II.

The first time was so easy.

We are meticulous planners, my wife and I. Although we didn’t originally sit down and plot it out, our lives together had major milestones that we hit nearly every year.

In 2006, we moved in together.

In 2008, we were engaged.

In 2009, we both finished graduate school.

In 2010, we were married.

In 2011, we took our honeymoon to Italy.

In 2012, our first child was born.

Boom. Boom. Boom. Like clockwork, everything happened pretty much as we had planned it. We had begun to passively try to conceive while in Italy, but it didn’t happen, which I maintained was because my child wanted to be born not only in America, but specifically in Philadelphia.

Still, my wife was pregnant after only one month of actively trying. That’s good hustle. We attended every doctor appointment, she was healthy the entire time, and everything looked good.

The following June, we brought a big, beautiful, healthy child into this world. A year after she was born, I changed jobs and the year after that, we moved out of the city and into the house that our kids would know as their home.

The plan was working perfectly.

III.

It wasn’t long after we had moved that we began talking about having another child. Our daughter was approaching her third birthday and it seemed like the time was right. Moreover, my wife was about to be thirty-five years old, which is considered “advanced maternal age,” which sounds better than “geriatric pregnancy,” but still means the same thing. Plenty of women have babies at thirty-five and later, of course, but if we were going to have another one, why wait?

So we began trying in a passive way, hoping for the best, but not yet obsessing over it. We weren’t concerned. The first one had been conceived so quickly and, besides, as my wife often said, “I’m Puerto Rican, I’m meant to have babies!” That’s Anthropology 101.

After about a year, we were no closer to being pregnant. Even the apps and ovulation kits weren’t working. Due to a variety of reasons, including job uncertainty and concerns of when the baby might be born, we skipped a month here and there. Finally, we saw the doctor and he said that since we had not been trying consistently, he was hesitant to suggest fertility treatments.

“Keep trying,” he said. He then pointed to our daughter and added, “You can get pregnant. Your proof is right there.”

I had been saying the same thing, but we also knew the reality of the situation. This was different than the first time. Something was wrong.

We eventually had an appointment at a highly regarded fertility clinic. They gave my wife all sorts of tests and after reviewing them, the doctor explained what was happening.

She said, “The fallopian tube is like a car wash, the cilia push the egg along the tube to the uterus. Your tubes are like a tunnel, so the egg just sits there. Not only does that mean that it won’t reach the uterus, but it’s also dangerous because it could lead to an ectopic pregnancy.”

“What causes that?” we asked.

“It could be a number of things. We don’t know. Or it could be that you’ve always been that way, that it’s normal for you and you got lucky the first time.”

We were skeptical.

“Could it be the C-section?” my wife asked.

“No, absolutely not,” the doctor said.

The certainty of her response struck me as odd. She had just gone to great lengths to explain that they don’t know what caused it, yet could definitively state what didn’t cause it? If she had said something along the lines of “Anything’s possible” or even just an equivocal “maybe,” it would not have seemed so strange. Virtually everyone knows what kind of impact major surgery can have on a body and having trouble conceiving following a c-section is “not the norm, but aren’t exactly rare either.”

We didn’t argue with her, but we certainly discussed it afterwards.

The next few weeks were spent planning everything. I spent hours on the phone with the fertility clinic’s financial coordinator going over costs and what was covered by our insurance. Much of it was, but certainly not all, so we would still be forced to pay thousands of dollars out of pocket. In some cases, the eggs were covered, but the sperm was not. I’m not a doctor, but don’t you need both to make a child?

Because of the state of her tubes, the doctor had suggested in vitro fertilization (IVF), which combines the egg and sperm outside of the body and then implants it directly into the uterus.

However, the insurance company would only cover IVF if intrauterine insemination (IUI), another fertility treatment that places sperm in the woman’s body, failed twice. The goal of IUI is “to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization.” I was hopeful but not optimistic, if only because this would still be dependent upon the tubes.

Soon thereafter, the process began.

Every evening, my wife had to go into the bathroom and use a needle to inject herself with the necessary medicine and she had to wake up at 5 a.m. every other day to go to the clinic for blood tests and other checkups. This went on for weeks. The medication made her feel bloated, gassy, and uncomfortable. All of this is not only physically taxing, but emotionally draining as well.

I had by far the easier job. I had only a few predawn wake-ups, on the days when I had to submit my donation to the cause.

You’d think that at such an early hour the place would be empty, but it was often so crowded that the office sometimes ran behind. The infertility market is booming, which inevitably invites entrepreneurs and other businesspersons. The waiting room was usually filled with people like us — most in their mid-to-late-30s or older, red-eyed and haggard-looking, a mixture of hope and despair on their faces as the perky early morning TV anchors prattled on in the background.

When my name was called, I was led to my room and given my directions — fill out this clipboard, take this cup, make sure you collect all of the sample. The room had a single chair that was an uncomfortable cross between a chaise longue and a regular, upright chair. There was soft music playing, but I wasn’t sure it would drown out every sound. There was a magazine rack on the wall that housed copies of Playboy, Hustler, and Perfect 10. The chair faced a small TV that looked like a dorm room hand-me-down on top of a cabinet with a DVD player and a VCR. I opened the cabinet door and saw a stack of DVDs including Carolina Jones and the Broken Covenant and Playboy’s Hot Panty Party and VHS tapes without their boxes, so you’d have to look at the label to know that the title was Fuck Holes #2. Of course, there was another label that said, “PLEASE REWIND THE TAPE.”

Be kind, please rewind.

Not wanting to rely on the clinic, I brought my iPhone and earbuds.

I once saw an interview with Jenna Jameson in which she explained that men always came up to her and began bragging that they should star in a film with her. At that point, she would say, “Okay, do it right now, let’s go,” and they were never up to the task. It’s easy to imagine how you’d perform in certain situations until you’re actually in one of them.

Most men believe they have the virility of Greek gods, that they can perform on command, and any questioning of their prowess is an indictment of their masculinity.

Yet, having to provide a sample in a sterilized environment with all of the accompanying pressure and expectations two days in a row is not the most romantic of conditions.

I remember on the second day receiving the news that the sperm count was lower than the day before. Well, that’s generally how it works. If you hit the ATM two days in a row, you’ll have less money available to withdrawal the second day.

We did this entire cycle — injections, tests, appointments, blood work, donations — twice for IUI. Both times failed, just as the doctor had predicted. It was disappointing and frustrating, but we tried to remain optimistic.

We now had to hope that the doctor was correct and IVF would be the solution.

IV.

In truth, not everything went as planned the first time.

It was ten days after her due date and my wife was still pregnant. Shockingly, she was not happy about it! Finally, they decided to schedule a time to induce her into labor. It was scheduled for a Monday morning, but due to other people’s impatient babies that needed to escape immediately, it wasn’t until that afternoon that we packed our bags, kissed, and exited our home for the last time as a childless couple.

On the way, we talked about a variety of things, one of which was the bet. We had not found out the sex of the baby, but she was sure it was a boy. Everyone else, including older women with their incredible powers of prediction based on such ironclad science as the shape of her belly and whether she was gassy, agreed. I said it would be a girl. While some believed I did this just to be a contrarian, it was more than that. It was just a feeling. So, we made a bet. The loser would buy dinner for the winner at a restaurant of the winner’s choosing.

After arriving at Pennsylvania Hospital, America’s first public hospital, we sat in the waiting room for a while, our emotions a mixture of nervousness and excitement, but also impatience and a bit of boredom. Finally, they brought her into the labor and delivery room and began to prep her. After changing into a gown and getting all her vitals taken, labor was induced.

While we were waiting, we saw a pregnant girl of no more than eighteen pass our room en route to her own delivery. The midwife said that that girl would be done in no time, in and out before we’d finish. While we joked that this was unfair since we were there first, she explained that while our culture has changed and financial and career decisions often delay motherhood, human female bodies are still programmed to have children in their teens or early twenties.

At first, all was calm and quiet. She was knitting and watching Scrubs and Arrested Development DVDs as the contractions slowly grew. After a couple of hours, the reality of labor began.

She received an epidural and, when it was time, began to push. She pushed and pushed and pushed. She kept pushing. They saw the top of the baby’s head, but that was all. I alternated between holding a leg and encouraging her. We folded her into a U-shape for better leverage and the nurses and doctors exhorted her to push. Nothing. She said that it felt like the baby wanted to come out of her butt.

After a few hours, the baby’s heart rate began to plummet. They immediately told my wife to stop pushing. It was hard because doing so actually relieved the pain and the pressure, but it was too dangerous to continue.

The lead attending physician walked in and asked to speak to me and we stepped away from the bed and stood near the door.

“We’re going to have to give her an emergency C-section,” she said.

“But she really doesn’t want to do a C-section,” I protested. I remember my wife saying over and over throughout her pregnancy that she didn’t want to go through that process.

“Look, I understand,” she said. “I’m an Ob/Gyn. I had visions of a beautiful, natural birth where everything went perfectly. Yet both of my children were delivered by C-section. The baby’s heart rate is dropping and having her push is only making it worse. We need to get the baby out for the health of both of them. It’s happening. We have to do this.”

How could I argue?

The doctor walked over and explained the situation to my wife. The midwife, nurses, and everyone else began prepping her for the trip to operating room as residents came flooding in asking my wife if they could attend the surgery. She said yes to all of them.

In a few minutes, they were ready. She called out “I love you!” as they wheeled her away and I called back with words of encouragement. They turned the corner and were gone. One nurse stayed behind to hand me a surgical gown, shoe covers, and a cap. She said, “Put these on. We’ll come back for you in fifteen minutes.” She left and I was alone in a very quiet, very dark labor and delivery room, my only company being the used supplies and buckets of stuff that come out during a birth. I tried putting on the OR attire, but they had given me a medium gown, an item of clothing that wouldn’t have fit if I were still in eighth grade. Nothing seemed to be working.

It was 5 a.m. I had nothing to do but wait. I didn’t want to watch anything and I knew I wouldn’t be able to concentrate on a book. I pulled out my phone and checked Twitter. Not the most substantive website on its best days, I was sickened by the banality and superficiality of it. How could people fill 140 characters about struggling to wake up for work when my wife was on the operating room table? In fact, in that moment, I found all of the internet to be completely vapid and devoid of human meaning to the point that I began to question myself and my life choices. Why did I tweet? Why did I even own a phone? Wasn’t all of it just meaningless? Had I been wasting my life for years?The realities of birth, death, and emergency surgery have that effect of me, I suppose.

Finally, a nurse came to get me. She asked about my gown and I showed her that I could wear it as an apron and nothing more. She found one in my size, which I put on as fast as possible. I was led down the hall to the operating room. Before opening the doors, the nurse told me, “Keep your eyes on the floor. Don’t look up, don’t look around. I’ll lead you to her so you won’t bump into anything.” I did as I was told, keeping my gaze on my Nike slides with surgical coverings over them, trying to prevent my peripheral vision from taking in too much.

They brought me around a curtain and there she was, her hair in a bouffant cap, her body below the neck unseen on the other side of the curtain. She looked so drained. It was no longer incumbent upon her to push this baby out. She had done her best and now it was time for the medical professionals to take over. She was under the spell of both an epidural and a spinal tap, so her entire body from the neck down was numb.

The veteran doctors were explaining to the students everything that was happening. It’s a bit surreal when you hear someone say, “Let’s just move this out of the way,” and you know they’re referring to a human’s internal organs.

After a few minutes, a doctor in scrubs came over to our side of the curtain and leaned against the wall near us. She was the anesthesiologist.

“How are you feeling?” she asked.

My wife, who is both funny without drugs and an amateur hypochondriac, asked, “Am I going to die?”

The anesthesiologist smiled and said, “No.”

“Are you sure?”

“Yes.”

“How do you know?”

“You’re, like, the fourth person I’ve had to assure tonight that they’re not going to die.”

“You’re going to be fine,” I assured her, trying to be that perfectly supportive guy from a Hallmark movie.

“I dunno,” my wife said. “It feels like there’s an elephant on my chest and I can’t feel my legs. I think I might die.”

And so it went.

Finally, after what felt like hours but was probably actually closer to thirty minutes, I heard a sound that was a mix of cheer, relief, and wonder. That was immediately followed by the announcement, “It’s a healthy baby girl!”

My wife, exhausted but relieved, looked at me and said, “I owe you dinner.”

V.

After IUI failed twice, insurance would finally agree to cover IVF. Much of the process was similar, but unlike the majority of our other visits, we went together.

The first appointment was for the embryo fertilization. She once again had to take a series of injections in preparation for the invasive procedure and I once again had to donate to the cause. When I was led to the room and handed the clipboard and cup, the tech — a man this time — opened the door and began to explain everything. I cut him off.

“I’ve done this five times already.”

“Oh. Well, in that case…have fun,” he said and closed the door.

Three months later, after the frozen eggs had been run through a litany of tests and after we had gone through the holidays hoping for the best, the moment of truth had arrived.

“Happy Transfer Day!” the woman behind the counter said when we walked in. We went to a room and my wife was prepped. When the time came, they rolled in the incubator and the monitor so that we could actually see the implementation. We held our breath and waited.

Success!

I began crying. Not for me, but for her.

I remembered everything she had been through. The pain of labor, the concern of emergency surgery, the long, arduous recovery, the frustration of failing to conceive naturally, the questions about fertility, the injections and pills, the exhaustion of early morning appointments and late night bouts of wakefulness, the crushing disappointment of the failed IUIs, the fear that it would never happen, and, finally, the moment that it did.

I thought of all that and I couldn’t hold back the tears.

VI.

Nearly every doctor visit of her third trimester included the phrase, “It’s a big baby.”

Unlike the conception, the pregnancy had been completely normal and uneventful. The appointments became almost routine because everything was fine. She once again had an extremely healthy pregnancy with no problems — aside from the normal uncomfortability that comes with creating another life inside your own body.

Although she had had a C-section the first time, she had wanted to try to deliver the second one the “normal” way, which is referred to as a VBAC (Vaginal Birth After Cesarean). While doing so used to invite quite a bit of risk, it has become much safer, and therefore more common, in recent years.

Yet as the due date approached and my wife’s belly continued to grow, that became less and less of an option. Finally, the week before the due date, she went for her final ultrasound appointment and the baby was approximated to be about ten pounds, seven ounces. Those estimates are almost always on the high side but, regardless, as everyone had been telling us, it was a big baby. (In actuality, the estimate was accurate to the ounce so it turned out to be the right decision.)

Although this one was planned, she was still worried because she remembered the first time. Yet, for obvious reasons, this time around everything was much more structured, organized, and relaxed. Some things were the same, though. We told the anesthesiologist the story about the first time and my wife jokingly asked, “Am I going to die?”

I was handed paper scrubs and told to sit on the “Dad bench” and wait. After about fifteen minutes, I was waved into the operating room like a pitcher getting called out of the bullpen.

I entered the OR and it was like a remix of the first time. I sat by her head and began speaking to her like before, but she was much more cognizant this time and she was still able to feel the top half of her body. They told her there would be tugging and pressure and she squeezed my hand during those moments until the doctor pulled her out and held her up over the curtain for us to see the newest addition to our family.

Our journey, one that had taken years and thousands of dollars and hundreds of hours and countless worrying, had ended in the best way possible.

VII.

When I asked her if I should write about our experience, she didn’t hesitate.

“Go for it. Hopefully it will help someone else.”

There have been more than eight million babies born through IVF but yet there is still so much that people don’t know or don’t understand about the process.

This was our journey and these were our experiences and they may not be the same for everyone, but perhaps our story can help another couple overcome their fear or anxiety. Because it’s all worth it.

The injections, the early morning appointments, the stress, the worrying, the scheduling, even the costs.

It’s all worth it.

Christopher Pierznik’s nine books are available in paperback and Kindle. Check out more of his writing at Medium. His work has appeared on XXL, Cuepoint, Business Insider, The Cauldron, Medium, Fatherly, Hip Hop Golden Age, and many more. Subscribe to his monthly newsletter or follow him on Facebook or Twitter.