyright their writing."

Mark agreed that this was the most fantastic and foolproof idea he'd ever heard.  So, we being the not-so-mature or spiritually enlightened, but at least very clever, individuals we were, did just that.  And after our friends finally shared their good news with us, we were able to produce the envelope with a flourish and seal our reputations, both as greatly insightful predictors of pregnancy and as gigantic dorks.  Whatever.  The important thing was: we were right!

And we made them laugh, which was a relief, because it doesn't always happen that way.  Needing to be right can be seriously annoying.  It's a big glaring character defect of mine, and like most of my character defects, it's born of fear: the fear that I don't know what's real, that I can't trust myself or my own perceptions.  External validation is the rock on which I build my church to the fickle God of other people's opinions.

Over the years, in so many of my relationships, I haven't been able to hold on to my truth.  I'd state what I saw and be told I didn't see it, state what I felt to be told I didn't feel it, and I'd begin to doubt my own eyes and my own heart.  If you say the sky is blue and everyone else around you says it's red, how long before you get your eyes checked?  How long before you begin to wonder if you actually know what blue looks like?  How long before you start to call it red too?  And when someone whispers to you, "No, it is blue, and I have proof..."  That's when the "I was right and I have proof" victory dance begins.  The one that seems inexplicable to the pleasantly surprised and bemused pregnant woman you're confronting with an irrefutable postmarked envelope.

A recent NY Times opinion piece on toxins and autism has been making the rounds lately, and well, frankly, the piece bugs the crap out of me, and I can't quite figure out why. After all, it seems like, not just an excellent idea, but a complete no-brainer to want to ensure that that the products we use -- that go into our air and water and foods and bodies -- are safe and non-toxic. And it seems reasonable to be concerned, given the thousands of untested chemicals in use every day, about possible links to our health: from the way they affect our organs and tissues to the way they affect our neurological processes. And it seems reasonable to me to want to investigate what autism is and what causes it. And yet...

Maybe it's the fact that the first few paragraphs contain the words "frighteningly common" and "financial and human cost" and "burden." Words matter. And those words, rather than including my son Austen and others like him in the human family, set him apart, as a burden and a cost that the rest of us have to shoulder.

Maybe it's the focus on autism in particular. If the concern is truly about the effect of toxins on our health, why call out autism rather than talking about either cancers or neurological issues generally (both of which were mentioned almost in passing)? Instead, autism is set apart.  Autism is chosen to be the poster child for neurological issues; autism is the frightening specter from which we all must run; autism is the enemy; autism is the pawn in this political game.

Maybe it's that several paragraphs are spent on what pregnant women ought to be doing and only one sentence is spent on the mention that often, at least in the one quarter of autism cases that are genetic, there is nothing a pregnant woman could be doing differently at all. Maybe it's because I can already hear the same voices -- the ones who told me that the "costs" and "burden" of Austen being autistic were my own doing, because I vaccinated him, because I let him watch TV, because I had him when I was over the age of 30 -- now telling moms this is their fault for using the wrong shampoo or for painting their nails, when that may not be the case at all.  The factors are so complex and difficult to tease out that we simply do not know right now, and may never know.

Maybe it's that all of those things leave me feeling that autism is set apart, that my son and my family are set apart, that we are (and have brought on others) a burden and a problem to be eliminated, rather than being an integral part of a situation we all need to work through together.

Just before my son Austen was born, Mark and I bought a video camera, so that we could document each special moment of his new life. Of course, the milestones, like Austen, were quirky: giving his earliest smiles to a beloved bottle of hand lotion, refusing to eat his first (or any subsequent) birthday cake, typing words on the computer before he could say them, lining up dozens of Matchbox cars and counting them, writing math problems on his MagnaDoodle. There are hours and hours of videos ranging from delightful to dull, but there is one video, taken back in 2003, that is so painful just to think about that I fear ever watching it.

I was immensely pregnant with my daughter around the time the video was taken. My husband had lost his job and we had no income. I (being immensely pregnant) couldn't start looking for work right then and my husband was having a hard time finding work. We burned through the savings we had set aside for just such an emergency, and started living on credit (which was the beginning of our financial end and created problems that last to this day). My son was two-and-a-half and not yet speaking. We had just completed an emotionally exhausting series of evaluations that would eventually lead to a diagnosis of autism, but at that time, we simply knew that he showed significant enough developmental delays to qualify for early intervention services. And then, in the midst of all this, I discovered my husband was a sex addict and had been unfaithful to me both during and prior to our marriage.

I don't really remember -- don't want to remember -- how I got through that time. I know I stayed up nights crying and didn't get much sleep. I know that Mark got a job not long after his disclosure and that days were long and hard and lonely at home with Austen. (Of course, I think days would have been long and hard and lonely with Mark there too.)

One evening, at the end of another of those draining, painful days, Austen started crying in little fits that would come and go. I couldn't quite tell if he was tired or sick or in pain, and he couldn't tell me. It seemed as if his diaper was uncomfortable, but when I checked it, it was clean and dry. I didn't know what was wrong, if anything. But I knew that he was not happy, and that his unhappiness was wearing away at the gossamer thin strands that were holding my life together. At one point, he began crying in earnest: clinging to my leg, wanting me -- for what seemed like the hundredth time that day -- to pick him up and comfort him. And I couldn't. I was exhausted and frustrated, horribly anguished and hugely pregnant, and I just couldn't pick him up and hold him. So, he pulled on my leg and screamed and screamed as I looked down at him and cried and cried.

I felt that Death was looming near me, that I really would not live through this. So, I picked up our video camera, which was sitting on a shelf within reach, and I aimed it down at Austen's red, wailing face, as he stomped and thrashed, still clinging to my leg. And I said, over and over, between my own sobs, "This is not my life. This is not my life. This is not my life." It wasn't. This was not the way things were supposed to be. I wasn't supposed to have a husband who cheated on me and a marriage that was falling apart. I wasn't supposed to be powerless to help or comfort my child.

So, the tape rolled on the two of us sobbing, one on camera and one off. I thought when I died -- as I surely would -- that video would be the note I left behind in my despair. But I didn't die. I kept breathing. I cried myself out. I eventually put down the camera, scooped up Austen and took him to the pediatrician, who diagnosed him with a hernia and sent us off to the emergency room to see a surgeon. Mark met us there and sat down next to me on one of the hard plastic chairs in the waiting room. I let my head fall onto his shoulder and hid my eyes in his shirt as he held Austen on his lap and we waited.

Image credit: Photo by mindfulness on Flickr Licensed under Creative Commons

When I was about eight or nine, I took my beloved uncle's cigarettes away and started flushing them down the toilet. I didn't want him to die prematurely (as he did anyway). Even as a child, I was sure that if I showed him how desperately I did not want him to kill himself, he'd stop. He never did. I wanted that change to somehow be within my power, yet it was completely out of my control. Sometimes death comes before change...

When I was trying to have children, I feared I wouldn't be able to get pregnant. And once I was pregnant, I was so very afraid that I would die. Or that the baby would die. Or both. And sometimes, even with modern medical interventions, those things do happen, which made it all the scarier. It seemed to be within my reach to control it, and yet it was completely out of my control. Sometimes death comes before that new life arrives.

That child I was, flushing cigarettes down the toilet, wanted Change to come before death. That woman I was, urinating on a thousand sticks and eating organic foods and monitoring every movement, wanted Life to come before death. And fear - the real possibility that Change or Life might not make it - haunted every moment. What if that little embryo never forms? What if it never makes it through the gestation process? What if it never comes or never lives or never grows?

The last few years have been a slow process of letting go of that fear. It's true, that people may not change in time to save themselves from death or me from pain. I may not change in time to save myself or others. It's true that people die and get hurt and suffer: children and parents and people who never will be parents. But I can't control that. I can't control whether or not Change or Life forms. I can't control the length of that gestation process necessary for it to emerge, with lungs ready to take that first breath — and cry. I can't control when death comes and the chances end.

And that's definitely scary. But holding tight to that desperate desire to control the outcome led, not to a life free from that pain I feared, but to the pain itself. When I feel compelled to flush a figurative cigarette down the toilet, I remember I have to wait for Change to gestate and let go of the fear that it may never come.

Over the years, I had seen doctors, taken prescription medications, been to physical therapy and even a posture class. Yet with pregnancy and children, the pain only got worse, until it became nearly unbearable when I unexpectedly became pregnant before my daughter was one. My back was one big perpetual knot of spasming muscle. One day, as I was lying on the floor weeping because I was in too much pain to get up, I knew I needed something more. I called a chiropractor that day, and it did indeed help, but my back would deteriorate into pain again between each visit. The treatments were soothing the pain, but not healing the cause. So, I signed up for a yoga class. I expected yoga to help my back, but I was not prepared for how much it would, and I certainly wasn't prepared for how much it would heal me spiritually as well as physically.

When I was a child, I used to go jogging with my father. He instilled in me two lessons that I was to take into every aspect of my life: push through the pain and sprint the end to show you've got something left. Those lessons got me to a place the world would view as success: an education at a prestigious university, jobs that have paid well, a home in an upper-middle class neighborhood and a comfortable lifestyle. But learning to push my body, and myself, beyond my natural limits, came at a price as well.

In yoga, one of the constant refrains has been "listen to your body," something I have spent a lifetime learning not to do. Back in June, we were working on stretches that targeted our shoulders. My shoulders are very tight, and I couldn't believe I had to accommodate them as much as I did. Those shoulders should be able to do more. Damn it! What they were capable of was pathetic. I'd just try to stretch them a little more. Ok, that hurt a little, but those shoulders weren't working hard enough. They deserved a little pain! If I pushed them a little more than what they wanted to do, those shoulders would loosen up and stretch the way I wanted them to from now on right? Wrong. What I got was a shoulder joint that was sore and had to be treated gently for months.

I didn't teach my shoulders anything. They are teaching me. I am learning to listen to my body, to understand and accept my limits. I am learning that to challenge myself, I don't need to hurt myself. And I'm learning that insisting on carrying heavy loads by yourself will leave you aching, in back or in spirit, for years.

I once had a co-worker who used to bitch about her pregnancy all the time: how tired she was and how huge she was and how in pain she was and blah blah blah blah blah. And I thought, "What a whiner. How hard can it be? You gain a little weight and then in nine months it's all over. And at the end of it, you have an adorable baby that grows up into a fun little kid."

I didn't count on that "little weight" shifting all of my internal organs out of the way to make room for itself: pressing on my bladder, so that I had to visit the bathroom every 30 minutes and pressing on my lungs, so that I was constantly out of breath. I didn't count on morning sickness that lasted all day, every day; or on being so exhausted I could barely function; or on paralyzing migraines; or on joints so painfully loose that I could barely dress and certainly couldn't walk up stairs; or on sugar in my urine, which meant gestational diabetes tests that involved ingesting huge quantities of disgustingly sweet medical orange drink and the removal of many, many vials of blood.

And after it was all over, and my son was born, I didn't count on being so physically beat up from a vaginal delivery that at the six week post-partum visit, I was screaming in pain when the doctor examined me. Before the delivery, I didn't think I'd be able to go two weeks without sex, so I didn't count on not being able to have sex at all for months and not being completely comfortable doing so for a year. I didn't count on post-partum depression in the form of massive anxiety attacks: anxiety attacks that sent me to the emergency room thinking I was having a heart attack. I didn't count on more migraines: migraines that made the left side of my face and arm feel numb, migraines that would take MRIs and ultrasounds and more vials and vials of blood to diagnose. I didn't count on a baby that cried all the time or a toddler that couldn't learn to talk and required evaluation after evaluation and hours and hours of therapy. I didn't count on a year without sleep. I didn't count on not even starting to feel like my non-anxious, non-depressed, non-aching, non-sick self again for such a very long time.

When my son was a year and a half, I began, just began, to start feeling normal again. He was finally sleeping, so I was finally sleeping; I had lost my pregnancy weight; my body had healed; I had weaned him, and the migraines and anxiety had disappeared with the breastfeeding hormones.

And then, before my son was two, I found I was unexpectedly pregnant with my daughter. I cried when I saw the pregnancy test results; it had all been so hard, so unbelievably unexpectedly hard, and I was so scared to face all that hell again so soon. But there was no question my husband and I wanted this second baby. It felt like destiny: not the timing I would have chosen, but she was meant to be. And if I had to go through hell again to have her, so be it.

After she was born, I knew I was through having children. Shortly after my daughter was born, my son was diagnosed autism, meaning the chances I would have another child with autism, another child who would need the level of energy and time and resources as my son, were between 1 in 10 and 1 in 20. I was over 35, which brought its own set of risks, both to me and the baby. Between my husband's job loss, my pregnancy and my son's needs, our finances were shaky enough that another child would cause us to lose our house. My husband's sex addiction had come to light during my pregnancy with my daughter and our relationship was still reeling from the consequences. And most of all, I was physically, mentally and emotionally at my limit with two. Nothing about us felt like it would survive a third child: not our marriage, not our finances, not our mental health, not the well-being of our two existing children.

So, I asked my doctor about birth control options; she recommended an IUD, which was as effective as surgery, but less invasive. A few months after I got the IUD, before my daughter's first birthday, I was feeling sick and exhausted. One day my back went into spasms that caused me so much pain that I just lay on the floor, unable to get up or move or take care of the kids. I'd been through this twice now, and I knew how I felt: I felt pregnant.

I took a home pregnancy test and sobbed. I was that one in a thousand statistical blip where the IUD failed. I called my husband at work, hysterical. Mark told me he would support me through whatever I decided and encouraged me to meditate on it. I searched my heart and found that the last two pregnancies felt meant to be, even though I was scared and overwhelmed when I got pregnant with my daughter, she felt like destiny. This didn't feel like destiny; it felt like another cheap shot from God. And He wasn't going to help me, and that voice inside me said only, "Know yourself."

I looked at my daughter and thought about how many special challenges she had growing up in her brother's shadow; he was older, but it will always be harder for him to navigate the world than it is for her, and already that dynamic was difficult for her, for us, to navigate. I thought about how much more she would need to take on her own care, as a toddler, and I wept. I thought about losing the house and making the kids, especially my son who is so sensitive to change, move. I thought about the stress the pregnancy and child would put on an already crumbling marriage. I thought of the kids without their father. And I thought about another daughter or son, one I knew I would love as much as the two I had, and one they would grow to love too.

I made an appointment with my OB and her ultrasound confirmed a pregnancy. I saw the little heartbeat flicker on the screen, and I ached. I had hoped there would be something wrong: that it was an ectopic pregnancy or a blighted ovum, that I felt pregnant but the baby was already too damaged to survive. The baby seemed healthy so far, but I also knew that getting pregnant with an IUD in meant I had a higher risk of miscarriage and birth defects (higher even than what I knew was an already high risk). As I slumped down, tears rolling into my lap, my OB gently asked what I wanted to do, and I told her I wanted to terminate the pregnancy.

We scheduled the surgery, and a few weeks later, I wasn't pregnant anymore. I still cry whenever I think of that little flickering heartbeat. I don't know what that flicker might have become. I didn't wait to find out if it would fade out itself in a miscarriage or be born disabled or typically developing or terminally ill or perfectly healthy. I didn't know if that child would grow up to be institutionalized or to cure cancer or if it would grow up at all. I only knew that, as much as I would, and did, love it, it would rip our lives apart. And I knew, at the time, I didn't have the strength or the faith to bear that burden on top of everything else. I knew that I chose to sacrifice what might have been to protect what already existed: my mental and physical health, a marriage being tenuously rebuilt and above all, the two children who needed me and a stable home. I did what I felt I had to, I did what I could, I did what I felt was right, and in the eyes of those outside my life, I'm sure I didn't do enough.