Read an Excerpt

Introduction

Afterbirth   

When my son was a few weeks old I started writing my first book. This book. My milk came in and, finally, so did the words. I started to write, as Hélène Cixous put it, in the white ink of my milk. Neither came easy at first, but a decade on I wonder if the difficulty, the frustration, the tenderness, and the damn constraints were what birthed the book. That I wrote not in spite of the pram in the hall, but because of it.

Those early weeks of motherhood unfold in another, you might say, mothertime. The first six weeks, when I overcame the tyranny of the blank page (and established breastfeeding!), even have a name. An inadequate one, like so many of the words that issue from pregnancy, birth, and motherhood. They are known as the fourth trimester, as though it were the last stage of pregnancy and not the first of life.

So. There was this baby. The same one, I had to keep reminding myself in the hospital as I was confronted with the belly still mountaining before me, who roiled in there for nine months. Give or take. Because it’s not actually true – or convenient if you happen to be embarking on a book of nine essays charting the nine months of pregnancy – that a pregnancy invariably takes nine months. Many are more like ten. Mine included. 

Anyway. Back to the baby. Here he was with his elegant fingers, wise face, and my father’s nose, and yet still, in so many ways, still there, roiling in my womb. He was an internal organ that I carried around on my soft, leaking, also new person. He was an independent creature with his own bodily functions, which were produced by mine. He was a person, already. There he lay, arms and legs of his sleep suit trailing off his mini-limbs, snuffling on his back at the foot of the Moses basket. Sorry… Moses basket?! Yes. The bed where the baby (theoretically) sleeps is still, in the culture in which I gave birth, named after the Old Testament story of Moses, the infant left by his mother (in an act of protection not abandonment) in a wicker basket amongst the bulrushes of the River Nile. The language given to you by history when you are handed the baby is not just inadequate, it is often archaic. And without thinking much at all about it, I used it. I put the baby in the Moses basket. (Then, as history also dictates, he started crying so I took him out again.) 

At the same time changes were taking place in another impenetrable chamber of my body. My mind. Throughout my pregnancy I had been thinking about this book I might write. Which, in itself, was typical. Throughout my life I have carried ideas for books around with me like others carry house keys, but none had amounted to actual books. This one was different. To use a pregnancy term, it was viable. And so, for the rest of my pregnancy, this book of curious, digressive essays grew in my mind in tandem with the foetus fattening in my belly. I couldn’t write it, no, I was too busy with its subject, but I did start to read. 

What did I find? At first, very little. And as for books telling the stories of black, brown, and queer expectant and mothering bodies – which is to say, mine – even less. There was no Maggie Nelson’s The Argonauts nor Deborah Levy’s Hot Milk. No Jacqueline Rose’s Mothers, Claire Kilroy’s Soldier, Sailor, or Olga Ravn’s My Work. Elena Ferrante’s Neopolitan Novels had not yet been translated and published in the UK. Avni Doshi hadn’t written Burnt Sugar. Sheila Heti hadn’t written Motherhood. Prescription was the order of the day in pregnancy and birth literature. Being told what to expect when you’re expecting seemed to mean being told what to do. There were exceptions but it is not easy to be an exception, which I would find out myself soon enough. If you are seen at all, and most likely you won’t be, you will be misunderstood, laden with responsibilities that aren’t yours, and punished. A Life’s Work by Rachel Cusk was a tender, frank, and courageous psychical study, but look at the viciously misogynistic backlash with which it was met. 

The foetus kept doing his thing, and I did mine. I read Sylvia Plath, Sharon Olds, Hélène Cixous, Margaret Atwood, Jhumpa Lahiri, Kathleen Jamie, and, always and forever, Toni Morrison. Then, casting the net more widely, Leo Tolstoy, Nan Shepherd, Shakespeare, Mary Shelley’s Frankenstein, and James Joyce’s Ulysses. I became increasingly struck by how little I knew about what was happening to me, month by month. How little I understood the silences breeding across centuries. Silences in which my book would also, unsurprisingly, be engulfed. 

Mothering is a practical business. So, too, is writing. When I wrote Expecting, I was new to both roles, figuring things out at the level of the baby and the sentence. As I wrote the foetus in question transitioned from newborn to toddler. He crawled. He walked. He spoke. He jumped. He spun things. He tried to pluck the moon from the sky. Mothers still ask me how on earth I wrote a book during that time. The unsatisfactory answer, which is really why anyone writes a first book, is that I must have really, really wanted to. I made it happen in the way that no amount of willing can ever make a baby happen. (Trust me, I tried.) 

First, the structural stuff, which we ignore at our peril. I took voluntary redundancy from my full-time job as a journalist and with the money bought the gift which all mothers are desperate to be given. Time. (You can’t, unless you’re really loaded, buy sleep.) I looked after the baby and wrote. I paid a childminder to look after the baby and wrote. I jettisoned the advice to sleep while the baby slept – I never was any good at taking advice or sleeping during the day – and wrote. I wrote straight after feeds when the baby was sated, opening my laptop with buzzing breasts and brain. (Letdown is a very electric feeling.) I wrote on park benches, one hand tapping the black glass of a tablet, the other pushing the buggy back and forth in the unending project to keep the baby sleeping. I wrote instead of taking a shower. I wrote on the sofa while the baby lay in his jungle gym, opening and closing his fat fishmouth hands at the mirrors dangling on strings. I wrote as though my life, by which I mean my sense of self, depended on it. Which, in a way, it did. 

A memoir is a document of the times as well as a life. Rereading Expecting, I am struck by all that has happened, so much of it detrimental to women’s bodily autonomy, in the intervening years. It is beyond the scope (and word length) of this essay to list all the heartbreaking ways in which our rights have been dismantled during the last decade. I will mention only a few examples. Here in the UK, where I birthed and was birthed, the number of women dying during pregnancy or soon after childbirth has reached its highest level in almost twenty years. Asian women are twice as likely to die than white women during pregnancy or soon after birth. Black women are three times more likely. In Italy the right-wing government has ordered state agencies to cease registration of children born to same-sex couples, effectively removing mothers from their children’s birth certificates. Maternal death rates are rising again in many countries and in 2020, a woman died every two minutes from preventable causes related to pregnancy. And on June 24, 2022, the US Supreme Court overturned Roe v. Wade, ending the federal right to an abortion. Twenty-one US states have since banned or restricted abortion. The time for writing the stories of our bodies, for fighting with and for them with all the tools at our disposal – our words, our feet, our votes – more than ever, is now. 

I wanted Expecting to be a deeply political book. When I wrote it I was invested in the intimate story I was telling being both particular and universal. My womb, but also everywomb. It mattered to me, hugely, that I didn’t explicitly explain, label, or, by association, justify the identity of the body doing the writing. This was not the story of a brown, bisexual, leftwing, feminist, second-generation pregnancy. This was the story of my pregnancy. I wanted to seize the narrative for myself. I wanted to hit the ground running, write without explaining why I was here or what I was up to, just like any so-called majority writer unthinkingly does. I was influenced by the way Toni Morrison wrote her first novel, The Bluest Eye, and Alan Hollinghurst wrote The Swimming Pool Library. Not ‘Look, this is how people like us live’ but ‘Come, join me, I admit you into my confidence’. I wanted the sociopolitical, historical, racial, and patriarchal structures of my specific situation to breathe through every single hard-won line. I still want all these things, but we are now living in a time when being explicit about what you mean is also important. So to nail my rainbow colours to the mast, when I write ‘pregnant woman’, ‘woman’, ‘mother’, or ‘motherhood’ in Expecting, I include anyone who includes themselves in this description, and lives, and births, in its confines, hazards, shadows, and liberations. Mothering, like gender (and writing!), is in the doing of it. It is more verb than noun. And there have always been so many of us labouring unnoticed at its coalface.  

Another thing that struck me when rereading: how much it mattered to me that the nine chapters were essays. We were not living in such pro-essay times then in the UK. Some in the publishing industry advised me not to use that word, as it might put readers off. Why did I care so much? Sometimes we need an older iteration of ourselves to provide the answer. Forty-four-year-old me reckons it’s because I wrote Expecting in the first truly restricted time of my life. Motherhood. A deeply pressurised time. A time which necessitates a narrowing of some horizons and, though I couldn’t see them then, a widening of others. And an essay, in the original Montaigne sense, is structured in direct opposition to this contraction of horizons. It comes from the French ‘essai’ meaning to attempt or try out. It is an open door. It is an aimless meandering. It is an experiment for its own sake. It is mothertime-friendly (as in nice and short). It is freedom of the mind.  

Also, how invested I was in metaphor! In finding my own metaphors, as Plath had done. In coming up with new ways to say the things that had been said wrong, or not said at all. In lyricism for its own fecund sake. In – cringe – using three adjectives when one would do. I regard my first book like I do my teenage self. She’s a bit much, but she had… what’s the female equivalent of balls? Labia majora?! These days, I’m edging closer to Sontag than Plath. I want to stop messing about, strip away the metaphors, look directly at the thing itself, and describe it. Clarity is more beautiful to me now than metaphor. 

Finally, I am struck all over again by what I did not know. Not about pregnancy and birth but as Sontag called it, the night side of life. Illness, and death. In the same decade I became a mother, I lost a mother. My mother. The one who made me. So I notice now, with some discomfort, that when I wrote about death in Expecting it tended to be as a theoretical counter to birth. Metaphorical only. How could it have been otherwise? I had not been forced to look directly at death itself.  

Nor, indeed, had I seen motherhood. The moment that probably touches me the most is the sole appearance of my son at the close of the penultimate essay, “throwing cushions to the floor and running fire engines up the arms of the sofa.” What I also didn’t know when I wrote those words, but was starting to strongly suspect, was that he, the foetus forever sealed in the womb of this book, was autistic. That life would look nothing like I thought it would. That it would be harder, better, and much less (and, okay, sometimes more) frightening than I could have imagined. That four years later, almost to the day, his sister would be born, turning me into one of those insufferable women who say giving birth was the happiest day of their life. That more life, and death, would happen. That we would be okay. That it really would be a beginning, after all. 

Chitra Ramaswamy, January 2024 

One

November

But the beginning of things, of a world especially, is necessarily vague, tangled, chaotic, and exceedingly disturbing. How few of us ever emerge from such beginning! How many souls perish in its tumult!

The Awakening, Kate Chopin 

An unremarkable Sunday morning in November. A noirish time of year when nature’s reel turns monochrome and the world becomes as smudged as old newsprint. Sombre November, as TS Eliot called it. The last gasps of another year. On the morning dog walk the leaves were pockmarked from an excess of autumn and had lost their florid complexion. They were beginning to blacken now and stick to my shoes as though slick with a thin layer of oil. It was the eleventh month of the year, though Novem means nine for it was the ninth month in the Roman calendar. Nine months. A clue dropped by a season, like so many leaves.

And so with all this promise of death I found myself taking a test proposing life. A frightening test, though perhaps there is no other kind. A test taken by oneself in the privacy of one’s own bathroom towards the end of another year. A test whose result is revealed not by a mark on a page but by a stream of one’s own bog-standard urine. A test for which there are only two results. Either life is there, burrowing in a place as close to you as your own heartbeat yet as mysterious as the inside of a mountain, or it is not and life, the other kind, goes on. How very simple. And how brutal too. 

Like however many millions of women before me and who knows how many in tandem, I squatted, hovered, took aim and waited for a blue cross to materialise in a tiny window of possibility. I had done this a few times in my life. In Glasgow in my early twenties when my partner at the time had just moved to London and I felt vengeful and very alone. The result? Relief. r more recently in Soho, in one of the new breed of budget design hotels characterised by receptions without people and rooms without windows. That time? Disappointment. On both these occasions, the result had been negative. Life, the other kind, had gone on. 

This time was different and as is often the case with major moments, I knew before I knew. I had eaten oysters twice in the previous week – unusual in itself and almost wilful in retrospect – and felt seasick as each sup slid down my throat. I had drunk whisky, smoked roll-ups and sung along to the Proclaimers in Edinburgh’s The Port O’ Leith, which in its own salty way is no less glamorous than sipping Bellinis in Venice or going for bagels in New York. The Porty, as it’s known to locals, is an icon of Leith on my street, with its skew-whiff nautical decor and rousing nightly rendition of ‘Sunshine on Leith’ when last orders are called. But instead of feeling the euphoria that comes from belting out ‘sorrrrroooowwww’ with the bonfire of Laphroaig on my breath and the scent of the Firth of Forth on the air, I felt jittery. Five days previously, there had been a small rusty mark on a pair of pants, a question mark written in blood. It was enough of a hint for me. 

And yet I had cause to doubt what is known in the business of trying to conceive – and one soon discovers that it is first and foremost a business – as an implantation bleed. That is, the moment when the ball of cells that goes by the dramatic name of a blastocyst burrows into the wall of the uterus, the most minuscule of plants taking root and making the ground shed tears of blood in response. Little blastocyst blasting its way into the world, so small and uncertain it has yet even to become embryonic. 

My partner and I had been trying to make this everyday miracle happen for almost eighteen months. It had not been easy for us. We were two women for a start. The story was the kind of romantic comedy that would never get made, with all the madcap races across cities and highly charged encounters in hotel rooms you might expect. Stories that were good for dinner parties but bad for life. We had already done so much. Our preparation had been flawless; all we lacked was an outcome. 

To start, a civil partnership to ensure we would both be the parents of a baby that might never be, a leap of faith that no heterosexual couple is required to make. Bizarrely, this needed to take place not just before birth but before conception, making the most private of acts a matter of public interest from the outset. And so it went on. Three donors and three corresponding excruciating encounters up and down the country. Home insemination kits bought off websites with deflating names like prideangel and fertilityzone. Blood tests at the GP’s to ensure I was fertile. Dispiriting monthly trips to buy yet more ovulation tests, cruelly addictive (and expensive) little sticks that so resembled pregnancy tests I began to feel dumbly thrilled when they showed up positive. Then a growing obsession with donor profiles on international cryobank sites, where you can buy sperm by the syringe and have it delivered to you in a hissing nitrogen tank, which if nothing else sounds like the birth of a post-modern superhero. And finally, a number of exchanges in a series of hotels with neither windows nor souls. 

Every month, these brief encounters grew at once more workaday and strange. They began to gain an air of desperation, of waning passion and lost faith, sentiments that afflict most clandestine hotel trysts in the end. And the fact was they weren’t working. Like November, we remained sombre, in limbo, aching for our lives to turn Technicolor, to end and begin again. The frustration that comes when your body refuses to submit to your will grew exponentially, fattening like the foetus it seemed would never be. Meanwhile, I grew increasingly defiant towards my own flesh and blood. I knew my body less and less with each passing month, just as we slowly grow to see a partner we no longer love as a stranger. To fail to get pregnant when one badly wants to is to engage in the most treacherous kind of battle: with one’s own innards. We can no more will a baby into our bodies than we can draw an illness out of them. 

Now I waited once more. Watched the beads of condensation on the cistern as they trembled, brimmed over and wept. Listened to the pigeon that had taken up residence outside our bathroom window for much of the autumn cooing with the persistence of a clock. Pictured Claire, my partner of eight years, a few feet away in the sitting room with the dog curled at her feet, waiting too. Witnessed the world distil itself, telescoped by anticipation into a chain of beautiful moments. Like words, life has a way of becoming poetry when slowed down. 

You must wait three minutes before reading a pregnancy test. The length of a pop song or an ad break. During this time I found myself feigning nonchalance for the benefit of no one but myself, imagining a camera lens hovering above my head as we do when we sense something monumental is afoot. I left the bathroom, paced our hall, allowed myself a Hitchcockian moment of suspense with all its long shadows and discordant strings, and then returned to the scene on which the plot of my life suddenly hinged. Finally I allowed myself a close-up. There it was. The revelation I had been imagining for so long. A moment not entirely unlike the adverts on television with their staunchly white couples flashing white teeth against white backgrounds, making fertility look oddly sterile, as innocent as ordering a salad for lunch. The vertical line was a little less significant than the horizontal, but it was a blue cross nonetheless. And beside it, an fools guide to deciphering the message. + = pregnant. - = not pregnant. A turning point, the kind that is mammoth enough to be experienced twice. First as raw moment, all heartbeat and terror. Second as story: dramatised, edited and reconstructed even as it unfolds.

‘I’m a riddle in nine syllables,’ wrote Sylvia Plath in her 1959 poem ‘Metaphors’. Nine syllables. Nine lines. Nine months. The arc of pregnancy, with its triptych of trimesters, is as meticulously structured as a poem. Though, of course, one cannot break free of the conventions of pregnancy. There is no way to subvert its stanzas. Plath wrote these blackly humorous lines that peter out into quiet desperation when she was pregnant with her first child, Frieda. Six months after Frieda’s birth on 1 April at home in London, Plath published her first collection of poetry, The Colossus. The birth of her baby marked her birth as a poet, but in many ways it was also the beginning of her death. Pregnancy symbolised Plath’s own gestating consciousness, dark and wild, which she feared would consume her in the end. ‘I have a fear, too, of bearing a deformed child,’ she wrote years earlier in her journal of 1956, ‘a cretin, growing dark and ugly in my belly, like that old corruption I always feared would break out from behind the bubbles of my eyes.’ 

‘Metaphors’ is funny: the joke is on her, and on all pregnant women who are reduced to mere metaphors as they rise like yeasty loaves. Plath would remain as ambivalent towards motherhood as she was towards pregnancy for the rest of her short life. Or rather, she was a woman brave enough to spill its secrets, good and bad. And how could she have been otherwise at a time when the word itself was riddled with shame? When a pregnant woman was still a walking euphemism? In a family way. In a delicate condition. With child. Enceinte. Expecting.

Plath understood the tricksy nature of pregnancy, its deep and perplexing riddle, its silence as dark as the womb. She understood its peculiar contradiction: the problem of how you can be at your most lonely during the one time in your life when you are never alone. In philosophy the exploration of how a being relates to its world is known as the problem of self. Just think how this problem doubles, trebles, multiplies when there are at least two people inside one body. Plath understood what it was like to all of a sudden, after living with such unthinking ease in one’s own body, feel like ‘a means, a stage, a cow in calf’. She understood the wondrous absurdity of it. ‘Vague as fog and looked for like mail. / Farther off than Australia,’ she wrote in one of her most famous poems, ‘You’re’, addressed to her unborn child. ‘Right, like a well-done sum. / A clean slate, with your own face on.’

Plath made sense of pregnancy by travelling beyond experience to a place where only metaphor would do. Her approach was to write about pregnancy by not writing about it, by veiling it, perhaps even illuminating it, with metaphor. It was all too lonely a place to live in the end. In February 1963, while Frieda, then two, and her one-year-old brother Nicholas slept in their cots, Plath placed her head in the oven and turned on the gas. She put towels around the kitchen door so that the fumes would not reach her children. ‘You are the one / Solid the spaces lean on, envious. / You are the baby in the barn,’ she wrote in one of her last poems, ‘Nick and the Candlestick’, addressed to her baby boy. Her children had been her saviours. Yet Plath was imprisoned in the bell jar, an image that in its own way recalls pregnancy too. After all, pregnant women often feel trapped in their bodies, or rather their bodies become the trap. And isn’t the womb, too, a kind of jar, albeit one we cannot look inside with the naked eye, one whose contents remain unseen until the lid is opened. 

What, then, is the riddle of pregnancy? How are we even to begin to understand it? To find the right metaphors? Or perhaps even to abandon them: to crack open the jar and spill the contents? To cast aside the sentimentality, sanitisation, science, prescription, self-help, emotionally manipulative doggerel, lies, misconceptions, misogyny, unwanted advice, politicking, and the never-ending slew of news stories that serve only to patronise, petrify or pacify us? How do we find some meaningful understanding of one of the most thrilling, challenging and alien experiences of all? To describe what it really feels like to grow a person within a person? To tell the curiously silenced story of how every single one of us began?

Pregnancy. The word both sounded heavy in my mouth and suggested a kind of heaviness. It had something to do with its staccato rhythm, the way it began harshly and then finished with a soft purr, as if it were a pregnancy in reverse. It wasn’t an easy word to speak aloud, just as it wasn’t an easy experience to articulate. This made me like its awkwardness: it suited it. And what of its meaning? In Latin, praegnans translates literally as ‘before birth’. It has long had a significance reaching beyond its description of the gestation of a foetus. There is the sense of pregnancy as carrying weight, depth or meaning. The pregnant pause. The pregnant moment. The pregnant utterance. By the late fourteenth century, to be pregnant also meant to be convincing, weighty or pithy. A pregnant argument was a compelling one. Then there was its sense of fullness and creativity. Its wonderful state of potentiality. I wanted to return to this definition of pregnancy as being ripe with meaning itself. To be pregnant with meaning as much as with child. 

So much in pregnancy had been obscured by euphemism and it had happened over centuries. It was an experience that despite (or perhaps because of) being so unspeakable, has always been loaded with verbiage. The word ‘pregnant’ was itself a metaphor. Then there were all the historical synonyms – heavy, great-bellied, teeming, bound, pagled, bagged. And finally the sayings and expressions, varying across the world and ranging in tone and meaning from descriptive, humorous and prudish to derogatory and simply weird: up the pole (first used to denote pregnancy in Ulysses), bun in the oven (or, in French, ‘bacon in the drawer’), knocked up, in pig, in the family way, stung by a serpent.

There was also the trajectory of the thing itself. In a time when haste and choice and control meant everything, a pregnancy could not be speeded up. It was a journey characterised by its length, stubbornness and difficulty, and an ascent that had to be undertaken all the way to its peak. There was no veering off course. The journey was laid out before me: charted by nature herself. Though mountaineering had historically been seen as the most masculine of sports – the need to conquer, to get to the top and survey the world from its ceiling – here was perhaps the most challenging climb that the body could make, and it was categorically feminine. I wanted to chart my pregnancy as one might a great journey, follow it as one might a trail. Walk the river all the way back to its source. Find a new route to the summit of Everest. My body would become a map. No, it would become the landscape itself. Its contours would be the topography, each month would become a milestone, each trimester a landmark. I might tick off rare moments with the satisfaction of a birder. I might mark months with the relish of a hiker bagging Munros. I might even enjoy getting lost. And what of birth? It would become the resting place. The end of the line. The top of the mountain. The final destination. The place where the wild things are. ‘The black force,’ as Plath called it in her extraordinarily detailed description of Nicholas’s birth, also at home, in her 1962 journal. ‘I had nothing to do with it. It controlled me.’ And then? The product, the issue, the baby in the barn. 

Later that day Claire and I went for a walk in the Hermitage, an ancient woodland straight out of a Grimm’s fairytale and the kind of sheltered place that is particularly prized in a northern city blasted by wind and haar. The kind you burrow into, which seemed apt for that other journey on which I was embarking. In fact, this twelfth-century former hunting ground would bookend my pregnancy. Exactly forty-two weeks later I would wind up back in this deep green gorge, beating the very same paths on the day I went into labour. 

Even in Edinburgh, where a daily commute through a medieval town carved into ice-age rock makes you somewhat inured to all things old, the Hermitage feels ancient. These are some of the oldest trees in the city, as gnarled and characterful as storybook giants. Ash, beech, sycamore. Weathered, wide, Victorian in age and grandeur. Though wild boar and deer were once hunted here, these days you’re more likely to see locals in Hunter wellies calling on their Labradors, who invariably go by the name of Monty. As usual Claire and I made for an unusual couple, a sentiment so familiar it perversely made me more at home. Like all happy outsiders, I have always felt most myself in the places where I fit in the least. Well, here we were: two women, one British Indian from London, one Scottish, walking that most maligned and working class of dogs, the Staffordshire cross. And something else accompanying us too, a secret, a potentiality. Whenever fellow dog walkers asked a question about our dog, only one of us would be addressed, as though it were unfathomable for both of us to own her. If this was the case with a dog, how would we be seen – or rather not seen – with a baby?

We wandered in a daze, barely talking. I felt that odd commingling of excitement and dread that comes with getting what you want. My belly, as flat and featureless as a field, whirled with wish-fulfilment and a sense of the unknown as our dog thundered up the slopes ahead of us in search of squirrels. Everything as it always was, everything utterly changed. I felt too jumpy even to place a hand on my own stomach, which suddenly seemed to belong to someone else. Despite my long-held belief that a woman’s rights override those of her foetus, I felt that perhaps it did. 

Our news was still new, as unspoken and frightening as a family secret. We were shocked by it, and this too was shocking, for how can something you’ve been planning so meticulously still surprise you when it comes off? The fact is I had been trying to conceive for so long that I had forgotten the point of it all. I was like the fisherman so stunned by the catch squirming on the end of his line that he throws it back in the water. The ritual of the rod, the river and the lure had so consumed me I had forgotten about the fish. And now that I had come to the end of the line, I realised that, like so many ends, it was only another beginning. This, too, was part of pregnancy’s riddle. 

The following morning, just to be sure, I did another test. Another blue cross. Another aftershock, smaller but still seismic. These two tests were my gathering evidence and were infinitely more convincing than anything that was happening inside my body, which seemed like an abstraction next to something so concrete, so external. That pale blue cross meant so much more to me than what was taking place inside a body I no longer knew. I carried those two sticks around for weeks, feared them like a superstitious person fears a rabbit’s foot, for any object imbued with such power resonates with both good and bad luck. Meanwhile I felt nothing. My body remained a stranger. I didn’t feel pregnant, but I did feel altered, like a walking phantom limb. No, even more transported than that. It was as though I had switched places with my shadow and was destined now to follow my body at a slant, disappearing here and lengthening there, climbing up walls or rippling over pavements, lagging behind or jumping ahead. I felt furtive like a shadow, too. Slippery. 

A week later I was at the Early Pregnancy Unit, awaiting my first scan. It is not customary to have a scan before twelve weeks but there was some concern I might have an ectopic pregnancy, one in which the fertilised egg implants outside the uterus. There had been a little spotting but I was oddly unperturbed. I am not given to such boundless optimism but I was already realising something unexpected about my expecting self. Her responses were slower, not in a lumbering, mindless way, but slow like the tortoise who wins the race. I would need to get to know this creature, just as I would need to get to know the one slowing her down. 

As well as all the staid, enduring, Athens-of-the-North stuff, Edinburgh is a city of surgeons. Doctors from all over the world have for centuries been drawn to this small capital hemmed in by the sea on one side and an extinct volcano on the other. It has a medical feel to it that is difficult to place: one gets the sense that a lot of ancient body parts in formaldehyde lurk behind the doors of its elegant buildings. Newness sticks out in what Muriel Spark called ‘the city of Calvinism, high teas and loveless alliances’, destined always to feel like a flash in the pan. 

The Early Pregnancy Unit is at the Royal Infirmary, a particularly brutish example of the new and home to Scotland’s biggest maternity unit. More than six thousand babies are born here every year. As Claire and I arrived I recalled my father, one of those men with a great respect for medicine until it’s being applied to himself, on his first visit to the city. He lifted his large nose, the same one I inherited at birth, and took in a long, theatrical draw of Edinburgh’s particular brew of hops and cold sea air. ‘Hmmmm,’ he said, with a reluctant sense of awe. ‘Smells like solicitors and surgeons.’ 

In keeping with all this, the hospital has a long and illustrious history of delivering babies. It was here in Edinburgh, in 1847, that James Simpson became the world’s first doctor to use ether and later chloroform in a case of childbirth. For this desire to relieve the suffering of women he was condemned, both by the establishment and the clergy who accused him of ‘seeking to rob God of the cries of anguish and the pleas for forgiveness which sinful women require to express during childbirth’. In 1872, two years after Simpson’s funeral, the largest the capital had ever seen, the Edinburgh Royal Maternity Hospital – the first dedicated unit of its kind in the city – opened as part of what was described as ‘probably the best planned hospital’ in Britain. By 1939, almost a decade before the establishment of the National Health Service, the Simpson Memorial Maternity Pavilion had opened next to the main Victorian hospital. It must have been a great source of pride. Indeed, entire generations of Edinburghers, including much of Claire’s family, continue to fondly refer to themselves and their own as Simpson’s babies. 

These days it’s a different story, one of the NHS in microcosm. The original Victorian building is now part of the Quartermile development, a joint venture by a bank and ‘conglomerate’ that houses converted luxury apartments, offices, newbuilds, artisan bakeries, mini-supermarkets and various other aspirations that tend to come with so much glass and stone. The new £190-
million purpose-built Royal Infirmary, funded by private finance, is far away on the southern outskirts of the city and must be reached by car or a long, gloomy journey on a bus mostly populated by pensioners travelling solo. The majority of the site, which opened in 2003, feels as if it’s taken up with a sprawl of alphabetised car parks. Charges apply, of course. 

Anyone who has had the misfortune of going to hospital in the opening decades of this century knows the drill. The walk past the huddle of inpatients who may or may not be auditioning for a Beckett play, smoking outside the entrances in dressing gowns. The revolving doors emblazoned with the inflammatory words: ‘One in three of us has bacteria that can kill!’ Once inside, the shops, providing that ever-present retail hum, which is reassuring at first and then sinister when you remember why you are here. WHSmith, a bank, hairdresser, clothes shop and café selling packet sandwiches and bad coffee. The branding everywhere, a constant reminder that you have entered the age of the hospital as corporation, where patients are consumers and money buys life. The sound of your shoes squeaking over shined floors, as frightening as the boy riding his bike through the corridors of the Overlook Hotel in The Shining. The random patients lying on gurneys along the way, glassy-eyed, resigned, waiting. The feel of an airport lounge, of being manoeuvred this way and that, and the child-like resignation that comes with being told precisely where to go. Except the destinations here are places you hope you will never visit in your waking life. Neurosurgery, dialysis, palliative care.

When we arrived at our destination we sat beside two other sets of couples, avoiding eye contact as is customary in any British waiting room where there is a common purpose. I had been told not to go to the toilet as a full bladder makes for a clearer scan. And so we all sat sipping water and crossing and uncrossing our legs with the choreographed rhythm of characters in a BBC comedy sketch. My eyes were drawn to a poster – a warning about something or other – of a woman’s distended belly in close-up. A bump, as it is known in the oddly disembodied language of pregnancy. The most rotund of tundras. Her belly button, once a deep pool, had flattened into a crater on an arc of pale moon. There was a vertical, not-quite-straight line running from rib cage to pubis. A ley line across an open field. And in the midst of this awesome bodyscape a hand, tiny and perfectly formed, reaching out through skin. A starfish drifted up from the bottom of the sea. A disturbance at the earth’s core. I reacted to that poster like a healthy person reacts to illness. It seemed impossible; like something that could happen only to someone else.

Inside the examination room the routine began. Some blood was taken from my arm to test how much of the pregnancy hormone hCG, the one that produced those two blue crosses, was present in my body. A hell of a lot, which was why I was starting to feel sick. This is the hormone that creates the cells that make a placenta, the great bloody sea sponge that feeds a foetus for nine months. I lay down and a cool, clear jelly was applied to my stomach by a woman with an inscrutable face. She moved a small device called a transducer around like a gold-panner searching for treasure, homing in on particular areas and pressing down harder than I expected. She looked not at me, but at the monitor to her left. The room, like her face, was lit by its screen. This, combined with the drama of it all, made it feel like we were in a cinema. Claire and I even held hands in the dark like sweethearts on a first date. I held my breath and experienced the same delicious anticipation that comes when waiting for a movie to begin, the same delicious shyness felt when touching someone in the dark without looking at them. 

There was no film to be seen. It was too early in the pregnancy and also I was told I had a tilted uterus. This would prove to be a characteristic experience of pregnancy: finding out bewildering facts about the body I thought I knew so well, usually divulged in such a mundane way that I wouldn’t even think to ask what any of it meant. It was like opening my back door and discovering a whole new world in my garden. A tilted uterus. Claire asked if it would prove a problem during labour. That she was thinking so far ahead, already, shocked and touched me in equal measure. The answer was no. A tilted uterus was just as normal and healthy as one that didn’t tilt. I listened to this short discussion about my womb with complete detachment. I had no idea what they were talking about. 

The sonographer asked if I would consider an internal scan. I agreed, and removed my underwear, put my feet together, and dropped my knees. What felt like a speculum was inserted inside my vagina and up against my cervix, a tightening sensation familiar from years of smear tests, and the next thing I knew my uterus was on the monitor, a pulsing, shifting sea of grey and foamy white. It was the most perfect thing. It looked so much like every other uterus in the world that it was hard to believe it was mine. This was my first view inside myself, yet I found it hard to grasp that it was my view, and it was of me. It reminded me of the first time I went to New York. Approaching the city from JFK, a tin can of an airport, in the requisite yellow cab driven by the requisite talky New Yorker, the famous skyline came into view. Steps in the air made of skyscrapers. New York, New York. Taxi Driver. Breakfast at Tiffany’s. Sex and the City. I saw the things I couldn’t see – a bridge over water, the Statue of Liberty punching the air, steam rising from drains, doormen blowing on their fingers outside Art Deco apartment blocks. The view was too iconic, too familiar, too obscured by its own image. It was superimposed on itself. I couldn’t see it with my own eyes. I couldn’t own this most famous of cityscapes for myself.

The same thing happened in that darkened room, looking at my own uterus. It was too iconic. Too womb-like. Too much its own metaphor. The more I saw, the less I saw. But there was more. In the upper left corner, if you could call it a corner, a tiny oval with a dot in the middle. A cartoon fried egg. An eye. The tiniest of black holes. It needed a professional eye to be seen, but once pointed out it was undeniable. My own little Big Bang. The beginning of it all. 

We were sent back out to the everyday world of car parks and bodies you can’t see inside with a scrap of paper. It looked like a handwritten receipt, the kind you get when you buy a piece of secondhand furniture. And just like a receipt, it was immediately lost in the nether regions of my bag, never to be seen again. But I remember exactly what it said. Pregnancy sac. 5–6 weeks. 6mm long. Three lines of terse, exquisite poetry. And not a metaphor in sight.