Once upon a time. Listen.
First, how about a question.
If you were a young woman of, say, twenty-seven (the optimum age, so I’ve been told, for conceiving, carrying, delivering a child), and there you were facing the O&G across his desk, him in crisp blue shirt (you see him from a bit above the waist, up), silver hair, twinkly-twinkly eyes, you in white linen jacket with amazing dark resin buttons, new short-short haircut, unimaginably long silver earrings, and he says something along the lines of: ‘Well, as you know, the past tests indicated the absence of a uterus. However, it is not all bad news. It could be possible for you to bear a child, providing we can access a suitable uterus, suitable for implantation’—what would you do?
I can see you’re not quite comfortable. You’re not the only one.
Youngwoman (Y) felt her head spinning. Her uncle had had a heart transplant. Lived for fifteen years afterwards. Her boyfriend’s brother had had a kidney, donated by his cousin. Transplants were therefore not unknown to Y, and she had heard tell of the medical possibility of receiving a uterus, but the idea of it, suddenly out there on the table in front of O&G was, she found, breath-taking. She was dizzy, and O&G suggested she lie down again. She lay there on the white sheet for a long time in the gentle silence of his room, and the nurse brought her a cloudy white sweet drink. O&G spoke to her from time to time. There were the words ‘access’ and ‘suitable’. Sometimes O&G used the term ‘womb’, which was a word that Y found much more disturbing, somehow, than uterus. It rhymes with ‘tomb’, for one thing, and it hangs in the air, before the comma, when you say ‘Blessed is the fruit of thy womb, Jesus’. Y was a Catholic, and she had prayed for a medical solution to her dilemma. Here it was. Transplant of a Suitable Uterus.
Y had been examined by O&G when she was sixteen. The doctor wanted to determine why Y was not menstruating. The result of the examination was the establishment of the fact that Y had been born without a uterus. This condition was, apparently, not uncommon, although no reliable statistics are available. At the time of the discovery of the absence, there was no imagined solution. The only miracle would be a Lourdes-type miracle, and Y had no ambition for such a dramatic intervention. As well as being Catholic, the family was a great believer in the wonders of the medical profession. Y’s mother was a nurse and her father was a successful manufacturer of prosthetic limbs. So here was the miracle of the medical solution, the proposition of a transplanted uterus.
There are other matters hanging on all this, other things to attend to. There’s the question of not having children out of wedlock—so there will have to be a wedding. (Y was conceived before her parents were married, Y being known at the time as The Consequences. The priest at the little church of the Infant of Prague—he was affectionately known as Father Shotgun, did a brisk trade in weekday weddings in the sacristy. For a couple of Confessions and a nice big donation to the mission fund, he was more than happy to oblige.) Y’s case was, you can see, different from that of her mother. Y and her boyfriend IT (works in Information Technology) could (and did) engage in as much sexual congress as they liked with no Consequences. Unless, obviously, Y were to access a suitable uterus, in which case Y and IT would best be wed in advance, all things considered. IVF would be necessary—sperm from IT, egg from Y, resulting foetus implanted in the transplanted uterus. It occurs to me that they’d better check out the fertility of IT before they tie the knot. You’ve heard of irony. You know about twists of fate. (Sigh of relief. They did check him out, and all was well.) In spite of having no uterus, Y had a healthy pair of ovaries. IT was keen to marry and have children (well, to begin with, a child).
Yes—now—in this day and age, it may be possible to conceal some medical secrets, but not, I imagine, the transplant of a uterus. I think (I could be wrong about this) that at least close family members are in on it all. Particularly when the donor of the necessary organ is the mother of the donee. (I checked for a better word here, but there doesn’t seem to be one. So Y is the donee.) Take the womb away from the mother and give it to the daughter who knows it well from the inside. Yes, take it, said Y’s mother. Take it with my blessing. Life is a matter of give and take—and hope and trust—and a certain amount of philosophy.
Y’s mother checked it out with Y’s father who was cool with it. (Wait until he hears about the ‘chunks’ of blood vessels that will have to be removed from the body of Y’s mother, and the risks to the life of the donor. He might not be so gung-ho then.) And although the news was received by the family of IT with some bewilderment, they agreed that it was generally a ‘good idea’. Y will have to take lots of medication during the hoped-for pregnancy. Fine. Then there will be the business of IVF. This can be long and wearing and even unsuccessful. And if she has two pregnancies, the uterus will be removed after the second one. Fine.
So things were going along well, and O&G was assembling a formidable team of surgeons from all over the world. He was preparing Y and her mother physically and emotionally for the procedure, which would take about fifteen hours of surgery. And first there was going to be a wedding. Do you Y take IT to be etc. etc. Yes of course she does. But they had to be certain Auntie P didn’t get wind of the fact that this was no ordinary wedding. If she did, the fat would be well and truly in the fire. Auntie P was conservative in every way, and had even disapproved (strongly) about the heart transplant. Bodies are God-given; you don’t shift the pieces around. Auntie P was terribly old, living in practically the mists of time. She had never had any children. History does not of course record whether or not she had a uterus in the first place. Her husband died young in a skiing accident.
There are two main characteristics of Auntie P that have bearing on this story. She was old, as I said, being the great-aunt of Y’s mother, who was named after her. And she was very very rich (a silver mine and pig farms and chicken farms and a smallgoods factory on the edge of the city). She will die and leave fortunes to deserving relatives. (Oh no—I thought I could just deal with love and maybe death here, but suddenly it all comes down to money.) So Auntie P had to be insulated from the truth, kept in the dark about the transfer of the uterus. Don’t let the cat out of the bag. It was easy enough; you tell her lots and lots of good things; you leave out the bad bits. Y is marrying her sweetheart. In church. Happily ever after. End of story.
So Y and IT (and Y’s mother of course) had to decide whether to have the wedding before the transplant or the transplant before the wedding. How about having the wedding first, while Y is still in the pink of condition? After all, the surgery, the medication and so forth might (might!) impact on her health and interfere with the beauty of the bride, maybe. They had the wedding. Auntie P was there, and delighted the happy couple with an enormous cheque. We’re getting to the bit I don’t want to tell you—you might have had an inkling when I used that word ‘chunk’ back there. Brutal language, used by the surgeons. Yes. Along with the uterus, they had to take chunks of blood vessels out of Y’s mother, and Y’s mother did not survive. She died two weeks after the surgery. Heart attack. Auntie P was too frail to go to the funeral, and was told a few lies about the cause of death. Y was also too fragile to go to her mother’s funeral. It was a terrible, conflicted time for everyone. You simply can’t imagine the guilt that poor Y felt. The mourning family rallied, and the transplant itself was a great success, Y’s mother’s uterus living on in Y. The place from which Y came has been placed inside Y and will provide the incubator where Y’s child, Y’s mother’s grandchild, will grow. Everybody seemed to get their head around this without too much trouble.
Y and IT bought a house by the sea, and with energy and hope they set about furnishing a nursery and conceiving a child. The drugs she had to take disagreed with Y, but it was all worth it (apart from the shocking loss of Y’s mother) because within due season Y’s IVF treatments were successful, and sure enough she was delivered, by caesarean section, of a beautiful baby girl. The child was named Primrose Mary (for such was the full name of not only Auntie P but also of Y’s mother). She was a living reminder of her grandmother’s sacrifice—a rather heavy burden for a little girl. Auntie P sent a very satisfactory cheque and a silver cup for the baptism (so many religious ceremonies one after another) and also an exquisite set of antique nesting Russian dolls, all royal red and fancy gold. One doll giving birth to another and another and another. Is it remotely possible that somehow Auntie P had got wind of the transplant, and was commenting on it in her own funny old way? Without complaint? Without disapproval? Oh surely not. And yet, and yet, it was an interesting and strangely apposite gift, the Russian dolls. You never quite knew with Auntie P. She had second sight, for one thing. She dreamt about the skiing accident a week before it happened—she tried to stop him from going to the snow, but he would go. It would always be a question in the family—how much does Auntie Primrose know?
As it turned out, what with the drugs and the IVF and one thing and another, Y and IT decided to have the uterus removed (it had served its purpose). So Primrose Mary would be their only child. She was healthy and beautiful, and clever as well, bearing many strong resemblances to Y’s late mother—although she had her father’s eyes. The Russian dolls, arranged in a vermilion row, took pride of place on a high shelf in the nursery—they were admired but never touched. And in the fullness of time little Primrose Mary inherited shares in the silver mine—and became the owner of the smallgoods factory on the edge of the city.
So that’s a happy ending, then, isn’t it?