Trigger warning: If anything about a prenatal doctor's appointment might be upsetting for you, please read the note at the end of this chapter before proceeding.
"You can look at a picture for a week and never think of it again. You can also look at a picture for a second and think of it all your life."
— Donna Tartt, The Goldfinch
Rory's palms were clammy as she tried to focus on the tiny TV in the waiting room at the doctor's office. She shifted in her seat, unable to get comfortable, wondering how long they'd be waiting. She wondered if she should've brought her old copy of Swann's Way; she probably could've finished the whole thing by now.
"Daytime TV commercials are the worst," Lorelai said, leaning toward her. "Let's make a bet. Loser buys pie. I bet the next commercial is for one of those fake colleges. No, wait, super-sketchy car loans. No, wait, mesothelioma lawyers!"
Rory gave her a serious look. "Can we just sit here quietly? I really just want to sit here quietly."
"Silence it is," Lorelai said, closing an imaginary zipper across her lips. She looked aimlessly around the room. There were a couple of visibly pregnant woman, one by herself and the other with her husband, and a few older ladies. The lighting was fluorescent, and a big pump bottle of hand sanitizer sat on the counter. There was no coffee.
The next commercial appeared. "Are you looking for a program to teach you computer skills and change your life?" the voiceover said. Lorelai grabbed Rory's arm but made a pained show of keeping her mouth shut.
"That doesn't count. You changed your pick twice." She sighed. "Okay, fine, guess the next one."
"Rory?" a nurse called. They jumped up, practically before she'd finished the second syllable. Rory followed the nurse down the hall, and Lorelai trailed Rory.
"I'm going to leave you here with Jeannie, who's going to take some blood. When you're done, you can use the bathroom directly across the hall to give us a urine sample. Then you can meet me in room 4."
Ten minutes later, Rory and Lorelai were in the exam room. The nurse handed her a pile of documents. "This is a pamphlet about cord blood banking. These are some forms you need to sign before you leave today. This is the information you need to make an appointment for your next ultrasound and genetic testing - you'll get an ultrasound here today, just to confirm the pregnancy, but the next one is at a different office," she recited. Rory nodded along. Research cord blood banking; fill out forms; make an ultrasound appointment. She added them all to her mental list and would put them on her actual list as soon as she got home. Right after 'Call Logan.'
"Here are some samples of prenatal vitamins," the nurse said, handing her a plastic bag with a few boxes in it. "Try them all and when you find one you like, give us a call and the doctor will prescribe it." Rory took the bag and handed it to Lorelai. She was already taking prenatal vitamins; she'd read about the importance of folic acid during pregnancy. But maybe the prescription ones were better. She'd look into that too.
"Now I just need to get some information from you," the nurse said, bringing up Rory's file on the computer. She recorded the basics, like height and weight, and took Rory's blood pressure. "When was the first day of your last period?" she asked.
"Um," Rory said, thinking. She never really kept track, but her birth control kept her periods pretty regular. Until it failed completely, of course. She scrolled through the calendar on her phone; she knew she could pinpoint the date because she ran to the store for tampons and picked up a gyro at Al's on the way home, and he only did Greek on the third Saturday of the month. "September seventeenth."
"Okay," the nurse said, typing. "That gives us an estimated due date… of June third."
"Oh, no," Rory said, horrified. She turned to Lorelai. "June third!"
Lorelai closed her eyes and shook her head and half-laughed. "June third," she said, rubbing Rory's back to reassure her. "Perfect date. It'll be fine."
Rory crossed one arm over the other, rubbing her elbow, shoulders scrunched. "It seems like a bad omen to me."
The nurse squinted at the screen. "Oh, wait, I clicked the wrong date." She corrected it. "It's June twenty-fourth, actually. Sorry."
Rory's shoulders relaxed. "Much better."
"Let's stick with that one," Lorelai said. "Sold. Final answer."
The nurse was probably immune to nervous rambling, working in an OB-GYN's office. She continued: "So you're probably around eight weeks along. The due date is just an estimate, anyway. The doctor will give you a firmer date when she does the ultrasound. If you download one of the pregnancy apps it will tell you how big the baby is each week. I think eight weeks is a raspberry." She held up her thumb and forefinger, holding an imaginary raspberry between them.
"A raspberry?" Rory touched her stomach, awed.
"You think that's cute now, but wait until it's a watermelon," Lorelai interjected.
A few minutes later, Dr. Bell entered with a brisk knock. She was older than Rory but younger than Lorelai, warm but no-nonsense, and Rory could see why someone might want her in the room as they were pushing out a baby.
Dr. Bell got right down to business. "I can see that you got all the paperwork. And before you leave we'll do an ultrasound. But first I want you to ask me any questions you might have. There's a lot of information out there about pregnancy and I know it can be overwhelming."
"Great." Rory pulled a notebook out of her bag. "I have a lot of questions. Exactly how much caffeine can I have? Oh, and which pregnancy books do you recommend? How many appointments will I have throughout my pregnancy? And what are your thoughts on the whole debate about inducing before forty-two weeks?"
Dr. Bell laughed. "Let's start with the caffeine." She answered each question patiently, and Rory took three pages of notes.
"I think that's it," Rory said, double-checking her list. "What's next?"
The doctor smiled. "Just the ultrasound. And based on your dates, we should be able to see a heartbeat."
Rory's stomach fluttered.
"This ultrasound is transvaginal," the doctor said, gesturing at the probe attached to the machine. "It shouldn't be painful but it might be uncomfortable. I'll be back in a few minutes." She handed Rory a paper lap cover and stepped into the hallway.
Rory undressed in silence and sat on the table, paper over her lap. The room was chilly, but the temperature wasn't the only cause of the goosebumps on her arms.
"There are so many jokes I could make about that thing," Lorelai mused, looking at the probe.
Thankfully the doctor returned before Lorelai could pick one. "Let's see this baby!" She turned off the light and sat in a rolling chair.
Rory's heart was beating fast as she put her feet in the stirrups and laid back. "Mom?" she said faintly.
"Yeah?"
"Can you take a picture of the screen?"
"Oh, she can take a picture. Or even a video. Sometimes they move around," the doctor said.
Lorelai squeezed her shoulder and pulled out her phone. Everybody turned to look at the screen.
"If you feel any pain at all, let me know. I'm going to insert the probe now," the doctor said.
Rory craned her neck to look at the screen. This is the first time I'm going to see my future child, she thought. She didn't know what to look for. There was some black, and some fuzzy white, and a big dark circle in the middle.
"Okay," the doctor said. "Let's see —"
She was quiet, clicking around the screen. Lorelai stood next to Rory, phone ready to take a photo. Rory watched the screen.
"Let's see — I'm having a little trouble — hold on," she murmured. She adjusted the probe. "Oh, there — wait, I thought I saw it," she said. She clicked and clicked and was quiet again. "Sometimes this machine is tricky — let me try…"
Then she flipped a switch and parts of the screen lit up red and blue. "This just checks for blood flow."
She kept clicking.
"Have you had any bleeding or spotting?" she asked.
"No," Rory said, and it started to dawn on her that this wasn't going the way it was supposed to go. She looked at her mom's face; Lorelai was squinting at the screen. She laid back and looked up at the ceiling, feeling like she'd just swallowed something very cold. She was distantly aware of the fact that the doctor was wiggling the probe around to change the view, but the feeling didn't register.
Each click of the mouse was deafeningly loud in the church-like silence. Eventually Lorelai lowered her phone and put it in her pocket. Rory felt acutely like something she'd been holding tightly had slipped out of her grasp and out of sight.
The doctor withdrew the probe and took off her gloves. She turned on the light.
"It's possible that you're not as far along as we thought," she started. "A week can make a big difference this early."
"I only had sex once after my last period," Rory said. "The dates — the dates can't be that far off."
The doctor nodded. "Okay. Well, we're going to do another ultrasound in a few days, and some blood tests to confirm. But if your dates aren't off, then it's likely what's called a missed miscarriage. It's when you miscarry but the body doesn't recognize it." She patted Rory's arm. It was a practiced pat, one she'd probably delivered a thousand times before. "I'm so sorry."
"Oh," Rory said.
She launched into an explanation, something about hormone levels and chromosomes and a lot of other things that didn't matter, and Rory heard none of it.
Lorelai nodded along the entire time. "So, what happens next? She just has to wait until she starts bleeding?"
"She can," the doctor said. "But there are other options. If you wait it out, it may take weeks. Or I can give you some medication that will make it happen. You will probably have painful cramps, and there will be a lot of bleeding. Or you can have a dilation and curettage, or a D&C, which is a minor surgical procedure where we'll remove the contents of your uterus. That would be my recommendation, but it's your choice."
Her choice. What a choice. What a joke.
The doctor stood up. "I'd like you to come back on Friday, okay? Make sure you stop by the front desk on the way out. And take all the time you need in here. No rush."
She left the room and shut the door behind her.
"Maybe it's just off to a slow start," Lorelai offered. "She didn't say for sure."
"She said, 'Take all the time you need,'" Rory said flatly. "It's over." And then her face crumbled and Lorelai wrapped her in a hug and she cried. For something she'd never intended but readied herself to embrace. For a stupid body that perpetrated a lie. For a door that had just closed, resoundingly, in her face. It felt so real, but it wasn't even real enough to bleed.
Trigger warning: For those who scrolled down from the top, this chapter contains an account of a prenatal doctor's appointment at which Rory learns that she has had a missed miscarriage. It does not describe any of the physical symptoms of miscarriage, but it does describe the experience of a transvaginal ultrasound, being informed that a missed miscarriage has occurred, learning the options for treating the miscarriage, and the initial emotional reaction. If reading about this may be distressing to you, you may want to skip this chapter and the next one, which will describe more of the emotional aftermath and some of the details of the experience of a D&C.
For everyone: Miscarriage is heartbreakingly common. Almost a quarter of all clinically-recognized pregnancies end in miscarriage. It happens to people whose pregnancies were planned; it happens to people whose pregnancies were unplanned. It happens everywhere, every day. My goal in this chapter and the next one is not to get rid of Rory's pregnancy for the sake of plot convenience, but rather to do justice to the portrayal of an experience that is so prevalent.
