GRACE AND GRAVITY

by Jane Palmer

instead of clergy—were to track and keep the records of events, not ceremonies: births, marriages, and deaths. Divorces were not added to the list until later. By transforming the recordkeeping requirement to events, babies who died before their christenings were now counted, as were those who were not buried in a church’s cemetery.

It is easy to take vital records for granted. We might only think about them when we need to show one to a bureaucrat. It’s an odd thing that we have these pieces of paper that prove to someone we exist, or are eligible for citizenship, or we are married, or that someone died. Yet,
these pieces of paper give us legal legitimacy and entitlements.

When my wife and I were dating and moved in together in 2006, we were in our late twenties. Gay marriage was legal in Massachusetts, while other state legislatures were frantically trying to change their constitutions to make marriage “a union between a man and a woman.” We were
living in Missouri, and didn’t expect same-sex marriage would become legal there. In February of 2009, we became domestic partners in St. Louis City. It was mostly symbolic, but it did give us visitation rights if either of us ever found ourselves in a hospital or jail. We were planning a move to DC when, in April of 2009, Iowa became the third state to legalize same-sex marriage. DC law at the time would recognize a marriage certificate from another state, even though it was not yet legal for same-sex partners to marry there. Two weeks before we drove east, we drove north to Des Moines and, after a short ceremony, we were officially, as we called it then, gay married.

Eight years later, in 2017, our twins were born at thirty-one weeks at Holy Cross Hospital in Silver Spring, Maryland, right outside of DC. We were prepared for a long stay in the neonatal intensive care unit (NICU). Starting at week sixteen of my pregnancy, Baby B was diagnosed with intrauterine growth restriction. The membrane that separated the twins grew in a way that meant Baby B, as the doctors called the fetus, had less access to my placenta for nutrients. We began to drive an hour each way to Johns Hopkins University Hospital in Baltimore once or twice a week for intensive monitoring of the growth and vitality of the twin fetuses inside of me.

The most likely scenarios were: Baby B would die, Baby A would live, and I’d have to carry both until Baby A’s delivery, or Baby B would die inside of me, and so would Baby A. As my belly grew, I carried the prospect of death every day of my pregnancy after Baby B’s diagnosis.

Three weeks before they were born, I was put on in-patient bed rest in the high risk unit at Holy Cross. Every hour, a nurse checked my vitals. Each night they listened for two heartbeats. I imagined Baby A and Baby B playing tag and hide and go seek inside of me as I waited for the nurse to say whether she heard both heartbeats in addition to mine.

My OBs at Holy Cross were antsy. They wanted to deliver at twenty-seven weeks, but my Hopkins doctor convinced them to delay. We hoped to get to at least thirty-two weeks. My wife and I joked that each day was like the Dread Pirate Roberts in The Princess Bride: “Goodnight, Jane. Good work. Sleep well. I’ll most likely deliver you in the morning.”

On the first day of the twins’ lives, we each held a tiny, breathing, sleeping baby, connected with wires to beeping machines. G* (Baby A) was 3 lbs. 1 oz. and M (Baby B) was 1 lb. 11 oz. We had done it. The NICU nurses and doctors would take it from here. I had been a NICU baby in the 1970s, born at thirty-three weeks. There was no NICU in the suburban hospital where I was born so I was transported to Children’s Memorial Hospital in Chicago, where I stayed for a couple of months. My twin niblings were born at twenty-seven weeks, and they were healthy seven-year-olds when our twins were born. We’d made it to thirty-one weeks. Our babies were alive. And so tiny.

I was fumbling with the banana-yellow hospital-grade pumping machine when the nurse came in to give us the paperwork for their birth certificates. We had prepared for this moment. Our queer friends who’d had babies in this hospital told us to ask explicitly for the gender-neutral version of the form: the one that said “parent” and “parent” instead of “mother” and “father.” I was ready
to hand her back the form and demand the correct one, but when I looked down, it was the correct version. Shortly before the twins’ birth, the U.S. Supreme Court ruled in Pavan v. Smith that all states must list same-sex parents on birth certificates. We filled out the paperwork, one
for each baby, and returned it to the nurse. A couple of weeks later, on my way to the NICU, I picked up the birth certificates from the health department. We were officially gay married and the legal same-sex parents of our beautiful babies.

After the twins were born, I had eight weeks off from work on short-term disability. I spent my days with the twins and the nurses in the NICU. My wife went back to work so she could save her paid time off for when the babies came home. The nurses encouraged me to sleep as much as
I could, given I had to pump every three to four hours. But it was hard for me to be away from my babies. I would arrive around nine a.m., say goodbye to my wife who was visiting before work, and stay until around six p.m. Our friends had organized a meal train, which meant that almost every evening, we had takeout or a home-cooked meal waiting for us on our porch. Most nights, we went back to the NICU for a couple of hours after dinner. Our time at the NICU was a blur. I remember my aching boobs. I postponed visits to the pumping room as long as possible because I didn’t want to stop holding my babies.

I remember the beeps. My babies were attached with wires and tubes to machines that beeped incessantly. We learned to distinguish between the normal ones and the oh-shit-the-nurse-is-running-and-something-is-really-wrong beeps. I remember the other families—their joys, their pain, and the way sorrow and stress lined their faces.
One night I woke up to a phone call from the NICU. M was not okay. They needed my consent to do something. There were so many calls like this, asking for my permission to give platelets, do a blood transfusion in his tiny arms, add or remove another wire or tube, put him back on the
respirator. This time it seemed more serious than before. There was something wrong with his stomach. They were going to stop giving him breast milk and put him back on the feeding tube. We rushed to the hospital in the predawn darkness. I fell back asleep in the chair by his bed with
the now-familiar beeps and buzzes serving as an unsettling lullaby.

Then, M got better. Both babies were doing great. They no longer had feeding tubes, and we got to give them my breast milk in tiny bottles. We’d be out of there in no time, the nurses said. We had a discharge meeting that covered what we should expect when we brought the babies home.

The meeting was concrete evidence we had made it to the end of this harrowing NICU journey. We organized a group of friends to come over on an upcoming Saturday to help get the house ready. We had two cribs to put together, two highchairs, two of everything, still in boxes, since we hadn’t known if we would make it to this date. A couple of days later, I was driving to the NICU when my wife called from the hospital: “M is sick again,” she said. I was at a stoplight at University Avenue and Piney Branch Road. I wailed. Cars honked and I put my foot on the gas pedal while trying to decide the quickest way to the hospital through my snot and tears. When I arrived, the nurses told us that they were transferring M to Children’s National in DC. He had necrotizing enterocolitis, which is a gastro-intestinal disease that affects some premature babies.

They called it NEC. G would remain at Holy Cross, but might be moved at a later date if M needed to stay for a while. I was okay with this plan. Children’s National was one of the top hospitals in the country. M was going to be okay. I rode in the ambulance with M while my wife followed behind us in our car. The ambulance slowed for every pothole. I wanted them to hurry up, but we all knew how fragile baby M was. He kept getting sicker. We stayed at Children’s for
five days. My wife’s parents came to town to hold G while we stayed at M’s bedside. Our day was punctuated by doctors and nurses coming in and out of the windowless dark room that had cubicles for four babies. Every two to three hours, I pumped very little breast milk, often right
next to M’s incubator, not caring who saw my exposed boobs. My wife and I took turns sitting and sleeping in the one chair next to M or hanging out in the visiting room down the hall. It had windows, more chairs, and no beeps and buzzes.

They cut open my baby to discover the NEC had destroyed his intestines. They told us that sometimes the intestine can fight back and rebuild its walls, but that it was unlikely. They would monitor his intestines for a couple of days to see what happened. This meant they did not sew
him back up. Children’s is a teaching hospital, so students came in often to see the “micro” preemie and his decimated intestines. One of my best friends from childhood, a nurse practitioner and midwife, stayed with us and refused to leave despite the many requests from the
NICU nurses. Other friends and family members stopped by with food and comfort. The doctors told us if M lived, he would be without working intestines and have constant diarrhea. No sleepovers or pizza parties for this little one.

One night there was a torrential rainstorm. We only knew about the storm because my friends, who were coming to visit, texted to say they had to pull over because the rain was so bad. We walked down the hall to the visiting room to watch the storm from the top floor of the hospital.
We looked out over the city and saw a double rainbow. Maybe everything was going to be okay for my babies.

I was pumping in the chair next to M’s bed when my phone rang. It was the Holy Cross NICU. G was sick. Possibly with NEC. I crumpled over in my chair and started to slide off of it but couldn’t make it to the ground because of the tubes connecting my breasts to the pumping machine. Both of my babies were dying, and I couldn’t be with them. They were putting G back on a feeding tube for at least fourteen days to monitor his stomach. They told me they wouldn’t need my breast milk for now.

We met with M’s doctors. They confirmed what we already knew: his intestine had not regenerated. He was not going to make it. It was time to say goodbye. But first, a photo shoot. They wrapped M in an elephant-print blanket to hide the hole in his tiny stomach. A nurse came in with a camera and we posed with our baby. They had a grant from a nonprofit that would send us edited photos without the wires and tubes. Next, they made casts of M’s tiny feet and hands. Then we waited. I held M until it felt like my boobs were going to burst. I gently passed M to my wife so I could pump, and a few minutes later, the beeps stopped.

The day M died was the Saturday in August we had organized our friends to help get the house ready for the twins’ homecoming. When everyone arrived, they discovered our basement had flooded during the double rainbow rainstorm. As we held M until his final moments, they spent the day saving what belongings they could, ripping up and replacing carpet squares, and hiding anything that we had two of. Behind the closed door of the basement half bath was a crib (still in the box), a crib mattress (still wrapped), a highchair (still in the box), and a car seat (still in the box). Later, we donated them all.

G was still sick, possibly dying. Every time I walked into the Holy Cross NICU I could hear him wailing. In a room full of babies in tiny boxes, his cry was the loudest. He was hungry. His brother was dead. His moms had not been holding him. I tried to get back into my routine of visiting. But I felt like I was walking through cement. And there are so many logistics after a death. M’s body was being stored until we made some decisions. I didn’t want my baby to be in a storage locker. Children’s had a grant to cover the cremation costs at a funeral home in a Maryland suburb. The director told me we could buy urns from them or take the ashes in a box to do what we wanted with them. I didn’t want my baby’s ashes in a box.

When we went to the funeral home, we asked for multiple urns—a biodegradable one to bury when we planted a tree in M’s honor, a necklace we could take with us on our adventures as a family, and a traditional urn for the mantel. We paid $317 for the three of them. So many tiny
urns for so few ashes. It made us laugh. We were relying on dark humor a lot during those months. The funeral director did not laugh and told us in a serious tone that there was one more matter to attend to before we left.

One of us needed to identify the body before cremation. We decided it would be me. I wanted it to be me. My wife didn’t want to remember him this way, but I wanted one more chance to say goodbye. I wanted one more minute with him after the thirty-one weeks he was inside of me and the four weeks he was outside of me. He was wrapped in a blue blanket and looked like he was
sleeping.

A couple of weeks later, G was getting better. We were hopeful. The nurses thought he had become sick because they’d increased his formula intake while I was at the hospital with M and couldn’t get my breast milk to Holy Cross. I thought he was sick because he knew M was gone.
The nurses would help us get approved for a prescription hypoallergenic formula that would be covered by my insurance company.

I was at home getting ready to visit G when my phone rang. I saw it was the funeral home, and I assumed they were calling to tell me that the urns were ready.

“Hi, Mrs. Palmer. It’s Bob from the funeral home. I need to ask you something about the death certificate. You see, and please know that I have no control over this, you see… well, what I need to know is—would you like your wife to be listed as the father or not listed at all?”

I was stunned. He said there was no place on the death certificate for a same-sex parent.

I told the funeral director I’d have to call him back. I refused to believe there wasn’t a way. Soon after, our friend was able to get us an appointment with DC’s state registrar. She agreed to meet with us personally. On a warm September day, as I drove down North Capital Street NW, I kept my eyes looking straight ahead as I crossed Michigan Avenue NE. I didn’t want to see Children’s, or as I called it then, the place babies go to die.

I sat across from the registrar as she manually edited M’s death certificate to list my wife and me as “parent” and “parent.” I asked her why, in 2017, this was an issue. She said, “They’re working on it.” She was kind and apologetic.
When I got home, I put M’s death certificate in a manila file folder with the twins’ birth certificate and our marriage certificate. We were officially gay married, the legal same-sex parents of our beautiful babies, and the documented parents of our deceased baby M.

Every year, on August 5th, we celebrate “M Day” by painting rocks and bringing them to M’s tree that we planted in upper northwest Washington, DC. As its trunk grows wider and its branches grow taller, the tree serves as its own vital record of our son’s short life.

Postscript: As of December 2024, DC Vital Records is still working with their vendor to update their system to allow for same-sex parents to be listed on a death certificate. They are willing to provide manual edits upon request.

*My wife and children’s first names are not included above for privacy reasons.

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Jane Palmer is a queer writer who lives in Maryland. As an advocate, activist, social worker, and professor, she has dedicated her career to ending gender-based violence. She is currently a part-time student in the MFA creative writing program at American University in Washington, DC. Her poems, creative nonfiction, and children’s books focus on themes such as resilience, resistance, healing, grief, loss, and queer joy.