Early in my first pregnancy, about three years ago, I did a thing that a lot of pregnant women do. I picked up my phone and scrolled through videos of pregnant women doing cool things. In one, a woman with a big belly—she must have been about seven months—was surfing. She wore a bikini, and her legs looked strong. Her hair blew behind her shoulders when she slid down a wave. When I watched the video, I thought, Wow, good for her! in a not-sarcastic way. Weeks later, on modified bed rest to protect my endangered pregnancy—marooned on my sofa, unable to confidently shower or walk upstairs for fear of triggering labor—I thought of the surfing woman again, this time huffily. “Good for her!” I said to myself, and returned to my book.
The book I was reading was Edith Wharton’s “The Custom of the Country,” from 1913. It’s the story of a beautiful social climber named Undine Spragg who attempts, through a series of opportunistic marriages, to infiltrate the highest ranks of New York society. I liked Undine because she existed in a time different from my own. Also, she did whatever she wanted. When Undine falls pregnant—a wrench in her plans—she throws a fit. Her husband tries to calm her down. “But, Undine—dearest—bye and bye you’ll feel differently—I know you will!” he says. “Differently? Differently?” she responds, in a rage. “When? In a year? It takes a year—a whole year out of life! What do I care how I shall feel in a year?”
Undine is selfish. She wants to look nice and go to parties. She’s not thinking of her husband or child or anyone besides herself. (Indeed, she turns out to be a pretty terrible mother.) Still, I admired her unself-conscious anger, her lack of shame. She’s mad, dammit! I texted a friend of mine, from the crumb-covered sofa where I was spending all my time, telling her that I’d tried to read “Wolf Hall”—a book about King Henry VIII trying to secure an heir—but that I’d had to stop because it’s all about wombs. “Oh god true,” she wrote back. “I suppose too now you see EVERYTHING is about wombs.”
Two weeks earlier, at the midpoint of my pregnancy, I had gone in for a routine scan. The National Health Service hospital in the part of North London where I live is one of those places—like a Roman ruin smashed between a barbershop and a Pret a Manger—where the city shocks me with its age. In the Northern California suburb where I grew up, where kids greeted the orthodontist like an old family friend, the medical facilities resembled office blocks or strip malls, and had gleaming interiors. In London, my hospital was housed inside a faded Victorian complex built during the smallpox epidemic. It sat on a site that opened in 1473 to treat lepers.
To get to my appointment, my husband and I passed a building with an enormous clock and a sign that read “Small Pox & Vaccination Hospital,” and entered into a separate building labelled “Female Receiving Ward.” A stained-glass window depicted the Madonna and child. I remember almost nothing from the scan except that the baby was fine. The technician moved the wand over my belly, making her checks. We saw the outline of his profile, his little nose.
Afterward, she printed a few photos for us to take home, and we examined them in a nearby café. This is going pretty well, I thought. My pregnancy thus far had been uneventful. Everything I had read about had happened on schedule. The powerful changes to my sense of smell and appetite. The swelling. The nausea. The nausea passing. The baby was a raspberry and then an avocado. He was growing ears and fingernails. I bought new clothes in an overpriced maternity shop. I continued writing stories. I went on vacation, and swam in the sea. My husband and I looked at each other. A baby!
An hour after our appointment, the technician called me. I was sitting at home trying to write. The baby was fine, but she had noticed a little funnelling around my cervix, she said. She hadn’t wanted to mention it at the time because she wasn’t sure exactly what she had seen. “O.K.,” I said. I tried to remember what the cervix did. The cervix should remain long and closed until the end of the pregnancy, she said. If it opens too early, you might have to get a stitch. “A stitch?” I said. It was probably nothing, she said. The doctor would call me if there was a problem. That was a Friday. The weekend passed. I Googled “cervix” and “funnelling” several times. “A marker of cervical insufficiency,” I read, “increased risk of spontaneous preterm delivery.” It seemed the cervix was really quite important. Funnelling can appear on a scan in the shape of a U, a V, or a Y. I tried to remember if I had seen a U, a V, or a Y during our scan. U, U, U, I thought. V, V, V.
On Monday, I was working at the British Library when the doctor called. I told him what the technician had said. He seemed annoyed. “She shouldn’t have told you that,” he said. The cervix is a dynamic organ, he explained. It can move and wave naturally throughout pregnancy without anything being wrong. I was youngish, and had no other red flags. Nothing in my family history. She shouldn’t have said anything at all, he went on, but since she had, and since I was now worried, he would book me in for a follow-up scan in a month’s time. He seemed busy.
I returned to my desk. I thought of my cervix waving and wiggling like action lines in a comic book. Zoing! Boing! Up until this point, I had felt proud of how I had been able to keep a lid on my anxiety during the pregnancy. I would breezily drink a coffee, and explain that Emily Oster had said in her book that it was absolutely fine to drink multiple cups a day. (And do you have a copy? I can lend you mine!) But here my covert Googling caught up with me. I booked a private scan for Wednesday. We had plans to travel to Sweden to visit my brother-in-law on Friday. “For peace of mind,” I kept saying, until the phrase lost its meaning.
On the way to the private scan, I ate a cold spinach-and-feta roll from a bakery in my neighborhood. One of the minor casualties of my pregnancy is that I can no longer eat one of these rolls without experiencing sickening pangs of adrenaline. (I still eat one occasionally, but I prepare myself ahead of time.) The doctor who examined my cervix was a soft-spoken Russian man who ran a small clinic in the financial district. Almost as soon as he inserted the probe, he fell quiet. He removed it carefully and asked me to get dressed. Very calmly—his voice was almost inaudible—he told me that my cervix was opening and I should go to the hospital. Immediately. We should hurry, he said. We might still have time. Perhaps we could take an Uber?
Time for what? I remember thinking. And then, Oh, no. We got in an Uber and crossed the city. “Good thing we ate beforehand,” I said, stupidly, as the car crept toward our ancient hospital. Once there, I was examined and my notes were reviewed. The soft-spoken Russian turned out to be a well-known expert, and his assessment was taken very seriously. I was told I would need an emergency surgery. By then, however, it was late in the evening and no consultants were available. I was placed in a room with curtains for walls to wait until morning.
I didn’t sleep well. All around me, women were in the last stages of their pregnancies, groaning, creakily uncomfortable, waiting for labor to start. I heard a woman to my left begging to be induced. I was only twenty weeks along and had hardly considered the mechanics of birth. My belly was still a small swell—a hill you might picnic on rather than a mountain to be scaled—and nowhere near an encumbrance. I didn’t feel qualified to be there.
In the morning, one doctor after another spoke with me. I seemed to have something called “incompetent cervix,” they explained. “Incompetent?” I said. I imagined my cervix as a well-meaning but chronically disorganized employee in the corporation of my body. “Whoops!” she’d say, cheerily, having mixed up the files again. The condition was also sometimes called short or insufficient cervix, one doctor said, apologetically. They would need to place a rescue cerclage around my short, incompetent, and insufficient cervix to prevent it from opening. I was presented with choices that didn’t feel like choices. The procedure carried a risk of miscarriage, they explained, but not doing it would almost certainly result in miscarriage. I signed the forms.
The surgery shares some similarities to a C-section. I received a spinal to numb my lower body and was awake while the doctors worked. My husband put AirPods in my ears to distract me. I tried not to think about my water breaking on the table. Afterward, everyone seemed relieved, and that was disconcerting. A midwife spoke with me in the recovery room. If my stitch held over the next twenty-four hours, that was a good sign, she explained. If it held during the following week, that was better. If I made it a month with the stitch intact, I would reach twenty-four weeks, or viability, when the baby has a better chance of survival. She suggested taking the next month off work. I should avoid stress, she said, and try not to exert myself. No lifting, no baths, no exercise, no sex. She offered to write me a note.
My first thought was, I can’t believe this lady thinks I can take a month off work. My second thought was, I can’t feel my legs. The situation seemed ludicrous. I had work to do. We were going to Sweden on Friday. I wasn’t even that pregnant. What was I supposed to do? Cross my legs and try not to go into labor for the next—I did a quick calculation in my head, one that I had avoided until that moment—five months? Yeah, right. Nice try, lady.
Pregnancy is forty weeks long, but it feels much longer on bed rest. When you’ve been asked not to move much in order to protect your unborn child’s life, time stretches out before you like a vast, inhospitable landscape. You must navigate this terrain, carefully, by the subtle markings left behind by previous travellers. In this strange land—a deserted space—time becomes a location, a place to get to. I will get to twenty-four weeks. I will get to twenty-eight weeks. If I can make it to thirty weeks. In the ten weeks I spent on modified bed rest, I sometimes imagined my body as a ship with holes in it travelling toward the safety of land.
In reality, I was not going much of anywhere. I shuffled between the bed, the bathroom, and the sofa in our living room. Our apartment, though charming, inconveniently occupied the top two and a half floors of a converted Victorian terrace house, and somehow contained four flights of stairs. Our bedroom was a cozy attic space that the previous tenants had probably used to store luggage. Lying on the sofa in the living room, I stared out the windows at the brick façades and clay chimneys of the houses opposite ours. Above them was a wide patch of sky, where I watched each afternoon fade into night.
At first, I felt nothing. And then I felt fear. I was afraid of the stairs. I was afraid to get dressed. I was afraid to bend down to tie my shoes. To roll out of bed incorrectly. In the days after returning from the hospital, I was afraid to shower, or make a sandwich, or open a window. Only lying again on the sofa could I imagine the pressure being taken off my cervix, the baby secure inside me.
What I knew about bed rest before my pregnancy came from literature. Victorian women fainting and being put to bed. Charlotte Perkins Gilman’s narrator in “The Yellow Wall-Paper” losing her mind while taking the rest cure. (I also knew about bed-rotting, from TikTok.) Rest as a treatment for illness became popular in the late eighteen-hundreds, after a physician named John Hilton published a collection of lectures on the subject, “Rest and Pain,” in 1863. Its use began to fall out of favor after the Second World War, when it became clear that injured soldiers recovered faster when they spent less time in bed. In pregnancy, however, despite evidence that it may cause harm, its use persists.
Virginia Woolf spent weeks of her life in bed, though not while pregnant. “I am in bed with influenza,” she wrote in her essay “On Being Ill.” “But what does that convey of the great experience; how the world has changed its shape; the tools of business grown remote; the sounds of festival become romantic like a merry-go-round heard across far fields.” In “Mrs. Dalloway,” she writes disdainfully of a doctor’s orders to “rest” in bed: “Rest in bed; rest in solitude; silence and rest; rest without friends, without books, without messages; six months’ rest; until a man who went in weighing seven stone six comes out weighing twelve.”
But in illness Woolf also found something mystical, a liminal space where “the whole landscape of life lies remote and fair, the shore seen from the ship far out at sea.” Those going to work were “soldiers in the army of the upright,” whereas the ill were “deserters,” and “outlaws.” “They march to battle,” she wrote, of the healthy. “We float with the sticks on the stream; helter skelter with the dead leaves on the lawn, irresponsible and disinterested and able, perhaps for the first time in years, to look round, to look up—to look, for example, at the sky.” Lying on her back, she notices that the clouds are magnificent. “Some one should write to The Times about it,” she joked. “One should not let this gigantic cinema play perpetually to an empty house.”
