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A Piece of My Mind
April 27, 2021

Becoming a Mother and Gaining Perspective

Author Affiliations
  • 1Ann and Robert H. Lurie Children’s Hospital of Chicago, Chicago, Illinois
JAMA. 2021;325(16):1611-1612. doi:10.1001/jama.2021.5160

I met my daughter 3 days after I birthed her. Nobody expected me to meet her at all. In the preceding hours, I survived her emergency delivery, more than 6.5 L of blood loss, a failing liver, kidney injury, and a second emergency surgery. My family flew in from around the country as my husband prepared to be a single parent. I was expected to die on the day my daughter was born.

After taking my first shower in a week, my husband combed my hair and wheeled me down to the neonatal intensive care unit (NICU) to meet our tiny, mighty daughter, Juniper. In the hallway, nurses nodded their heads at me, knowing exactly who I was—I was the only mother in the NICU who hadn’t yet met her child. I was the patient who drove terrified residents out of obstetrics. I was the patient who demanded to look at the x-ray confirming her own endotracheal tube placement and who reminded the ICU team to check her ionized calcium while receiving her 11th unit of packed red blood cells. I was the case that would change the hospital’s management of acute, massive, postpartum hemorrhage. When we arrived at Juniper’s bedside, I stood frozen next to the clear, plastic box as I struggled to find the right words. “I love you” didn’t feel quite right.

Throughout pregnancy, I had dreamt of this special moment when we met for the first time. What actually occurred was far from the joyful image that I had envisioned. I hadn’t heard Juniper cry when she was born. She didn’t do so, and I wasn’t alert enough to hear her even if she had. Her newborn body wasn’t placed on mine moments after she arrived; instead, she was rushed to one intensive care unit and I to another. So, instead of saying “I love you,” I introduced myself. Juniper was placed on my chest, my left hand covering her entire 2-pound body. “I am your mother.” I said it again and again, tears streaming down my cheeks, recognizing the weight of these words.

I always thought I was prepared for motherhood. For years, I had pictured myself, a pediatric intensivist, as the ultimate protector and advocate. But at the end of each shift, someone else arrived at the hospital to take my place and continue the job. Motherhood is different. There is no revolving door, no downtime after a long shift, no protected time to handoff to the next clinician. Motherhood is a one-way street with no map of the curves or potholes or open road ahead.

I sat there with my eyes closed, imagining Juniper’s life and thankful for mine. I thought about the first time I would see her face without respiratory devices and tubes taped to her cheeks. I thought about driving away from the hospital as a family of 3; the first time she’d call me “Mom” and say, “I love you”; and inevitably, a few years later, “I hate you.” I looked forward to experiencing the world through her curious mind. I thought about being able to teach her right from wrong and good from bad. I wanted her to know her self-worth, be happy, and feel loved and protected. And then…my thoughts were interrupted by beeping monitors and the cry of another premature baby, muffled only slightly by the curtain between us.

My joyous introduction to motherhood was threatened by an unexpected preterm birth and unnatural newborn experience. We were isolated and alone. Instead of extended family waiting in the lobby with balloons and hugs, hospital visitation policies during COVID-19 physically distanced us from our support systems. Because my own traumatic experience was too painful to share with others, I felt emotionally distanced from friends and family—too exhausted, sad, and weak to explain. On our first night home after I was discharged from the hospital, my deflated body stood next to my husband’s and our newborn’s empty bassinet.

For the first 46 days of Juniper's life, I was replaceable—a mere bystander. A donor supplied breast milk for nutrition while I healed. I felt guilty that I was not the one supporting my daughter’s growth and development and simultaneously grateful for such a generous gift. My womb was exchanged for a warm box, technology replacing biology. My protective eye was superfluous as her heartbeat, oxygen saturation, blood pressure, and respiratory rate were constantly displayed in neon numbers on monitors above her head. Someone else changed her diapers. I never thought I’d yearn for that responsibility. But alas, all my husband and I wanted was to find some bit of normalcy in the extreme environment into which we were thrown.

I grieved the loss of control and everything I had expected from childbirth. It was painful—the emotional trauma far worse than the physical. As a physician, I knew that Juniper was where she needed to be, no matter how I wished otherwise. But knowing and accepting are 2 different things. Only after I accepted this wrenching reality was I able to begin to heal. Delivering her early, quickly, and safely and allowing her to recover and grow in the arms of strangers was the most altruistic gift I could provide. Our distance from each other was necessary so, when the time was right, I could be present to care for Juniper.

And then one day, we left the hospital behind us. It didn't feel like that day would ever come. This game of watching, waiting, taking 1 step forward and 2 steps backward, and all the while being patient is not unique to my situation. All physicians, patients, and advocates for loved ones experience it; however, not everyone experiences all roles at once. As a physician, it's easy to glibly say, “It'll be OK,” completely devoid of understanding how vague and vapid those words are. As a patient, there is nothing you can do for yourself. Your care is in the hands of others, who you pray are well-trained and well-rested. After all, your life depends on it. As a parent to a child in need, your role as caregiver is diminished and you hope that surrogates are warm, loving, and nurturing.

The perspective I’ve gained from being a critically ill patient and new mother is an invaluable education on vulnerability and advocacy, neither of which can be taught in a classroom or textbook. This experience will make me a better physician, listener, partner, and parent. It has taught me to be more patient, provided me a deeper empathy for advocates, and instilled in me the importance of acknowledging uncertainty. I know this story will become part of our family’s history and that this is only the beginning. With time, this experience will become a distant memory, nothing but a stepping-stone on what will become a long, beautiful life together.

Section Editor: Preeti Malani, MD, MSJ, Associate Editor.
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Article Information

Corresponding Author: Lauren Rissman, MD, Ann and Robert H. Lurie Children’s Hospital of Chicago, 225 E Chicago Ave, Chicago, IL 60611 (lrissman@luriechildrens.org)

Conflict of Interest Disclosures: None reported.

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