My Hysterectomy: A Love Story
"Wasn’t having kids something I was built to want? I didn’t feel permitted to question that. Nothing and no one around me suggested I was."
Today marks the one-year anniversary of the Supreme Court overturning Roe v. Wade. As someone who was once afraid to even know I didn't want kids—who was handed the pass I couldn't give myself in the form of an adenomyosis diagnosis and a hysterectomy to treat it—one of the first things that struck me after the Dobbs decision was how much more difficult it would now be for many other women in this country to opt out of motherhood if they preferred that, and to vocally own their lack of interest in it.
The Dobbs decision turned back the clock on so much progress, legally and socially. To mark the occasion, I thought I’d share with you an (updated) excerpt of my memoir, And You May Find Yourself…, about my circuitous, inadvertent path to a kind of non-conformity that, on a cellular level, I probably always knew was right for me, but didn’t feel permitted to embrace. Here’s hoping we can find a way to overturn the Dobbs decision. And that some day, opting out of motherhood will be seen as an acceptable option for anyone inclined toward it. (I also shared this today in Memoir Land, another of my newsletters. If you subscribe to both, apologies for the overlap!)
It’s not an all-out lie when I tell my first husband I’m leaving largely because he’s ready for a family and I’m just not there yet. What we have here is a scheduling problem, I tell myself. It’s 1992 and I’m a few months shy of 27. There’s still plenty of time for me to come around to feeling the urge to have kids. People assure me, “You’ll know when the time is right.” I believe them.
~
Fourteen years later—2006—I’m a weeping mess on the drive across the river to Rhinebeck from my home in Rosendale, NY, the one I moved into with my new husband, Brian, the year before, after we lost our New York City apartment. The occasion should be cause for celebration: Brian has just become a grand uncle. We’re on our way to the birthing center at Northern Dutchess Hospital to meet the baby. But little Henry’s timing sucks. He enters the picture when Brian and I are trying—well, “trying”—to become parents ourselves, even though the standard issue built-in maternal alarm I’ve been told about still hasn’t gone off.
I’m now 41, Brian is 44, and we’ve hit a surprisingly heartbreaking juncture in what had begun as a willy-nilly, passive approach to family planning, originally meant to entail nothing more than ditching birth control and “letting the Universe decide” whether or not we should have kids. Fourteen or so months into newlywed-frequency fortysomething-on-fortysomething action, there’s no baby. It looks as if the Universe has decided.
We aren’t supposed to question this. On the dating site where we met in 2003, Brian and I both used the word “ambivalent” when describing our interest in having kids. Since then, when friends and relatives have inevitably asked, our official stance has been a shrugging, “If it happens, it happens.” But when the Universe hands down a decisive, “No,” it’s as if everything gets turned upside-down and we enter Bizarro World.
Cut to scene of us taking out a calendar to schedule sex around my ovulation cycle…to me hanging upside-down in sarvangasana for 10 minutes after each go at it…to Brian racing a plastic cup to a lab in the next town before the crucial thirty-minute time limit is up…
The occasion should be cause for celebration: Brian has just become a grand uncle. We’re on our way to the birthing center at Northern Dutchess Hospital to meet the baby. But little Henry’s timing sucks. He enters the picture when Brian and I are trying—well, “trying”—to become parents ourselves, even though the standard issue built-in maternal alarm I’ve been told about still hasn’t gone off.
We figure he’s got this. He’s one of six kids, and he’d been party to two accidental pregnancies (followed by abortions) in the years before I met him. But, as my gynecologist explains, it’s easier and less invasive to rule out men’s fertility issues, so they’re always tested first. Once we’re done going through the motions with him, we can get down to the business of figuring out what exactly is wrong on my end, beyond a painful pelvic auto-immune condition called endometriosis, which I was diagnosed with at 18.
…Cut to scene of my boyish, usually upbeat husband looking stunned and crestfallen when his test results come back. Sperm count: negligible. Motility level among what few sperm he has: next to none. Brian surprises us both by going wobbly and collapsing into the nearest chair. He’s not at all macho, and yet, he is devastated by the news of his questionable virility. I’ve never seen such sadness in those hooded blue eyes. It destroys me. It also scares me. I wonder: does this mean he isn’t truly ambivalent? Does he actually want children? Are we going to have to do something about it?
Now comes the most unlikely scene of all in this Bizarro World montage: a visit to a fertility specialist. Yes, that’s us there in the antiseptic waiting room—the couple who’d been content to casually outsource this major life decision to Whoever Is In Charge Of The Universe. The free spirits who resent anyone who dares to impose on the precious time reserved for our assorted creative pursuits. Me—the person to whom goldfish seem an imposition, who can’t keep a houseplant alive.
And you may find yourself…at a fertility clinic. And you may ask yourself… Well… How did I get here?
~
The doctor is tall and fit, and he smiles too much. When he enters the consultation room, he wastes no time before launching into an upbeat infomercial about the miracles of In Vitro Fertilization (IVF) and Intrauterine Insemination (IUI). The man goes on and on. I’m rarely granted a full five minutes with my primary care physician or my regular gyno, but this guy seems to have all the time in the world to try and close the deal.
“What about the cancer risks associated with fertility drugs?” I ask. My maternal grandmother’s death from breast cancer puts me at high risk.
The doctor’s smile tightens. “You’ve been reading too much WebMD.” That’s all he has to say about that. He admits our chances of conceiving are relatively slim, even with his aid. That information hardly has a chance to sink in before he’s off on another tangent, regaling us with happy stories of patients who ended up reproducing after all, even though all hope had seemed lost.
I keep waiting for him to indicate that we’re categorically different from those couples, that we’re in some way disqualified as candidates. That we should just give up. But he doesn’t. He just keeps talking. As he continues, a foreign, greedy feeling suddenly arises, and I think, Let’s grab this slippery possibility before it’s whisked away again…
With his sales pitch over, the doctor escorts us to a beige room in the back devoted entirely to calling insurance providers about qualification for coverage. He introduces us to the woman who is going to help us, and she is very friendly and kind. She makes a call to our insurance company, and isn’t on the phone long before she dully says, “Thank you,” to the person on the other end and hangs up. She places a box of tissues in front of me before speaking, and I know.
“I’m sorry,” she says. We’re not covered. Not for anything, not even this appointment. We’ll have to pay for it out of pocket.
My tears surprise me. It’s as if a rug has been pulled out from under me, yet I barely have any recollection of ever stepping onto one in the first place. The woman fetches the doctor and he comes back to talk to us some more. He suggests we try one round of IVF if we can afford it. We can’t. “Some couples use their home equity lines of credit,” he says. That’s what people are doing in 2006, two years before the housing bubble bursts. For a few days, we consider it.
Back at home, I read the fine print on the paperwork we’ve been given to fill out. There’s a disclaimer I must sign, stating I’m aware that in some studies, fertility drugs have been associated with an elevated risk of reproductive cancers.
That fucker. Too much WebMD my ass.
~
We’re still navigating this alien vortex the day we go to meet little Henry—newborn son of Matthew, Brian’s then 29-year-old nephew.
I wipe my eyes before leaving the car. Brian gives me a squeeze, and then holds my hand through the parking lot as I fight back more tears. Suddenly the prospect of meeting a brand new baby is heartbreaking. This is unusual, because newborns have never held much appeal for me. I see a newborn, I see a bottomless well of urgent, indiscriminate need, and it freaks me out. I fear not knowing exactly what’s needed. I fear feeling put-upon and unable to escape.
I tentatively enter the birthing room, afraid that merely laying eyes on Henry will crush me. His mother—Matthew’s girlfriend, Lori—is propped up slightly in bed, holding him.
“Here,” she says, lifting the baby, gesturing to Matthew, wincing with every micro-movement. “Can you take him for a little while?”
Matthew reaches over and grabs his six-pound son, who is not much bigger than one of his father’s huge hands. This is the tiniest baby I’ve ever seen, wearing the world’s most miniscule diaper. Although, come to think of it, is that how tiny all newborns are? I wouldn’t know. I’m not much in the practice of meeting children on their first day of life.
Now comes the most unlikely scene of all in this Bizarro World montage: a visit to a fertility specialist. Yes, that’s us there in the antiseptic waiting room—the couple who’d been content to casually outsource this major life decision to Whoever Is In Charge Of The Universe. The free spirits who resent anyone who dares to impose on the precious time reserved for our assorted creative pursuits. Me—the person to whom goldfish seem an imposition, who can’t keep a houseplant alive.
Matthew scoops the baby up to his chest and proceeds to lose himself in what I imagine to be the powerful, all-consuming new-parent love I’ve always heard about. He notices me staring. “You want to hold him?” he asks, extending his arms. I’m terrified. I haven’t held many newborns. Henry looks so unbelievably fragile.
“I’m not sure I know how to hold him the right way,” I say.
“It’s not that complicated,” Matthew snaps. All-consuming love or no, Matthew’s been up 36 hours and would probably like me to give him a break.
I take a deep breath and step forward. I lift my hands.
Then—PFFFFFFFT. PFFFFFFT-PFFFFFFFT.
“Was that a fart?” I blurt, retreating almost involuntarily.
“Probably more than a fart,” Matthew says.
“Do we need to change him again?” Lori asks. “We just changed him.”
“No,” Matthew replies. “I don’t think it was that much.”
I’m viscerally repelled—and at the same time, mortally self-conscious about it. I don’t know which is worse, how disgusted I am by the mess in Henry’s diaper, or how disgusted I am with myself for feeling disgusted. Regardless, I can’t ignore my overwhelming aversion to holding that writhing, pink creature.
“I’m so sorry,” I say. “I can’t do this.”
On the ride home I cry some more. I’ve been crying a lot these days. Heading to the hospital, the triggering thought had been, “I’ll never have this…” Heading home, it’s, “I’ll never truly want this,” and the sense it means something is fundamentally wrong with me.
~
In the weeks following, the Universe seems to taunt me with the notion that in fact there is something fundamentally wrong with me.
First, Brian and I receive an interesting visit at the family-ready three-bedroom Victorian house with a yard we bought in Rosendale two weeks after marrying, just as we were losing our apartment in the East Village. We answer a knock at the door to find a cluster of people, several of whom have slightly different variations of the same face. They’re members of a family who’d lived in our house from the late 1940s to the early 1970s, all of them visiting from out-of-town to inter their late mother’s ashes. “We were a Brady Bunch family,” one of them says as they take us on a nostalgic tour of our own home. “There were ten of us.” At one point, all ten children lived there, together. Ten kids lived in our house. And there I was, dreading the thought of giving up my vintage floral wallpapered “office” (which doubled as our guest room) to just one child.
Next, a few days later, we’re out in the backyard having lunch when through the lilac hedge at the edge of our property we spot a set of tiny eyes peering at us.
“Who are you?” says the voice of a five-year-old boy, dispensing with pleasantries.
“I’m Brian, and she’s Sari. Who are you?”
“I’m Nicholas,” he says. “But who are you?”
Who are we? “What do you mean?” I ask.
“Whose mommy and daddy are you?” he says. There’s an implied “duh” in his tone. “Who are your children?”
Oh. Thanks a lot, kid. I work hard not to take on a five-year-old’s judgment, rendering me strange and irrelevant for my lack of offspring. After I break the news that we haven’t got any children, Nicholas pauses for a moment to think.
“Well…then who’s gonna play with the toys?”
I’m stumped by this one—an existential question, a Zen koan—not least because there are no toys in our yard. Not a one.
~
There are two incorrect assumptions people make upon meeting me in my fifties. The first is that I have kids. When I make it clear I don’t, new acquaintances often redden with embarrassment and trip all over themselves trying to find the right words. “Don’t worry,” I always assure them. “I’m okay with it.”
That happens to be both an understatement and a lie—an understatement because I fucking love not having kids; a lie because I often judge myself harshly for that, which leaves me anything but okay.
My harshest self-judgements arrive when I’m in the company of people who have kids. I compound my self-criticisms with projections of how I imagine they see me, telling myself I’m a sad specimen of an adult woman—lazy, coldhearted, cynical, misanthropic. Damaged. None of this is out of left field. It’s related to things people around me say. “Life is a conveyor belt,” muses an older acquaintance, “it delivers all of us to the same points, one by one. And then it’s over.” Some of the “points” mentioned are parenthood, then grandparenthood. It makes me realize that instead of the conveyor belt everyone else is on, I’m off to the side, on a hamster wheel, revisiting the same life challenges over and over before I finally master them. In another conversation about a woman roundly considered a “train wreck,” an acquaintance defends the woman by saying she has “done normal-people things” like raising children and holding the same job for decades. I realize that by this definition, I do not qualify as “normal people.”
The second mistaken assumption people make about me: once they learn how happy I am to not have kids, they assume I’m “childless by choice.” They ask, “When did you decide you didn’t want kids?” But the thing is, I didn’t decide. I didn’t have the nerve to—not even to let myself in on the secret that I didn’t want kids. I hid it from myself. I turned my mind away from the topic altogether. I blanked out on it, went completely numb.
On the ride home from meeting baby Henry, I cry some more. I’ve been crying a lot these days. Heading to the hospital, the triggering thought had been, “I’ll never have this…” Heading home, it’s, “I’ll never truly want this,” and the sense it means something is fundamentally wrong with me.
In the decade-plus following my divorce from my first husband, I never so much as entertained the topic of whether I wanted children—even though I had two accidental (and unviable) pregnancies and abortions. Each time, I had strong feelings of get this out of me, which I attributed to getting pregnant at the wrong time, by the wrong men. But then I didn’t look any more deeply into it than that.
This is the crazy thing I’m saying: throughout most of my twenties and thirties, I avoided gauging my own level of interest in making babies, in any kind of conscious way. I suppose that in and of itself, that should have said something about my level of interest. It didn’t matter that I was surrounded by the predictable chatter about ticking clocks. Friends obsessed over theirs. Family members treaded lightly but still inquired about mine—or half-joked that I should reproduce at least for the sake of having someone to care for me when I grew old. The neighbor upstairs, a slightly older gay man who’d come to my parties, felt compelled to stop me in the hallway one day when I was 35 or 36.
“If you want to have kids,” he said urgently, and completely unsolicited, “you should probably do something about it soon.” He added a cautionary tale about his sister waiting too long before she figured it out. She was now in her late forties, childless and regretful.
Even amid all that talk, in the thirteen years between ending my first marriage at 26 and embarking on my current marriage at 39-and-change, as I flitted around the East Village with a string of Peter Pans, I firmly resisted considering whether I was interested in motherhood—in truly knowing my own heart. “Ambivalent” seemed like a sufficient descriptor, a safe place to land that didn’t require me to really think, because I was too afraid to really think—to confront the gap between what I might really want, and what I thought I was supposed to want. Wasn’t having kids something I was built to want? I didn’t feel permitted to question that. Nothing and no one around me suggested I was. The few other childless women in my world growing up were demeaned, treated as less-than.
Looking back now, I think I was also afraid to know that I wanted to be an “art monster,” unencumbered by motherhood in my creative pursuits, because I believed such a desire was selfish and shameful; afraid to realize that my struggle with depression and my pessimism about the state of the world made it seem unfair to bring kids into the world—more specifically my world, the one in which I, a frequently depressed person, might give a kid a shitty life.
On the flip side, I was also afraid to poke around the tender region of the heart where maternal longings lie, for fear of discovering I might actually possess some. What if I found I wanted kids, only to learn I’d never be able to carry them to term because of my endometriosis? What if I wanted them, but couldn’t find a partner in parenting because of my penchant for choosing non-committal men?
I was afraid to know my own heart and mind—afraid to make up my mind and choose wrong. So I didn’t choose. I just sat on the fence and waited for some wise outside force to push me over into what I hoped would be the right direction.
~
How appealing to turn your fate over to…something, to believe there’s some greater power you can defer to in the face of life’s most frightening decisions. I have a complicated relationship to faith. With my clergy-kid baggage, I’m inclined to reject formal religious practice, but I’m also tempted to believe in something, or an assortment of somethings from column A and column B. I’m always aware of when, astrologically speaking, “Mercury is in Retrograde,” and when it is, I’m inclined to blame everything from car problems to tense human interactions on it. I have in my possession not one but two copies of Shakti Gawain’s Creative Visualization: Use the Power of Your Imagination to Create What You Want in Your Life and a copy of The Secret video. I’ve also been to more than my share of psychics. When I was younger, I’d ask them to predict whether and how many kids I’d have, as if I were trying to get a sneak peek at the answers to an upcoming quiz at school.
For someone who can be rather skeptical, I can also be rather suggestible. This becomes glaringly obvious when, in 2007, a homebirth midwife hires me as a ghostwriter for her memoir and predicts that just by working with her on her many birthing stories, I’ll miraculously conceive.
~
Cara’s eyes light up as I fill her in on our bad luck at the fertility clinic, and subsequently with acupuncture, herbal cleanses, dry skin brushing, castor oil packs, plus a litany of other holistic infertility antidotes. How with each unlucky gamble, the emotional stakes have risen—how I’ve gone from sensing no maternal instinct, to feeling desperate.
“I have a good feeling about this,” Cara says. “You’re going to get pregnant writing this book.” She believes that is partly why I was “brought” to her. She’s very persuasive, and I want to be persuaded. I begin to believe something greater than me has brought me to Cara, that I am somehow meant to write her book. Maybe working closely with her, constantly discussing pregnancy and childbirth, I’ll be like those women who seem to only be able to conceive after they’ve adopted and been immersed in baby life.
After Cara’s book is finished, another year and change goes by, and no pregnancy. I’m now approaching 42. Tick, tock. As time runs out, I become increasingly anguished. I feel powerless, confused.
It’s in this state of turmoil that I attend the annual holiday party for a Manhattan law firm, one of Brian’s I.T. clients. It’s my third or fourth year attending this party, so I’m acquainted with the cast of characters: the attorneys, their spouses, and their ever-growing ranks of offspring, who clamor noisily about. With many of the attorneys in their thirties, conversations tend toward the “I can’t believe how much she’s grown!” and “When did he start walking?” variety.
In the thirteen years between ending my first marriage at 26 and embarking on my current marriage at 39-and-change, as I flitted around the East Village with a string of Peter Pans, I firmly resisted considering whether I was interested in motherhood—in truly knowing my own heart. “Ambivalent” seemed like a sufficient descriptor, a safe place to land that didn’t require me to really think, because I was too afraid to really think—to confront the gap between what I might really want, and what I thought I was supposed to want.
This year I’m not in any emotional condition for forcedly cooing at babies and asking toddlers to hold up however many fingers represent their present age. Fortunately I’m rescued by Ginny, a pixie-ish lawyer, and her husband, who don’t seem too terribly interested in the kids, either. They must have noticed I was keeping my distance from the veritable nursery at the center of the holiday tableau. I’ve had two glasses of wine—my limit—which probably explains how Ginny and I quickly get onto the topic of infertility, right down to the anatomical nitty-gritty of Brian’s and mine.
After Ginny nods to her husband to suggest he move away so we can talk alone, I unload on her—all of it: my trajectory from detached ambivalence to “letting the Universe decide” to actually considering paying for IVF with our home equity line of credit. My lingering doubts about whether Brian and I are cut out for parenthood. The sense that my sorrow over being unable to reproduce isn’t necessarily an indication of a desire to have kids.
Following my flood of emotion, Ginny opens up. “We tried, too,” she says quietly, “a long time ago. We thought we wanted kids. We were very sad when we failed. But we’ve actually come to be very glad about it.”
I let that sink in for a moment.
“You know what the Dalai Lama says about those who can’t have children?” she asks.
“No,” I say. “What?”
“He says they’re off the hook, for this lifetime.”
I tuck it in my back pocket.
~
When I get home—and for years to come—I search the Internet for that quote, or anything resembling it. Into the search field I type “Dalai Lama on those who can’t have kids,” and “Dalai Lama on infertility,” “Dalai Lama quotes on being childless,” to name a few variations. None of the results come even close. But fuck it. I decide to believe what Ginny has said is true. There’s no way I’m letting go of a hall pass like that, from so high an authority.
And then I’m let off the hook in a different way: I learn that I’m certifiably ill equipped for having kids—like, equipment-wise. I have such painful menstrual cramps so often, and for so long—fifteen days a month, most months—that my gynecologist thinks it’s more than just endometriosis. She sends me to a uterine specialist.
After he examines me, the doctor determines I have adenomyosis, a condition related to endometriosis, in which the uterine lining corrupts other layers of the uterus, including the muscular walls.
“You need to have a hysterectomy,” he says matter-of-factly.
Some part of me expects to fall apart when I hear these words, but instead, I feel myself suddenly relax. What the doctor has said rings true on a cellular level. My body knows it to be irrefutable. How could I have not thought of that before? I mean, I had thought of it before, but as a remote fantasy on the most unbearable days of my cycle. Like, “How great would it be if I could just have this fucking thing yanked?”
Once I’ve had a couple of days to try on the knowledge that, no, really, I will never have another human emerge from my loins, I think: YES. I am officially off the hook. My doctor and the Dalai Lama said so.
~
I undergo a Davinci Robotic Hysterectomy and experience tremendous relief immediately, and not just physically. It’s as if I’ve been granted a reprieve from some looming, difficult test, like the SAT. I take additional comfort in the surgeon’s report on the wretched condition of my uterus.
“There’s no way you’d have ever been able to carry a baby to term,” he assures me. Knowing this makes me feel confident that those two pregnancies years ago—one of which was ectopic, the other of which I began to miscarry before my scheduled abortion—would never have resulted in my becoming a mother. But even more than that, it makes me feel as if I have permission to consider that maybe… I… just… didn’t… want… kids. It’s as if I’ve been given a doctor’s note: “Please excuse Sari from procreating in this lifetime, as she is not in any way built for it.”
~
As liberating as it is to be given an out, it’s disappointing that I still feel as if I need someone other than me, someone with greater authority—some dude—to give it to me. Why can’t I give myself the out? Why do I need the Dalai Lama and the surgeon to all rubber-stamp my choice, or what would have been my choice if I’d ever thought I were allowed to choose?
I’m not alone. At a party a few years ago, I came upon a group of women around my age huddled in a corner. They shushed each other as I approached. “We’re talking about not having kids,” one said after an uncomfortable pause. “About choosing not to.” The group looked at me for an awkward moment, waiting to see whether I’d identify myself as one of them before saying more.
As liberating as it is to be given an out, it’s disappointing that I still feel as if I need someone other than me, someone with greater authority—some dude—to give it to me. Why can’t I give myself the out? Why do I need the Dalai Lama and the surgeon to all rubber-stamp my choice, or what would have been my choice if I’d ever thought I were allowed to choose?
This sort of thing keeps happening—I find myself in the company of women, old and young, who are first “coming out” about not wanting kids. It’s 2022 and women are still speaking in hushed tones about deciding not to be mothers. The overturning of Roe v. Wade this past June will only make such a decision more difficult for some, and virtually impossible for others who live in states where abortion is outlawed and hormonal contraception is increasingly difficult to obtain. This Supreme Court decision occurred just as the conversation around bypassing motherhood was only beginning.
Although we’re finally talking, some of us still have a long way to go—toward knowing and owning what we want, and feeling entitled to not conform, or give in to the societal pressure to have kids. I hope it won’t always be this way.
Thank you for this fantastic essay, Sari! Incredibly thought-provoking.
Thank you for your raw honesty and vulnerability, Sari! I resonate with so much of what you said. Thank you for speaking your truth so that other women can do the same! Keep shining your light, Sari!