From Issue 23: "Fertility Awareness" by Brianna Avenia-Tapper (Nonfiction)

Fertility Awareness                                                                 

Brianna Avenia-Tapper

Reading Time: 8.5 minutes

"Fertility Awareness" debuts in Issue 23 of Tahoma Literary Review. The theme is both evergreen and particularly topical. The essay grabbed me from the first sentence to the last. On my first reading of the piece, I didn't realize I was holding my breath until that last amplified phrase.

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Ann Beman
Nonfiction editor


Cathy was waiting for someone’s child to die. That’s how it is when you need an organ, and her son needed new lungs. For a short time, I waited with them. I slept on the floor of the Ronald McDonald house where Roland watched Peppa Pig and Cathy made almond-butter smoothies to push through his feeding tube. While they attended doctors’ appointments, I listened to the bees in the Olson Family Garden on the eighth floor of the St. Louis Children’s Hospital. In the garden, life cascaded over curving flower beds and flung itself across the tidy paths, flitting from bloom to bloom and then rising suddenly to a top branch before taking off into the endless sky. In the garden, there were ants and twigs and scattered soils. It seemed almost a mistake—such surplus, such fertile mess—just feet away from silent antiseptic hallways where everyone was either fighting or dying.

The summer I visited Cathy in St. Louis, she cleaned the phlegm from Roland’s trach, and coaxed him into the bath. She woke up over and over again, at all hours, every hour, every night, to calm her restless child. While she waited for Roland’s new lungs, we went to the Missouri Botanical Gardens and looked at the lily pads and roses and the glass-paneled conservatory. We wandered through the rock garden where low, thick thyme carpets filled all the available space between the rocks, insatiable, baking in the sun. We pushed through the giant bushes by the edge of the lake and looked into the brown water where stripe-necked turtles poked their pointed noses at the surface. The low branches of fat lake-side bushes brushed against our shins.


In The Garden of Your Fertility, a comprehensive explanation of the “fertility awareness” method of birth control, author Katie Singer begins with a quote from Susan Griffin. We know ourselves to be made from this earth. We know this earth is made from our bodies. For we see ourselves and we see nature. We are nature seeing nature.

My mother has spent more time in the earth than anyone I know. She grows food from rich soil with her own hands. She has exactly one joke. It goes like this: What do you call people who use the fertility awareness method of birth control? The punchline is parents.

My mother used the fertility awareness method. She did not intend to become pregnant with me. It was not something she would have chosen. While I moved inside her, she dreamt that she was being chased by something heavy and fanged. Each night she would run and run, the hot breath of the fanged thing so close behind, it was almost a part of her. In another of these repeated dreams, my father burst into flames.

She married him anyway. I was there with her at their wedding, burrowed deep inside her yellow dress. We listened together when my father sang from the front of the church. Inch by inch and row by row, gonna make this garden grow... all it takes is a rake and a hoe and a piece of fertile ground…


“It’s very common, isn’t it, to hope for miscarriage?” My mother asks me, anxious. Remembering, perhaps, that day in the church, the yellow dress, when she was young.


I read a story years ago, about a young woman who became pregnant accidentally. At the same age, maybe, as my mother had. In the story, the woman’s life was over. She would have to marry the man who made it so. And then one day unexpectedly there was a small thin trickle of blood down the inside of her leg. Here! said her mother, handing her a hoe and pointing toward the garden. Go! This is your chance. There, in between the rows of growing things, the woman raised the hoe over her head again and again, drawing it through the dark earth, slicing through the hopeful shoots of new weeds, more and more blood coming, soaking the back of her dress.


My mother went into labor with me while she was hoeing. She had a job on a farm in Maine that summer, warm under the New England sun. That day when the contractions started, she was hoeing a row of young tomatoes. It would have been June then, the tomatoes still small and green.

Growing plants is similar to growing children. Both can be a fertile accident, like weeds. The earth, our bodies, seizing on their eternal elemental purpose to propagate, to blossom, to begin anew. The difference between plants and weeds is one of intention. Weeds are the ones the gardener does not want. My mother spends endless hours each summer fighting weeds, kneeling in the dirt and pulling with her hands, or standing and hacking at the soil with a hoe. On some beds, she lays down dark black plastic like a fitted sheet, tucking soil in around the edges. The seedlings she wants to grow are transplanted to small holes in a long line through the center of the plastic. This plastic is meant to block the sun, so that all the weeds will wilt and shrivel.  


At the St. Louis Botanical Garden, Cathy picked Roland up on her shoulders, his trach swinging in the air against their bodies, the willow bows drooping low to the earth behind them. Willows are a symbol of sorrow, of course, with their eternal weeping, but legend also has them growing along the Euphrates in the mythical Garden of Eden, in the Fertile Crescent, that rich soil between the Mediterranean Sea and the Persian Gulf. It is the Cradle of Civilization, the land where Christ was born, where Adam and Eve ran naked and where Eve ate that forbidden apple. It is where humanity learned both gardening and shame.


At the Botanical Gardens, we saw fruit trees, hawthorn bushes, wild plum, Osage orange, and perfect, brilliant bird cherries too bright to possibly be real. It reminded me of my mother, of how she will need to learn to graft. Fruit trees grow from graphs, like organ transplants. Gardeners, like surgeons, insert a new and foreign branch, a scion, into an already thriving trunk. Sometimes, as with organs, the graft does not take. The root system remains, but the scion dies. This kind of failure is most common when the scion is too different from the base. A black cherry can be grafted on a bird cherry, but not onto an Osage orange. The orange and cherry are too unlike each other. You can often tell where a tree has been grafted. There is a bulge. The trunk swells outward around the point of contact, where the new branch is hanging on, hoping for life. Scion’s second meaning, after all, is child.


Once a child young enough has died, once a fresh pair of lungs has been relinquished, Cathy must wait again. She waits to see if Roland’s system will accept the lungs. His body might reject them. Transplanted organs, sometimes called allografts, are often rejected. Allografts may experience hyperacute rejection, obvious immediately, or chronic rejection, the low-grade kind of neglect that never ends.


Some scientists think of the human fetus as an allograph. It is foreign tissue, after all, including genes from the father, and so technically an alien invader in the mother’s body. It should be destroyed by the mother’s immune system. But somehow this fetal allograph manages to escape attack. It survives the battle that organ allographs so often lose. When the embryo implants, the cytokines aren’t activated. The embryo isn’t destroyed by the mother’s inflammatory response, as Roland’s new lungs may be. When the embryo implants, it creates a sort of protective covering that deactivates the immune response in that area. It is as if the child itself calls forth a shield against the mother. As if the fetus is already fighting with her mother for her own becoming.


We were pregnant at the same time, Cathy and I. The summer Roland was born I stood on the beach of a small lake in a bathing suit, stretching up towards the sun. The woman next to me eyed my midsection doubtfully.

“You’re how far along?” she asked.

“Eleven weeks,” I announced, and plunged into the shallows of the sun-stroked lake, imagining the tiny fetus swimming inside me, just as I swam through the waters of the summertime earth. I wriggled my legs through the slimy stems of tangled lily pads.

To my boyfriend Elliot, I declared, “I’m having a baby.” I reached across the space between us to touch his arm, “If you want to be with me, you are having a baby too.” There was a string of long silent days during which I waited and he did not answer. And then there he was beside me, at the entrance to the rest of our life. He wanted me, he said, and he wanted our baby. My breasts ached and my stomach churned.

The day before my twelve-week appointment, a week before Roland was born, there was blood on my underwear. Lacking any reference point for the meaning of this dark stain, I called the doctor and he told me to come in. He looked inside me. And then he said,

“I’m sorry, I can’t hear a heartbeat.”


Days later, a brand-new Roland came into the world. I flew to a tiny airport in Wausau, Wisconsin, and stayed for two nights, held the curled-up Roland on my chest. I watched Cathy hold her newborn child below the window that looks out at her garden. The second day, I sat beside Cathy while she tried, like all the new mothers before her, to convince her child to nurse. She fixed a tiny plastic tube to her chest with white surgical tape, so that one end hung at her nipple, dripping milk, while on the other end, she had attached a syringe. I held the syringe, and she held Roland’s small head, aimed him at her breast. Together we tried, without success, to make him suckle.


After I got home from Wisconsin, I bought a plant. It had large leaves laced with white, a sturdy stem. I set it by the window, where there was light, and I gave it water. Soon, new leaves sprouted. At first, I checked on it each day, fingered its soil and gently brushed the dust off its leaves. Soon, I bought more plants and set them beside the first until there was a whole potted garden crowded under the window. My mother saw this little garden when she visited my apartment.

“Brianna!” she cried. “You have plants!” I swelled with pride, as though we both believed these tender green things growing between us could make up for all the barren space.


I still have my window garden. Each thing growing there was chosen. A peperomia hangs in the corner, a peace lily bows its broad leaves from the center of our dining table. There is a stout and cautious jade and an enthusiastic rubber plant outgrowing its pot. They crowd around our biggest windows slurping up the afternoon sun. My daughter Josephine was conceived as I built this garden. She was not an accident. She was a choice. She was born on the first day of spring, when everything begins to bloom.


Roland is tall and strong now, a handsome six year old with working lungs. He can climb and swing and loves to splash in any water he can find. Cathy takes him back to St. Louis every six months, so that the doctors there can monitor his progress. She takes him to the Botanical Gardens on every trip. They walk under the trees and run through the fountains and brush their arms against the lake-side bushes.

My own daughter has a T-shirt handed down from Roland. She asks sometimes for that shirt, for the one Cathy gave her, and we dig through her closet, looking together to find the thing she has chosen. We visit Cathy and Roland at their home in Wisconsin on Mother’s Day. Roland has a giant trampoline now in the backyard that he loves. At their house, I watch Roland leaping on his trampoline, catapulting my daughter and Cathy toward the sky, their bare feet specked with cut grass. And I think, 

I choose you, I choose you, I choose you.

Reprinted with permission of the author

Avenia-Tapper had this to say about her piece:

My memoir-in-progress probes the connection between love and choice, and this essay grew out of my exploration of that connection. It also began with a desire to write about my friend Cathy, whom I admire.

Brianna Avenia-Tapper lives with her family in New York City, where she is hard at work on a memoir-in-essays about impermanence, interdependence, Russia, and motherhood.
Instagram: @aveniatapper  Twitter: @AveniaTapper