rivka | Entries tagged with second pregnancy

It's been a year. (If you're pregnant, please don't click through the link.)

I would have had a six-month-old now. Playing with toys. Maybe sitting up.

If that pregnancy had not ended, I would not have become pregnant with the Niblet who is, at this very moment, trying to batter his way out of my belly with his feet. He would not exist. I will always look at this baby and know that great grief made him possible.

I have no great meaning to extract from what happened to us a year ago. I can only say that you endure what you must because there's no other choice, and eventually it ends. Suffering is finite.

I haven't forgotten; I don't think I could. Who I am has been shaped by what happened a year ago. I can still contact the sadness. But I'm not there anymore.

I survived.

I was already feeling fragile this evening before I discovered that someone had hacked Respectful of Otters.

Michael and I took the hospital L&D tour this evening. We were just there on Saturday afternoon for Alex's tour, but I guess that I was focused singlemindedly enough on her experience, or the surrounding details were different enough, that it didn't hit me the wrong way.

Tonight it did.

We were in a group of six or so glowing beaming hopeful expectant couples. A childbirth educator led us onto the L&D floor. Just across the hall from the nurses' station was the little registration room. I glanced in as we walked by, just for a second, and there was a woman sitting in the patient's chair, crying. Hand up to her face. Nonswollen belly.

This time last year I ~~thought I~~ was eleven weeks pregnant. I had just had my first midwife visit, at which everything looked great. I had told Alex that I was pregnant, and the two of us were looking at pictures in pregnancy magazines together. Two weeks afterward I was sitting hunched over my nonswollen belly in that same registration room, crying, having discovered that what I thought was a baby was just a bloody mess of misdirected cells. Getting ready for emergency surgery.

Everything brought it back. The brief glimpse of the crying woman. Standing at the window of an L&D room looking out at the gorgeous 16th-story view of the city by night. The childbirth educator mentioning the two operating rooms on the floor and the 24-hour anesthesiologist. Asking her about triage, did we have to go through triage, realizing only in retrospect that the reason the idea filled me with such dread was that I'd spent a good long time in triage before my D&C. Remembering how I had felt hearing the heartbeat of a laboring woman's live baby on the monitor, on the other side of the curtain, before I got my headphones on.

My due date is a week to ten days after the anniversary date of my D&C. I don't know if I will be thinking these thoughts, having these memories, when I go to the hospital for the birth. Maybe I'll be too focused on labor, too focused on my imminent baby. Maybe it will help that I've already freaked myself out now with the vivid memories that are apparently still locked on to that place. Maybe it will help to be prepared next time, because I swear that for some reason it never occurred to me that it would be hard to go back to L&D, because apparently it's not like I'm a psychologist or a reasonably insightful person or anything.

Maybe I should discuss this with my midwife and doula, but it's hard to think of what to ask for that would be helpful.

Yesterday was my due date for my lost pregnancy. Tomorrow, my current pregnancy will reach thirteen weeks - the point at which I lost the other one.

This is a weird place to be.

I am so, so grateful to be pregnant on the day that, by all rights, I should've ~~given birth~~ been complaining bitterly about when was the damn baby going to come already. I've been watching for this day for the last six months, and praying that I'd be pregnant when it came. I know it would be far harder if I were still feeling broken and barren.

And yet it's also hard to be where I am. The end of the first trimester is supposed to be a tremendous relief - the point at which you know that, probably, everything is going to be Just Fine. The point at which you tell everybody. The point at which vanishing symptoms are cause for relief, not anxiety. Last time, at this point, I had even broken out my least-obvious pair of maternity pants. This should be the point where I can relax, having made it through the dangerous part of pregnancy, and look forward to the genuine pleasure that is the second trimester.

Instead, this is the point where I feel like I'm at risk of being utterly blindsided by tragedy.

I've joined a really good mailing list called SPALS: Subsequent Pregnancy After Loss Support. The SPALS list has helped me keep my sanity through some scary early signs of trouble with this pregnancy, and I admire these women for the supportive community they've created. But the reverse of that support is that participating in SPALS makes me all too aware that you can actually lose a pregnancy at any time. Lots of women on the list have had stillbirths.

My midwives told me to take my progesterone supplements until 13 weeks, which I am interpreting as "the end of the 13th week" rather than as "the first day of the 13th week." After that, they say, my placenta should have totally taken over progesterone production, making supplementation unnecessary. But honestly, as much as I hate those damned things, stopping using them feels like stepping out over a cliff and trusting that something I can't see will break my fall. Who knows whether my placenta knows what the hell it's doing? If I wasn't making enough progesterone, who says it will make enough progesterone?

My first-trimester symptoms, bless them, are hanging on until the bitter end. I've had a bad cold this week, and postnasal drip + human chorionic gonadotropin = ZOMG incredible nausea. I expect that as my cold goes away, so will the nausea. In the meantime: my jeans still fit. I have the Incredible Pregnancy Rack of Doom (now size 36H!!), but that's the only place I've put on any weight. There are still eight days until the midwife appointment at which we may (may) be able to hear the fetal heartbeat with a Doppler. I'm still a few weeks away from the earliest possibility of feeling fetal movement. At the moment, to borrow a phrase from

fairoriana, this is Schroedinger's Pregnancy.

It seems like such a cruel trick of fate that all of these dates converge: the lost due date, the gestational age at which my miscarriage happened, the point at which pregnancy symptoms are scheduled to go away, the point at which I'm supposed to remove the supports and trust my body to do the right thing hormonally.

In retrospect, I didn't have very strong pregnancy symptoms with my miscarried pregnancy. At the time I certainly felt tired and nauseated, but there's just no comparison to the way the first trimester is beating me down this time around.

It's not totally intolerable, and in fact I actually find the symptoms reassuring. I need all the evidence of pregnancy that I can get. But... it's the difference between having to be careful about what I eat and sometimes being unable to eat; between often feeling tired and often needing a nap to get through the day; between outgrowing my regular bras and outgrowing my maternity bras. (ZOMG I have outgrown my maternity bras and I'm only just entering the ninth week.)

I produced pregnancy hormones last time - enough to make a placenta, even though it had nothing to support. My pregnancy symptoms were real. But they were a shadow of what I'm experiencing now that I'm churning out enough hormones to support an inch-long fetus.

Seventeen days after my D&C, the pathology report is still not back. That's the bad news.

Fortunately, though, that's the only bad news. Based on the way my HCG (human chorionic gonadotropin, a.k.a. "pregnancy hormone") levels have been dropping like a stone, taken in context with the immediate experience of the D&C, my midwife is certain that what I had was a "blighted ovum" - a fertilized egg so messed-up that it made a placenta but wasn't able to grow or sustain an embryo.

My HCG level as of Friday was a stunning 33, down from 190 the Friday before. (I don't know what it was the night of the D&C.) We have high hopes that it will hit zero sometime this week. Then my body can go about the business of returning to its normal rhythms.

An exam showed that everything is getting back to normal: uterus and ovaries feel normal, cervix is closed, and there's physical evidence that the hormones are normalizing.

We can start trying to conceive again as soon as I've had a couple of normal cycles. If I get pregnant again, we'll monitor the pregnancy more intensely: HCG levels beginning at the positive test, progesterone levels, an ultrasound at 7 or 8 weeks. But there's no reason to believe that this would happen again. It was one of those random chances.

Needless to say, I'm still very very sad. (Wow was it hard to be back in my midwives' office.) But it's a big relief to know that there isn't anything horrible hanging over my head. There's no physical aftermath to a blighted ovum pregnancy. No long and frightening period of monitoring. We can just focus on the long, long job of picking up the pieces, emotionally.

So: sad, but thankful.

The short version: My bleeding got worse, and my midwife had me come to the hospital whether or not they had room for me. I had to wait a very long time. In the interim, the bleeding got downright dramatic. I had the D&C, and by a couple of hours later I felt surprisingly okay: tired, crampy, and weak, but okay. I waited even longer for the hospital to finish things up and then came home. Michael, Emily, and

wcg are heroes.

( The long version: warning: includes a description of what makes bleeding qualify as 'downright dramatic,' plus some other graphic content )

Still home. Waiting for the midwife to call back.

( disturbing material, as usual )

D&C is tentatively scheduled for 4pm today. I say "tentatively" because the L&D unit at the hospital is busy today, so they may not have time to see me. ( disturbing material below )

My friend Emily is going to pick Alex up at nursery school at 5pm and bring her to her house, where she can play with her friend Zoe and have dinner. Her neighbor will watch Zoe during pickup, so we don't need to worry about dropping off Alex's carseat. If we wind up being at the hospital longer than expected, Emily will bring Alex back to our house and put her to bed. We've arranged for a key for her.

Nursery school will explain to Alex at 4:45, but not before, that she's going home today with Miss Emily instead of with Papa or Mama. Emily will explain to Alex that Mama is sick and had to go to the hospital, but that Papa is taking care of me and I will be home soon.

Emily will bring something by tomorrow for us to have for dinner. God, she's a good friend. It's so nice to know that I can just rely on her to make things happen.

Our minister Phyllis is coming by in about half an hour to talk with me and Michael. One of my church friends asked if there was anything she could do, and I actually thought of something for once: she could call the church and let someone know that we need pastoral care, and why. I kept wanting it, but not being able to imagine picking up the phone and making the call and explaining things. So thank God for Megary. And Phyllis.

When the midwife's assistant called and told me not to eat anything more today because of the D&C, I asked her if that meant no water as well. Then I used the time it took for her to check with the midwife and call back to drink a big icy cold glass of water, which was good because when she called back she limited me to ice chips. I think that means I'm going to be fully sedated for the procedure, which, good. There's no way I want to be conscious to experience or remember this.

Am I leaving any kind of necessary preparation out? I've got the pacing-the-floor part covered. Anything else?

I had to walk down the baby aisle at Rite Aid to get to the pads I need for the bleeding.

I had been doing so well, this morning. Cuddling Alex, making her a special breakfast, pressing my cheek against her hair and reading her stories. I was able to play with her and even laugh. My real live girl. I thought, I'll survive this.

And then there I was in the Rite Aid parking lot, icy rain bucketing down on my bare head, sobbing so hard I couldn't fit my car key in the lock.

I don't think this can possibly be my life.

I'm sorry. This is just going to be an awful journal to read for a while. I honestly won't mind if you don't.

I can't believe that my midwife got through that whole conversation without using the word "cancer" or "tumor." Because if this is gestational trophoblastic disease? Then it's a tumor. Even in the benign form, 20% of patients wind up needing chemotherapy because some of it grows back. And there are also forms that are initially malignant.

The NCI website describes GTD as "highly curable," so we're not talking about tragic deathbed scenes here. But it looks like she wasn't kidding about the intensive monitoring, and for damn good reasons.