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be a bright(er) landscape. As the hours passed, I continued in my necessary retreat inward, focused on my breath. This pain is purposeful, on loop. Breathe. In and out. This pain is purposeful. It is normal. Everything is okay, I’d silently encourage. I can do this, I’d reassure myself. We can do this.

And finally, there she was. My daughter. Just after nine o’clock in the evening, midway through a strong push, sweet Noa Raye came into the world, curious and calm, and mere hours after a rainbow so fortuitously glowed outside the window of my hospital room. My rainbow baby. Here. Safely. The little being who’d spent the preceding nine months growing, thriving, and kicking about inside my body. I’d spent those months in varying degrees of unrelenting fear, but within moments of catching her and bringing her to my chest, the energy swirling inside me began to shift. I exhaled. Not all the way, of course. What I’d lived through to get here was as poignant and real as ever before.

Immediately following her arrival, Noa snuggled up on my chest and began suckling. I was in awe of her. I lay back on the hospital bed, my girl cozy in my arms, and drank in this surreal moment: her vernix-covered body, the sound of her breath as I fondled her little toes, and the fact that I’d actually made it to the other side of pregnancy.

About thirty minutes after Noa’s arrival, the nurse brought her from my arms over to the counter to be weighed and measured. Suddenly, I was propelled back into a state of fear. I couldn’t hear Noa. “Is everything okay?” I asked, panicked as the nurse weighed her. “I can’t hear her. Why can’t I hear her? Is she okay?”

Even though Noa had made it earthside, my angst pressed on. In fact, it instantaneously morphed into something else altogether.

“She’s just taking it all in,” the nurse said lovingly. “She’s just looking around. Calm as can be.”

Gobsmacked by these feelings, I was truly taken aback that I was not in the all clear of these exhausting concerns, but I gently reminded myself to breathe. She’s here, on loop, she made it. These compassionate thoughts rivaled the discordant refrain of what-if what-if what-if that I had expected would be quieted upon her arrival.

I was suddenly face-to-face with the realization that yes, she’d made it through pregnancy and into the world safely—But how will I know if she’ll last?! It was unnerving to witness myself transferring the fear from pregnancy to newborn in real time: Maybe she was safer on the inside, I pondered. Perhaps the pregnancy worry was a waste after all, and what I should have been even more concerned about was her staying alive upon delivery.

I didn’t see this coming: the next dimension of trauma. What I’d have to see through experience was the fact that what I’d thought was the finish line was actually the start of another marathon altogether.

I’d heard stories about sudden infant death syndrome and rare, fatal diseases of babies within the four walls that make up my office, but only now did those narratives make their way into my bloodstream via cortisol, into my now-deepening well of worry.

• • •

As time went on and Noa grew little by little, the way I thought about my loss and the fragility of mortality morphed. With this darling daughter of mine earthside, I couldn’t help but study her in deep awe, marveling about the fact that this beautiful person wouldn’t have joined our family had my first daughter made it. Such a mind-bending, existential road I had found myself on.

Navigating motherhood in the wake of Noa’s birth was, for a time, excruciatingly uncomfortable. It was as if a piercing alarm bell had gone off and was ringing at a pitch no one could ignore: the sound was a constant reminder about the vulnerability of life. No amount of thick skin could be located. It was all just too raw. Anything can happen at any time, I’d think. Where had my capacity for denial gone? It was one thing to parent Liev after my loss, but now with two little ones underfoot and a world of angst brewing inside, I struggled to maintain a sense of calm.

In those years when Liev was our only child, I was free of this great worry, but now, with two lives to raise and protect (and the loss under my belt), I found myself deluged by hypervigilance—deeply porous and more anxious than I’d ever been before. The cacophonous symphony of what-ifs was a constant, and fear-based thoughts popped in at inopportune times. Autopilot and denial eventually kicked in to help me master my days as a mother of two, but it took a while before I could quell the sound of those alarm bells that were ringing all too often, robbing me of the poise I’d had when I was a mother to one and no other. Post-loss motherhood: a whole different ball game.

• • •

As time moved forward and my feet steadied on the ground, I finally had the chance to fully relax—to unclench my teeth, release the morsels of antagonistic anxiety, and marvel at Noa’s existence in a state of peace. I fell hard in love with her, and Liev was taking his newfound role as big brother in stride. I was feeling much more like myself and was well into the swing of my clinical practice again. I was back in the saddle. But on occasion, something seemingly mundane would flip a switch, and I’d find myself thrust right back into that post-trauma, distressed state of mind. Seeing this in my patients was one thing—I knew how to reassure them that what they were feeling was, in fact, normal—but when it was me, knee-deep in flashbacks or flooded by anxiety, I had a difficult time deciphering up from down, left from right, what was real and what my anxiety was manifesting.

Our grief doesn’t dissipate overnight,

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