Right after I got married to my second husband, Andy, in 2008, my womb ached for a second child. I blamed it on some spectacular love hormones and the strong desire to give my son, Jake, 4, from my previous marriage, a sibling. “No child should live without a sibling!” I declared, because I had all of the answers about child rearing.

Pregnancy came easy to me, and I considered myself one of the lucky ones – until the arrival of debilitating and relenting nausea. Starting at six weeks, I was on a diet of only crackers and Cheerios and still spent hours dizzy and wilted over the toilet. The extent of my mothering involved burying my head in a pillow while Jake watched Dora The Explorer. By the time I hit the eight-week mark, I was admitted into the hospital for dehydration.

In the hospital, I was attached to an IV of fluids and powerful anti-nausea drugs usually reserved for cancer patients. My midwife and the high-risk pregnancy doctor she was working with diagnosed me with hyperemesis gravidarum, a severe form of morning sickness that can potentially last for 20 weeks or, worst case, for the entire pregnancy. According to the CDC, hyperemesis occurs in 0.5 to 2 percent of pregnant women – that translates to 60,000 women a year who are actually hospitalized. But the Her Foundation believes those numbers are significantly greater because they only represent in-treatment care – they don’t account for women treated by their doctors or midwives, or those who go untreated altogether.

A few weeks earlier, I had been desperate for a baby. Now, all I could think about was getting an abortion. According to the hyperemesis non-profit group, Her Foundation, I wasn’t alone. Ten percent of women with hyperemesis terminate their pregnancies. What did I really want?

I thought about my life with Andy. I had a beautiful, curly-headed boy who adored his new stepfather, bonding over fart jokes and Star Wars. I was working toward an MFA degree in creative writing. House in the suburbs. Good friends. Family. We were happy. Yes, I wanted a baby – but maybe it had been my biological clock tricking me (nature at its finest). I was 37, still in the honeymoon stages of my new marriage, and I was incapable of maintaining a conversation with my husband, let alone taking care of my child. Some people have stamina for torture. I am the kind of person who cries if I have a hangnail.

“Why is this happening?” I asked my midwife. Sure, I had some nausea with my son, but I managed to commute to my job in Manhattan up until my due date.

“Every pregnancy is different,” she explained. She also revealed the scary details of her own pregnancy: With her first son, she vomited every day for 28 weeks. With her second son, she vomited every day for the entire pregnancy.

She had two crappy pregnancies, she said, which resulted in two amazing sons. She told me it would be hard, but promised me that I’d get through it.

Would I?

I had another friend who lived in Truth or Consequences, NM, who vomited 20-30 times a day in the beginning of her pregnancy and described it as “being in hell most of the time.”

“I’m not sure this is worth it,” I said to Andy. “I want to end it before it’s too late.”

“You’re dehydrated,” he said. “Your mind isn’t clear. Think about how badly you wanted another baby.” But I couldn’t visualize a baby at the end of the road, only a narrow tunnel of ginger tea, paralyzing exhaustion and open toilet bowls to hang my head in. I foolishly thought my pregnancy would be celebrated with butterflies and lollipops (oh, the haze of parenting). Pregnancy (and who am I kidding, motherhood) is affixed to certain expectations – glowing skin, beautiful hair, long nails – and then we’re crushed when our visions come up short.

Once Andy left the hospital that night, the nurse offered me Ambien. I counted my meds: a steady mix of Zofran and Reglan (another anti-nausea medicine) and now sleeping pills. Tack on depression. This baby was contaminated with poison – emotional and chemical.

At home, I was attached to an IV for three more days and then a new invention: the Zofran pump. The pump was attached to a syringe filled with Zofran and hidden inside a black bag. (“It’s like a cute purse!” my best friend said. “It’ll be in Vogue next week, you’ll see.”) The off-site nurse instructed me to stick the needle in the thick area around my belly button or the fatty part of my thigh. “What fatty part?” I’d cry. My stomach was hallowed. My love handles shriveled.

Soon, my pregnancy began to resemble a relationship with a toxic lover. I want you. I don’t want you. You’re making me happy. You’re making me sick. Two cords were attached to me: one, my unborn daughter’s, the other, an intravenous tube of Zofran.

“How can this be a good thing?” I’d say to Andy. The high-risk pregnancy doctor from the hospital reassured us. Our midwife reassured us. The baby won’t be brain damaged. The baby will have all her limbs. Yes, the fetus is getting enough nutrients even though you’re on a diet of Zofran, Vitamin Water and tamari rice crackers. Yes, the drugs are safe because studies say there hasn’t been a significant increase of infant malformation. You’re fine.

Paranoia set in. If it were 1908, I would have died. Maybe my pregnancy wasn’t meant to be. Reflux, hormones, genetics and a predisposition to nausea are often to blame, but the exact cause of hyperemesis is unknown, according to the National Organization for Rare Disorders. Every day it got worse, even with the medication. “Look at the bright side,” my off-site nurse would say. “At least you’re eating one saltine.”

When I wasn’t acting utterly irrational by wishing Andy an afterlife filled with horrible pregnancies and resenting him for being healthy, I talked more about an abortion.

“We could adopt,” I said. “There are so many kids without homes.”

“It’s not my body,” Andy said. “If you don’t want to do this – don’t do it.” And there it was. What would happen to our family, how big it would be, or wouldn’t be, was up to me. “Really,” he said. “I’ll be fine with it if you want to end it. I love Jake as if he were my son. He’s enough for me. I don’t want to see you suffer like this.” But did he really mean it? Didn’t he just want this ordeal to be over so he could have his wife back, the one who liked to have sex and drink wine on the patio?

At 10 weeks, I was in the hospital again. I was down to 114 pounds. My face was gaunt, my arms were bony and my already skinny legs on my five-foot-four-inch body were stick-like and weak.

“It’ll be the last time you’ll ever be this skinny again,” my mother said. “Enjoy it while you can.” Nothing like a Jewish mother to give you perspective. She stroked the back of my head and kissed me.

“Listen to your mother,” the nurse instructed. “You’ll gain the weight back. Trust me, sweetheart. You’ll gain it back.”

But I didn’t want to hear the upside. I just wanted to go back to a time when my life was less complicated. When I was healthy. When I wasn’t pregnant.

This time, I discussed an abortion with my midwife.

“How much time do I have to decide?” I asked.

“Look, an abortion would solve your current problem, but it might give you problems on the other end. Know what I mean?”

I knew. An abortion would mean no biological kids for Andy and me, because after this experience, we would never try again. And what about a year from now? Would I question myself relentlessly, wondering if the nausea would have eventually subsided?

By my third day in the hospital, my midwife scheduled an ultrasound. Ten pregnant women waited in the lobby of the ultrasound clinic. Their bellies were wide, their cheeks round and their breasts were large. If I kept this baby, I’d stop looking like an emaciated string bean – eventually, I’d look like a beached whale.

I knew once I saw the image on the screen – even if my fetus resembled a tadpole – I wouldn’t be able to go through with the abortion. I’d have to decide.

I could blame my falling in love with Andy on neuroscience, evolution and sex hormones, but my ravenous desire to have his baby was about creating family together. Hyperemesis depleted me of any joy. There were many reasons to end the pregnancy. But up until that point, I hadn’t connected with the one reason not to end it: a baby.

The sonogram image was clearer than I had expected. A visible shape, a head, a curve of the back. I could see it all. It was real. It was ours. Sickness and all.

A few hours later, Jake climbed into the hospital bed with me. How was camp? Good. Did you swim? Yes. When are you going to swim with me again, Mommy? When I’m better. Hey Jake, guess what? What? Mommy’s having a baby. You’re going to be a big brother.

He jumped up and down on the bed, almost knocking over my IV tubes.

“Let me see your stomach, Mommy,” Jake said, and lifted my shirt. My ribs poked out under my skin and my belly inclined like the valley of a ski jump. “I love you, baby,” he said.

The nausea settled down at 20 weeks, creeping back in for short visits, and then walloped me again in the ninth month. I tried acupuncture and chiropractic, but nothing ever worked.

This past February, Elke Vivienne was born. In the first hour of her life, she cried, and I mean screamed bloody murder. Nothing soothed her – not the breast, not warmth, not rocking, not the swaddle. So we cried together. Let it out, baby girl, I thought. Let it out. She carried the residuals of my anger and ambivalence. How could she not?

But she’s a beautiful, dreamy baby with almond-shaped blue eyes and the most complacent smile. I kiss her neck up and down. I suck on her toes. I inhale her. Jake adores her too; he kisses and hugs, and reads stories to her in her crib. I’m in adoration of my two healthy children and the family we have together.

Now it’s time for an I.U.D.