Giving Birth in the End Times

Writer Emily Holleman stares down the apocalypse and into the terrifying optimism of motherhood.

Illustration: by Lucy Jones
Illustration: by Lucy Jones
Illustration: by Lucy Jones

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Smoke plumes over the parched hillside as we load up our two cars for our first wildfire evacuation: passports and a few bags, one neurotic pit bull and six very disgruntled barn cats. At the last minute, we toss in some baby essentials (car seat, co-sleeper) — but surely, surely we’ll be back home before we need them. Nearby, two wild turkeys peck at the new fire break, unperturbed by the human frenzy, the gathering of domestic animals, the churning of fields.

It’s August 2020. And I am 36 weeks pregnant.

A week earlier, we’d been counting our blessings — the sort of feel-good California nonsense that ran contrary to every fiber of my jaded New Yorker soul. But on that deceptively bright afternoon, I’d indulged. First on the list was our home: my husband’s family ranch in the Santa Cruz mountains where we’d moved from Brooklyn three years before.

Like so many “classic” journeys West, ours had begun in a quixotic vein. On paper, it was a job offer for my then-boyfriend, now-husband, but the impulse ran deeper than that. We were both fed up with New York for the reasons 30-something artists often are: a growing disillusionment with our respective industries; the churn of yuppification driving our friends from the neighborhoods they themselves had gentrified not long ago; the pervasive sense that there’s always someone younger than you dying to do the same thing for less. And so, we wanted to embark on a new adventure together, something utterly different — and what could be more different than trading cramped city living for bucolic rolling hills? The ranch itself held an almost mythic status for my husband. It was the childhood kingdom where he once visited his uncle and grandmother and played out his Tolkien fantasies; the steady rock of home after his parents got divorced.

But, it turns out, we’d come to California in the end times. The apocalypse grew starker the farther west we drove. When we passed through Montana, the big sky clogged with smoke as fields burned alongside the highway. As we wound down the Oregon coast, the heat sizzled. We reached the ranch on the hottest day in San Francisco history. We drove down to the beach to escape the heat—only to find a small brush fire blocking our path. The Bay Area of my husband’s childhood was in its death throes. Destroyed by tech bros and venture capitalists and, most irrevocably, by climate change. Since our arrival, the Golden State has seen its population decline for the first time on record.

Living out in all that damn nature — a 25-minute drive from just about anything — felt claustrophobic. I missed home. I yearned to hop on the subway. Trade gossip with the self-proclaimed mayor of my block. Stumble home and stop, shame-faced, at the corner bodega for a bag of expired Goldfish crackers. Engage with that pulsing, beating, bleating hum of humanity that is New York City.

But there’s nothing like a global pandemic to make you see the value of wide-open spaces. To find the beauty in sunburnt grasses. To see the hills dotted with live oaks not as yellow but as gold. To watch the fog unfurl like dragon smoke and think — this, perhaps this can be enough.

The second blessing we’d been fool enough to name was my “easy” pregnancy. I’d been 15 weeks pregnant when COVID-19 shut down the state. My in-person appointments migrated to video. I purchased a scale and a blood-pressure cuff; I dutifully reported the results every month. By and large, I felt pretty good. Healthy. But this fiction, too, was about to go up in flames. The temperatures soared, the barn cats’ fur crackled, my feet ballooned.

The morning of our evacuation, I have my first in-person OB/GYN appointment in months. By this point, I’m accustomed to the realities of a pandemic pregnancy. The strange disconnect when I talk to anyone who gave birth before COVID-19, who never worried if their partner would be allowed into the delivery room, or Googled “will the hospital separate me from my newborn if I test positive for COVID?” In the empty waiting room, the “don’t sit here” printouts have vanished along with the chairs that accompanied them. The pandemic has dragged on for five months, and the furniture has adjusted itself accordingly.

The doctor gives me bad news — the baby is in breech. The hard, round protrusion jutting beneath my rib cage is, indeed, the baby’s head, not his rump as I’ve been trying to convince myself for weeks. We schedule a version— a procedure where a doctor tries to turn the baby right-side down — for the following Friday.

There’s something else, too. My blood pressure clocks in at 151 over 97. The chatty nurse grows quiet. She looks at me, then back at the reading. She asks if I was rushing to get here. If I suffer from white-coat syndrome. With the cocky self-assurance of a person young enough and lucky enough to believe that their body won’t betray them, I tell the nurse I’m stressed. We’re under evacuation warning. By the time she straps the cuff back on after the appointment, my blood pressure has returned to normal.

Preeclampsia, the dangerous and maddeningly enigmatic condition that my high blood pressure augurs, has plagued (wo)mankind since the dawn of history. Back in the fifth century B.C.E., Hippocrates blamed it, along with so many other lady ailments, on the wandering womb. In the intervening two and a half millennia, doctors haven’t figured out the cause. The prevailing theory is that the problem starts in the placenta, the organ that nurtures the fetus in the womb: In women with preeclampsia, the blood vessels that form to deliver oxygen to the placenta are too narrow. In its efforts to feed the growing baby, the body kicks into overdrive. Your blood pressure skyrockets; your kidneys falter; your liver might fail. In the worst cases, the “pre” vanishes and you “progress” to eclampsia — seizures which can be deadly to both mom and baby.

Preeclampsia is characterized by a list of associations that often border on patient-shaming: risk factors include poor diet, obesity, diabetes, and chronic hypertension. For complex reasons that likely involve structural racism, unconscious bias, and biological weathering, Black women in America develop and die from preeclampsia at significantly higher rates than white women do.

Returning, then, to my certainty that I am perfectly well, high blood pressure or no, thankyouverymuch. We could call it denial. We could also call it a particular cocktail of white, able-bodied, and socioeconomic privilege. After all, none of those risk factors applied to me.

Days later, as another nurse lines my hospital bed with bumper pads to protect me in case of seizure, I’ll wonder at my arrogance. Just two years earlier, my older sister dropped dead at 35. Who was I to think that my body wouldn’t betray me?

Almost exactly nine months after we first arrived in California, my sister Julia died, both suddenly and predictably. She was 35 and, by most outward metrics, in good health. But, as hard as she fought, she’d been gripped by both depression and alcoholism for over a decade.

In the months after Julia dies, wildfires flame up and down the state. Eight-five people perish as Paradise is razed to the ground. I try to work on my new novel, a cli-fi dystopia that offers little escape. I spend a lot of time sitting in a large wooden crate, socializing a litter of barn kittens. Sometimes, I meet Julia’s college roommate, Casey, in San Francisco. We go to coffee shops that are both like and unlike the ones I missed in Brooklyn. Places where using the bathroom requires an app and a QR code. The world is literally on fire, and this is what Silicon Valley innovation has to offer: the monetization of what should be public goods. Over burritos and tears, Casey tells me stories about her toddler son. Funny words that he’d string together, and how when she says they can’t go outside, he knows to respond: “Too smoky?”

The decision to have children has always struck me as an essentially selfish one: You choose, out of a desire for fulfillment or self-betterment or curiosity or boredom or baby-mania or peer pressure, to bring a new human into this world. And it has never seemed more selfish than today. From a global perspective, having a child in a developed nation is among the most environmentally unsound decisions you can make — a baby born in the United States adds another 58.6 tons of carbon to the atmosphere per year. (That wipes out the net positives of my 25 years of vegetarianism in roughly three months). On the individual level, as fires rage and hurricanes form, as water grows scarce and fields lie fallow, it’s hard not to wonder: What kind of future can we offer a child?

And yet. On some level we still believe that a baby, our baby, will bring the world, our world, so much more than his carbon footprint. On another, we believe, like so many before us, that a baby can be the only balm after a loss. That it will transform me from a bereaved sister to something new and alien: a mother.

The day we evacuate, in that now-annual tradition among Western states, Gavin Newsom declares a state of emergency. The fire that we’re fleeing is the smaller of two mammoth blazes threatening the state. A CalFire spokeswoman on TV advises that all citizens should be “ready to go” in case of wildfires. “Residents have to have their bags packed up with your nose facing out your driveway so you can leave quickly.”

We joke about how absurd it is that every single Californian should be living in a perpetual state of emergency preparedness. It isn’t funny.

The truth is that we’re the lucky ones. We won’t be sleeping in our cars outside Half Moon Bay High School, hoping that the Red Cross can find us a hotel room. We have a safe place to go that will accept us and our veritable menagerie in the middle of a pandemic. My in-laws live an hour’s drive away. And for once we’re grateful they’re on the far side of Santa Cruz.

So we settle into our cushy evacuation digs. I check Twitter for updates on the fire lines. I lie upside down on a propped-up ironing board to encourage the baby to flip. I dutifully record my blood pressure twice a day. When I go into a local lab on Monday, I pass a woman around my age. Her hair mussed; her clothes rumpled. I overhear her tell the security guard that she is evacuated from Boulder Creek. Her house has already burned down.

The call comes late that afternoon. We’ve gone for a walk on the beach to distract ourselves. A brisk ocean breeze keeps the smoke at bay.

The OB tells me that I need to go to the hospital in two days and that I should be prepared to deliver. Depending on whether they can flip the baby, they will either induce labor or perform a C-section.

I press my hand against my stomach, cupping what I now know is my son’s head. I dig my heels into the sand. I know with every fiber of my being that this child is not ready to be born. He has literally put his foot down. Wildfire evacuations? Smoke-clogged skies over the Bay? A global pandemic? Nah, thanks, Ma. I’ll stay inside.

Something primal stirs. A desperate need to protect this child — from the world, from the climate, from the overreach of litigation-fearing American doctors. This baby, I am convinced, does not want to come out. He needs a few more weeks inside. My lab work hasn’t even come back yet. Two high blood pressure readings? From a person evacuated from wildfires during a pandemic? And I feel fine.

So, for the first time in my life, I argue with a doctor, first patiently, then furiously. I tell her that I cannot possibly give birth in two days. That we’re evacuated. That we might not have a home to return to. That, as freelancers, we both lost a lot of work during the pandemic. That my husband, whose industry has been completely upended, has an enormous gig with a new client. That I can’t imagine waiting until Friday can make any difference. The doctor takes out the cudgel: “You need to stop worrying about money and start worrying about your baby.”

It is the first time anyone has pulled the “bad mother” card on me, though I’m sure it won’t be the last. I sputter. I am livid. I tell her we’ll be there.

Things at the hospital go well until they don’t. The baby flips; the cheerful dry-erase board is decorated with a beaming sun, the names of the on-duty nurse and physician, and the words “Preeclampsia: Mild.” The next morning, my blood pressure soars, and “mild” is replaced with “severe.” The blood-pressure cuff is now accompanied by a catheter and an IV that pumps me up with magnesium to reduce the risk of seizure. The bumper pads are up now, too.

The hospital, the beeping machines monitoring my vital signs, the proliferating IVs, it all reminds me too much of Julia. The three days I sat at her hospital bed — holding her hand, reading Redwall to her, so sure that she could hear me, that the stories we shared in childhood might somehow draw her back. So sure that she would pull out of her coma, that one day we would make macabre jokes about her hospital stay. That she wouldn’t die. That our story couldn’t end that way.

But here, in this hospital, the wool has lifted from my eyes. I now know how these stories end. And I am sure that one of us isn’t going to survive. It takes the last bit of my resolve not to tell my husband, in a fit of melodrama, to save the baby if the doctors have to choose. (In later, clearer moments, I realize that medicine doesn’t work that way. But in the throes of magnesium-laced labor, the brain latches to the cinematic.)

So much of what could go wrong does: The baby crowns but every time I push his heart rate drops. We try three more times with a suction cup fused to his head, the pediatrician’s eyes glued to the heart monitor, periodically shouting for me to stop pushing so a nurse can press the baby back inside and massage his heart rate up again. At some point, a switch is flipped, alarms blare: an emergency C-section. I’m rushed down the corridors amid flashing lights to the operating table. My husband abandoned in a delivery room awash in blood. Someone shouts back, “We’ll come back for you if we can.”

My son is wrenched from my seizing uterus — weak from the magnesium and letting out only the smallest cry. He is rushed to the NICU for oxygen and observation. But he lives. We live. And, in the end, we get to go home.

The night that Jude is born, our evacuation order is lifted. The fires that burn parts of Bonny Doon and Boulder Creek never reach the ranch. We are so very lucky. Even though I doubt that luck can last.

After the dust has settled, my father — my somehow still optimistic, boomer father — keeps talking about how crazy it will be for Jude to learn about the day he was born, in a pandemic while evacuated for wildfires. And all I can think is how much I wish Jude might grow up in a world where the summer of 2020 sounds aberrational. I suspect he won’t. As I write this, fires descend on Lake Tahoe, defying all efforts of containment, and Hurricane Ida has devastated the Gulf Coast. Headlines blare about “extreme” weather, and I wonder when the newspapers will lose the word “extreme.”

I know that the world in which Jude grows up will be plagued by more and more environmental disasters. That cataclysmic changes to the climate will exacerbate the other inequities we face as a nation and a planet. That we are living in a real way on borrowed time, under the shadow of carbon that’s already been released as more fossil fuel continues to burn and burn and burn.

Although that future still terrifies me and part of me wants to disengage, to say “Let it burn” and “Fuck you” to all that, I can’t. I don’t have that luxury. I have no choice but to believe that the future — troubled as it will be, stripped as it will be of my biting, brilliant sister — is still worth living in and fighting for. To believe not just in destruction, not just in accruing loss after loss after loss, but in counting blessings. Finding those small moments of joy. The smile on Jude’s face as he bashes his mouth into my cheek. “Boop,” I say as I tap his nose. The same sound Julia used to make when I tapped hers.

This isn’t the ending that I’m looking for. And it isn’t just an ending either. It’s a beginning, too. An often frightening one. And, for now, that has to be good enough.

Giving Birth in the End Times