The night before my routine ultrasound, I cried for two hours, as waves of sadness crashed over me, and took me deeper and deeper into a sea of grief, a grief so deep there were no words, only tears, a grief so deep I couldn't reach its center. Finally, exhausted I slept. I dreamt then that I began to bleed, and a small amount of tissue flowed out with the bleeding.

When I awoke in the morning, I remembered the dream, but since I wasn't actually bleeding, I wasn't very disturbed by it. Rather, I found myself still overcome by the waves of grief crashing over me. I went about my day fighting back tears, but since I couldn't identify the source of the grief, I didn't allow myself to cry.

"We have a problem," the doctor informed me That afternoon, I went for the ultrasound. As I lay on the table, I eagerly watched my baby appear on the screen. There was its head, its spine, a mystery finally revealed. Although we don't usually find out a baby's gender, I was overcome by a feeling that this time I would find out, as though after this ultrasound there would be no more mysteries.

"We have a problem," the doctor informed me. And slowly he broke the news that the baby I was now seeing had in fact passed away a month previously. For the past month, I had been carrying a baby who was already dead. Impossible, I thought. How could my baby have died, and my body not have known? And yet I remembered the dream, and the waves of grief that had crashed over me all last night and this morning. My body had known. My body had been trying to tell me, to prepare me for this moment. Finally I understood the source of my pain. Finally I cried.

I met with the doctor and we discussed the problem. Obviously, the situation could not continue. The baby would need to come out. Usually, in such cases, the mother's body spontaneously begins to expel the baby, but since my body had not, I would need to go into the hospital for medical intervention.

At almost six months, an induced labor seemed the best solution, although another procedure also existed, of removing the baby under general anesthesia. Not every hospital performed the procedure, called D&E, at this stage. The doctor recommended that I return home, and call the hospitals in the morning to make an appointment. Obviously, if I began to bleed, I should go straight to the emergency room.

I returned home, convinced that now, its message finally revealed, my body would act as in the dream, and begin bleeding. But no, in the morning I called the various hospitals, and discussed the options they offered. The thought of going through labor with no baby to birth seemed intensely sad, and made the D&E more appealing. Yet the thought of the baby being removed while I was unconscious seemed somehow like a rape, an intrusion on my body's right to say goodbye to the baby it had nurtured for almost six months. I sensed my body's need to be involved in this process, despite my natural aversion to pain.

I could not carry this baby for another week Furthermore, no appointments for a D&E were available for a full week, and I could not carry this baby I now knew had died for another week. I accepted one hospitals' option for an induced abbreviated labor.

The messages were confusing. This would be a labor, this would not be a labor, there would be contractions, there wouldn't be real contractions, essentially I would lie in bed, and the baby would fall out. I would not need to push.

After a chemical substance was introduced into my uterus, I was told to lie. A painkiller would be available if I needed it. Almost immediately I was gripped by powerful and intense contractions, made excruciating by my immobilized position. Here was labor as I had always dreaded and avoided in my previous active and informed labors. Unable to use movement to cope with the pain, which had begun with no buildup, I accepted the painkillers.

I was transferred back to my room to labor until the baby would come out. Painkiller was administered intravenously, but now I was told, having accepted painkiller, I was forbidden to get out of bed. Still, I utilized every position available to me while technically remaining on the bed. I rocked through my contractions, and for a time it helped. Still the intensity built until I felt an intense need to move in a way the bed did not allow.

I had briefly considered taking a labor coach to the hospital, since I didn't really understand what I was getting in for, but I found it hard to ask someone to accompany me into the unknown. I regret this now. The induction procedure ushered me into an intense and active labor, for which there had been no preparation, as in a natural labor in which the body slowly accustoms itself to the successive stages of labor.

Despite what I had been told, this was indeed real labor. I was shaking, vomiting, and in severe pain.. Defeated I accepted the next level of painkillers, narcotics, which I was assured would remove the pain entirely. The narcotics administered, the sides of my bed were now put up to ensure that I wouldn't fall out. Luckily for me, one side was broken, which would ultimately provide me with an escape from this nightmare of passive, bed-confined labor.

I slept, waking up to experience intense contractions which the drugs did not relieve The next few hours passed in a drug induced haze. I slept, waking up to experience intense contractions which the drugs did not relieve, only to fall asleep immediately afterwards. I lost all sense of time and self. I was still experiencing pain, but I was powerless to respond to it in any way.

Yet a sense of betrayal remained. They promised me the narcotics would take the pain away, and they didn't. In rebellion, I crawled out of my bed, into the comfortable armchair at the side of the bed. I rocked in the armchair, dozed, and woke to powerful contractions. I was still caught in a nightmare, and yet I felt more in control, more self-aware, more supported by the armchair in which I had chosen than the bed they had forced on me.

Hours later, the narcotics began to wear off. During all this time, no staff had come to check on me or inquire about my well-being. I was very much alone. My husband offered as much support as he could, but he was as clueless as I was to what could really help. As the medicine wore off, I realized that labor is comprised of two simultaneous processes – a woman in labor and a baby being born. Here, in this labor of darkness with no birth to focus on as the reward for this pain, there was only one process – my labor and how it would proceed. The medical world has always been blind to the dual nature of this process, and now with no birth to monitor, they were oblivious to the reality of the labor proceeding in room 116, or the experience of the woman who labored there.

As the narcotics relinquished their hold, I was faced with a decision as how to proceed. I was still experiencing painful and intense contractions. I knew I had to make a choice. I could take an epidural, and relinquish control completely, in the hope of finally being pain free, or I could take an active role, get up, and begin to use gravity and movement as I had learned in my previous labors of light to advance the labor and help it progress. I wanted help deciding. I wanted to know how much progress had been made. I sent my husband to ask a nurse to come check me.

I was angry. I was abandoned. I was alone with no guide. My husband returned alone. The nurse had declined to come, saying that since I did not have to be completely dilated for the baby to come out, there was no point in her checking. I was angry. I was abandoned. I was alone with no guide, except for my previous experiences in labor. I prayed for strength.

I sensed somehow, that my labor had lost its momentum during the hours that I had drifted in a narcotic haze, and that if I would continue to not respond to the contractions in an effective manner, the labor could continue indefinitely. My husband felt the same way.

I also found myself prepared to deal with these contractions in a way that initially I was not. My body had become accustomed to the pain, and regained its equilibrium. I no longer needed to escape this pain, which had begun so suddenly and intensely. Now I could cope with it.

I was suffering. I decided I had to act. I would tell no one, but I would begin to actively push the baby out. They had told me I would not need to push, but it had not been true. I would push this baby out. Alone, I would deliver this baby, and thus bring an end to this seeming endless pain. I could not bring my baby into the world the way I had envisioned, but I could bring myself out of this labor.

My decision was strengthened by another conviction that I wanted to hold my baby in my arms, and say goodbye before we parted, and though my contact with the medical staff had been very limited, nevertheless, I sensed that they would not approve of this decision, and would perhaps even attempt to prevent it. But my body had carried this baby, and I believed it deserved an opportunity to say goodbye.

I went deep into myself. I told my body that it was time to release this baby. The baby had already been dead for a month as my body continued to hold on. But it was time to stop being pregnant now. It was time to move on. I willed my body to let go, just as I had in previous labors when I had told myself to open up and let the baby be born. Now I told my body that it was time to give this baby up, to let the baby go to the next world.

I told my body again it was time to let go I got up. I walked around. I tried different positions. I went back and forth to the bathroom. Soon I was in constant motion, not sitting, just moving, rocking, walking. I went back to the bathroom. Alone in that room, the door closed to the world, I told my body again it was time to let go. I pushed, and the baby came out easily, still encased in the fetal sac. I held it in my hand, and felt its tiny head and spine, that I had seen on the ultrasound monitor. I said goodbye.

Then I came out of the bathroom, and told my husband to go tell the staff the baby had come. The nurses came in hysterical. How had this happened? Why hadn't I called them? How could I stand there, holding my dead baby? Why didn't I care that I was bleeding? Why was I not in bed? Why had I not done things their way?

I took a shower. I got into bed. Their hysteria was far away from me. In their decision not to be part of my labor, in their declining to come check me and help me make the decision as how to proceed, they had lost the right to be part of when and how this labor would end.

That decision was made as it began, in a private conversation between my body and myself, when my body first began to communicate its deep waves of grief.

I write this story, which is not a birth story but a story of labor, and how a woman can choose to communicate with her body even in a time of pain, sadness, and deep loneliness. Even in a hospital environment that is alien and hostile to that communication process. Even if initially she gives up the right to that communication.

"And as I walk through the valley of death, I will not fear evil, because You are with me" (Psalms 23:4). Some labors are a walk through the valley of death. But we can still walk upright and with dignity, knowing that G‑d walks with us. I don't know why I had to make this walk, but I know that I needed to make it consciously and actively, to escort my baby into the next world.

Goodbye baby. I'm glad I got to hold you, if only for a moment. I'm glad I overcame my fear of pain so I could consciously labor to bring you release from this world.