A week later we had another ultrasound, this one to look at the baby's nuchal fold measurement, an early sign, sometimes, of heightened risk for Down syndrome. Ultrasound rooms are dark and cool and quiet places. While the technician guided her wand on my tummy and looked at her monitor, my husband and I looked the other way, into a monitor set up just for us. The baby bubbled into view, yielding some obvious features — skull, spine — while others looked mysterious and hard to read, etchings in a language I don't know. The easy thing to remember is that dark is fluid and white is tissue. At twelve weeks, the baby is just around two inches long.

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The room got quieter as soon as the technician pushed and angled her wand to see the baby's neck and spine. What should have been a tiny line of darkness looked like a deflated balloon stretching from the baby's neck down its back to its rump. I simultaneously noticed that it looked wrong and immediately deleted the thought from my mind, asking instead about the profile, the legs, the hands. My husband asked if we could have a picture. The technician said sure, but didn't save or print one. She removed the wand from my belly, wiped up the sticky blue jelly, and told us the doctor would be in soon.

As soon as she left the room, I began to cry.

A doctor we hadn't yet met entered, measured in silence for what seemed like years, then crossed his arms and sighed. He told us that instead of the two millimeters they expect to see, our baby's nuchal translucency measured 76 millimeters, off their charts. He suspected Trisomy 18, a chromosomal disorder that kills most affected children before birth, and the remainder a few days or weeks after. The rare child who survives more than a few months with Trisomy 18 will be profoundly mentally retarded and painfully physically disabled. Virtually none survive more than a year or two. We immediately scheduled another test to confirm the diagnosis, but the doctor pointed out that even if this baby didn't have a chromosomal disorder — a vanishingly small possibility — it almost certainly had other major physical problems.

Nobody can prepare you for how quickly things change. "We can't do anything for these kids," the doctor said, "but the best we can do is tell you early." What he said violated the carefully drawn terms of the abortion debate — to call the fetus a kid even as you make plans for termination — but he was right on both counts.

Nobody can prepare you for how quickly things change. That morning I had been thinking about beds. Specifically, I was strategizing the family sleeping arrangements like a particularly complex word problem in math class: If we moved the toddler into a big boy bed sometime just before the new baby came, then we would not have to buy or borrow a new crib. But how to time it? Move too soon, and we might destroy our toddler's good sleep habits, do it too late and we'd risk intense sibling rivalry as he saw a new baby move into his beloved crib. Would we move the two into a shared bedroom, and when? I looked forward to converting our current guest room into a nursery for two, and re-inventing the toddler's room as a smaller guest room.

A few hours later I was planning for a procedure you don't have at my age unless there's something terribly, terribly wrong. We agreed we would almost certainly terminate the pregnancy, we would say goodbye to this very much wanted, very much loved child.