Maribel Quezada Smith: I’m staring at my midwife as she’s giving me instructions, my husband’s to my right and there’s an oxygen mask on my face.

Midwife: Push, push, push. That’s it. That’s it. That’s the push. That’s it. Right there. That’s it, Maribel. Good job.

Maribel Quezada Smith: I can’t believe we made it this far. I can’t believe we’re all alive, considering only a few weeks ago I thought I was going to die. I grew up hearing the stereotype that Latinos are fertile human beings expected to produce large families. And this stereotype was mostly confirmed everywhere I looked. My grandparents all came from large families, and my maternal grandmother had eight children. I have 32 FIRST cousins. Yes I know all of their names. Suffice it to say that in our Latino community, there’s a familial expectation for procreation. Many of us who come from catholic unpringings are taught that children are a blessing, and a part of the step in fulfilling our purpose in life. This is my personal story about the guilt we feel when we’re not living up to those expectations. It’s also a story about loss, grief and finding courage. There are experiences in this story that many can relate to, but few are often invited to share. You’re listening to the Pulso Podcast. We’ll be back right back.
It’s October of 2019, and I’m about to take a pregnancy test. I’m not sure but I have the feeling that I’m pregnant. How? Because I’ve been here before, yet we’re still child-less. Only this time I don’t feel excited I feel, scared. Because I’ve already gone through a miscarriage. And even though I’ve been doing all the “right things”, even before trying to get pregnant again, like taking my prenatal vitamins every day, exercising and even avoiding alcohol, I still have no control over the outcome. And like me, many other people out there have experienced this feeling. According to the National Library of Medicine, 25% of known pregnancies in the United States end in a miscarriage, which is a pregnancy loss before 20 weeks. After 20 weeks, the CDC estimate that about 24,000 babies are stillborn every year. Knowing that the odds of miscarriage increase after the first one, I’m compelled to record this journey, as a way to help me process all of the feelings and thoughts currently inside my head. And so there I am sitting on my bathroom floor, staring at another pregnancy test.
Okay. It’s been three minutes. The C line is very clear and noticeable and the T line is also very clear. Oh my gosh. So I call out to my husband, Doug.. Can you come in here please? Doug sees the results and has the same reaction I do. Because of my previous miscarriage, we’re both cautiously happy. That same night I have a secret conversation with my voice memo app. I wish like I wish I could just be super happy. There are just so many things going through my mind right now. Like, what, if it happens again? I’m scared. I never wanna go through that again. It sucked. Seven weeks later I start feeling the first trimester. Think of every pregnancy symptom you’ve heard of and I have it. The mood swings, the nausea, the sleepiness, the crying, oh my God the crying. It’s now the middle of November and I can’t keep control of my emotions. I’ve been keeping track of my hormonal changes in my video journal… I cry at commercials. I cry at movie previews. I understand that it’s probably the hormones, but oh my God. And the other thing that I’m realizing is that I can’t believe how disrespectful and mean I have been to my mother after all she went through to have me. The fucked up part about having a miscarriage is how messed up your hormones get. I remember crying all the time, from sadness and also from just feeling out of whack. It’s not that different from being pregnant, only it’s worse, because you don’t have a baby to look forward to. I remember crying every time I would see a little boy or girl, I would get all choked up and my eyes would fill with tears. At eight weeks of pregnancy it’s finally time for the first ultrasound. I can’t wait to see our baby for the first time. Doug and I wait patiently as the technician searches around for a moment and then she says:

Ultrasound Tech: So, first thing is when you’re looking here mm-hmm I see two acks here. What does that mean? So, oh my gosh, there are two babies.

Maribel Quezada Smith: Oh my gosh. Oh, are you serious? Oh, my God. Oh my God.

Doug: Buy one, get one free. There goes my golf game.

Maribel Quezada Smith: With the amazing news, Doug and I leave the doctor’s office feeling like we won the lottery. I mean we’re getting two babies! We can’t even believe it, we feel so lucky, it almost feels like God is helping us make up for what we lost before. For my part, I feel grateful, and at the same time cautiously optimistic because of what happened before. It’s week nine and the nausea just started getting worse. Because of the miscarriage in the summer, you know, I’m a little bit nervous about anything that I feel that doesn’t feel normal or whatever, you know, but obviously I call the doctor and she said, I should be fine. Tomorrow I will be 11 weeks pregnant. Anyway, I’m waiting for Doug to get home because I asked him to bring me a junior bacon cheeseburger from Wendy’s and he is very late. Doug finally gets home and I devour the burger. I’m in this stage where I can only eat what I immediately crave, otherwise I can’t eat anything. Now with a full belly, I have one more thought… I think everyone’s doing all right. We go in for a checkup next Friday. So, I’m confident that everything is gonna be fine and the babies are growing. I still have, you know, that PTSD that I’m dealing with as well. Anyway, I’m trying not to worry too much.
On Friday December 13th I woke up feeling like a kid on Christmas morning! I’m super excited because today we’re headed to our first heartbeat checkup. At the doctor’s office, the OB has trouble finding the heartbeat for one of the two babies.

Dr. Speaker: Could you hear that one? That fast one? Okay. I cannot find a spot where you are not, and the baby is, um,

Maribel Quezada Smith: She says there’s no cause for alarm, sometimes it’s hard to separate the heartbeats when you are having twins, so she sends me to their ultrasound technician for a second look. She finds two heartbeats! I’m looking at the screen now, watching both babies, and Doug and I start breathing easy again. Watching the ultrasound of my two kiddos intently and not noticing that the technician quitely excuses herself to leave the room. When she comes back, the doctor is with her and she has a look of panic on her face and I think her hands are shaking? Her first words are: “There’s a problem with baby A.” I turn to Doug as I feel like a thousand pounds of rocks are raining on me. “Anencephaly” she says. I start balling. She says Something about the baby’s head not forming all the way, but I’m crying so hard I can no longer listen. What I don’t know is this isn’t the worst part…
It’s December 15th. I’m now nearing the end of the first trimester of pregnancy. We’re scheduled to see the high risk OB next week. It just seems like a lifetime to wait. I found this website, uh, called , which I’m so grateful for because I was reading personal stories from many other mothers. What happens is that a lot of the time the baby will develop, like we’ll keep growing, but it won’t grow as much as the other one as the one that’s developing normally, so when they’re born, um, sometimes they’re born alive. Sometimes they’re not born alive. I know I have to get through it. I know like, I’m mad and I’m sad and I’m angry. And I don’t know what to feel. I never thought that this would happen to me.
Every day after December 13, 2019 I’ve wondered this question. “What did I do wrong?” According to a report released by the CDC in 2019, birth defects are significantly more prevalent in Hispanic and Native American communities. The risk factors are not well known though according to the March of Dimes website, there are some findings that point to possible social factors like: access to preconception and prenatal care, age and weight, Pollution and environmental exposures to strong chemicals like pesticides, lead, radiation or chemotherapy medicines, or secondhand smoke during pregnancy. But other than being 35 when I conceived, most of these factors don’t apply to me or the way I live my life. A few days after receiving the devastating news, Doug and I meet with the specialist and I get my first 3-d ultrasound. This is the first time we receive an official confirmation that Baby A has a birth defect and it’s called anencephaly. Baby A will not survive after birth. And that’s even if we make it to term. I ask the doctor to worse case it for me and he tells me that if the baby dies inside my womb, it could potentially force us to go into labor and deliver much earlier. All of this is scary to hear, especially when he starts talking about preeclampsia, and other life-threatening things that come with a high-risk pregnancy. For the next 8 weeks, they’ll be monitoring my cervix very closely to make sure it stays closed and I don’t go into labor early. Even though the doctor gives me some answers, I still have no idea how to feel, and I spend most of my days trying to figure out how the hell we’re going to survive this, because there are days that I feel like I am dying inside.
Today is Friday, December 27th. I’m now 14 weeks and two days pregnant and I’m still nauseous. And I should be feeling really happy but I’m not as happy. I really envisioned coming home with two babies. Now that’s not gonna happen now. We’re just gonna come home with one baby. And I don’t know, I think a part of me still somewhat in, in denial and wanting to kind of believe that maybe we will come home with two babies, two healthy babies. Some days I’m fine. And some days I cry all the time. Mostly I’m confused.
Besides struggling with my emotions, I also feel like I’m in a constant argument with time. I spend my days doing the math. Can we make it one more day? Can we make it one more week? Every Wednesday for the next 8 weeks I thank God, the stars and everything that makes it possible for us to keep going, because every week we get closer to our due date, and that means we all have a better chance of surviving the labor and delivery. But every day that goes by is also one less day we have with baby A. On February 24th I record again…
I feel guilty sometimes because you know, like we have stuff on the registry and we’re starting to get some gifts and the baby stuff comes in and it’s just for one. And then sometimes I feel guilty because like I’m constantly thinking about, okay, what middle name are we gonna give Rency? I feel guilty because I’m not doing the same kind of attention or emphasis for AZUL, which is our other baby that we decided to name AUL. I just got tired of calling them baby A and maybe B. I really wanted to honor both babies.
Even though nothing about my pregnancy is normal. I’m determined to make everything else go as normal and cliche as possible.
Our baby shower is coming up in a few weeks in Ohio. I’ve started a Pinterest board with ideas for the baby’s room, for the nursery.
Shortly after recording that last message, I start writing to my kids in a journal. April 9th, 2020. We’ve been together for almost 7 months now! So many things have happened, but the most unpredictable one is this COVID-19 virus. It’s a virus that started in China about four months ago, then came to the U.S. It started with a few cases, but spread so fast that it’s officially turned into a world-wide pandemic. It’s incredible, but in less than a month the world is completely different. Papá and I have been social distancing for almost four weeks. Meaning we stay home and we don’t go anywhere except for a walk or to the grocery store. We’ve stayed busy with home decorating projects but not everyone has been as lucky. Millions of people around the world are now unemployed and a lot of businesses are closing down for good. There are no sport activities allowed, no concerts, no parties, and kids are also home from school. Of course this means our baby shower was canceled, but we discovered something kind of cool. We had a virtual one instead and it was actually fun! On the other hand I still go to the doctor every two weeks to check on you guys. But Papá is not allowed to go with me anymore. Because of the pandemic, I have to go alone. And when I arrive they have to check my temperature, ask if I have virus symptoms like coughing or shortness of breath and everyone has to wear a face mask that covers our mouth and nose. The day before the governor ordered restaurants and events to shut down, there was a text message going around saying that there would likely be a severe shortage of food. People were running to the stores, emptying shelves, and lining up just to get inside. I couldn’t find any toilet paper two days later. And last night I had a panic attack. It was the first time in a few weeks that I felt like we might not survive this pregnancy. If this food shortage is real, I’m worried that I won’t be able to get enough food to stay healthy and feed you guys. Your dad held me and told me we’ll be fine. But I’m still freaking out. We can’t hang out with anyone because if I or Doug gets sick we could be quarantined from seeing you guys after you’re born. It’s already happened to women in other parts of the country and the world. Some of them have even given birth without their partners there. A few days after writing this, I wake up in the middle of the night feeling panicked. 3:34 in the morning and I can’t sleep. I think I’m stressed maybe too, because of all this coronavirus shit going on. This is probably one of the hardest times. I’m struggling to stay calm and to stay sane. And every day I feel like it gets worse, the news gets worse and the numbers get bigger. And I just am, I just wanna know that we’re gonna be okay. The next day I start meditating. Abril 29. Today is April 29th Just did my morning meditation. I’m 32 weeks pregnant today. Yay. My feelings are all over the place as I get closer and closer to the delivery. We have just been preparing, what we’re gonna eat, who’s gonna be allowed to come over, who’s not. Cuz that’s the other fun thing during Covid 19. I have another ultrasound appointment tomorrow and we’re checking on growth.
Good morning. How are you? Good. Did you have an appointment? Yes, I have a 9:00 AM ultrasound.

Front Desk Speaker: Okay. Go ahead and sign in for me and the last question, and then I’ll, um, take your temperature.

Maribel Quezada Smith: The ultrasound technician is going through the usual 45-minute thorough check. She’s measuring each baby. Rency’s growth is normal but Azul is another story…

Ultrasound Tech: So you’re 32 weeks. Mm-hmm um, but the baby measures 26 weeks. So we’re like a full six weeks behind now.

Maribel Quezada Smith: This means she’s no longer growing very much if at all. But her heart is still strong and she’s holding on. One of the biggest questions I had was “what will my baby look like?” Anencephaly is such a rare condition that you don’t always know until birth. Like this, maybe I have a head at, at all, like any kind of face.

Ultrasound Tech: So I, I can’t see, I can’t see the front of the face, but typically. They have up to their eyes to eyes. Right. And then this part is gone.

Maribel Quezada Smith: The tech touches the top of her own head to visually illustrate the part that Azul will likely be missing. So the baby would have a face here. Yeah. And, and most, and most of the time you get an idea of what they look like. Early May arrives and the final preparations start. It is May 7th. I had a very interesting conversation with the bereavement doula about options for a Azul, um, for body donation and organ donation. Doug and I decide that we want Azul’s life to have a deeper impact on our community. So we agree to donate her organs for research. And there are all kinds of logistical things involved with this that I never thought I would have to do.

Cremation Man: Cemetery office. Let’s get someone to assist you. One moment please. Thank you for holding. How can I help you today?

Maribel Quezada Smith: Hi. Um, I was calling about questions regarding, um, what we would need to do for cremation, um, of, uh, one of our babies.

Cremation Man: For a baby?

Maribel Quezada Smith: Yes. June 1st 2020… This past month has been insane. The governor of Arizona has allowed some businesses to re-open and people are starting to go out in public again. The most difficult part right now-aside from this global pandemic- is that we’re also entering into a serious social crisis. Last week another person was murdered at the hands of police. The man’s name is George Floyd, and according to the news, he was arrested because he had bought cigarettes with a fake bill and was intoxicated. He was unarmed. And when he was arrested, the police officer put him on the ground face down, and then put his knee on the man’s neck for eight minutes, regardless of the fact that the man repeatedly told him he couldn’t breathe. The man died in this position, and when the ambulances arrived they didn’t even try to revive him. Fue horrible! Someone recorded it all. Y entonces el pais exploto. People have been marching in the streets every day and at night there have been constant violent encounters with the police, people breaking into businesses, setting cars on fire, and smashing windows. A lot of people are feeling angry, sad and hopeless. Papá and I are worried, sad and angry- we’re both worried about the kind of world that you will be born into. Black people have been abused and hurt for centuries and we cannot allow this to continue. Por el momento, we’re at the mercy of a state-wide curfew. This means no one is supposed be out of the house after 8 p.m. Unless they’re working. In the news they said that this is the first time since MLK was assassinated that there is a curfew in so many cities around the country. And in the midst of all of this unrest, you two, Rency and Azul are about to be born! Time is a struggle for me. So many times throughout this pregnancy I focused on making time go faster, because all I wanted was to give Rency the best beginning in life, but in doing that I didn’t realize that I was rushing to the ending as well. The time when Azul would no longer be with us, and this makes me feel guilty. The past few months I’ve connected with two babies, but I only get to bring one home. “Will she feel pain?” I ask my doctor at the final checkup. “No” he says. “She’s missing the part of her brain that allows that connection.” “But If she can’t feel pain, will she feel my touch?” I ask myself. “Will she know how much she means to me?” There are no logical answers anyone can give me. But maybe this is not a time to think logically. Death, hopelessness, injustices, in less than nine months our lives have been turned completely upside down, and somehow I have to find it in myself to think optimistically. I have to believe in something good. I can feel the protective motherly instinct switch flip on. Every part of me wants to hold my two babies and let them know we will ALL be well, even if only for a few moments.
June 2020.

Dr. Speaker: He’s push. Wow. He poisoning. He coming. He’s almost here. Push, push, push. He’s almost here. There you go.

Maribel Quezada Smith: I take a breath. Rency comes into the world first, and Azul arrives about a minute later.

Dr. Speaker: Push, push, push. Well, we still doing so good. Good job, mama.

Maribel Quezada Smith: A few minutes later, lying next to her brother on my chest, Azul passes away. On Mother’s Day week of 2021, Doug and I hike to our favorite spot in the Piestewa mountains of Phoenix to spread Azul’s ashes. It took me a long time to let go of her physically. Emotionally, I’ll never let go of her. All I can do is thank her for holding on. And being there for me and her brother. Gracias, Azul Alexandria. I can’t tell you how many times people have told me to: “have faith, everything happens for a reason” Well, this entire experience taught me that sometimes shitty things happen to good people for no greater reason at all. And it doesn’t necessarily mean you could have prevented it. Are there things I can say I’ve learned from this experience? Sure. But that doesn’t take away the pain & it doesn’t erase the guilt that comes with losing a baby.
Before we wrap, if you know someone who’s gone through pregnancy or infant loss, here’s what you can do to help: Don’t ask them when they’re gonna try again, or suggest that they should have more kids. You don’t know the kind of mental and emotional pressure they already feel without your adding to it. If you’re someone who’s experienced pregnancy or infant loss, share your story, even if it’s only with a few people. Hearing other people’s stories has helped me process my grief and feel less isolated. What I have learned is that we all need community and support not just during the hard times, but every day. I’ve learned we could all stand to be more empathetic and respectful of each other’s struggles and life choices. It’s very easy to pass judgment when you’ve never lived through someone’s experience.