Amidst the emotions and pain of labor, Vivian can no longer repress her grief over losing Dutchy. The immensity of her pain highlights how much she relied on Dutchy to give her life a sense of hope, meaning, and belonging. Losing him means losing the only person who (she feels) truly understood her. Her grief over “a future [she’d] dared to envision” highlights how much she risked just by letting herself believe in love and hope again. She then gives her daughter away because she knows that love always carries the risk of loss, and she feels she can’t tolerate the pain of loss “ever again.”