YOU MIGHT ALREADY sense it before the doctors tell you they cannot find a heartbeat — while you cover your eyes to avoid seeing the ultrasound picture of him floating inside you. You might already have had the strange feeling that nothing is held in its place anymore.


THEY MIGHT SUGGEST you give birth instead of letting them cut your son out of you straightaway. You’ll heal faster that way. You will bring him into the world instead of having them take him from you. You will have no visible scar.


IF YOU MEET your neighbor on the stairs when you go home from the hospital to get your things, knowing your nine-months-pregnant belly is filled with a dead boy you will have to deliver, and your neighbor asks when you’re due, tell him anything at all. Talk about tomatoes or his laundry, but make sure to look down and concentrate on getting into your apartment, even if he seems confused or offended. Open your door quickly and slip inside, where you can stare at the changing table.


TRY TO AVOID symbolism and metaphors, and leave fate out of it, too. Fate was not preparing you for this loss when you were an eight-year-old farm girl and held that stillborn piglet for hours in the barn. And don’t waste time wondering if there is a connection between your dead boy and your mother with Alzheimer’s, who is also disappearing.


FORGIVE THE DOCTOR right away when she asks if you will want a fetal autopsy. Don’t even imagine how that works or who does it. Likewise, forgive her when she brings you a brochure with options for burials, cremation, and baptism (which, it turns out, is allowed only if the infant was alive at birth). She is doing her job. She doesn’t make the rules.


IF YOUR BOY doesn’t come out of you right away, or in six hours, or after three days of hormone treatments that are meant to induce labor; if after six days and then the weekend, too, when they send you home again because you can’t sleep with the sounds of women in labor and all those babies just one or two or three doors down from your room; if after eleven days of walking around the hospital while other pregnant mothers smile at you (and you even meet a man you know who says, Oh, is it time? nodding at the hospital and your belly, telling you he is leaving tomorrow for a vacation in southern France, as though everything were completely normal); if after twelve days of waiting and wondering why the highest doses of hormones are not working and hearing them tell you, Some women just can’t produce contractions; if after twelve days of baths and oils and acupuncture, still nothing comes out of you — no blood, no body — and your cervix isn’t open at all, even though every day one of the midwives pushes her gloved fingers up inside you and checks, even though they’ve rubbed gels on your cervix to soften and open it, even though they can feel the head and tell you this while you ask yourself how you are supposed to push 7.7 pounds of dead boy through your vagina; if they finally want to slide a long, pointed plastic stick into you to puncture the membrane that separates you from your boy’s death; if they ask you for permission to do this, let them. Let them.


BUT PLEASE REMIND yourself in the days afterward that nothing was wrong with your uterus or your cervix or your contractions just because they did not quickly squeeze out the person you had carried inside you, stroking his feet through your skin, for nine months.


IF YOU THOUGHT an epidural would be given through a little needle in your arm, because you’d always skipped that chapter of the pregnancy book, don’t beat yourself up when you realize on the stretcher on the way to the anesthesiologist — as the doctor is describing the procedure to your husband so he can sign the papers — that the needle will go directly into your spine. Don’t be confused when they first use a small needle, which is just for the local anesthesia so that you don’t feel the bigger needle going in right afterward in two spots. You might feel it anyway. Or you might jump even though you don’t feel it, sitting naked, hunched over the table while two anesthesiologists tell you to relax, to be completely still as they try stabbing you again, saying, It must not have worked; she is still feeling it. Don’t worry if you start shaking uncontrollably, crying uncontrollably, especially when they ask, What’s wrong?


IT MIGHT FEEL like you have fallen in love with the midwife when you are finally sedated and hitched up to the epidural pump, and she wraps you in a warmed blanket, and you hear her place a catheter and remove fourteen hours of urine from your body.


WHEN THE BOY’S head crowns, you might think it is the whole body — it will feel that big, especially if he is your first and your eyes have been closed since you went into labor. You might say something like Thank God, even though this is the initial step toward letting him go.


WHEN YOU PUSH exactly as the midwife tells you to, after she hands you a big, sturdy cloth hanging from the ceiling that you are supposed to pull, and finally all fifty-two centimeters of your boy’s body gushes out, you might feel euphoric and powerful, even if everyone else in the room is crying, even if you can hear the midwife and the doctor blowing their noses softly. You might do something seemingly crazy like laugh or whoop. You might tell yourself your body is magic.


IF THEY ASK you if you want to hold him right away, and you say, Not yet — not yet because you are still scared to open your eyes; not yet because you are exhausted and in shock; not yet because seeing this means he is not inside you anymore, not inside your womb and not inside your future anymore — don’t feel bad. Don’t imagine later that the first thing your boy heard from you was rejection. Don’t tell yourself your own mother hadn’t really wanted you at first either, because you were a girl. Don’t imagine that your dead boy wanted to lie on your warm chest, against your warm heartbeat and your swollen breasts, and you didn’t let him.


IF HIS SKIN has come loose, or is blue or gray or white or bloody or any other color than the skin color you’d imagined your boy would have, he is still perfect. You can still look at him and hold him and kiss him. You and your husband can still tell him he is cute and everything you wanted, his bright-red lips shaped like yours, his fingers like his father’s.


HOLD HIM ANY way you can. Don’t worry about hurting him or breaking him. That won’t happen. If he is already in a basket, try to feel the weight of just him.


IF IT IS AUGUST, he might start to smell or look different in the few days you have with him before you are released. The nurses might take him in a styrofoam box to a cooler overnight to slow the process of his decay. By day they will bring him out to you so you can gaze at his face and your in-laws can come see him, too, though they will hardly look at him or touch him. You will be proud he is in the world now and you didn’t need a C-section and you didn’t need stitches and you endured ten hours of contractions and here he is in his basket with perfect toes and fingers, ears and hips. You will want someone to say, Congratulations, you did it! You made him out of nothing but longing.


EVENTUALLY THEY WILL ask you to stand up, and when you do, you will feel like a squeezed sponge, liquids pouring out of you — you won’t know from where, which holes, blood or pee or dead-boy fluids or shit. Let it all come out like tears. You might even faint dramatically on the toilet. Grab hold of the sink and breathe in and breathe out and try not to think about anything at all. Surrender. You are still alive.


WHEN YOU FINALLY are ready to leave the hospital, or the hospital is ready for you to leave — with your huge sanitary pad and your boy’s birth certificate, which is also his death certificate, and the candle the midwife made with his name on it, and the flower you picked on one of the walks you took daily, waiting for the contractions — you will have to say goodbye. You aren’t allowed to keep him. You’ll have to leave him in his styrofoam box, and, when they bring him to you, he might be cold because he has been in the refrigerator overnight.


HUG THE MIDWIFE with all the strength you have left. It might have been her first stillbirth, too. She might be trying to conceive. She might be pregnant. She might have lost a boy of her own.

PEOPLE AT WORK or in your choir, people you love and who love you, will try to say kind things to you now. They will often ask if you are pregnant again, because even after four or five or eight months your belly might still look pregnant, and pregnancy is what they all still want for you. You will be tired. You will eat a lot. You will touch your belly a lot. Tell them no.


CONSIDER DIETING IF you like, but realize that your body might still need its bump. No matter how much or how little you eat, no matter what or when, you might weigh exactly what you weighed at the height of your pregnancy. For at least the whole first year.


YOU MIGHT STOP going into churches for a while, but probably not because you think, If there is a God, then why did he kill my baby? More likely because of all those cherubs; those cute, fat, sculpted cherubs on the ceilings — not to mention those paintings of Mary, and how many times someone invariably says, He died for us.


YOUR MILK WON’T necessarily dry up in the first year, even though they told you six weeks maximum; even though you took the pills and wore the bra they said to wear; even though you drank gallons of sage tea; even though you stopped squeezing your breasts in the shower or letting your husband drink from them in the deepest night, pretending his mouth was the mouth of the boy you’d cradled inside you. You might even dream your boy died because you forgot to feed him. It will seem like a simple mistake in the dream, easily fixed with all that milk.


IF A NEW neighbor moves into the apartment above yours and her one-year-old cries pretty much all the time — and she is a neighbor your landlord chose because he thought you’d bond together as mothers and your babies would be screaming on both floors and nobody would care — don’t hate the baby or the mother or the landlord. Don’t look out the window of your kitchen at them in the yard having a barbecue — everyone passing the one-year-old around and laughing — and hope the approaching clouds turn to rain. Don’t be bitter when the mother later tells you, I saw you going out the other night, and I was so jealous. Ever since Jonah’s birth, I haven’t been out once. She wants to be your friend.


IF ONE OF the Syrian refugees in the language-skills class you teach — a thirty-year-old with false teeth and burn scars — says he thinks it isn’t good that so many Westerners have no children and tells you he himself already has five, don’t take it personally. He knows nothing about your past, as you know nothing about his. Concentrate on teaching the language lesson. Concentrate on the future tenses.


YOU MIGHT START feeling good again sooner than you’d expected. You might go for a bike ride or even laugh. You might have sex. Don’t feel bad about this. It probably won’t last.


YOU MIGHT BLAME your husband for something he said, or you might blame yourself for refusing the final ultrasound. You might yell, There will never be another baby! You might even begin to come up with new names, girl names for a whole different story: Lola Josephine. Phoenix. You will wonder if you could ever do it all again. The odds of it happening again are just the same as the odds of it happening the first time, aren’t they?


YOU WILL WONDER what to do with all those cute little outfits, especially the silk-screened onesie your cousin made. And what about the diapers for newborns? The handmade doll still in its painted box? If you ever did manage to have a second child, could you dress it in the knitted white booties you’ve stared at all this time? Would the new baby know? What about giving them away to someone — could you bring yourself to say he’d never even worn them?


YOU MIGHT GO swimming where you went swimming when your son was alive inside you and think, This water once held him.


IF ONE OF your youngest students tells you his parents said some people lose their babies from smoking and drinking, tell him kindly that you do not smoke or drink. When you get home, call his parents and tell them, too. Then cry onto the changing table.


YOU MIGHT VISIT your son about six months after the initial burial service and find his grave is now a hole where an animal has dug, though the director of the forest cemetery will assure you later in an e-mail that the animals — mainly foxes — never get down as far as the biodegradable urns; they just like digging in the loose dirt, especially in winter. Don’t be upset. At least there are animals out there with him. If it helps, you can try to imagine a mother fox’s paw reaching down, touching his urn.


WHEN YOU FEEL strong enough, join a yoga class for postpartum moms. In the bathroom, while getting changed into your spandex pants and oversized T-shirt, spend some time looking at the wall of baby photos above the changing table. And when one of the other moms asks you after class if you have a baby, think for as long as you need, and then tell her the truth. Say no. Say yes. It’s up to you.