As soon as the baby is conceived problems begin. Mailhot must come off her medicine because of the pregnancy and begins to scream at her son Isaiah and question Casey’s every word. She is both confused and disgusted by her behavior, though it often feels “justified” (68). She and Isaiah move in with Casey, and it's contentious. Mailhot realizes she can’t trust Casey and worries that he will leave her the way he did at the hospital. She attends her first MFA residency in Santa Fe, and Casey drives her. On the way, Mailhot discovers text messages on his phone that prove he was cheating on her months after they’d agreed to be monogamous. She punches him in the face, and he develops a black eye. She feels more comfortable at her residency among other Indians, though she struggles with her mental health. On the way back, she considers getting an abortion. The doctor recommends a late-stage procedure because of her severe bipolar symptoms, but Mailhot can’t go through with it. She reflects on her mother and motherhood. She finally gives birth to the baby, who had caused her so much pain that during labor, she feels as if the pain doesn’t compare to the torture she endured during pregnancy.