"Am I Normal?" Understanding Your Reactions After Loss

Bianca Stifani, MD MPH FACOG

Bianca Stifani, M.D., M.P.H., FACOG, is a board-certified obstetrician-gynecologist and complex family planning specialist. Originally from Italy, she grew up in Belgium and moved to New York since 2002. Dr. Stifani is passionate about global health and has worked in multiple countries throughout Europe, Africa, and Latin America. She also loves conducting research about reproductive health and teaching research methods to residents, medical students, and other faculty members.

Colleen Denny, OBGYN

Dr Denny is double board-certified in obstetrics and gynecology and complex family planning. She is a fellow of the American College of Obstetricians and Gynecologists and a member of the faculty of the NYU Grossman School of Medicine. She is passionate about teaching and mentoring the next generation of gynecologists and obstetricians, and has received many resident physician and medical student teaching awards over the years. As director of the family planning service at NYU Langone Hospital—Brooklyn, she works hard to make sure that people can access time-sensitive reproductive healthcare quickly and smoothly.

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Volunteer also expressly waives any claim for compensation, whatsoever, including Disability Benefits or liability on the part of Knafayim for such services as a Volunteer.

Medical Treatment
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Volunteer (and Guardian) understands that, except as otherwise agreed to by Knafayim in writing, Knafayim does not carry or maintain health, medical or disability insurance coverage for any Volunteer. Each volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.
Volunteer (and Guardian) also understands that Knafayim does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness.

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Volunteer (and Guardian) understands that all such information must be treated as confidential.
I agree not to disclose confidential information to any person or entity for any reason or purpose whatsoever, except when authorized to do so on writing. I will also make certain that any disclosures are made in a private setting in which no one can overhear any information that is conveyed. I understand unauthorized disclosures are considered grounds for immediate termination of volunteer status.

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I authorize Knafayim and/or its agents to make an investigation of my background, references, employment, education, and criminal history record information which may be in any state or local files, including those maintained by both public and private organizations, and all public records, for the purpose of confirming the information contained in my application and/or obtaining other information which may be material to my qualifications for placement as a volunteer. This authorization shall remain in effect for as long as I remain an

Employee or Volunteer.
If I am no longer an Employee or Volunteer as a result of any investigative report resulting from this authorization, Knafayim will provide me a copy of that report along with a summary of my rights under the Fair Credit Reporting Act.

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Volunteer (and Guardian) expressly agrees that this Release is intended to be as broad and inclusive as permitted by the local and state laws, and that this Release shall be governed by and interpreted in accordance with the local and state laws.

Any dispute arising out of or relating to this agreement, its interpretation or application, or the breach thereof, shall be settled by arbitration by Knafayim s designated Bais Din as selected by the Board of Directors of the Organization, which may be amended from time-to-time and without notice.

I am aware that Knafayim reserves the right to terminate or modify the conditions of my participation in Knafayim Activities, including dismissal from Knafayim at any time, for any reason, with or without cause, notice or liability.

Release and Waiver
Volunteer (and Guardian) expressly understands and agrees that they are not an employee of Knafayim and they will not receive any compensation or remuneration of any kind for services or duties performed therein.
Volunteer (and Guardian) does hereby release and forever discharge and hold harmless Knafayim its directors, officers, employees, agents, successors, and assigns (collectively, Knafayim, Inc. from any and all liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from any and duties and functions required in the administration of Volunteer€™s position and such other duties, functions and responsibilities as are otherwise directed or specified by Knafayim from time to time (the “Activities”).
Volunteer also expressly waives any claim for compensation, whatsoever, including Disability Benefits or liability on the part of Knafayim for such services as a Volunteer.
Medical Treatment
Volunteer (and Guardian) understands that this Release discharges Knafayim from any liability or claim that the Volunteer (or Guardian) may have against Knafayim with respect to any bodily injury, personal injury, illness, death, or property damage that may result from Volunteer’s Activities with Knafayim, whether caused by the negligence of Knafayim or its officers, directors, employees, agents, or otherwise.
Volunteer (and Guardian) does hereby release and forever discharge Knafayim from any claim whatsoever that arises or may hereafter on account of any first aid, treatment, or service rendered in connection with the Volunteer’s Activities with Chai Lifeline or with the decision by any representative or agent of Knafayim to exercise the power to consent to medical or dental treatment as such power may be granted and authorized in this release.
Insurance
Volunteer (and Guardian) understands that, except as otherwise agreed to by Knafayim in writing, Knafayim does not carry or maintain health, medical or disability insurance coverage for any Volunteer. Each volunteer is expected and encouraged to obtain his or her own medical or health insurance coverage.
Volunteer (and Guardian) also understands that Knafayim does not assume any responsibility for or obligation to provide financial assistance or other assistance, including but not limited to medical, health, or disability insurance in the event of injury or illness.
Confidentiality
Volunteer (and Guardian) understands that in the course of their contacts with families served by Knafayim, Volunteer might learn privileged and confidential information that is of a highly personal nature. Examples of such information might be but are not limited to; medical condition and treatment, finances, living arrangements, employment, identifying information and relationships among family members.
Volunteer (and Guardian) understands that all such information must be treated as confidential.
I agree not to disclose confidential information to any person or entity for any reason or purpose whatsoever, except when authorized to do so on writing. I will also make certain that any disclosures are made in a private setting in which no one can overhear any information that is conveyed. I understand unauthorized disclosures are considered grounds for immediate termination of volunteer status.
Background Check
I authorize Knafayim and/or its agents to make an investigation of my background, references, employment, education, and criminal history record information which may be in any state or local files, including those maintained by both public and private organizations, and all public records, for the purpose of confirming the information contained in my application and/or obtaining other information
which may be material to my qualifications for placement as a volunteer. This authorization shall remain in effect for as long as I remain an Employee or Volunteer.
If I am no longer an Employee or Volunteer as a result of any investigative report resulting from this authorization, Knafayim will provide me a copy of that report along with a summary of my rights under the Fair Credit Reporting Act.
Other
Volunteer (and Guardian) expressly agrees that this Release is intended to be as broad and inclusive as permitted by the local and state laws, and that this Release shall be governed by and interpreted in accordance with the local and state laws.
Any dispute arising out of or relating to this agreement, its interpretation or application, or the breach thereof, shall be settled by arbitration by Knafayim s designated Bais Din as selected by the Board of Directors of the Organization, which may be amended from time-to-time and without notice.
I am aware that Knafayim reserves the right to terminate or modify the conditions of my participation in Knafayim Activities, including dismissal from Knafayim at any time, for any reason, with or without cause, notice or liability.

Raizy Bristowsky

My baby was born and taken directly to the NICU.

Less than 24 hours after she was born, a social worker came to my room to talk to me. She said she was there to guide me on dealing with a baby in the NICU, explained the schedule, and discussed insurance policies. She also advised me to submit my daughter’s birth certificate as soon as possible. She handed me a few pamphlets about insurance, the NICU policies, and Social Security, but I was more focused on her mismatched outfit while following the design on her plaid skirt.

When I thought she had finished her prepared speech and was ready to leave, she took out a stapled three-page yellow booklet, and handed it to me, saying, ‘’You might want to consider placing options for your baby, as her complex medical needs will be too difficult to care for at home.’’ I wanted to yell at her but I remained silent, but I thought, She doesn’t know I’m a good Jewish mother, and I will bring my child home; I will never, ever abandon my child! as images of institutionalized and neglected children swarmed through my head.

I took the booklet and scanned through the list of names I had never heard of before and didn’t know existed, but I was never going to give away my child. I knew I wouldn’t be needing the list- my baby was coming home!
In the few days following her birth, I learned more medical terms than I had known all my life. My baby was attached to many wires. The prognosis was not good, and the medical predictions were very pessimistic. I was also told that her medical condition was too complex to be cared for at home.

With that thought in the back of my mind, not only did I leave the hospital two days after her birth empty-handed, but I returned to a home where no carriage or bassinet awaited a baby’s arrival and where there were no Pampers, wipes and baby essentials.

It was just me, walking back into my house, minus the baby I had carried for nine months; in her place there was only an ache in my heart. The ‘’It’s a Girl’’ balloons in the kitchen were just another reminder of the lack, piercing my already hurting heart.

The next morning, I was back in the hospital to visit my baby. As I walked into the NICU, her nurse asked, ‘’What’s the baby’s name? She needs a name!’’

‘’She doesn’t have a name yet,’’ I responded. ‘’We wait to give a name on Saturday, when the Torah is read in the synagogue.’’

‘’I know, I’ve heard about that, but she needs a name. If you don’t name her really soon, I’m just going to call her Faigy!’’

I laughed and was so touched by how caring the nurse was, but then it took a moment for me to wonder, How do I really know what she’s calling her? She might be calling her Faigy or any other name, and I have absolutely ZERO control over it.

This was my introduction to a new kind of mothering, one that I never really knew existed or dreamed I would ever get to know. As long as I am not my child’s primary caregiver, taking care of her all the time, this is the new reality I was facing, but at that point I was not yet aware that I would not be my child’s primary caretaker.

Until that moment, I had not realized or internalized the ramifications of not taking my baby home. And that was only the firs learning moment. For sometimes I fell that is till have not learned or accepted fully what it means that my child does not live in my house.

I might be the one who names her, but do I really know what she is being called?

At the age of three months, my daughter came home, but not to my home- to her home, a special home where her medical, emotional and physical needs are met 24/7. She is surround be a loving, caring staff at Sunshine Children’s Home, which is first a home and then a skilled nursing facility.

Her home was a very different reality than that of the abandoned children in institutions I had envisioned, but I was right, too – I didn’t abandon or give up my child. I found her a place she can call home.

Yes, I did, indeed, need that booklet. I used it as a reference when inquiring about various facilities. I called the social workers listed there, spoke to them about what their facility offered, and then booked a tour to see the place. Then I went ‘’shopping,’’ visiting numerous homes, speaking to the staff, hearing what they could offer my child, and at the same time getting a feel of the location and trying to figure which one would best fit our needs.

I entered into a new type of motherhood that I never knew existed.

I am her Mommy, and I make all medical decisions, I shop for her clothing and I am in touch with the staff that cares for her. BUT I come as a visitor. Unfortunately, I’m not the one who cares for her on a daily basis, yet I’m the one wo cares about her so much!

Having a child who doesn’t live at home is a roller coaster of emotions; my heart and my brain can at times feel miles away. Logically, placing my daughter was and is the best for her, but that doesn’t mean that it isn’t painful.
I may not be her primary caregiver, but I’m still her mother.

I gave my daughter what no one else in the world can give her. Hashem chose me to give birth to this special child, and I am grateful for the journey on which He has led me. It’s not always easy, but through it all He guides me, navigating me through a kind of motherhood I never knew existed.

I wanted to thank you for last night’s event, but how can I put my feelings of gratitude into words? How do I explain what it meant to be able to just BE and FEEL without judgment or fear of being misunderstood? It was so liberating. Like a good deep long breath to keep going. Your words of chizuk resonated and stayed with me. I keep replaying it in my mind. Thanks tons!!

Thank you so much for your unbelievable concern and support. Your care and guidance was all I needed. I could not have gone through my ordeal without your experience. Thank you for guiding me with my choices and for getting me into Beth Israel Hospital.

I had a stillborn about a month ago and received your binder from the hospital. It was so nice to feel some sympathy and to be able to read poems and articles that reflected the emotions I felt but wasn’t expressing.
What you do is truly beautiful and only Hashem could and should repay you many times over.

I recently joined your group because my daughter had a stillborn baby last month and was told about your organization.

I listened to the past three sessions of the teleconference series and found them helpful and informative. Last night’s talk by Malkie Klaristenfeld was so beautifully done. She expressed the pain and feelings of loss and “how can I go on” that anyone who has experienced this kind of loss knows only too well. She gave us listeners chizuk to strengthen our emunah at a time when it is not always easy to do so. Thank you so much, Malkie.

I, too, had a stillborn baby, albeit forty years ago now, and there was no such group at that time (that I knew of) to help navigate the loss. I tell my daughter that she will be okay again, never forgetting this baby, but with time, learning to factor a new reality into normal living.

Thank you so much for providing support to all those who need it.

It’s not easy putting pen to paper to express such deep feelings of hakaros hatov to you.
Where do I start?
You held my hand from the very beginning…
On that fateful day, as I stumbled out of my doctor’s office, my mind pounding, my insides screaming, it was the slip of paper with your contact info crumbling in my hand as my heart crumbled along with it…
And you were there for me, extending yourself so selflessly in my utter time of need.
You provided me with resources in moving ahead with halachic inquiries as well as medical needs. (I only found out later from Karen how much time and trouble you saved me by booking the appointment from a “side angle.”)
But it was a lot more than that. It was the emotional support. It was like having a life jacket while being thrown into a stormy sea.
As you can imagine, it’s been tough the past few weeks.
I know there’s so much to be grateful for. But the pain is there. So deep and raw. The void! At times, I feel like I’m being swallowed up alive into it. And just when I feel like ‘’I’m getting over it,’’ a new ocean of tears threatens to take complete hold of me.
So I must say your care package went a long way. The heartrending stories reached the core of my being. I cried along with the writers and as each story came to a climax, something within me lit up again.
I found comfort in your CD too. The harmonious tunes managed (to some degree) to soothe my
tormented soul.
I daven with all my heart that no more of our sisters be tested by a loss of my dimension.
Yet, since it was meant for me to go through this, I want you to know that one positive attribute I took out of it is מי כעמך ישראל
A heartfelt thank you

There aren’t enough words in the entire world to express the thankfulness and appreciation we
feel. We constantly felt like you were standing at our side with your kindness,
patience, guidance, and reassuring words.
It was only 2 days until Shavuos and you told us we’ll be done and over by the time Yom Tov comes, and we were!
You got us an appointment in a very short amount of time, when it was after hours already, with an amazing doctor and staff. They babied us and made us feel like we were the only patient at the time.
You sent us a care package within hours of us reaching out to you.
We kept you both on the phone with us, calming our fears, answering our endless questions and you were mechazek us in our greatest time of need.
כל מי שעוסקים בצורכי ציבור באמונה, הקבה ישלם שכרם

When my world shattered and my heart was breaking apart, the dark curtain of utter helplessness was lifted with the warmth and compassion in your voice. The ongoing support through the phone conferences and your weekly texts helped me grope my way through the darkness.
Now, baruch Hashem, when I have a healthy baby boy, I can cry with gratitude to Hashem for my bundle of joy, for sending me a balm for my heart and, of course, for sending me Knafayim to hold my hand.
May you be blessed with continuous health, lots of nachas from your family, and brachah v’hatzlachah for your amazing work. May we hear only besoros tovos.

I have no words but my heart is full of thanks. In this very lonely journey of loss, you have made it a little less lonely. You validated and normalized incredibly painful thoughts and feelings.
As my journey continues and we try again, I know I ride on the wings of hope, chizuk, and support you provide.

Tizku l’mitzvos

I thought I would never smile again…
It’s been five months since I lost my baby. Five months of overwhelming pain and emptiness, of confusion and intense emotions. Five months of learning how to cope and function again, to learn how to adjust to a new me after the traumatic loss.
Knafayim—you’ve been there with me through it all! The conference calls and peer support groups have made a tremendous difference. The tools and support you have given me have empowered me.
I now, baruch Hashem, can smile again, a much stronger and more real smile than before.
Thank you! Thank you! Thank you!
May Hashem continue to bentch you with everything good!

The Empty Sac

Sara Esther Crispe

I had only been married a few months. A lot had been going on since we decided to spend our first year of marriage in Israel. Two months after the wedding, we packed our suitcases and embarked on this journey to the unknown—both in terms of the land and in terms of our life. While I had spent a significant amount of time in Israel, my husband had never been there. And as newlyweds, we were still really getting to know one another in this new framework of husband and wife.

To add to things, we came with about a thousand dollars total in our savings, with no jobs or real idea as to how we were going to survive. We knew that we wanted my husband to be able to spend the first year learning in kollel, in yeshiva, since after that he would not be able to dedicate all of his time to learning. I, therefore, was going to work and support us. However, we never factored into the equation that we arrived weeks before the month of Tishrei, filled with Jewish holidays, and the worst possible month to seek employment.

Our apartment was barely bigger than a shoebox, and with no air-conditioning, it was unbearable in the heat of the Israeli summer. It had been a few weeks with no work, no prospects, and no break in the heat wave, when suddenly I began feeling terribly nauseous.

It took me another week or so to decide to take a pregnancy test, and to my surprise and shock, I found myself staring at two small lines in the window. I was nervous, scared and overwhelmed. As much as I so badly wanted to have a baby, the timing seemed terrible and I wasn’t sure how we would make it. We also knew that in our situation we would have few people supportive of our decision to have a baby right away. To them it seemed irresponsible, premature and entirely inappropriate.

Needless to say, my job hunting now became nearly impossible. Just getting out of bed in the morning was extremely difficult, only to board a crowded bus, feel sick, and find myself jumping off in the middle of nowhere desperately seeking a garbage can.

I was used to being in control of my life. I was organized, kept track of things, and made sure to do what needed to be done. Suddenly, I was a mess. I was forgetting everything, felt and looked terrible, and couldn’t do the most basic task without becoming completely exhausted. I would sleep endlessly, accomplish what seemed to be nothing, and still be tired at the end of the day.

Then one day I noticed the slightest trace of spotting. I didn’t really think twice about it, but then I noticed it again. At this point I decided to call a doctor and ask if I should be concerned. When I was told to immediately get to the office for an ultrasound, I froze.

Until this point, my pregnancy had been a given. After all, I hadn’t been doing anything to prevent it, so of course I was pregnant. And so, I thought that of course I would have an easy pregnancy, of course there would be no complications, of course I would have a smooth delivery, of course I would have a beautiful baby.

I was wrong.

It never occurred to be that there could be a problem. If anything, this pregnancy had been interrupting my normal life, and I was a bit annoyed, though generously putting up with it. I was excited about the baby, just had no patience for the process of getting there.

My husband went with me to the doctor. It was Succot and it was my birthday. I remembered how in high school my best friend and I had decided the perfect age to get married and the perfect age to have a baby. A few days before my birthday, I thought about how I actually got married at that “perfect” age, and now I was pregnant with our first child at the “perfect” time. I hadn’t planned on spending my 24th birthday in the emergency room.

Immediately, they wanted to do an ultrasound. I had not yet had one and, not realizing how serious my situation was, felt quite excited to see my baby. I looked at the chart in the room, figured out how far along I was, and couldn’t wait to find a little fetus with developing arms and legs swimming around.

The doctor jelled my stomach, and I watched the screen as he moved the instrument around. “Here is the sack,” he said as he pointed to a roundness appearing in the screen. He continued to search, yet had a blank expression on his face. As I stared at the screen, I couldn’t understand what he was looking at since I didn’t see anything.

“I’m sorry, but the sack is empty,” he said, trying to sound apologetic. Silence.

How do you respond to that? What does that mean? I am not one to cry around others, but the tears just started to stream down my face. Empty?

The doctor tried to calmly explain that I had a blighted ovum. That the pregnancy never actually happened, and that I basically had a group of cells inside a pregnancy sac, but no fetus.

His words kept echoing in my head over and over.

Empty. Empty. Empty.

From the moment he said those words, my life was empty.

My husband didn’t know how to comfort me. I didn’t want to be comforted, I wanted a healthy baby. But suddenly I was left with nothing to do. It was as if nothing had ever happened. It was as if I had fallen for some false reality that never took place.

For three months, I thought I was carrying around a baby. I spoke to this baby, I connected with this baby. I loved this baby.

In truth, at least medically speaking, I was never really pregnant. I had pregnancy cells, but no pregnancy. So while my belly swelled and body went through the typical symptoms, the problem was that the fetus itself was missing.

I felt like a fool. I thought that I should have known better. After all, how could I be so out of touch with myself and my body, that I couldn’t even realize that this baby I was connecting to didn’t even exist?

The rest of my experience was only more horrible. There was the doctor who had helped me who wouldn’t continue to see me since my insurance didn’t cover him. There was the emergency room where I waited for endless hours, and then when there wasn’t a spare bed I was put with the women who had just given birth. As I sat and cried, they cuddled their babies. There were the nurses, who though they were trying to be kind, told me not to worry, that I was young, that I would get pregnant again.

The truth is that I was in too much of a daze to have even cared. The wounds were still so raw that I didn’t even feel them. Physically, I knew I would be fine. Emotionally, I wasn’t sure how I would manage.

The thing I remember most is that I felt so alone. I felt like there was no one who could understand me, and no one who had gone through this before. Until this time, I didn’t know anyone who had been through a miscarriage. Or so I thought. My husband wanted so badly to be supportive and helpful, but I wanted him to feel my loss, the very same way I felt it, and he couldn’t. He had also lost a pregnancy, but it hadn’t grown, or for that matter, not grown, inside of him. He could sympathize, but he couldn’t empathize.

I felt like a failure as a woman. It wasn’t rational, but that was how I felt. What was wrong with me that I couldn’t even carry a healthy pregnancy? What if I never could? The thoughts were overwhelming. I was terrified that maybe I would never have a child.

And then I thought about all the times that I was annoyed with my pregnancy. All the times I had wished that it had happened at another time. And no, by no means did I think that I had caused this loss. By no means did I think that this was some form of punishment. But rather, I so badly wished that I could have used the time to have recognized what a miracle pregnancy is. I wished that I had been grateful for the fact that I did conceive so easily, for so many others weren’t that lucky.
Until I had miscarried, I knew nothing about miscarriage and thought that it was a very rare occurrence. I had no clue how common it was or how many women had suffered.

Suddenly, as those who were close to me found out about my situation, the phone calls starting pouring in. Women who had numerous kids, who always seemed to be pregnant, told me of their stories and losses. One woman who had just had her seventh child, said that for each baby she birthed, she had lost one. I was amazed. These women were supportive, helpful and encouraging. They were proof that life would go on and that there was no reason to believe that I wouldn’t be able to carry a healthy pregnancy. But most importantly, they drove home the message that nothing, absolutely nothing, can be taken for granted.

I did not get pregnant immediately after, as some had told me I would. I did not feel better a few weeks later either. To be honest, I was traumatized for some time, and in a certain sense, forever. I had lost a part of me with that pregnancy. There was a baby that would never come into this world, and there was an innocence and arrogance that protected me that was shed for good.

Unfortunately, this was not my only miscarriage. I suffered another one a few years later. But this time, the knowledge that I was not alone and that there was nothing wrong with me made it that much more bearable. Yet it was still horrible and scary. This was my third pregnancy, and two had been miscarriages. Not a good ratio. Even though, unfortunately, the statistic is that one in three pregnancies end in miscarriage.

Through my losses, however, I was also able to gain tremendously. Had it not been for my suffering, I don’t know if I ever would have been able to appreciate a healthy pregnancy in the same way. I had a level of gratefulness with my pregnancies that I carried from the moment I found out until the birth. When I was tired, irritable or not feeling well, I reminded myself of the blessing and miracle and how happy I was that my baby was healthy.

And I learned that you can never know what someone else is going through. And you can never know where they’ve been. Everyone has a story. Everyone has a difficulty. No one can be judged.

Though I lost two pregnancies, both in the 14th week, I have been blessed with four children, fairly close in age.
With the oldest 6 and the youngest 1, often I am asked how many more I plan on having. Often if I call someone I haven’t spoken to in a while, the first question is “Are you pregnant again?” Little do these people know that while I may seem like a baby making machine, I cried for months after the loss of my two pregnancies. These people don’t realize that with my second baby I was rushed to the emergency room in my second trimester as I gushed blood, and they did not think my baby would survive. They do not realize that with my third child, he did not appear on three ultrasounds and I was scheduled for a D&C, when in truth my dates were wrong and he was simply too young for them to see the heartbeat. No doubt I have been blessed. But I wouldn’t say that I have had it easy.

Rabbi Ginsburgh, my rabbi, taught me the most beautiful lesson after one of my losses. He explained that every soul that is brought into this world comes for a very specific reason and serves a very special purpose. We live our lives to fulfill this mission and it takes each individual a different amount of time, along a unique and specific journey. In addition to new souls that come into this world, there are also reincarnated souls that come into this world to complete what they hadn’t been able to in their previous lives.

Sometimes these souls need to live a full lifetime, others for just a few years, others for only a few months, even at times just a few days. Then there are the souls that need so little to complete their mission, that their soul only needs to come into a body long enough to beat its heart or simply create a pregnancy. These are the highest of all the souls-the souls of the truly righteous and pure tzaddikim whose mission took so little to complete.

However, for the woman who had lost her pregnancy, this does not take away the pain. This does not take away the suffering. But it does give it meaning and it does make it easier. While I pray for myself and for others to only have pregnancies, births, babies, and children that have much to complete and much to accomplish so that they live long and full lives, I feel fortunate to know that my loss was not for nothing. Unlike what the doctor had said, that sac was not empty. And all the morning sickness and emotional trauma did serve a purpose. A very important purpose. For I was chosen, for one reason or another, as the conduit to aid a very holy soul in its vital and final mission. And that means the world to me.

The information provided is for informative purposes only and in no way is intended to give either medical or halachic guidance. Please consult your doctor or rabbi for any questions in these sensitive areas.

Dear Mommy,

I know you are full of guilt and feel terrible about yourself for what you did to me. You have been beating yourself up about the whole episode for some time now.

Well dear Mommy, I would like to share my perspective on what transpired. It is important that you know that I was aware and with you the whole time. It was our shared experience.

I was there in the beginning when you were so full of joyous anticipation. Awaiting my arrival, just five months after your last baby was born. You were so excited for him, that he would have a sibling so close in age. I watched, as you pushed forward, still filled with joy as your home slowly fell apart because you were too sick to move and function properly. I saw how you tried to remain a kind and calm mother to my siblings even though all you wanted to do was curl up in a ball under the covers. I was with you when a blood clot formed somewhere inside you and traveled through your heart lodging itself into your brain. I traveled with you all the way, sirens blaring, to the hospital. I heard you proudly answer the doctors’ question with, “yes I am expecting.” I was with you as you went through harder, longer and more painful procedures all because it was safer for me. I saw how you fought to protect me and how I was your light that kept you company in the ICU. I was with you as you thought about how you would be able to feed me one day when you couldn’t even feed yourself now. I also knew how determined you were that come what may, you would make us work. I was there when your team of doctors sauntered into the room, holding their clipboards, bearing the news that if you wanted to live, you would have to part from me. I experienced your shock when one of the biggest gedolim of our time paskened that I had to go. That you were not allowed to carry me to term. I saw your inner struggle to comprehend how you were going to ultimately choose your life over mine. I felt your desire to hold me and hug me and keep me safe. I had been too small for you to have felt my little limbs yet, and I know the sadness that caused you. If we would have only been granted a few more days together, you could have felt my gentle movements. I heard as you spent the next few days, before our scheduled hour of separation, talking to me and telling me again and again how much you love me in all the words you knew. I heard you apologize repeatedly, over and over. I felt your guilt. I felt how much you despised yourself.

But dear Mommy, you need to know that this was never really your choice.
I was never placed inside your womb with the intention of being born one day. My Neshama needed you, and only you, to help me reach my tafkid. We were never meant to live in Olam HaZeh together. And you were meant to fulfill the mitzvah of V’nishmartem me’od l’nafsoseichem in this exact way. And though we will never hold hands together the way you dreamt we would, there will come a day when we will B”EH spend eternity together.

So dear Mommy,
You really are my loving Mommy. And I am your forever grateful child. I am here in Gan Eden in the very highest place that any Neshama can wish to be. Thank you for taking such good care of me and being my loving ride to the place where all mothers pray that their children ultimately (after 120) end up.

Forever grateful,
your Neshamah

My Secret

Should I schedule for Thursday? Should I wait another week? Another month? Timing was just one of the many questions filling my mind with fear, anxiety, and trepidation. While the uncertainty was so overwhelming, hope was still very much a part of every fiber of my being. Yet, I felt it slowly slipping through my fingers. How I longed to grab hope and hold onto it in a very tight embrace. How I longed to feel and hear assurances that it will all be okay. But it was not to be.

Just a week before, I had gone for my regular monthly obstetrical visit. As the doctor was performing the exam, it was taking way longer than usually and he was awfully quiet. “Last month, the doctor suggested I should do chromosome testing, but I declined,” I said, but my attempts at conversation yielded poor results.

The doctor wiped the transducer and looked me in the face. “It is no longer optional. You will take it today. I have to know what is going on with this baby. Your fluids are low and the placenta looks larger than normal. As for the baby, it looks very squished in.” He called for a nurse and explained the situation to her and then continued, “I am also sending her to the top fetal radiologist in the country, Dr. Daniel Cohen for further testing and a consultation. Please give her a referral.”

I walked out of the office dazed. The doctor did not have answers to any of my questions. What followed were two days of waiting, days of questions that none of us could answer and assumptions that almost drove us mad, as well as lots of prayers and hope that kept us sane.

The night before my appointment I was gripped by an intense fear. “Who knows if this doctor is as good as they told me? Maybe I should call a referral agency? Maybe there’s someone better?” I needed someone to guide me. Who would be the one? “Ah, Faigy Lichtenstein!” A close friend of mine had told me that she’s a doula who has lots of knowledge in obstetrics. Upon contacting her, I found her kind and compassionate and reassuring, and she asked me to keep her updated so she can guide me where to go from there.

We arrived to our appointment 15 minutes early, but ended up waiting close to an hour, an hour filled with hope and tehillim and a fear of the unknown. Finally, it was our turn.

The ultrasound technician was clicking away for quite some time and then went out to consult with the doctor. She came back for more images and then left again. After about an hour of testing, Dr. Cohen himself came in. His towering figure and serious demeanor called for instant reverence. “My silence means that I’m concentrating,” he said. “We will consult in the consultation room when I’m done.” What needs such intense concentration? These words alone sent chills down our spines. We had no idea what was going on. What ensued was another hour of clicking. The air was so thick I hardly allowed myself to breathe. Every now and then we hard the whoosh of blood flowing. I tried to glimpse the monitor to get an inkling of what was happening. All I saw was the spine of my baby in a breech position and the red and blue flow of blood vessels. The doctor kept switching transducers and made me flip positions every now then. His forehead was creased in concentration as he glided the transducers over my abdomen one after the other. At last, he wiped them off and got up to leave, instructing us to meet outside.

We entered the consult room and he slid the door closed behind us. Quietly, he sat down, facing us. The room was small, with just a few chairs and a little table, as well as a box of tissues prominently displayed. The doctor cleared his throat and began. “You have zero fluids. At this point, the lack of fluids usually indicates a lack of kidneys or malfunctioning kidneys. I switched transducers and made you switch positions to try to see if there were any renal arteries. Unfortunately, neither kidneys nor renal arteries were visible at this time. In my 30 years of experience, a baby like this is incompatible with life.” He waited for us to absorb the impact of his words and then continued. “The lack of fluids hinders lung development and the lack of kidneys prevents waste removal. If such babies survive the pregnancy and delivery, they die shortly after birth.”

“Can the situation improve? Is it possible that they’re there but they are so small that you didn’t see them? Is it possible to get back the fluids?” I asked. He answered our questions, but didn’t seem too hopeful.

The fatal news were delivered by the professional in a solemn manner. We saw how hard it was for him to convey the diagnosis and read the sympathy spread over his features. Thirty years of experience hadn’t made such a diagnosis easier for him. Still, the full impact of his words did not penetrate our minds. He said that we should come back in two weeks, but when we asked to schedule an appointment we were told that we shouldn’t yet. And we didn’t understand why.

We walked out quietly, each wrapped in our own world. I was physically and emotionally drained from the grueling ultrasound exam. We sat into the car and I dialed Faigy. “Somebody will be in contact with you shortly,” she said.
“What’s her name? Who is she?” I asked. “Her name is Malkie and she has experience with these things.” We just sat there, not knowing what to do or where to go next. As we were contemplating our next move, my phone rang. Malkie instructed me to send her my medical records and assured me that she will be in touch.

The questions kept surfacing one after the other. Can anything be done to save this baby? What happens now? Is it as bad as Dr. Cohen said? Should we go to another specialist? Later that evening, Malkie confirmed what Dr. Cohen had said and forwarded the report to Rav Unger, to seek rabbinical guidance.

Meanwhile, I didn’t hear from my obstetrician, not that day nor the next. I was furious and frustrated at their lack of support for their patient and I called them myself. They, too, confirmed my diagnosis and encouraged me to have a D&E, the sooner, the better. A D&E? For me? How does a nice Jewish woman have an abortion? This was something that didn’t sit right with me. I was bewildered and hurt. I couldn’t grasp the turn of events. What was happening?

Every morning I awoke feeling that it will be fine, but as the day wore on and I got to speak to medical experts and professionals, I quickly realized it was all illusionary. All of a sudden, I found myself sobbing in middle of the day and in middle of my nights. What had been discomforts in anticipation of joy had faded in the impending sorrow. I felt abandoned by my team of doctors who had sent me for further testing and not followed up. Fortunately, Hashem sent an angel my way. Malkie from Knafayim picked me up where my doctors had dropped me and held my hand. She arranged for us to get a second opinion, and consulted with Das Torah on our behalf. She listened to my questions and supported me in my insecurities. And then, when I felt all our resources had been exhausted and all our options outlined, she blessed me warmly that Hashem should give me clarity to do what’s right. I felt like I was treading in strange territory where I did not belong, but I had the support of Knafayim and that made me more confident that I was headed in the right direction.

After consulting with another expert Dr. Dar, Director of the Division of Fetal Medicine and Ultrasound at Montefiore Medical Center, and then talking again to the medical team that had given up on my baby, I realized that as strange and brutal as it sounded, it was time to schedule my D&E. I had gotten the go ahead from Das Torah and my husband had cleared his insecurities with them. We were headed in the right direction. But for me, this seemed all wrong. Yet, this was not a nightmare that I would soon awaken from. It was really happening. And it was happening to me and my baby. I just had to make my decision when to actualize Das Torah’s psak – a psak that was so gut wrenching and so hard to accept and yet left no room for further questioning. It was Tuesday when I placed the call to schedule. In the depth of my heart, hope still fluttered on its fragile wings. “ Maybe,” I thought, “they will do another ultrasound before the procedure and find fluids”.

The next two nights I did not sleep much. The butterflies in my stomach were fluttering nonstop. My mind was in turmoil. I even thought I felt movement in utero, but it was probably just the stress doing somersaults in my abdomen.

I was about to enter my fifth month, but Thursday I would no longer be pregnant. I will go into the hospital with a little heart beating inside me, but I will leave without. Wednesday evening we made arrangements with Knafayim to come gather the remains of our baby boy- the remains of all our hopes and dreams of the past few months. The thought made my innards clench and squeeze the breath out of me. I wanted my baby. I wanted to do everything in my power to save my baby. But wherever I turned I was told that my baby was incompatible with life. He will die within the next few days or weeks in utero, be born still, or in the rare event that he might survive the pregnancy, he will for sure not survive more than a few hours. I felt powerless in the face of reality.

As Thursday dawned and we made our way to the hospital, I davened and still hoped. When we arrived to the facility and discussed the procedure with the nurse, I asked her “What about an ultrasound? Won’t you do one before?”

But she so casually replied, “When you come to us, you don’t need that anymore.” And then, my last sliver of hope crumbled.

A few hours later, my husband and I walked out of the hospital liberated and bereft. What had hovered over us for the past 11 days had been lifted, but along with it went our hopes and dreams for the baby to be buried. In its place remained a gaping hole filled with pain and grief.

Life will never be the same. I’m not sure in which direction this will take me, but I am hoping to heal and emerge a better person.

Even after being faced with that submissive acceptance of our powerlessness, it was harder than ever to see Yad Hashem. It was so there, yet so hidden. On the surface it seemed that we were actually making decisions. In reality, these decisions were above and beyond our capacity. As a result, just the thought of the chain of events was unbearable for quite some time.

I feel tremendously grateful to Hashem for sending Knafayim our way during this crucial time. And I feel forever indebted to Knafayim for being there for us. Knafayim was our guiding light in the darkness, and a pillar of strength to keep us from falling apart. Its ongoing support system is balm for my soul.

While I know unequivocally that we have done the right thing, my brain still wages an ongoing battle with my emotions which are having such a hard time processing it. To build that bridge between heart and mind is a tedious task, and I am constantly working on it.

If I, who have been through this, have such a hard time processing it, how can I ever trust someone else to not be judgmental if I tell them I had a termination?

Today was the day
I was to smell
The roses… The happiness
To hear the ringing of the bells

Today was the day
That I would have studied your face
Looked at those dimpled cheeks
As I held you in my embrace

Today was the day
My heart was to break into song
To dance above the rooftops
To feel that I belong

Today was the day
To hear that beautiful newborn cry
To have whispered all my love to you
alas…. instead I said my goodbye

You came into this world
Touching me oh… so silently
For that short hour you were here
You’ve left me behind your legacy

You’ve taught me that
Even though I’ll never understand
That I’ve got a loving Father
That it’s all part of the master plan

You’ve thought me that
It’s all about control you see
If I relinquish all of it
I’ll regain my serenity

You’ve taught me that
To truly listen is an art
And that true belief is letting go
That we’ll never be far apart

And now Neshamela
As this day comes to a close
Grant me the strength, the courage , and faith
To continue this journey with poise

Fourteen years ago I gave birth to a baby girl. Four hours later she died because of an internal malformation that was undetectable during my pregnancy. During my short hospital stay, nurses and doctors seemed to avoid me and my questions. What they did say was about the same as what my friends and family were saying, “You’re young. You’ll have other babies. Try to forget.”

I didn’t want any other baby, I wanted that one! Forget? How could I forget? Instead I was overwhelmed with crushing, breathtaking grief. I remember how empty I felt the day I left the hospital…an empty womb and empty arms. I never really knew her but I missed her and ached for her so desperately.

Soon after I returned home, everyone acted as if they had already forgotten her, as if they expected me to also forget. Someone had removed all the baby items I had acquired before coming home, hoping to spare me the pain. Instead, it felt like a further denial of her existence. When I tried to talk about her everyone became very quiet, changed the subject or left the room. Friends were very careful not to say anything that might remind me of my experience. Baby shower invitations didn’t come in the mail. Birth announcements didn’t come in the mail. Many stayed away because they simply did not know what to say. My husband had three days to “get over it” before he was expected back at work. The world kept on spinning as if nothing had happened. I remember thinking that I must have lost my mind. I thought that if my baby had lived for a while, if people had gotten to know and love her, maybe then I would have been given the affirmation to grieve the way I needed to. But I was the only one with any memory of her, the only one who had a chance to love her. I had no one to share that with, not even my husband. Most of his grief was for me and for the dream we had shared for this child. I felt all alone as I began my mourning.

Over the years, after much healing, I have had the opportunity to speak with other parents who have had experiences which are similar to mine. As a result of that, and also as a result of my search for answers to all those unanswered questions. I have compiled a list of several “truths and non-truths” concerning the grieving process as it relates to perinatal bereavement.

This is not intended to be the absolute word on the subject, but rathe a guage for the unexpected emotions felt by parents who have suffered this type of loss. Most of the parents I have spoken to agreed that the uncertainty of their grief was frightening and may have been alleviated had they know what to expect.

Friends and family may also benefit from reading this so they might understand the special kind of pain and emotions involved in this type of loss and allow them to be expressed

The Truth Is…

The truth isn’t that you will feel “all better” in a couple of days, weeks or even months.

The truth is that the days will be filled with an unending ache and the nights will feel like one million sad years for a long while. Healing is attained only after the slow but necessary progression through the stages of grief and mourning.

The truth isn’t that a new pregnancy will help you forget.

The truth is that, while thoughts of a new pregnancy soon may provide hope, a lost infant deserves to be mourned just as you would have with anyone you loved. Grieving takes a lot of energy and can be both emotionally and physically draining. This could have an impact upon your health during another pregnancy. While the decision to try again is a very individualized one, being pregnant while still actively grieving is very difficult.

The truth isn’t that pills or alcohol will dull the pain.

The truth is that they will merely postpone the reality you must eventually face in order to begin healing. However, if your doctor feels that medication is necessary to help maintain your health, use it intelligently and according to his instructions.

The truth isn’t that once this is over your life will be the same.

The truh is that your upside-down world will slowly settle down, hopefully leaving you a more sensitive, compassionate person, better prepared to handle the hard times which everyone must deal with sooner or later. When you consider that you have just experienced one of the worst things that can happen to a family, you will become aware of how strong you are.

The truth isn’t that grieving is morbid, or a sign of weakness or mental instability.

The truth is that grieving is a work that must be done. Now is the appropriate time. Allow yourself the time. Feel it, flow with it. Try not to fight it too often. It will get easier if you expect that it is variable, that some days are better than others. Be patient with yourself. There are no shortcuts to healing. The active grieving will be over when all the work is done.

The truth isn’t that grief is all-consuming.

The truth is that in the midst of the most agonizing time of your life, there will be laughter. Don’t feel guilty. Laugh if you want to. Just as you must allow yourself the time to grieve, you must allow yourself time to laugh. Viewing laughter as part of the healing process, just as overwhelming sadness is now, will make the pain more bearable.

The truth isn’t that one person can bear this alone.

The truth is that while only you can make the choices necessary to return to the mainstream of life a healed person, others in your life are also grieving and feeling helpless. As unfair as it may be, the burden of remaining in contact with family and friends often falls on you. They are afraid to “butt in”, or they may be fearful of saying or doing the wrong thing. This makes them feel even more helpless. They need to be told honestly what they can do to help. They don’t need to be told, “I’m doing fine” when you’re really NOT doing fine. By allowing others to share in your pain and assist you with your needs, you will be comforted and they will feel less helpless.

The truth isn’t that G-d must be punishing you for something.

The truth is that sometimes these things happen. They have happened to many people before you and, unfortunately, they will happen to many people after you. This was not an act of G-d’s punishment. Bad things happen to good people all the time, though we can’t understand G-d’s master plan. Sad and tragic occurrences are a part of life. It isn’t fair to blame G-d, or yourself, or anyone else. Try to understand that it is human nature to look for a place to put the blame, especially when there are so few answers to the question, “Why?” Sometimes there are answers. Most times there are not. Believing that you are being punished will only get in the way of your healing. Remind yourself that all of G-d’s ways are good, yet as mere mortals, that good may not be readily revealed to us. On the other hand, it is a time that may be used for introspection.

The truth isn’t that you will be unable to make any choices or decisions during this time.

The truth is that while major decisions such as moving or changing jobs are better off postponed for now, life goes on. It will be difficult, but decisions dealing with the death of your baby (naming the baby, arranging and/or attending a religious ritual, taking care of the nursery items you have acquired) are all choices you can make for yourself. Well meaning people will try to shelter you from the pain of this. However, many of us, who have suffered similar losses, agree that these first decisions are very important. They help to make the loss real. Our brains filter out much of the pain early on as a way to protect us. Very soon after, we find ourselves reliving the events over and over, trying to remember everything. This is another way that we acknowledge the loss. Until the loss is real, grieving cannot begin. Being involved at this early time will be a painful experience, but it will help you deal with your grief better as you progress, by providing comforting memories of having performed loving, caring acts for your baby.

The truth isn’t that you will be delighted to hear that a friend or other loved one has just given birth to a healthy baby.

The truth is that you may find it very difficult to be around a mother with young babies. You may be hurt, or angry or jealous. You may wonder why you couldn’t have had that joy. You may be resentful, or refuse to see friends with new babies. You may experience negative thoughts towards your friend’s new found happiness, yet feel guilty and wonder how you became such a dreadful person. You aren’t. You’re human, and even the most loving people can react strangely when they are actively grieving. If the situation were reversed your friends would probably be feeling the same. Forgive yourself. It’s Ok. These feelings will eventually go away.

The truth is that sometimes you might blame one another…

The truth isn’t that all marriages survive this difficult time.

The truth is that sometimes you might blame one another, resent one another, or dislike being with one another. If you find this happening, get help. There are self-help groups available and grief counselors who can help. Don’t ignore it or tuck it away assuming it will get better. It won’t. Actively grieving people cannot help one another. It is unrealistic, like having two people who were blinded at the same time teach each other Braille. Talking it out with others may help. It might even save your marriage.

The truth isn’t that eventually you will accept the loss of your baby and forget about this awful time.

The truth is that acceptance is a word reserved for the understanding you come to when you’ve successfully grieved the loss of a parent, a grandparent, or a beloved older relative. When you lose a child, your whole future has been affected, not your past. No one can really accept this, but there is a resolution in the form of healing and learning how to cope. You will survive. Many of us who have gone through this type of grief are afraid we might forget about our babies once we begin to heal. This won’t happen. You will always remember your precious baby because successful grieving carves a place in your heart where he or she will live forever.

Excerpted from Inspiration and Insights, published by Mesorah Publishing and The Child I Never Knew Taharas Hamishpacha International

Malkie Klaristenfeld

From the start, this pregnancy was shadowed with fear and uncertainty. Medical issues kept on cropping up, like mushrooms after a rain. As soon as one was diagnosed, the next one peeped out and made itself known.

I was scared.

Simply and unashamedly afraid.

For the first few weeks, I reined in the excitement that the promise of new life carries on its wings – especially at my age, when the merest sliver of promise is a blessing. The days turned into weeks, and slowly – in an agony of doubt – the weeks morphed into months.

I counted them carefully. The first trimester crawled past. I spent sleepless nights agonizing will it? Will it not? I spent the hours reaching out for some security that all will be ok.

As days passed and time started moving I slowly began to trust. I began to feel slightly more secure.

And I allowed myself to feel. To imagine. To dream.

I saw myself holding this little, precious neshamala and marveling at its innocence and perfection. I pictured the reactions of my excited children, as they would welcome the new addition with warmth and enthusiasm.

Stop, Malkie! My logical mind urged me. So many complications. So many worries. The high blood pressure. My sugar. All medical issues…You know that ‘cautiously optimistic’ is the way to go.

But I was sold. It has been a few years since I held a newborn that was all my own. I could not clamp down on those treacherous feelings that teased me to…Relax, Malkie! Everything will be alright! You’re nearly at the end of the second trimester…

Every ten days to two weeks saw me tramping off to my appointments. Another run-through of all the numbers. Another sonogram. I remember my doctor once telling me– I love those visits where there are no issues. Simple and normal.

10:30 a.m. on Tuesday, December 31st was to be just one more in this long line-up of appointments. The anxiety that had been stalking me for so many months peaked the night before this routine visit. My husband, too, grappled with a sudden upsurge of fear and doubt.

“Come with me,” I asked, only half in jest. “I’m scared to go alone.”

Reluctant to acknowledge his fears and validate my own, he tried to conceal the growing lumps of unease. “There’s no need,” he countered. “It’s just another appointment. But – but you’ll call me as soon as it’s over.”

I nodded, reminding him that since this visit would necessitate a detailed sonogram, he shouldn’t expect to hear from me before noon. The die was cast.

Tuesday morning, 10:00 a.m.

I left the house, closing the door behind me with deliberate movements. Much as I tried to convince myself that this visit would mirror the others, my heart refused to cooperate. Would my baby show signs of disability? Of deformation? Would something be…wrong?!

That’s as far as my thoughts took me. A child who was not well. A baby who would need special care. I had even mapped out who I would call once I would get that diagnosis.

I walked through the doors of Methodist Hospital and submitted myself to the ministrations of an unfamiliar, tight-lipped sonographer. Numbers were recorded, measurements were taken. All routine. Blessed routine.

My heartbeat quickened as the sonogram appeared on the screen. My baby!

Seeing the little life developing inside of me is a thrill, no matter how many times I’ve seen it before. There it was; a beautiful little silhouette outlined with that special halo that only Hashem’s protection could provide.

I smiled involuntarily and then looked closer.

The screen was static. Unmoving.

There was nothing to mar the perfect picture. Nothing to signal even the slightest hint of life.

Can words be put to a chasm of searing, wrenching pain?
Can words describe agony – sheer, unbridled agony that takes the heart and shatters into millions of bleeding slivers?!

“There is no heartbeat,” I said.

Silence. And then this unfamiliar sonographer matter-of-factly repeated my words. “There is no heartbeat”.

I didn’t scream. I didn’t cry. I didn’t even blink.

Instead, I froze.
My thoughts and emotions froze into a single block of ice. I saw the silent screen and the sonographer’s impassive face…but I could not react.

“When did you last visit the doctor?” she asked.

Trivial questions. Mundane matters. I did not answer, waiting for the empathy and understanding that would surely follow.

But no. The stranger who had stepped into my world at this moment of rawest pain simply headed to the door.

“I’ll call another doctor,” she threw over her shoulder.
And that was it.
I was alone.

Just me and my silent, silent baby.

It’s over! – Malkie

I sent the short, biting text to my dedicated OB, Dr. Grazi. My jumbled thoughts could not contrive more than those two hurtful words.

I can’t believe this. I am shocked. Malkie, please know that you did everything you could to keep this going! – Dr. Grazi

The ice thawed slightly. I took a deep, shuddering breath and reread his kind words, time and again.

My baby! I wanted to scream. Do you hear?! I did everything I could for you! Appointments, consultations, precautionary measures…I wanted to give you the best chance possible! I wanted to give you…the world!

It was a calming thought; a validating statement. I had done everything possible.

11:00 a.m.

Now what?
I stood in the corridor of Methodist Hospital, toying with my cell-phone uncertainly. Was I supposed to call someone? Update anyone? Summon help or support?

Thankfully, I had another hour before my husband would expect to hear from me. An hour to reconfigure.

“Oh, Mrs. Klaristenfeld!” an enthusiastic voice greeted me.

I turned to face the smiling countenance of Dr. W., a valued professional contact. “So how’s it going?” he inquired solicitously.

And there, in that deserted corridor, the tears finally came. It was embarrassing, to say the least. Breaking down in the presence of a respected doctor with whom I deal with professionally was not…comfortable. But I cried. I cried for the sudden, wrenching loss. I cried for the little baby who was to be such a special gift when I hadn’t expected to receive another. I cried for myself and for my husband who was still unaware that we had lost our child forever.

“This was my biggest fear,” I finally said, amidst the tears. “I have buried so many children, Dr. W.! Too many. Little babies who were taken from me through D&E procedures… They were mutilated! I feel that I betrayed them; betrayed their perfection; betrayed their memories!”

Dr. W. was silent and I forged ahead. “I cannot do this again! This precious neshama must be delivered without trauma. I want my baby to remain…complete. As complete as she is right now.”

“I’m calling Dr. L.,” he finally said. “He’s an expert in the field and he’ll tell you whether it’s medically prudent.”

Dr. L. approved. Based on my history and medical status, he felt that a regular delivery would not pose any threats.

I walked down to the lobby of Methodist Hospital and…just stood there.

I had come through these doors just two hours previous with the hopes that only a would-be mother could entertain. And now…now I was standing in the same spot, bereft. The life inside me was no more.

It was noon. My husband was waiting to be reassured that our precious child was developing normally.

I called. It was the most horrific phone call I ever had to place. How does one trample on the title Tatty with such cold, untenable facts? I stood outside, in the bitter cold of this wintry day, and I told him that…it was no more. Our baby’s heart was no longer beating.

With fingers numbed by cold, I picked up Dr. Grazi’s call. He had nothing to offer me except his concern. I was scared to broach what concerned me most that I had been deprived of the opportunity to raise my child…I was determined that I would do all I could for her, so long as I was given the chance. Apparently, maternal instincts exist even in the shadows of death.

“I don’t want you hurting my baby,” I emphatically told him. “If there’s a possibility – any possibility – of delivering my child complete, nothing will stand in our way!”

And Dr. Grazi stepped up to the plate, as I knew he would. Although he believed that the better approach was to do a D and E, he promised to do whatever it takes to give me that one remaining comfort, in the safest way possible.

“Rethink your decision,” he urged. “But if this is what you want, then we’ll stand behind you every step of the way, it’s the least we could do for you.”

The tears were once again tumbling over each other at this simple gesture of warmth and empathy. Dr. Grazi would be in the hospital on Thursday, and I knew that I would wait for him. Irrationally, I was glad to have this extra day with my baby. I would have one more day to carry my child close to my heart, before she would be taken from me…forever.

I came home and walked straight towards the couch in my dining room. I sat down heavily…and sat…and sat. Hours passed in silence, as I continued sitting in the same position. I couldn’t talk. I couldn’t think. I couldn’t even feel.

Instead, I fielded a tangled web of questions that grew thicker and more complex as the minutes ticked by. The pain and scathing agony cowered in their respective corners, as a surge of anger overtook me.

I’m calling it anger though it’s hard to define it as such. I was hurt. I was resentful. I was confused.

Hashem! Tatte in Himmel! What message are you sending me?!

The words reverberated deep inside of me, echoing in the silence that had snatched my soul. In my mind’s eye, I saw the Kahon Gadol earnestly doing the sanctified avodah of Yom Kippur. With each movement, he melodiously intoned Achas v’achas… One for one. One for two.The words reverberated deep inside of me, echoing in the silence that had snatched my soul. In my mind’s eye, I saw the Kahon Gadol earnestly doing the sanctified avodah of Yom Kippur. With each movement, he melodiously intoned Achas v’achas… One for one. One for two.

But I can’t even say that! Tatte, for me…there is no achas v’achas! You’ve given me eight wonderful, healthy children…but You’ve taken so many more! Fourteen, Ribono shel Olam! I have brought fourteen korbanos for You…

I couldn’t cry, though the tears burned the insides of my eyelids. Fourteen! Haven’t I given enough?!

For years, I have been counseling and supporting and guiding couples experiencing a loss…a loss just like my own.

What are You telling me, Tatte?! What is the message in this heart-slicing pain?! I have helped so many of Your suffering children specifically in this realm!

Was it anger? Was it confusion?

I could not pinpoint the exact feeling…but it was strong. It tortured me continuously, as it still does so many days later. I know – in my mind, that is – that everything happens with a cheshbon, with a purpose. But knowing is not enough. Will my heart ever reconcile with this seeming incongruity?

I called the school secretary to inform her that I would not be coming in the following day to give my scheduled lesson. How could I speak about emunah and simcha when my entire being was crushed into a shifting mound of questions?

The hours ticked by slowly, chiming the hours in annoyingly joyous tones. The children came home. Supper somehow landed on the table and Bedtime was dealt with. And I sat. I sat on that couch and stared sightlessly at the familiar walls of my home.
I was barely present.

As the clock ticked on, I vacillated between the silence of my bare walls and the inconsolable tears. There were moments that I wondered how many tears one could produce? How full could the cup get?

Later in the evening, I mustered the strength to inform some of my closest friends. They didn’t know what to say. In a shocking realization, I intuited that no one could give me what I gave to others. They asked intrusive questions and offered hurtful comments.

I knew that they didn’t want to hurt me. They were groping in the dark, trying to find something decent and comforting to say. But they didn’t know. They just didn’t know.

I suddenly came to a strong realization. What a service I was actually offering those experiencing what I now once again was going through. How much fine tuning went into each conversation. And what a skill true empathy is. Oh how this hurt. I was alone. Alone with no one to give me what I needed most.

The lchaim of a close cousin was scheduled for that night. I attended, betraying none of the turmoil that held me captive. I smiled. I wished mazel tov. I greeted my mother; my grandmother; my chattering family.

They looked at me with smiles in their eyes, as they calculated how far my pregnancy had progressed. They did not know that it had come to an abrupt stand-still. They did not know for I did not tell them. There was no reason to ruin the family simcha. There would be time enough for that.

The hour was late and tomorrow’s ordeal peeked out at me from behind the stars. I was scared. So, so scared. I needed to take someone along with me; to support me. The names of my friends flashed through my mind, but I dismissed each one immediately. They couldn’t give me what I needed. They could not – or would not – offer the support that would help me get through this.

For more than a decade, I had always dropped everything to be there for others in this situation. I sacrificed so much to make things easier for them! My comfort meant nothing. Even my husband and children were sometimes pushed aside to ensure that I could be there when I was needed.

Would no one be able to do the same for me?!
The answer was hurtful and unequivocal.

Wednesday Evening 12am

Dr. Grazi was already at Mt. Sinai. He expected me to make my appearance so that…so that my baby could be taken away from me.

I didn’t want to go. Had I been a child of six, I would have thrown a tantrum and barricaded myself inside my bedroom. But I was an adult. A grown woman. An almost-mother.

So I went. I got into the car with my husband, hating the sleek vehicle that was taking me closer to the end. With every mile swallowed by the car’s gaping jaws, my fists clenched tighter. I couldn’t do this! Why am I allowing this? Why was I sitting here, letting myself be taken to the point of no return?!

Shakily, I called the number stored in my contacts as the chevra kadisha. I was constantly in touch with them, preceding or following miscarriages and stillbirths. Now, once again, I was calling them to contract their services. I needed them to make the final arrangements for a baby. My baby.

I asked the director whether there was any possibility of bypassing the office staff. He was unaware of the circumstances and told me that it could not be done. I was embarrassed to find myself at the receiving end of those who always dealt with me on the other side.

Why are you ashamed? I asked myself irritably. You’ve done nothing wrong!

But the feeling of discomfort did not leave me. None of the grieving couples I dealt with ever had any contact with the chevra kadisha. Only I was thrust into that horrific position…for there was no one else to do it in my place.

It was an awful feeling; a precursor of things to come.

I walked into the delivery room, appearing for all the world like a woman in the bloom of pregnancy. It was a fleeting moment; just a passing illusion.
The induction progressed slowly, and I took an Ambian capsule to help me sleep. As was to be expected, it was completely worthless, though its effects worked wonders on my husband, who was soon fast asleep.

I remained awake, haunted by a progression of little faces and tiny, delicate fingers. All those babies I had held and cuddled, supporting their parents as they bid them final farewells… All those pure neshomos who had flitted briefly through my life, leaving an imprint that neither time nor activity could erase…

They were all there, in the Mt. Sinai delivery room. I saw them lined up in a long, long procession…and once again, the questions surfaced.

Why?! Why was I being tested particularly in the area to which I had devoted my life? Perhaps I had not sympathized enough with the bereaved parents. Perhaps I had not given them all that they needed.

The stories replayed themselves in my mind, wreaking havoc on my already-shaky equilibrium. As labor progressed ever so slowly, I found myself thinking about the episode in Columbia; the wrenching heartbreak at Methodist; the couple struggling in Maimonides.

It was my story…yet it was theirs, as well. I felt, inexplicably, that my experience was a world-encompassing, communal tragedy, with thousands of spectators who had previously been helped. They had merited support… I felt so alone.

Dr. Grazi as usual went above and beyond to make this easier. He stayed beyond his designated shift. His presence did much for me, and his frequent calls checking on my progress were reassuring. Dr. Lanskowski, another member of the team, sent me a moving text that gave me a sampling of that ever-elusive support.

Malkie, I just heard about what happened. We’ll do anything to make this road just a little bit smoother for you. You have my #. Call or text if you need anything. – Dr. Lanskowski

Delivery was difficult and draining. Though the physical pain was overpowering, it was the emotional pain that nearly bowled me over. I was terribly and achingly alone. No one was there to hold my hand or to reassure me that these horrific moments would soon pass. No one could give me that which I gave so selflessly to others.

And worst of all – I couldn’t give it to myself.

I felt powerless; stripped of the tools that had helped countless others in my situation. I tried telling myself the words that I told them, but all I came up with was a feeling of cynicism; a strong sense of hypocrisy.

Malkie! I told myself. Get your act together! You’ve been doing this for years! Can’t you even help yourself?

But no, I couldn’t.

I was helpless and broken, like an injured bird pitifully dragged down by its useless wings.

The baby finally made her appearance. I couldn’t look. I couldn’t think. I could barely feel. After hours of not eating, I felt on the verge of collapse…but the Malkie Klaristenfeld who would have instinctively brought me a cup of refreshing water was confined to bed. No one could be my Malkie.

I asked for a cup of coffee, and gave exact instructions as to where milk could be obtained. I asked for another blanket, guiding my husband to the right closet where the spare blankets were kept.

I knew what was coming next. My little princess was lying there, silent and cold. She was mine. Mine. The doctors called her ‘a second-trimester pregnancy failure’. The reports filed her away with an offhand phrase – No cardiac activity detected.

But she was my little girl – now and for all time.

And I was her mother. The only mother she would ever have. A mother for mere moments…but a mother nonetheless.

“I can’t do it now,” I cried out. “I feel too detached. I’m not fully present and…and I can’t squander these moments!”

I knew that these precious few minutes would have to provide memories for a lifetime. I couldn’t afford to waste them! I needed to use them up to their fullest. How could I bond with my little girl when I was so out-of-sorts? I was terrified that I would waste the only chance I would ever be given.

Come on, Malkie, I urged myself. You know what these babies look like! You’ve seen hundreds of them! You know how to get acquainted; how to sing to them; how to bond with them…and then…to let them go.

But knowing was one thing. Feeling was quite another. That helplessness washed over me again, stronger and more potent than before. I was alone. I would have to face this all on my own.

My little baby girl.

For a moment, I saw myself bending over that tiny form and handling her with love. I saw myself soothing the bereaved mother, wiping her tears and holding her hands gently.

But then I saw…myself. I wasn’t Malkie of Knafayim. I wasn’t the giving, supportive presence that others had come to know. I was just a mother. A grieving mother whose daughter had gone even before she had come.

And I screamed.

I don’t know where those cries and shouts came from, but they echoed in the silent room for a long, long time. I couldn’t do it. I couldn’t even look at my bundle of innocent purity. I couldn’t!

The baby was still lying near me, completely covered. I didn’t touch the blanket. I just looked at that tiny form concealed under a pure, white blanket. It was so small; so helplessly fragile and tiny.

Somewhere in my subconscious, I realized that someone had softly opened the door and then closed it again. I was in my own world. It was a small world; a world just big enough for me and this little neshama’la who would soon be taken away, never to be seen again.

Suddenly, my little world filled up. Hundreds upon hundreds of stillborn babies crowded in on us, squeezing the air out of my lungs. It was so crowded and yet so eerily silent.

I saw myself handling those little souls, caressing them and smoothing their features so that their parents could form the most positive memories. I saw myself gently pouring water over their tiny little hands. I heard myself reciting nishmas over them; putting those little fingers over small and unseeing eyes for their first and last Shema.

Help me! I cried out to those innocent souls. I welcomed you into this world and escorted you out. I was there for you….but who will be here for me?! Hashem…WHY?!

All those babies that I had so lovingly held and given over to their Mommies, who I had caressed, cared for, stood lined up at my baby’s crib like a barricade hauntingly staring in my face, questioning– you too? How many more need to join us? How many of yours stand lined up together with us?

My little baby daughter and me. To get to meet each other and then… to inevitably say goodbye. And so, I ever so slowly leaned over to my baby – the one little baby in this whole parade who was and always will be just mine – and I uncovered her smooth little face. She looked so fresh. So perfect and untouched.

I counted her fingers. Ten perfect fingers and ten perfect toes. I looked at every part of my little girl’s body. So many minute details had come together. So much perfection and so much silence. Why, Tatte?! Why must her journey be so brief?!

I held the bassinet on my lap and looked down at her.
I felt the weight of her body on me and it felt so right. She was mine. She was my little girl; a perfect little rose that had never been given the chance to show me her velvet-soft petals.

“I think it’s time to…to take her back,” I was told slowly.

I flinched. Take her back?!

This was it. She was being taken from me forever!

כי מלאכיו יצוה לך…
May the malachim watch over you, my precious little one. They will come with you on this final journey while I – your mother – will stay far, far behind.

The bassinet was crossing the threshold of my room. It was going out – out – farther and farther away.

The feeling of my heart ripping to shreds was tangible. I was being torn apart. A piece of me was being taken away and I could do nothing to stop the pain; to staunch the wound.

She was gone. The room was empty.

My little girl was no longer there. I knew where she was and I couldn’t bear to think about it. I had seen too many little babies holed up in the cold, dark morgues of large hospitals.

And then once again I was left to the silence. An exhausted silence. Indescribable. No words for this painful journey…

The doctors insisted that I stay overnight and I was wheeled upstairs, to a double room. I would never have allowed any of my patients to be treated in this manner. I would have insisted on a private room…but there was no Malkie who could do that for me now.

I was so cold and vulnerable but the doctors were afraid to release me before morning. So I stayed there, in the uncomfortable hospital bed, letting the tears flow unabated. The night hours swam away on my tear-soaked cries and I was relieved when day finally dawned.

The relief was premature.

Early morning Dr. Grazi entered. Once more he came to offer me some comfort. To check up on me. And yet he found me in shambles. “Who will be your Malkie? Who will take care of you?” With tears in my eyes I just pointed upwards. But I knew this was going to be one lonely trip.

When I was actually preparing to get discharged from the hospital, I was nearly bowled over by the finality of it all.

Leave?! How could I leave and go back into the land of life? My daughter is here! My little girl – my dream – she is staying behind!

I tried pulling myself together, but my insides were a mess of unresolved fears and tears. It dawned on me then that I had never fully grasped the difficulty of this moment. Physically pulling myself away from my baby was…torturous.

The hours passed and yet there was no way that I was leaving. Leaving my little baby here alone? Hours passed, shabbos was approaching and at one point we had no choice but to leave.

We took our discharge papers and went to the front entrance. We stood at the door leading out of the hospital. I stared outside, wondering at the hustle and bustle that continued unabated. It seemed so foreign to me.

“Where is your baby, ma’am?” a security guard asked me.

Could a shattered heart shatter once again? Could unfathomable pain grow even stronger and more searing?

“In the morgue!”

Apparently, pain has no threshold.

When I finally settled myself into the car a kind friend had arranged for us, I felt just how high those pain levels could climb.

The car started pulling away from the curb and I wanted to scream; to halt it in its tracks. He pulled off with full energy and..And then…I saw them. All of my precious little babies who once were and are no more.

They were there, flying ever higher – away from me, away from my arms. I watched them flying higher, all fourteen of them, and I felt my body trembling uncontrollably. I was being torn to bits and there was nothing anyone could do to help me!

I wanted them to stay, my little ones. I wanted them to be close to me; to lean their soft, feathery cheeks on my hands. But they were gone. They were gone. My heart was screaming in sheer agony…and no one even heard.

And now we were to face going home… face once again lighting shabbos candles. Do we add an extra candle? Does she make a difference in our family kleidescope? Do I daven for her or does she daven for me? So many complicated and unanswered questions.

The next few days were simply torturous. An unremitting cycle of tears and frozen numbness. At one point, I ventured outside to stand on my stoop for several stolen minutes. The world was rushing by, and I was befuddled. It was surreal. How could anyone move ahead when life itself had just ground to a halt?

And then I saw her. A woman who looked just as I had appeared a few days previous. She was carrying life. She was carrying hope.
I was carrying nothing but a huge, gaping hole. A hole that pulled and tugged…but remained nothing more than a deep, black void.

The feelings swept over me in torrential waves. I couldn’t look at her. I couldn’t look at anyone, for that matter. I didn’t want to talk to my friends or family. I couldn’t bring myself to reach out. It felt strange; completely unnatural.

After decades of being the mainstay of so many, how could I so drastically turn the tables on myself? The violation of my privacy was also a huge hurdle that was – and continues to be – a sore point.

So many people are looking at me and gauging my reaction. How will Malkie Klaristenfeld of Knafayim deal with this? As a professional, she has all the tools in her back pocket…

But I don’t! I’m a grieving mother, mourning the little bundle of joy that will never be mine! Doesn’t anyone understand?

Right now, I’m not Knafayim. I’m not Mrs. Klaristenfeld.

I’m just…Malkie. A mother in pain.

A mother bereft.

The Peak and the Pit

Shaindy Shiff

“We couldn’t save your uterus.”

The first words I heard after I emerged from surgery following the birth of my son.

It had been a difficult pregnancy, but my doctor kept assuring me that I was low-risk, that the birth would be smooth. And it was. I felt the first contraction in the middle of the night. As arranged, we woke up my mother- in-law, who lives just two blocks away from us. She was there in five minutes, sending us off with a flurry of brachos and reassurance.

Labor progressed steadily. As the sun cast her first shaft of gold across the horizon, I welcomed a new light into my life.

“It’s a boy,” cried the doctor. I immediately looked at my husband, and caught the pure joy upon his face. My husband adores his three delicious princesses, and they adore him. But I knew how much he longed for a son. And now here he was, a wrinkled slip of eternity. My husband cradled the tiny form.

After watching them for several minutes, I held out my hands to reach for my baby, but suddenly realized that something was horribly, terribly wrong. The doctor’s face turned grave. He pressed a button on the wall beside me. Instantly, two more doctors rushed in. “Uncontrollable hemorrhaging,” I heard him say. Too soon I was lightheaded. I felt myself teetering at the edge of consciousness.

“Prepare the operating room. Have lots of blood on hand. She’s O negative.” The doctor’s orders were clipped and urgent. He turned to me. “We don’t want this to get life-threatening. We need to operate immediately. We’re going to try to save your uterus.” Try to save my uterus?! I looked for my husband, my baby. They were gone, whisked away by a resident. A form and a pen were thrust in my hand. I signed with trembling fingers, knowing not what I relinquished.

“My husband, I need my husband.” A kindly nurse took pity on me, found him and brought him to the room. He was ashen.

He looked down at me, wordless. The silence between us was heavy, pregnant with the ten years we’d spent together, with the children we shared, with our past and our now-tenuous future. The orderly came to wheel me away. “Say viduy,” my husband whispered, and he was gone.

Ashamnu, bagdnu, gazalnu, it was the dead of the winter, but I lived through every Yom Kippur I had ever experienced. Debarnu dofi, heavinu, v’hirashunu. I’ve sinned. Made so many mistakes. Please, don’t destroy me because of those sins. Spare me, spare my body, the future children I want to bear. Keep me whole.

The operating room was cold metal, bright lights, sea-green walls, sheer terror. I was transferred to the narrow operating table, hooked up to one machine after another. The anesthesiologist threaded an enormous IV line into my veins, large enough to deliver four pints of blood simultaneously, and it hit me: it wasn’t only my uterus I was fighting for. I was battling for my life.

He put an oxygen mask over my mouth and nose, hooked me up to yet another machine. A single injection. My world went black.

****

The surgeon looked defeated as he quietly told me my uterus was gone. I heard his voice, understood the magnitude of what he’d just told me, but felt nothing. I was numb, frozen. An inner defense mechanism kept my emotions on ice so I wouldn’t drown.

I was transferred from the operating room to the recovery room, hooked up to oxygen, antibiotics, fluids. I felt a profound disconnect. The woman on the bed couldn’t be me. I could not have just lost the fulcrum of my femininity.

The surgeon returned. I noticed the blood splattered all over his blue scrubs. My blood. He looked at me, groped for words.

“This is not a sad day,” he finally said. “You have a healthy baby and you’re alive. And you can not take either of those for granted.”

It took a full day before I was stable enough to be transferred to the maternity ward and reunite with my baby. While I relished having my baby lie beside me, it was excruciating to be on that ward of joy. The weightless infants with their wise, wrinkled faces; the battle-weary women shuffling down the halls; the exuberant father bearing enormous bouquets and bobbing balloons. I couldn’t bear to be surrounded by it all.

I made it through that week, a week of searing physical pain, and emotional pain I just managed to keep at bay. My husband brought our daughters. They thrilled at their brother, but I was so drained by their visit, I begged my husband to take them home.

I was discharged just in time for our son’s bris.

I had refused all company while I was in the hospital, and was overwhelmed at the prospect of facing family, friends, and neighbors all at once. Few people knew that though I had come home with full arms, my body was empty. I selected a nice outfit, applied my makeup carefully, but the pallor remained.

I entered the hall and looked around. Family members who had traveled for hours, friends from the different decades of my life, neighbors from our close-knit community—they were all there. I was engulfed with love.

The mohel asked to speak with my husband and me before the bris. “The day of a child’s bris is a momentous day for his parents,” he began. “There are three partners in the creation of a child — the father, the mother, and Hakadosh Baruch Hu. The bris is the very last step in creation. And all three partners have a part to play in it. Your tefillos at this time can impact your son’s entire life.”

He gave us both a laminated card with tefillos. “May you be zoche to raise him to Torah, to the chuppah, and to maasim tovim,” he ended. “And may you be zoche to make many more brisim.” My husband and I exchanged a long glance. The mohel didn’t notice.

I sat at the edge of the hall, my white-clad baby sleeping in my arms, and started to daven. I focused on every word, on the hopes and dreams I had for this baby, for all my children. I felt myself rise above the dull burning in my abdomen, above the ache in my heart. After a week of being surrounded by harsh din I felt enveloped by Hashem’s rachamim.

Our baby was alive and well; the complications I had suffered had all began after he was safely out of my body. I was alive. The surgeon had described how close I had come to leaving my newborn an orphan. But that hadn’t happened, I was at my baby’s bris, and would hopefully lead him to the chuppah.

I was acutely aware of what wasn’t, of what would never be, but along with the pain I felt peace. This was the course Hashem had charted for me. I would never know why He wanted me bereft of such a vital organ at such a young age. But I didn’t need to know. I knew that this nisyon was meant to build me, not break me. I knew I was loved.

“Kvatter,” the mohel called. My neighbor stepped up and took the baby. She was already in her mid-forties and had several children, but she hoped for just one more. Bless her with a baby, I silently davened, grant her a new life. The baby was handed to her husband and disappeared behind the mechitzah. I repeated the tefillos the mohel had given us, saying the words again and again, beseeching Hashem to grant this child health and wisdom, yiras shamyim and his portion in Torah.

“Shema Yisrael, Hashem Elokeynu, Hashem Echad,” my husband’s voice rang out. Echad. He is One. In the blessings and in the brokenness. In times of gladness, in times of grief. It is all from Him.

“Shehechiyanu v’kimanu…” Hashem had kept us alive. He had brought us to this day. He would continue to sustain us.

Then, the high-pitched, plaintive wail. “V’yikare shimo b’Yisrael…” a pause as my husband whispered the name, “Nesanel ben Shmuel Yosef.” Nesanel—Hashem has given. Some of our guests raised their eyebrows; surely none of our grandfathers had carried this name. But we wanted a name which, each time we uttered it, would remind us of the gift we’d been granted.

Soon the baby was back in my arms. I held him tight, so tight. I fed him and rocked him. He was soon slumbering. The caterer brought out the first course, and then the main. I barely ate. My three girls surrounded me, happy to have me back. I cut up their chicken, tucked potatoes into my toddler’s mouth. I let her sit on my lap, even though it hurt my scar. Acutely aware of the gift of every child, I wanted to embrace every moment we shared, to savor it before it passed.

A steady stream of people came to wish me mazel tov. I smiled and returned their brachos; the smile wasn’t the thin one I had pulled over my lips the past week but an honest reflection of the joy that welled up within.

After dessert, as the caterer pushed a broom around the tables, I stood by the mechitza and benched gomel. And all the men—my husband’s colleagues and shiur-mates and neighbors and friends, the same men who had davened for me a week before as I lay under the surgeon’s knife—answered a thunderous amen.

The guest began leaving, and I was suddenly so very tired. My mother-in-law sensed my fatigue and graciously offered to take the children home with her. “Shmueli can drive you home with the baby. The girls will all come to me until after supper. And I’ll send food over for you and Shmueli when I send them back.” I wanted to bond with the girls after having been separated from them for a week, but I was too weak to protest.

I half-dozed during the short drive home. Shmueli turned into the driveway and I jerked awake. The front door was plastered with brightly-colored signs. In the center was one my oldest had made, carefully stenciled letters reading “Welcome Home Mommy and Baby!” The next sign was filled with bottles, baby carriages, and hearts, while my youngest had decorated her paper with a riot of color hard to decipher.

I stood at the door for a long moment, gazing at the signs. Never again. The words slipped through my mind and stayed there, an imprint, refusing to leave. You’ll never again come home to a welcome like this. You’ll never again experience the thrill of bringing a new life into your home.

I carried the baby, while Shmueli followed with my suitcase. In the bedroom, the cradle we had purchased for our oldest was already set up. We had been shocked at how quickly she had outgrown it, but comforted ourselves that it would be used many times in the future. Never again.

Newborn diapers, four different pacifiers all sterilized, a stack of pristine undershirts so tiny they looked like doll clothing.

I needed to be alone.

Shmueli was looking at me uncertainly. “You can go to the office,” I said, fighting to keep my voice steady. “We’ll be fine. The baby is sleeping, and I’ll also take a nap. If I need anything I can always call your mother.” He lingered one more minute, but he had pressing deadlines. Soon I heard the front door shut, his key in the lock, the car pulling away.

I gingerly placed the baby in the cradle, gave it an absentminded swing. I was alone, for the first time since… since… From deep within, a cry rose up. A scream of despair; the wail of misery too strong to withstand. A tsunami of grief, harsh and wrenching.

I had lost my core, the essence of my womanhood. And the pain— it was a live, writhing being. It seemed to swallow me whole. I couldn’t see beyond the blackness which suddenly shrouded my life.

The baby snored softly in the wooden cradle. I sat in the rocking chair, sobbing and sobbing until the well of tears ran dry.

My little one will soon be four. There have been days of knife-sharp pain, feelings of loss that leave me short of breath. But baruch Hashem, never have I revisited the depth of agony I experienced the day of my son’s bris.

Neither have I managed to return to the tranquil serenity, to the clarity, emunah, and joy I was blessed with on that day.

The two serve as signposts. I know the pit I need to avoid. And I know the peak I can one day scale. So I struggle through tangled emotions, through insensitive comments, through bittersweet milestones. I struggle and fall, rise and climb, as I try to reach the place where I’ll forever feel my Creator’s love.

The Lost Road

This is a story that has waited to be written. For months, it festered under the surface like an old wound, sometimes aching dully, barely noticeable, and sometimes throbbing most painfully. I was not sure it was worth the effort or notable enough to be told to others. People have faced and overcome much greater challenges, dwarfing me and my pain by comparison. Finally, I took pen to paper, revisiting this chapter in my life, and hoping to find relief from the turmoil of the last months.

The story begins last winter. My life is routine and mostly predictable. I am busy with my children, my work. There is always the next event to prepare for— a Yom Tov, a birthday, a vacation, with short lulls in between. I march down a clearly mapped path on a two-dimensional plane, with slight elevations or dips of predictable irregularities. My current pregnancy is just another familiar stretch of the same road. The milestones are clearly marked: I know when the morning sickness starts, peaks and eases, when to expect the first kick, when I’d begin to feel unwieldy and when the “finish line” would appear.

And so, I have very little forewarning when the road ahead disappears. I rush to the doctor for an ultrasound check, with the nurse reassuring me, “Everything’s probably okay, but let’s just make sure”.

I see the baby on the screen, with its little arms folded and legs bent. I ask the technician, “Is there a heartbeat?”

“No.”

Every single thing I had in motion in my life is suspended at this moment as I verify: “The baby is dead?” She nods and whispers, “Yes”. I cry as I ask for the first, last and only picture of this child, and wonder why she doesn’t hear my world crashing down around me. She hands me a tissue box and walks out.

They schedule a procedure for the next day. I head home, going on with my routine in a daze. After all the children are asleep, I sit on the floor to fold laundry. I am overcome with emotions, unsure as someone whose sure footing has just disappeared.

I want tomorrow to be over already, so I can start to grieve and to heal. I also want to keep my little one inside, in the safest place, the only place where such little babies belong. The place that’s no longer sustaining a life but is now a walking tomb. Tomorrow I will have to let go. At night, I dream of hospitals, doctors and operating rooms. In the morning, barely rested and still in a daze, I arrive at the hospital. Everyone, from nurses to orderlies to doctors, is so kind and considerate. I am already in labor, resenting every contraction. For these pangs won’t bring me the “prize” as my previous labors did. By the time I am in the operating room, I feel very weary and overcome with anesthesia.

Like a diver breaking the water’s surface, I come back from my anesthesia-induced sleep.

I’m in the recovery room and everything’s a bit bleary. My mind commands a question before my mouth can form it. On the third try I manage to ask, “How did it go?” I am told that the baby was born intact. My body did most of the work- the labor pains did have a purpose. I ask to see my baby.

I recoil when they bring the little form on a towel. It is tiny-at six inches, no baby of mine ever looked like this. No living baby ever looked like this. I am in uncharted territory now; I have no expectations. I grope my way through this with the aid of my heart, that of a mother. Choking with sobs, I sing the Shema, as I sing it with my children at night. For this child, too, is going to sleep.

For the next few weeks, the contrast between my outer behavior and inner state is staggering. Only a handful of people knew that I was expecting, so I go on as usual, routine carrying me through the day. Inside, though, I am wrenched with grief. I long for my baby to be back inside, safe and growing. I stifle sobs in my pillow so as not to wake up the household.

Ten days after the loss, I am at my son’s school for the annual Melaveh Malkah. Suits and sheitels, full crowd, smiles abound. Here and there I see a baby carrier with a tiny bundle inside. Crowds of women swarm about, part around the babies: “Oh, how cute! How old? Mazel Tov!” I want to stand up and shout: “I also had a baby, less than two weeks ago. Don’t I also get a Mazel Tov?” As this silent scream dies in my throat, I wonder how many others display smiles, but hide deep-seated pain…

Moving on, I try to fill the void with new household projects. I take on commitments I couldn’t get to before. I read about esoteric explanations of pregnancy loss and the medical reasons. I understand and acknowledge, but I cannot snap back to the way I was before. I can no longer count on my trusty roadmap. It crumbled in that ultrasound room. The loss gouged a deep pit in my two-dimensional plane, with me at the bottom, trying to find my way back to a sure road.

It’s now nine months later. I wish I could say that I am fully back on track; stable and sure as a year ago. But I am not. I wish I could say that I am expecting again, full of new hope. But I do not know that. I do know that my world view has shifted. The pain brought a new dimension and new depth to my life. My children’s laughter is now a little more musical. The hues of the leaves in my yard are a bit more vibrant. The pink of the clouds as the sun sets is breathtaking and reminds me of my little girl, buried in an unmarked plot. I gave her a name, and I now have another reason for davening for Moshiach to come-so that I can hear her laugh, give her a hug, and get one in return.

Reprinted with permission from Binah Magazine

Michelle Silverman

The appointment began with excitement. To start, it was a warm November day; I didn’t even need a jacket when I left home. I was happy to have what felt like springtime when the cold of winter had already set in. And on top of that, I had begun having mild contractions so I knew the baby was coming any day. Sunshine, excitement and anticipation. I expected to end the appointment saying, “See you again really soon, I think!”

But it was sooner than I had thought.

The nurse couldn’t find a heartbeat.

The induction was slow and difficult. Hours passed without any progress. The baby was turned sunny-side up. “The baby,” the nurse explained dismally, “is typically able to assist the mother in moving into the right position for delivery.” This delivery though was far from typical. My baby couldn’t help. My baby was dead. And labor wasn’t progressing.

During this long day we had many visitors come to our room to say how sorry they were and to cry by our side. Among them were the hospital social worker, the Jewish chaplain and the Chief of Maternal Fetal Medicine. “We discovered the reason for what happened,” the Chief said when he came into the room. A huge feeling came over me. I couldn’t imagine what he was about to say. “It was a Fetal-Maternal Hemorrhage.” The baby had been losing blood, to some degree, over some amount of time. And then—too much blood. Having a reason offered some consolation though it couldn’t change where that had brought us to now. More crying. I had cried during my other deliveries, tears of happiness before meeting my babies. These tears, though, were not those tears. This experience on the Labor and Delivery floor was nothing like a previous experience. This was one I could never have even imagined.

More hours passed, along with more contractions. The nurse managed to flip the baby over so labor finally progressed, and then it was time. The room filled with nurses and doctors.

Wednesday, November 27, 2019 at 10:29pm:

Silence.

The final punch in the stomach. That was it. Our baby was born and really was dead.

It was the loudest silence. No newborn cry. Nothing. Any sliver of hope I had that something would turn out differently was thrown away. Every piece of me wanted to pretend this was a dream but now I had no choice but to face the truth. This was the reality. The worst possible reality. They weren’t wrong. I wasn’t dreaming. Our baby was born, and if you weren’t there to see it, you wouldn’t have even known.

I asked the nurse to take the baby to be weighed, cleaned and swaddled. I wasn’t ready yet to meet our baby. Nothing could have prepared me for the glaring dichotomies I was being forced to face: I just had a baby, but there was no excitement. I wanted to hold my baby, but I didn’t know how I could hold my dead baby.

Finally, the nurse brought in the bassinet with our baby. At first I was nervous to look. I gained courage and saw—a beautiful daughter. I couldn’t believe it—another girl! I had thought this time for sure the baby must be a boy. Another little girl! I burst into tears. The nurse had wrapped her in a soft, light purple crocheted blanket. “She is so cute,” I said, over and over again through my heavy sobs. She weighed 6 pounds and 15 ounces. She resembled Avital with her delicate features, but shared my cleft chin like Zissel does, and she took after Michael the most of the three.

After spending time with her I wondered why I had ever been nervous to look at and hold her. I was immediately in love and didn’t want to put her down. She was ours, at least for now. After all this time, she was here. The moment had finally arrived. This, though, was definitely not the moment we had been expecting. More tears. I told her how much we love her and how we will never forget her. How I wish it all could have been different. How I wish we would have been able to watch her grow up. How much her sisters love her and would have loved to play together. How much she would have loved them. How she will always be a part of me and our family. Forever.

She stayed in the room with us for the night in a cold bassinet, donated to the hospital by other bereaved parents. It had a cover to keep the cold air in. A bassinet with a suffocation hazard. But this was no hazard. She didn’t need any air. She wasn’t alive. It was the quietest first night of sleep after the birth of a baby. I lay there only wishing to be awoken from whatever sleep I had been able to manage by the sound of my baby’s cries. Yet only the sound of silence.

The next morning, Thursday, brought Thanksgiving…and Boston’s Chevra Kadisha, the Jewish Burial Society. A nice man who I had never seen before and have never seen since came into our room. He carried with him a checkered duffle bag filled with some things. I didn’t want to look too closely. That bag is what he would use to transport our daughter out of the hospital to her next stop. With our last holds and kisses we left our daughter behind, to the care of this unknown man with his bag.

Walking away from my daughter was the hardest thing I have ever done. The most unimaginable feeling. I felt like I needed someone to pull me out of the room. We left slowly but purposefully, for otherwise I would have run right back in. Just one more hug. One more kiss. One more “I love you.” We came in with a baby and left her there. We walked out of the delivery ward empty-handed. We went into the elevator and the doors closed, our daughter on the other side. Never to see or hug her again. No new baby in the car seat coming home. The tears continued to fall and the silence continued to pierce.

Twelve hours: the total amount of time we were given to spend with our daughter. Our hello was our goodbye. She never got to meet her sisters. Her sisters never got to play with her and share their toys as they had been anticipating. The photos we took of her and with her are the only ones we’ll ever have. Her beautiful face, her cute little nose. A few photos and a card with her hand and footprint are the only evidence of her existence outside of my memory and the few who met her. Those holds, kisses and words were the only ones we’ll ever get to share with her. And they weren’t enough. No tomorrow, no redos—this was it. Thirty-nine weeks and five days with her had come and gone. All too fast.

Then it was Friday. Sitting on the couch, around 2:00 pm we got the phone call we had been waiting for: our daughter’s burial was completed. My baby was put into the earth and covered with dirt. Buried. The thoughts continued to ring over and over in my head: my baby is dead. My daughter lives in a cemetery. My daughter is buried. She’s so close—just a 15 minute drive—yet an entire world away. She is gone and we are left with only empty arms and tears.

And milk. My body didn’t know my baby died. Engorgement was exponentially worse because I couldn’t relieve the pressure by expressing milk, otherwise my body would produce even more milk. The physical pain was excruciating, and mentally it was torture. Waiting and waiting for the milk to dry up. Three months of reminders that our baby isn’t here, after bearing the nine uncomfortable months of pregnancy knowing it would all be worth it for the light at the end. Yet only darkness. Our baby is gone. All that remained after the milk finally dried up was heartache and silence.

And guilt. The doctor insisted the baby didn’t suffer, but how could he know that? In my mind she was huffing and puffing trying so hard to gasp for air. Struggling for each breath, until she couldn’t any longer. My poor baby. She was inside of me, yet not protected. She was with me. In me! This was all happening under my nose. “How could I have had no idea?,” I ask myself again and again. Was it something I did? Something I didn’t do? Did I not rest enough? Did I eat something I shouldn’t have? Did I not eat something I should have? I replay the last year in my head looking for what I could have done to change the outcome. I also replay the last month of the pregnancy and create alternate endings. I imagine they do detect something and I have an emergency delivery and my daughter survives! Torture. I realize I am torturing myself. There is no alternate ending. There is no sense in imagining for there is no hope here. How could this have happened? I felt like I had failed my daughter.

All three of them, really. I was heartbroken to think of Avital’s disappointment upon having to tell her there is no baby coming home. Avital and Zici had been talking about the baby. We had been preparing Avital for the day I would go to the hospital and she and Zici would come and meet their new sibling. Avital was planning it all: sharing her crib, her toys, taking care of the baby. Overnight we went from talking about the baby and my belly to redirecting any mention of a baby, that is until we gained some strength and could tell the girls more about what happened. I could never have imagined this is the turn it would take. I felt sad for all of us. And I missed my baby. My sadness was heavy and all-consuming. My efforts to fake normalcy around Avital and Zici were futile. Avital told her teacher, “My Mommy is so sad.” I couldn’t be there for Avital and Zissel like I wanted. I couldn’t do much of anything anymore. There is no escaping loss and grief. My baby was dead and it was only becoming more of a reality. A terrible reality.

Facing the outside world exacerbates my new, devastating reality. Everyone is carrying on about their business. Their regular conversations. Their daily routines, much of which seems trivial when seen through my lens. My world is so dark, so shattered. It’s isolating. I go about my life feeling like a black sheep, wishing I could wear a sign telling everyone: ‘I just had a baby and she is dead.’ Then maybe people would understand why it’s hard for me to smile, why it’s hard for me to focus, why all conversations lead to one place in my mind: my daughter. Yet even so, no one can carry the burden as heavily. Alone, again.

Life continues, but it’s a new life. I have triggers all around me now. Seemingly ordinary, everyday things bump against my bruised heart. Innocuous places, days, foods, feelings and sounds stir up difficult feelings that wouldn’t cause anyone else to skip a beat:

A song plays in a store and I have to leave because it was the song we listened to on Thursday when we came home from the hospital.

Tuesdays: Tuesday is the day we learned there was no heartbeat.

Wednesdays: Wednesday is the day our third daughter was born and died.

Fridays: Friday is the day our daughter was buried.

Thanksgiving: The worst week.

Weather: Uncharacteristically warm winter days like that Tuesday.

West Roxbury: Where my daughter is buried.

Costco: The last place I went before the doctor appointment.
Honda Odysseys: The minivan we were going to buy to fit our new family of five. A reminder that we are five minus one.

Cabbage and peppermints: Milk depressants used to reduce my milk supply only bring me back to those mentally and physically agonizing first few weeks.

Chocolate covered almonds: The last food I ate before the doctor appointment.

I look at the world differently now. My life will never be the same again; I don’t get a break from this reality or these triggers. I don’t get to pause my feelings of grief. Grief has carved itself a comfortable spot deep inside of me. It feels like a new organ within me that I am forced to lug around wherever I go. I feel a persistent heaviness in the background. I can laugh and enjoy myself, but a layer of sadness, an invisible film, covers me. My daughter is missing and it pulls at me.

When people ask: “How are you doing? I hope you’re doing well.”
I respond: “Yes, fine, thanks.”
What I am really thinking is: “Doing well? Not really. I’m constantly mourning my daughter. But otherwise? We are okay and healthy, thank G-d. But how can I separate the two?”

When people ask: “How are your daughters doing?”
I respond: “They are good, thanks.”
What I am really thinking is: “Two of them are good and the other is gone.”

When people meet us and say: “Aw, two little girls. What a nice family.”
I smile and say: “Thank you.”
What I am really thinking is: “There were three. This isn’t our full family. We have another daughter.”

When people in the grocery store say: “Your baby is so cute.”
I smile and say: “Thanks.”
What I am really thinking is: “Zici is not my baby. She has a little sister. I have a truly little baby. Only she’s dead. And she was really, really cute too.”

When pregnant people and people pushing baby strollers make offhand comments, what I want to say is: “Please know pregnancy and motherhood is such a blessing. That it doesn’t always turn out perfectly, so be extra grateful for your babies. I was pregnant too. I had a baby too. No one ever thinks this would happen to them. I would be holding a baby too. But instead she is dead.”

I have flashbacks. Flashbacks to the ultrasound. Flashbacks to the calls I made. Dreams. Dreams wondering if we need to buy formula only to realize over and over again our baby is dead. I wake up at night with no chance of falling back to sleep—the reality too sad to just roll over and close my eyes to. The middle of the night leaves me alone with my sadness.

I will never get to see my daughter again. Never get to watch her grow. Never get to hear her voice. I don’t even know what color her eyes are. I only get to squeeze that purple blanket she was once wrapped in, now filled only with my tears. I miss her so much.

Three months have passed and I have cried nearly every single day since November 26th. My eyes used to be swollen from crying. Then I was able to count on two hands the number of times a day I cried. Now it’s on one hand. Thank G-d I have two living daughters who fill my arms, yet even still my arms feel so empty. Thank G-d we have a lively, noisy home, yet a pervasive silence rings throughout. My heart has been shattered, but slowly the pieces are being glued together into a new form. The reality has begun to weave itself into my new life. My necklace with the initials A and Z now also includes a November birthstone. I added a fifth candle right alongside the four I light every week for Shabbos. I am including my daughter in whatever ways I can.

Experiencing grief like never before has been scary and overwhelming, as uncharted territory often is. One of the biggest comforts is knowing that others share my burden. It provides solace to feel like I am not alone as I navigate through these dark, unrelenting clouds that hover over me. It is a relief to feel like I have people holding my hands, carrying my pain with them, understanding how deep my sadness goes and how difficult and horrible this really is.

What I have found helpful is having freedom to grieve in the way I want—to move through my journey in whatever way I choose. To do what I need to do, however I do it. I have learned that where I am is where I should be and whatever I am doing (or not) is the right thing.

“Things will get better,” “You’ll feel happiness again,” “You have two beautiful daughters at home,” “You’re young, you’ll have more children.” Well-intentioned statements like these can’t console me because they don’t change what it is that cripples me: that my daughter died. That I miss her. That my life with her in it has been erased and that there is no getting her back. That is why I grieve.

I want to talk about my baby. I don’t want to try to be distracted or to pretend nothing happened. She is always on my mind and I want to share that. That’s the way I get to keep her alive. By including her, not by ignoring her. I want it to be known that she existed and that others care that she existed. I appreciate messages checking in on me, reaching out, even when I don’t respond.

I would love to know that you too are thinking about my baby. I will never forget her and I want to know that you won’t either. That together with me, you’ll carry on her memory.

It’s hard not to be sorrowful. I could easily zone out and go deep down into that painful hole: reliving the doctor appointment, thinking about our only moments together and leaving the hospital without her, imagining how she would have grown up with her sisters, rewriting my life without my daughter in it. After all, sadness is my only connection to her. But I have learned that sadness is not an effective, long-term way to connect to her. We will never forget our daughter but instead we want to connect and keep her with us in a positive way.

In addition to having had a tree planted in Israel to bring life to her memory, we have decided to create a Gemach in remembrance of our daughter (L’Zecher Nishmas). Gemach is a Hebrew acronym for Gemilut Chasadim—acts of kindness. Gemachs offer their resources free for people to borrow. Our Gemach will specialize in rare items geared towards babies, such as a bilirubin blanket to help newborns who are fighting jaundice and a precise baby scale, as well as other common necessities like high chairs and pack ‘n plays. These acts of helping kindness all brought about because of our daughter.

I don’t know if I will always feel a pang when I think about eating chocolate covered almonds or if one day maybe I’ll smile when I do, because while her birth was the saddest day of our lives, it was also among one of the best—the day we met our daughter, Chama (חמה).

I love you, Chama and miss you so,
Mommy

Behind My Smile

We had to say goodbye to you;
But I will never let you go.
You are a part of me forever;
I am your Mommy and I love you so.

Something is always hidden behind my smile;
A piece of me is gone with nothing left to show.
I have only my memories of our short time together;
And only in my imagination I get to watch you grow.

Even though I don’t get to see you,
Or give you hugs and kisses like I thought,
I always carry you with me,
Forever in my heart.

I think about you always;
I imagine you in your special spot so up high.
I know you’re happy and everything is good there,
Though I miss you, that is why I cry.

The world stopped for me on that day;
Time has frozen still.
You will always be my baby,
And my heart will never be filled.

~Inspired and adapted by poems from other bereaved Jewish mothers

Laura Macissac MD MPH OBGYN

Laura Maclsaac, MD, MPH, is a board certified obstetrician-gynecologist with subspecialty training in Complex Family Planning. She serves as the Associate Program Director of the Complex Family Planning Fellowship Program in the Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai

Dr. Maclsaac has created and led family planning training programs in several academic medical centers in New York City. She is a distinguished medical educator as the first recipient of the Ryan Residency Training Grant for Family Planning and recognized with national as well as institutional teaching awards. She also served on an expert working group for the U.S. Medical Eligibility Criteria for Contraceptive Use in 2010 and the U.S. Selected Practice Recommendations for Contraceptive Use in 2013. She participates in national and regional work as a Fellow of ACOG, including course director for post-graduate courses in Family Planning at the National Clinical Meetings, serving on the Long Acting Reversible Contraception Committee, and is the Chair of Section 1, District I of the American College of Obstetricians and Gynecologists. She has also published in a number of peer-reviewed journals and presented her work at national conferences.

Dr. Maclsaac received her undergraduate degree from Barnard College and her medical degree from the State University of New York at Stony Brook. She completed her obstetrics and gynecology residency at Columbia Presbyterian Hospital and completed a fellowship in family planning at the University of California, San Francisco. With the support of an ACOG Women’s
Health Policy Award, she completed a Master in Public Health in Health Policy and Management from the Mailman School of Public Health at Columbia University.

Monica V Dragoman, MD, MPH

Monica Dragoman, MD, MPH, is a board certified obstetrician-gynecologist with subspecialty training in Complex Family Planning. Dr. Dragoman is the System Director in the Division of Complex Family Planning and also serves as Program Director for the Complex Family Planning Fellowship in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai. She also holds an appointment as Assistant Professor.

Before joining Mount Sinai, Dr. Dragoman most recently served as Medical Director for Clinical Research and Training at Planned Parenthood of Greater New York. While at Planned Parenthood, she managed an active portfolio of research, including NIH- and industry-sponsored investigations of new contraceptive technologies while actively providing patient care and clinical training for various cadres of the clinical team members. Dr. Dragoman also has held an appointment as Medical Officer in the Department of Reproductive Health and Research at the World Health Organization (WHO) in Geneva, Switzerland where she participated in the update and development of a number of key family planning guidelines, including the WHO Medical Eligibility Criteria for Contraceptive Use. She has also consulted on a number of reproductive health projects domestically and abroad for organizations such as WHO, the CDC Foundation, Gynuity Health Projects, Ipas, the International Planned Parenthood Federation (IPPF), and Planned Parenthood Federation of America (PPFA). Her research interests include innovating service delivery and improving quality of abortion care as well as contraceptive access and safety among various subpopulations. Her work has been widely published in peer-reviewed journals and publications.

Dr. Dragoman is a Fellow of the American College of Obstetricians and Gynecologists as well as a Fellow of the Society of Family Planning where she also serves on the Clinical Affairs Subcommittee. She is an active Board Member of Global Doctors for Choice.

Dr. Dragoman received her medical degree from Medical College of Ohio and a Master of Public Health in epidemiology from the Mailman School of Public Health at Columbia University. She completed her residency in obstetrics and gynecology at University of Texas Southwestern Medical Center and went on to complete a fellowship in family planning at Columbia
University/New York Presbyterian Hospital.

Rachel Masch, MD, MPH OBYGYN

Rachel Masch MD, MPH, is a board certified obstetrician-gynecologist. Dr. Masch holds an appointment as Associate Professor in the Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai.

Before coming to Mount Sinai, Dr. Masch directed the Reproductive Choice Service at New York University/Bellevue Hospital. While there, she developed a family planning curriculum that was nationally distributed. She is a Fellow of both the American College of Obstetricians and Gynecologists and the Society of Family Planning.

In addition to her family planning activities, she is also the Chief Medical Officer of Basic Health International, an organization dedicated to the eradication of cervical cancer. Dr. Masch is committed to education, research, implementation, policy and advocacy. She has published in a number of peer-reviewed journals and presented her work at national and international conferences.

Dr. Masch received her undergraduate degree from Brown University and her medical degree from Brown University Medical School. She completed her obstetrics and gynecology residency at the Reading Hospital and Medical Center and received a Master in Public Health in Health Policy and Management from the Mailman School of Public Health at Columbia University.

Jonathan Lanzkowsky, MD OBGYN

Dr. Jonathan Lanzkowsky, MD is an Obstetrics & Gynecology Specialist in Brooklyn, NY and has over 29 years of experience in the medical field. Dr. Lanzkowsky has extensive experience in Obstetric Care. He graduated from FINCH UNIVERSITY OF HEALTH SCIENCES / CHICAGO MEDICAL SCHOOL in 1993.

Peer Dar, MD OBGYN

Pe’er Dar, MD, is Director of Fetal Medicine and OBGYN Ultrasound at Montefiore and Professor of Obstetrics and Gynecology and Women’s Health at our Albert Einstein College of Medicine. Dr. Dar’s clinical focus is on the care of women who carry babies with disorders and medical conditions that may affect their lives and he leads the Fetal Medicine and Surgery Team at Montefiore. He particularly specializes in diagnosis and management of medical and structural abnormalities in the fetus and in complicated twin and triplet pregnancies. His expertise include performing detailed ultrasound examination of the fetus including fetal echocardiography (scanning of the fetal heart) and fetal neurosonography (scanning of the fetal brain) as well as performing in-utero fetal surgeries such as fetoscopic laser surgery for monochorionic twins with twin to twin transfusion syndrome, in-utero blood transfusion for fetuses with anemia and in-utero drainage and shunt procedures. Dr. Dar is also experienced in performing amniocentesis, chorionic villous sampling (CVS) and multifetal selective reduction for multiple pregnancies.

Dr. Dar completed his Doctor of Medicine from Tel-Aviv University in Tel-Aviv, Israel in 1986. He started his postgraduate education at Assaf Harofe Medical Center, Tel-Aviv University, with a residency in obstetrics and gynecology and a specialty in high-risk pregnancies from 1992 through 1998. He then came to Montefiore-Einstein, completing a two-year fellowship in medical and reproductive genetics. After spending two years as an attending-specialist in the field of prenatal diagnosis he completed in 2005 three-year residency in obstetrics and gynecology at Montefiore-Einstein. In 2007, he completed additional training in fetal surgery in world-known fetal surgery centers in France and Belgium.

Dr. Dar is very active in research and he is currently the principal investigator in many studies including international multicenter studies. His research focus is in fetal medicine and surgery, non-invasive prenatal screening and placenta accreta spectrum. He has shared his work in many peer-reviewed journals, textbook chapters, abstracts and invited presentations. He is also a reviewer for national and international journals including the American Journal of Obstetrics and Gynecology, Plos one and Prenatal Diagnosis.

Dr. Dar is board certified in both Obstetrics and Gynecology and Clinical Genetics and is a member of several professional societies including the Society of Maternal and Fetal Medicine, International Fetal Medicine and Surgery Society and the International Society of Ultrasound in Obstetrics and Gynecology. He has been regularly listed among Castle Connolly Top Doctors for obstetrics and gynecology in the New York Metro area.

Adam R Jacobs, MD OBGYN

Adam Jacobs, MD, is a board certified obstetrician-gynecologist. He serves as the Medical Director of the Division of Complex Family Planning in the Raquel and Jaime Gilinski Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai and is the Ryan Residency Family Planning Program Director for The Mount Sinai Hospital.

Dr. Jacobs holds appointments as an Associate Professor in the Departments of Obstetrics, Gynecology and Reproductive Science, Pediatrics, and Medical Education. He established multiple family planning training programs over his career, including development of formal family planning clinical training at The Mount Sinai Hospital in 2004 and a LARC training program at the Mount Sinai Adolescent Health Center. He has received commendation for his efforts as a medical educator, winning both the CREOG National Faculty Award for Excellence in Resident Education and an APGO Excellence in Teaching Award. He also received a national award for his clinical service. He actively served as a board member for several leading family planning service and advocacy organizations, including Planned Parenthood of New York City and Physicians for Reproductive Health. His research interests include abortion safety, understanding and reducing abortion stigma, and contraception for transgender individuals and adolescents. He has published in a number of peer-reviewed journals and presented his work at national conferences.

Dr. Jacobs received his medical degree from the University of Medicine and Dentistry of New Jersey and completed a fellowship in obstetrics and gynecology at Albert Einstein College of Medicine, subsequently joining the faculty at Mount Sinai

Joshua Klein MD, FACOG

Dr. Klein is a board-certified reproductive endocrinologist and assistant professor of Obstetrics, Gynecology, and Reproductive Science at the Icahn School of Medicine at Mount Sinai. He earned his medical degree at Harvard University, completing his residency in Obstetrics, Gynecology and Reproductive Biology at Massachusetts General and Brigham & Women’s Hospitals. He did his fellowship in Reproductive Endocrinology and Infertility at Columbia University and is board-certified in Obstetrics and Gynecology as well as Reproductive Endocrinology and Infertility.

Before leading the Extend Fertility Medical Practice, Dr. Klein practiced for several years at one of the largest academic IVF programs in the US, where he served as medical director for Reproductive Medicine Associates of New York in Brooklyn. Dr. Klein has authored and co-authored publications in leading peer-reviewed academic journals such as Science, Fertility and Sterility, and Obstetrics and Gynecology. He has also written numerous chapters for medical textbooks and has presented research at national conferences including the American Society for Reproductive Medicine (ASRM).

Dr. Klein sits on the medical board of several fertility advocacy organizations and regularly gives lectures and presentations to community groups on infertility and fertility preservation. He is a Castle Connelly Top Doctor and has been named a Super Doctor each year since 2017.

Zev Williams, M.D. PhD

Zev Williams, MD, PhD is the Wendy D. Havens Associate Professor of Women’s Health and the Chief of the Division of Reproductive Endocrinology and Infertility at Columbia University Irving Medical Center. He completed his MD and PhD training in Molecular Biology and Biochemistry at the Mount Sinai School of Medicine before continuing to the Brigham and Women’s Hospital/Massachusetts General Hospital for his residency in Obstetrics and Gynecology. After completing his fellowship in Reproductive Endocrinology and Infertility at Weill-Cornell, Dr. Williams then did a post-doctoral fellowship on RNA biology in the laboratory of Dr. Thomas Tuschl at Rockefeller University. As a physician scientist, Dr. Williams’ focus has been on helping those suffering from recurrent pregnancy loss and infertility and developing novel technologies and treatments to improve patient success.

Alan A. Adler, M.D., FACOG

Dr. Adler is currently an Associate Professor in the Department of Obstetrics, Gynecology and Reproductive Science at the Icahn School of Medicine at Mount Sinai and is a fellow of the American Board of Obstetrics and Gynecology. Dr. Adler is the founding member of New York Obstetrics and Gynecology and has been in private practice since 1993.

Dr. Adler earned his undergraduate degree and graduated magna cum laude from New York University and was inducted into the Phi Beta Kappa Society. He received his medical degree from New York University Medical School, where he was inducted into the Alpha Omega Alpha Honor Medical Society and graduated as valedictorian of his class. He completed his residency in
Obstetrics and Gynecology at Mount Sinai Medical Center.

Victor Grazi, MD OBGYN

Dr. Victor Grazi, MD works in Brooklyn, NY as an obstetrics & gynecology specialist and has 38 years experience.

He graduated from University Of Pennsylvania / School Of Medicine in 1984. Dr. Grazi has has worked on more claims relating to high risk pregnancy, encounters for normal pregnancies and vaginal delivery and vbac than other providers in the area.

Fran McCarthy, MS, RNC

Fran McCarthy has been a nurse for over 35 years. For 28 years she was a Neonatal Intensive Care nurse at New York Presbyterian Morgan Stanley Children’s Hospital where she cared for critically ill newborns and first began to understand how to care for families facing loss, death and bereavement. For over 5 years she has been the Clinical Coordinator of the Neonatal Comfort Care Program at NYP Morgan Stanley Children’s Hospital under the direction of Dr. Elvira Parravicini, attending Neonatologist in the NICU. The primary focus of this program is to provide perinatal palliative care to women who are pregnant with babies with life-limiting conditions. The program accompanies mothers and their partners and families through pregnancy, birth and the grieving process. Fran considers this work a privilege and feels she receives much more than she gives.

Victor A. Rosenberg, MD, FACOG

Dr. Rosenberg is Board Certified in Obstetrics and Gynecology and Subspecialty Board Certified in Maternal-Fetal Medicine. He is a Cornell and Yale trained physician with an active clinical practice in high risk obstetrics.

During his fellowship, Dr. Rosenberg conducted innovative research and authored numerous publications on the topics of infection complicating preterm premature rupture of membranes (PPROM) and preterm birth and the role of proteomics in the diagnosis of infection. He also conducted a prospective study investigating the mechanism of action for heparin in the treatment of thrombophilia during pregnancy.

Dr. Rosenberg’s current practice focuses on all aspects of Maternal-Fetal Medicine, also known as “High Risk Obstetrics,” including prenatal ultrasound, management of high risk pregnancies, the prevention of recurrent adverse pregnancy outcomes and thrombophilia in pregnancy.
Dr. Rosenberg is an experienced consultant and medical expert witness for both plaintiff and defense.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Phone support groups

The bereaved father’s experience of grief is seldom acknowledged, and it can be an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where men can explore the unique ways men respond to and process their grief, moderated by licensed mental health professionals.

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Guidance & referrals

Perinatal and reproductive loss creates a storm of confusion—decisions need to be made and they have to be made quickly. Often, the bereaved father will feel the weight of responsibility for these decisions more heavily.

Knafayim is a source of information and support for medical and emotional decisions, as well as medical referrals, fast-tracked appointments with specialists, patient advocacy, family support, and help with rabbinical consultations. We offer guidance as to how the bereaved father can best support his wife, and discuss the different ways men and women process grief.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Phone support groups

In a community where pregnancy loss is seldom discussed, the mix of emotions during subsequent pregnancies can be an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women share their stories and support each other, moderated by licensed mental health professionals. (In-person groups may be available depending on location.)

Guidance & referrals

Pregnancy after a previous experience of loss can be physically and emotionally challenging. Knafayim is a source of information and support for medical and emotional decisions, as well as medical referrals, fast-tracked appointments with specialists, patient advocacy, family support, and help with rabbinical consultations.

Guidance & referrals

Infant loss creates a storm of confusion—decisions need to be made and they have to be made quickly.

Knafayim is a source of information and support for medical and emotional decisions, as well as medical referrals, fast-tracked appointments with specialists, patient advocacy, family support, and help with rabbinical consultations.

Emotional doula services

When a couple knows their baby will be born still, one of our specially trained emotional doulas will support them through the birth and guide them in the process of saying hello in order to say goodbye. Their options will be clearly explained and presented so they can make informed decisions about how to spend these final moments with their baby and have a supportive space for their transition into the postpartum experience of loss.

Final arrangements

To protect the emotional experience of the bereaved parents’ precious few moments with their baby, we coordinate with the chevra kaddisha so the final arrangements are handled with dignity and respect for the family’s customs and rabbinic counsel.

Care packets

After a loss, the body knows it’s no longer pregnant but doesn’t know there’s no longer a baby to feed and will therefore produce milk. Our specially curated postpartum support packet is a collection of lactation cessation tips, products, and vitamins that offer bereaved mothers the information and practical support to help them transition through this painful process as quickly as possible.

Leaving the hospital following a miscarriage means leaving with achingly empty arms. Our Whispers in the Night support packet gives the bereaved couple permission to grieve through a thoughtfully curated collection of information, chizuk, and inspiration that includes a comprehensive book on loss and grief. These materials offer validation and solace that can be reached for again and again, at any time of the day or night. Both packages are available in many hospitals and medical centers or can be discreetly home-delivered by local coordinators.

Phone support groups

In a community where pregnancy loss is seldom discussed, having a baby born still can be an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women share their stories and support each other through their grief, moderated by licensed mental health professionals. In addition to the support group for general loss, we have separate groups for women who’ve experienced recurrent pregnancy loss (RPL) and for women who’ve experienced loss following infertility treatments. (In-person groups may be available depending on location.)

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

In-person events & retreats

The extreme secrecy most women maintain around their hysterectomy can lead to feelings of deep shame, embarrassment, fear of judgment, and loss of one’s sense of femininity. Several times a year, we arrange exclusive in-person get togethers for powerful post-hysterectomy support, inspiration, and comfort within a community of sisters.

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Phone support groups

Hysterectomy is an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women can feel safe to openly share their stories and support each other through their grief, moderated by licensed mental health professionals. (In-person groups may be available depending on location.)

In-hospital support

The immediate aftermath of a hysterectomy is a time of extremely painful loneliness and loss. Knafayim is there to hold a woman’s hand as she mourns the loss of her future babies and to let her know that she is not alone. Other women have walked this path as well and when she’s ready, there’s a sisterhood of support waiting for her.

Guidance & referrals

Hysterectomy and loss of fertility creates a storm of emotion and confusion. Knafayim is a source of information and support for medical decisions, as well as medical referrals, fast-tracked appointments with specialists, patient advocacy, family support, and help with rabbinical consultations.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Phone support groups

Grieving the loss of a baby one never got to take home an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women can feel safe to openly share their stories and support each other through their grief, moderated by licensed mental health professionals. (In-person groups may be available depending on location.)

Care packets

Our specially curated postpartum support packet is a collection of lactation cessation tips, products, and vitamins that offer bereaved mothers the information and practical support to help them transition through this painful process as quickly as possible. Leaving the hospital following the baby’s demise means leaving with achingly empty arms. Our Whispers in the Night support packet gives the bereaved couple permission to grieve through a thoughtfully curated collection of information, chizuk, and inspiration that includes a comprehensive book on loss and grief. These materials offer validation and solace that can be reached for again and again, at any time of the day or night.

Both packages are available in many hospitals and medical centers or can be discreetly home-delivered by local coordinators.

Final arrangements

To protect the emotional experience of the bereaved parents’ last moments with their baby, we coordinate with the chevra kaddisha so the final arrangements are handled with dignity and respect for the family’s customs and rabbinic counsel.

Continued comfort

When the baby lives beyond the birth, our focus is on providing palliative care for as long as the baby continues to draw breath. We support the family in any way possible, allowing them to cherish the time they have together.

Emotional doula services

When the time for the birth arrives, one of our specially trained emotional doulas will be there to assist at bedside and create a supportive space for the couple to bond with their baby for as long as they can.

Collaborative care

A diagnosis of fetal anomaly results in a team of medical professionals in various specialties. Our relationships and connections within the medical community allow us to create a supportive web of collaborative, cohesive, and compassionate care.

Guidance & referrals

Once the decision to continue the pregnancy has been made, Knafayim is there for ongoing guidance, patient advocacy, referrals to the specialists and medical centers best suited to the couple’s unique situation, and family support.

In-person consultation

When an expectant couple is blindsided with the devastating diagnosis that their baby may not survive the pregnancy or birth, they’re thrown into a turmoil of confusion and terrifying medical terminology. We provide immediate in-person option counseling, referrals to top doctors and assistance in getting appointments for second opinions, and access to the highest level of medical care and rabbinic guidance, empowering them to make informed and supported decisions regarding their next steps.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Phone support groups

In a community where the decision to terminate for medical reasons is never discussed, holding this loss can be an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women can feel safe to openly share their stories and support each other through their grief, moderated by licensed mental health professionals. (In-person groups may be available depending on location.)

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Final arrangements

To protect the emotional experience of the bereaved parents’ precious few moments with their baby, we coordinate with the chevra kaddisha so the final arrangements are handled with dignity and respect for the family’s customs and rabbinic counsel.

Care packets

When the pregnancy ends, the body knows it’s no longer pregnant but doesn’t know there’s no longer a baby to feed and will therefore produce milk. Our specially curated postpartum support packet is a collection of lactation cessation tips, products, and vitamins that offer bereaved mothers the information and practical support to help them transition through this painful process as quickly as possible.

Leaving the hospital following the termination of a pregnancy means leaving with achingly empty arms. Our Whispers in the Night support packet gives the bereaved couple permission to grieve through a thoughtfully curated collection of information, chizuk, and inspiration that includes a comprehensive book on loss and grief. These materials offer validation and solace that can be reached for again and again, at any time of the day or night.

Both packages are available in many hospitals and medical centers or can be discreetly home-delivered by local coordinators.

Emotional doula services

Whether it’s a scheduled D&E or an attempted natural delivery, one of our specially trained emotional doulas will be there to support the couple through the procedure and guide them in the process of saying hello in order to say goodbye. Their options will be clearly explained and presented so they can make informed decisions about how they want to spend these final moments with their baby and have a supportive space for their transition into the postpartum experience of loss.

Guidance & referrals

Once the painful decision to terminate the pregnancy has been made, Knafayim is there for ongoing guidance, patient advocacy, and family support throughout the difficult process, with referrals to the specialists and medical centers best suited to the couple’s unique situation.

In-person consultation

When an expectant couple is blindsided with the devastating diagnosis that their baby may not survive the pregnancy or birth, they’re thrown into a turmoil of confusion and terrifying medical terminology. We provide immediate in-person option counseling, referrals to top doctors and assistance in getting appointments for second opinions, and access to the highest level of medical care and rabbinic guidance, empowering them to make informed and supported decisions regarding their next steps.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Phone support groups

In a community where pregnancy loss is seldom discussed, having a baby born still can be an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women share their stories and support each other through their grief, moderated by licensed mental health professionals. In addition to the support group for general loss, we have separate groups for women who’ve experienced recurrent pregnancy loss (RPL) and for women who’ve experienced loss following infertility treatments. (In-person groups may be available depending on location.)

Care packets

After a loss, the body knows it’s no longer pregnant but doesn’t know there’s no longer a baby to feed and will therefore produce milk. Our specially curated postpartum support packet is a collection of lactation cessation tips, products, and vitamins that offer bereaved mothers the information and practical support to help them transition through this painful process as quickly as possible.

Leaving the hospital following a miscarriage means leaving with achingly empty arms. Our Whispers in the Night support packet gives the bereaved couple permission to grieve through a thoughtfully curated collection of information, chizuk, and inspiration that includes a comprehensive book on loss and grief. These materials offer validation and solace that can be reached for again and again, at any time of the day or night. Both packages are available in many hospitals and medical centers or can be discreetly home-delivered by local coordinators.

Final arrangements

To protect the emotional experience of the bereaved parents’ precious few moments with their baby, we coordinate with the chevra kaddisha so the final arrangements are handled with dignity and respect for the family’s customs and rabbinic counsel.

Emotional doula services

When a couple knows their baby will be born still, one of our specially trained emotional doulas will support them through the birth and guide them in the process of saying hello in order to say goodbye. Their options will be clearly explained and presented so they can make informed decisions about how to spend these final moments with their baby and have a supportive space for their transition into the postpartum experience of loss.

Guidance & referrals

Pregnancy loss creates a storm of confusion—decisions need to be made and they have to be made quickly.

Knafayim is a source of information and support for medical and emotional decisions, as well as medical referrals, fast-tracked appointments with specialists, patient advocacy, family support, and help with rabbinical consultations.

Messages of hope

Shabbos and Yamim Tovim are very vulnerable times for bereaved parents. Malkie’s weekly Erev Shabbos emails are messages of connection, chizuk, and inspiration culled from the weekly parashah. Her pre-Yom Tov calls offer divrei chizuk and practical strategies for the painful reality of entering another Yom Tov with empty arms.

Teleconference series

Without the familiar structure of levayah, shivah, and shloshim, grief can feel ambiguous and confusing. Our live teleconferences target the unique characteristics of reproductive loss, addressing topics such as trauma, am I still a mother, and what do I tell my siblings. This twice-yearly series includes 8 weekly presentations by medical professionals and therapists trained in reproductive trauma and bereavement care, followed by question-and-answer sessions. It is a safe space for bereaved parents to share their most painful questions and get individualized answers from experts in the field.

Phone support groups

In a community where pregnancy loss is seldom discussed, miscarriage can be an extremely isolating and lonely experience. Our phone support groups are a place of comfort and healing where women share their stories and support each other through their grief, moderated by licensed mental health professionals.

Therapeutic support

The lived experience of grief sometimes warrants one-on-one support from a mental health professional. We have cultivated a wide network of therapists trained in perinatal loss and facilitate referrals and funding (when necessary) for crisis counseling and bereavement support.

Care packet

Leaving the hospital following a miscarriage means leaving with achingly empty arms. Our Lingering Dreams support packet gives couples something to take home with them, something that acknowledges they deserve support for their loss. The thoughtfully curated collection of information, chizuk, and inspiration offers validation and solace that can be reached for again and again, at any time of the day or night.

Guidance & referrals

Pregnancy loss creates a storm of confusion—decisions need to be made and they have to be made quickly.

Knafayim is a source of information and support for medical and emotional decisions, as well as medical referrals, fast-tracked appointments with specialists, patient advocacy, family support, and help with rabbinical consultations.

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David B. Lubell, MD OBGYN

Dr. Lubell is board certified in obstetrics and gynecology. He received his Medical Degree from the Bruce Rapaport faculty of Medicine at the Technion Israel Institute of Technology in Israel, graduating Cum Laude. He completed his residency training at the Albert Einstein College of Medicine, where he received numerous awards and recognition for his medical research and clinical teaching skills. Dr. Lubell is an academic faculty member at Icahn School of Medicine at Mount Sinai Hospital in New York. He is actively involved in educating medical students and resident staff. In addition to being highly proficient in all aspects of OBGYN, Dr. Lubell’s special interests include vaginal birth after cesarean (VBAC) delivery, management of depression and anxiety in pregnancy, adolescent GYN, family planning, menopausal issues for women and minimally invasive gynecologic procedures. He is known for providing exceptional care based on a foundation of caring and sensitivity.

Still a Mother Support Group with Dvora Entin, LCSW

Still a Mother Support Group with Dvora Entin, LCSW

CLICK HERE for a Recording of Part 2 of our series “IT’S OK NOT TO BE OK”

"Am I Normal?"
with Merav Kaisman, LPC and Toby Klein, LMSW

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Locations

Main Location - Brooklyn

Bianca Stifani, MD MPH FACOG

Colleen Denny, OBGYN

Laura Macissac MD MPH OBGYN

Monica V Dragoman, MD, MPH

Rachel Masch, MD, MPH OBYGYN

Jonathan Lanzkowsky, MD OBGYN

Peer Dar, MD OBGYN

Adam R Jacobs, MD OBGYN

Joshua Klein MD, FACOG

Zev Williams, M.D. PhD

Alan A. Adler, M.D., FACOG

Victor Grazi, MD OBGYN

Fran McCarthy, MS, RNC

Victor A. Rosenberg, MD, FACOG

David B. Lubell, MD OBGYN

"Am I Normal?"with Merav Kaisman, LPC and Toby Klein, LMSW

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Fill the empty spaces with healing and hope.

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Locations

Main Location - Brooklyn

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"Am I Normal?"
with Merav Kaisman, LPC and Toby Klein, LMSW