Lying on the examining table, I gasped as the sonographer smeared cold gel on my stomach.
Then, as the grainy picture appeared on the screen beside us, I held my breath.
This wasn’t my first ultrasound. At this point in June 2007, I was eight weeks into my second pregnancy.
But whereas before I had prayed just to hear a heartbeat, this time I was praying there would only be one.
My husband and I started trying for a baby soon after we married in 2004. Eighteen months passed before tests confirmed there was no likelihood of my conceiving naturally.
We were devastated and decided to have fertility treatment right away. My husband’s father generously gave us the £3,500 for IVF, and we were over the moon when, in the summer of 2006, an early scan confirmed I was carrying twins.
The first trimester of my pregnancy progressed smoothly, and around 20 weeks, we began getting ready to become a family of four.
We painted the nursery and squeezed in two cots. We bulk-bought nappies, fitted two car seats and splurged on a double buggy. When we learned that both babies were boys, we chose their names: Alex and Josh.
Then suddenly, when I was 26 weeks pregnant, my waters broke and I was rushed into hospital. I was given drugs to prepare the babies’ lungs and told to brace myself for a premature delivery.
I was terrified. My antenatal classes were due to start the following week and I knew nothing about the labour process.
A fortnight later, on 5 November 2006, three months ahead of schedule, our boys were born, in a swift but terrifying labour about which I still sometimes have nightmares.
In addition to my own midwives and obstetrician, there was a nurse and paediatrician present for each twin, monitoring all three of our heartrates and crowding around me as I pushed.
It felt like a nightmare, and a world away from the magical birth I had envisaged.
I was permitted only the briefest of look at each of my babies before they were whisked into neonatal intensive care. They weighed a combined total of five and a half pounds, each fitting into an outstretched palm. Their skin was translucent.
Both boys were put in incubators and placed on oxygen. Later that day, I was allowed to hold Alex for a few minutes, and the following day, Josh was strong enough to come out of his incubator.
Premature babies often stay in hospital until around their original due date. Slowly, we began talking about when our sons might come home.
But in December, Alex contracted meningitis. His decline was rapid and horrific, and after he suffered a brain haemorrhage, we removed him from intensive care and held him as he died.
Grief hit me like I’d been hurled from the top of a skyscraper. It seemed impossible I was still breathing, when my heart had shattered into a million pieces.
And yet we couldn’t crumble. The day after Alex died, we walked back into neonatal intensive care to be with his twin brother. Every milestone Josh reached was bittersweet, and every setback filled me with fear that we’d lose him, too.
Thankfully, in February 2007, Josh was finally discharged from hospital.
We had given away the second car seat and cot, and the double-buggy, but I couldn’t bring myself to remove the letters from the nursery door that spelled out Alex’s name.
Five months went by in a blur, as I was still stumbling through grief and early motherhood. I felt numb and struggled to relate to other parents who had enjoyed easy pregnancies and labours. If I saw twins, I had to cross the road. It was too painful to watch what should have been my life.
And then I discovered I was pregnant.
Having conceived naturally this time, I should have been elated, but all I felt was terror.
Terror that it would be twins again and that history would repeat itself.
And so there I was at my scan, holding my breath and scanning a computer screen for the flickering light that would indicate a heartbeat.
Then there it was.
And then I saw the second one…
Twins again. I tried to leave the room, with my trousers still rolled down and gel still smeared across my stomach. This couldn’t be happening.
I spent the entire pregnancy in denial and refused to make any preparations. I couldn’t allow myself to imagine leaving hospital with two babies in my arms.
This time, I held on until 38 weeks.
Extraordinarily for a busy hospital, the midwife who delivered Alex and Josh was once again on duty. I had a photo of Alex with me, and she pinned it to the wall where I could see it, and told me to focus on the photograph, not the dozens of people in the room.
Two hours later, I delivered my second set of twins in 15 months: Evie and George. Thankfully, they were born healthy and were able to come home immediately.
Life with three children under two was chaotic but wonderful. Having twins again forced me to confront my feelings of loss, and slowly I began to enjoy motherhood.
There were moments when my grief spiked, such as when Josh started school, or when I saw how close Evie and George were. But over time, I learned to accept what had happened.
Having more than one child, though, does not make it any easier to lose one, and I will always grieve for my first-born.
Alex will always be a part of our family. We talk about him often and we have found small ways to remember him in ways that no longer hurt.
The day he died – 10 December – has become the day we decorate our Christmas tree, turning what was once a difficult and desperately sad day into something happier and more hopeful.
I have learned that grief is unique to each person experiencing it. I learned to give into whatever my body needed: to allow myself to cry, but also to allow myself to laugh without feeling guilty. I also found great comfort in writing.
Eight years after Alex died, I published my first book, and I have gone on to write six more bestselling novels, many of which touch on the subject of grief.
This year, though, I finally wrote explicitly about my own loss, and about what I’ve learned about recovering from grief.
Although the process was hard, it was also cathartic, and I’d urge anyone struggling with grief to try journaling or writing creatively. The conversations I’ve had with readers since writing my memoir have been profoundly moving, and it’s clear we need to have more conversations about death and loss.
Now, my surviving children are teenagers, and my life is full. My grief is very different to how it was in the immediate aftermath of Alex’s death. We never ‘get better’ from grief, but there comes a time when it no longer consumes us, and I am grateful to have reached that point.
My heart goes out to all those for whom grief is still raw. It is a small comfort to know you are not alone, but we are here, standing beside you, in the club none of us asked to join.
Clare Mackintosh’s memoir, I Promise it Won’t Always Hurt Like This, is published by Sphere and out now.
This article was first published on Apr 28, 2024.
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