How to Have a Hysterectomy

Call it a uterus. It’s an uglier word than womb, with its cradle shape and soft sounds, its biblical harkenings. Uterus is a science word. It’s an organ. Uterus, uterus.

Get rid of the baby things early: infant seat, toys, portable crib. You see them as encumbrances. You’ve tucked them in closets and cubbies and basement bins, but be warned: this will not be easy. You will look at the infant seat and remember how you brought your first son home from the hospital, abdomen sore from the Caesarean; how the mean pull of narcotics told you you’d never figure out how to put him into that thing without breaking something. That you would never heal. But remember that you did. You did heal. And you figured out how to safely place the baby into that seat, after all.

The clothes, too, you must give away, especially the doll-sized ones that you hold up now and think, How could my sons have ever been so small? Because you will remember: they were. They still are, three and six years old, but even so, they grew from nothing, nothing at all, in that womb of yours that now must be removed. Uterus. Those tiny clothes, the miracle of what transpired within you—thinking of them will make that strange, primordial desire to procreate begin to nag, so you must be ruthless and generous and give things away.

Stash a reasonable amount of nostalgia in a string-topped bag from a resort you once visited: Fuzzy Bee, the turquoise toy with buttons you bought the first time you ventured into Walmart without another adult, a few sleepers, a blue onesie with doggies. Get rid of the rest. Give it all to your best friend who is having twins the same week you’re having your uterus removed. Find a sort of peace in knowing that those things will be used instead of sitting in your basement until your boys have boys of their own. Stop telling yourself that if you need the clothes back, she’ll return them to you. You won’t need them back.

Take the compounded Ella—emergency contraceptive, cut up and re-dosed into smaller amounts, and not FDA approved—and try not to think about whether or not you like the idea of using a medication created to stop unwanted pregnancies. Try to manage the blaring headaches that start at the nape of your neck and swell forward, to the eyes and ears, pulsing at sound and light.

Heed the pharmacist’s warning to keep it far from children because (in her words), It can kill a fetus. Place it high up; keep it in a box and try not to worry about how your six-year-old takes pride in opening childproof bottles. Heed the pharmacist’s other warning to be careful about having unprotected sex because, again, the drug you’re on can kill a fetus. Don’t fret about how the label on the brown bottle says, “If you are pregnant, do not eat or touch this medication.” Don’t read into it too much. You will not harm your children with your touch. They will not become infertile. And it is probably safe to hug your pregnant friends, too.

Do not keep thinking of yourself as a Walking Infertility Bomb. Do not think about changing your mind. Say it aloud: You do not want more children. You might try telling yourself that you’re too old anyway, although you’ll soon become keenly aware of how many people older than you are having them. Still, those folks will be gray-haired and frazzled at their children’s graduation. You will be vibrant and—well, also probably gray-haired and frazzled, but younger just the same.

Do not think about the children you cannot have during times of intimacy.

Do not let your mother’s disapproval sink too deeply into your psyche. She believes that if you took communion daily and prayed for your tumors to be gone, you could avoid this surgery. This is rooted in a maternal desire for what’s best for you. You’re a mother: try to understand.

Celebrate the fact that you are about to enter the beautiful space of having guilt-free, unprotected sex with your spouse. No more fumbling with condoms. No more marking the calendar. No more counting days.

Flag the money you would spend each month on pads and tampons—the way you’ve been bleeding, this is not insignificant—and keep it for yourself. Instead of feminine hygiene supplies, you can buy yourself a shirt every 28 days. A scarf, maybe. A sweater on clearance. Or save up for skinny jeans that will fit comfortably over your belly once you no longer have a uterus the size of someone 20 weeks pregnant. Don’t bother trying to convince yourself that your growing abdomen doesn’t bother you: it does. And don’t feel guilty about the fact that it does bother you, that, with strategic clothing choices and careful sucking in, you can mostly hide it. You don’t want to have people at the grocery store asking you when you’re due, and that’s okay.

Remember, too, that the tumors are growing. That, untreated, they’ll keep on growing for another 15 years or so, until you hit menopause. That two doctors have said, probing around in there, those things have drastically changed your anatomy. You may not know precisely what they mean, but you understand: you see the bulging masses, you feel the pain every time your kids climb on your lap, you know the constant sensation of needing to use the restroom.

Let your six-year-old feel the tumors in your abdomen; explain the difference between the soft part, which is natural, and the hard part, where two softball-sized masses protrude. Fibroids, they’re called, or leiomyomas: firm, rubbery masses that grow during child-bearing years. Let him glide his small hands over your belly, the way someone does to an expecting friend. When he asks, Is it cancer, Mommy? Tell him with confidence—tell yourself this, too— it’s not, because, as your doctors have told you, it almost certainly is not, although the only way to know for certain is to remove the uterus and do a biopsy. Wonder who taught your son that word. Cancer, weighty with fact and fear. Assure him he cannot get these tumors, only mommies do. Explain in un-scary terms that the doctor simply cuts open your belly and takes them out, voila. No big deal.

Hug your sons close, press your chin to their spring-sweaty crowns. Cherish that they still like to be close to you, that they ask for it, want it. Be grateful that you had them before you needed this surgery. Think of your friends who’ve miscarried early on, who’ve had stillborns, who must grieve every year there is no birthday. Grieve with them. Treasure that there are children in your spare bedrooms, crumbs beneath the table, building blocks that gouge your feet.

Don’t think about the terrible days right after the Caesarean, the way bending and walking and lifting and sitting up was painful. Don’t think about how, soon, there will be similar pain. Remember instead, weeks after that first surgery: when your body began to feel strong again, when the fog of narcotics cleared. When for the first time in your life, the simplest movement came with a keen sense of gratitude. Remember how it felt to heal.