Blame Game

Last year, on April 5, I was 18 weeks and 3 days pregnant.  Late that night, I felt a sensation like a water balloon popping and a gush of blood. I was sure my water had broken. First thing in the morning, I went to the midwife's office. The baby's heart was beating away, loud and clear.  She gave me a fern test, which tests for amniotic fluid. It came back negative. My big anatomy ultrasound was scheduled for 20 weeks exactly; she decided to move it up a week - three days from then.

Two days later, my water broke for sure. This time it was clear, and I immediately went to the ER.

Five days after that, Caleb was born.

I'd had very minor spotting at the beginning of the pregnancy, but around 15 or 16 weeks it picked up, and there was bleeding to some degree nearly every day.  I learned later that bleeding like that can be a very typical symptom of cervical changes. I also learned later that the fern test isn't accurate when accompanied by blood and the blood can obscure the amniotic fluid, giving a false negative.

I question everything.  I blame myself, but I trusted my caregivers. I thought they would take care of me and my baby.

Why didn't the midwife tell me, after I'd gone in several times for bleeding, that I wasn't a candidate for midwifery care anymore?  Why didn't I get an ultrasound to look for the source of that bleeding? Why didn't she know that the presence of blood could give a false negative on a ferning test? Why didn't she order an ultrasound immediately upon my coming in with the concern that my water had broken?  In retrospect, waiting three days was completely insane. But I trusted her when she said everything was okay.  Why didn't she consult with one of the doctors at that point?  The midwife practice I was seeing was in a hospital, and shared office space, staff, and the L&D area with both the regular OBs and the high-risk doctors. Why didn't I insist on a second opinion??

I'm convinced that my water broke that first time, and that it broke a second time two days later (the bag can reseal, temporarily or permanently, after breaking). 

If I'd gotten an ultrasound at 15 weeks when I started bleeding, would they have discovered that my cervix was shortening?  Would I have gotten a cerclage at that point? Would that have saved Caleb?

If she'd used ultrasound to check on my fluid levels instead of using a ferning test, would she have discovered that my water had broken 48 hours before it broke "for real"? Would I have been admitted to the hospital at that point, given antibiotics earlier, gone on bedrest earlier?  Would the bag of waters resealed and stayed resealed?  Would that have saved Caleb?

We'll never know if different care would have changed the outcome.  Maybe it would have been the same and he would have died no matter what we did.  But maybe he would have had a chance if I'd been more knowledgeable; if she'd have been more aggressive.

I still believe in the standard of care that most midwives provide for low-risk, uncomplicated pregnancies and births.  I do believe that when I started bleeding at 15 weeks, the midwife should have bowed out of my care.  I do believe that when I was sure my water broke at 18 weeks, she should have bowed out of my care.  I don't blame midwives in general.  I'm not even sure I blame her specifically. I should have spoken up. I should have insisted on an ultrasound. I should have asked for a second opinion. I didn't.  At the least, we share blame. At the most, as his mother, the blame falls on me for not protecting him.

The what-ifs in do nothing but frustrate and sadden me, so I try not to think about them too much.

But please. Be an advocate for yourself and your baby. If something doesn't feel right or you don't feel like the care you are receiving is enough, speak up. Your baby's life may depend on it.

Emotions

I don't know why, but this week has been really hard. I made it past Caleb's due date, and it was hard, but I survived. A couple weeks later our good friends had their baby girl, and I'm just thrilled for them. Insanely jealous, of course, but I think that's to be expected. I love seeing pictures of her.

But for some reason, I've just been really emotional and sad this week. I don't know exactly why. I know I'm disappointed that I'm not pregnant yet. I know I'm sad that I don't have a newborn. I know I'm sad that I never got to complain about stretch marks or swollen ankles. I know I'm so frustrated that all these sixteen-year-old girls with no jobs and no insurance and no support keep getting pregnant. I know that I'm just so stressed and mad at work and every day that I'm there reminds me that I was going to quit after the baby was born and work from home on my own business, and take care of the baby. I know that I see babies and pregnant women everywhere and while it no longer sends a knife thought my heart, I still think about how unfair it is that it's a breeze for most women, but the women who seem to want it the most have to fight for it the hardest, and some of them never achieve it. I know that I got in a fight with Chris yesterday and started crying and couldn't stop and I'm crying now and I have to suck it up and stop because I need to leave for an engagement shoot in seven minutes.

My surgery is in just a few days, and I'm so excited. Not scared, yet. Talk to me again when they're coming at me with a scalpel and I might feel differently. But not yet. I'm excited, but I'm worried. For the vast majority of women who get the TAC placed pre-pregnancy, there's absolutely no impact on their ability to concieve. But for a very few number, it does seem to make it more difficult. I should be able to relax in comfort knowing that almost everyone is able to go on and have a baby with no problem, but once you're on the losing side of statistics, you never find numbers comforting again.

God, I just want to be pregnant. I just want a baby. Sigh.

Life, as it happens.

Since having a huge, epic cry over finding out that our "friend" is having a boy, I've been doing pretty good. And I have to give a shout out to Chris (who doesn't read this, but I still feel the need to give props) for dealing with me that night. I know he didn't quite understand where I was coming from, but he just let me cry and held me, which is exactly what I needed. And in the morning, I felt better. I won't say I'm entirely at peace with the fact that they're having a son (and that she's blogging about "folding cute, little clothes for my son...my special little gift to come.") but I got most of the emotions out during TearFest July 2010 and have been feeling pretty great since then.

I've talked a little bit before about our plans for any future pregnancies and what we've been doing thus far. I would wear a dirty diaper on my head if it meant that I would have a take-home baby in the future. I'd accessorize with air fresheners and glitter, but damn straight I'd rock that diaper 24/7 if it'd help. Hence the supplements I'm taking, the acupuncture I have scheduled for next week (so excited), the tests I've brow beaten my OB into performing, etc. Anything I can do to achieve a healthy pregnancy and healthy baby, I'll be all over.

That being said, I don't really know that my OB is on the same page as I am. I love her - she's very nice, extremely competent, and also very unworried. She's confident that it was just a fluke and that I don't need to make any changes for the next pregnancy, especially after all the tests came back normal. She's probably right. But I can't shake the feeling that I need to be doing SOMETHING proactive next time.

So today I called the Maternal-Fetal Medicine department (MFM) and scheduled a consultation. After my water broke, I saw one of the MFM doctors and he had mentioned that while not necessary, I could be a candidate for MFM care next time. Since I haven't felt 100% comfortable with the lack of action plan for next time (other than a couple extra checkups/ultrasounds), I want to explore my other options for care should I get pregnant again. I am not hoping for miracles; I don't think they'll be able to give me answers as to why this happened; I don't think they have some magic test that hasn't already been performed. I am hoping that they'll be more understanding and offer me weekly or bi-weekly checkups and ultrasounds to keep my mind at ease; that they might be more aggressive with treatments (even if unnecessary...if it can't hurt, I want to do it); that they might be more willing to work with an admittedly bat-shit-crazy-paranoid woman (a title which I loathe, but is well-earned).

I told Chris the other day that I have this sinking feeling that our journey isn't over yet and that this will happen to us again...that there is something wrong with me that the HSG and RPL screen didn't pick up. I'm sure that's coming from a place of pure terror and is normal when when something this devastating occurs for seemingly no reason. But in the back of my head, I can't help but think we have to go through this one more time before we get our take home baby. I hope not. I really, really hope that's not the case. I know people who have gone through this more than once and it's so fucking unfair. But they made it through...and I know that if it does, I can too. That being said, please god no.

Where's that crystal ball when you need it??

Planning Ahead

When I was pregnant with Caleb, I was extremely superstitious. I didn't buy anything for him until well into my second trimester. I didn't want to jinx anything. By the time my water broke, I had purchased a few outfits, but everything I had for him fit into one small box that is now packed up at my mom's house waiting for baby number two.*

I've always loved baby things, and started keeping a bookmark folder full of things I loved - toys, nursery decor, clothes, furniture - well before I was pregnant. Like maybe two years before I got pregnant (don't tell my husband!!). I came close to deleting it after Caleb died, but instead just renamed it and moved it so I wouldn't see it every day. After a month or so, I started slowly saving new things to it. Just one here, one there...but it was a start.

Yesterday I got an email that Threadless was having one of their rare $10 sales. Threadless is a community-based t-shirt design company, and on any given day there's a 90% chance that either my brother or my sister is wearing one of their t-shirts and a 60% chance that they both are (sometimes the same design). I don't wear t-shirts, but when I discovered that they sell onsies and kid's tees, I was beyond excited. So cute! When I found out I was pregnant with Caleb, I started stalking the Threadless site, waiting for one of those sales. The sale never happened in the five months that I was pregnant, so Caleb never got his Threadless onsies.

When I got the email, my heart leapt - and then sank. I had no reason to buy them.

But then. Then I had a revelation. Last time I was so cautious. I did everything "right." And a fat lot of good that did me. So screw it. I was going to take advantage of that $10 sale. And I was going to do it now, before the designs I loved so much went out of production.



And I did. I bought my next baby some onesies and some baby tees. I can't worry about what might happen next time. I am going to fully embrace the next pregnancy and the next baby and not be so superstitious. World, you will know when I'm pregnant the second the pee dries on the stick. I'm not wasting a moment before celebrating.

And maybe I'll have another loss. Maybe there won't be a next baby. I hope there will, but maybe there won't. And if that happens...well, I suppose the clothes will go to a niece or nephew. But I can't let that fear control me. I did last time, and I regret it.

So yes. I bought my as-of-yet-nonexistent-2nd-baby some clothes. And it felt great.



*I kind of love the idea that the next baby will have hand-me-downs from his or her older brother - just like in a regular, non-dead-baby family!

Devastated

This is the most difficult thing I've ever written.

On Wednesday, April 7, at 2am, my water broke.

I was 18 weeks and 5 days pregnant.

We immediately went to the emergency room, where it was confirmed via ultrasound that there was no fluid left.

The prognosis we received is not good. Most women deliver within 48 hours of their water breaking, and the vast majority of those who don't deliver immediately will within 10 days. Only 1-2% go on to deliver after a date when the baby could live outside the womb. We were admitted to the hospital and placed on bedrest. I received antibiotics for the entire two days we were there and IV fluids the first day. Baby and I were checked out every four hours - temperature, blood pressure, heartrate, etc. We received a second ultrasound Thursday morning. Baby continued to have a heartbeat, and this time they were able to measure fluid at a level of 1.4 (normal is 8-20). The doctor cautioned us that it was possible this was due to a different ultrasound technician or a better quality machine, but that it was something. And at this point, ANYTHING was cause for celebration. After we passed that 48 hour mark without delivering and appearing stable, we were discharged for strict bedrest at home.

I'm now at home counting every day that passes. Our first goal - 48 hours - has passed. Our next goal is the 10 day mark, which will be the 17th of April. After passing that, we'll be hoping and praying that we can make the 24 week mark, when our little baby would have a fighting chance of surviving.

Our big hurdles now are to prevent infection and to stay out of labor. I'm doing everything I can on both of those ends - staying laying down, drinking tons of fluids, saying my daily positive affirmations, taking lots of vitamins, and talking to other women who have experienced this who HAVE had a positive outcome. It's hard to stay positive with such slim chances, but we're clinging to that hope.

Be prepared for TMI about bodily functions and pregnancy:

The bleeding WILL stop.
My uterus WILL stay calm and relaxed.
My cervix WILL stay long and closed.
My amniotic sac WILL repair and replenish fluid.
I WILL stay infection-free.
Our baby WILL stay healthy and strong.

Chris has been absolutely amazing. He's taking such good care of me - I could never have imagined. I wouldn't want to do this with anyone else by my side. I'm lucky to have a strong family support system as well.

Anyone who stumbles across this blog, please send thoughts, prayers, positive vibes to me, to our baby, and to our family. I don't care if it's God, Buddha, your personal happy thoughts, or the Flying Spaghetti Monster....we will greedily and eagerly accept and welcome them all.

REALLY, Chewie?

I am sick of writing about blood and bleeding and spotting. So I'm not going to any more. Instead, I'm going to say "daffodils." Because it's spring!

Thanks to a huge gush of daffodils last night, I landed in the doctor's office AGAIN today. Granted, I've had some daffodils on and off this entire pregnancy, and Chewie Optimus Prime has been fine so far (according to that strong heartbeat). However, this was more daffodils than I've ever seen in my life in one big gush, so I was understandably freaked out. I called the doctor first thing this morning (after barely sleeping and many hours spent contemplating an ER trip) and they got us in right away. One concern was that since it was a gush (think water balloon bursting) that my water may have broken. The end result, after much prodding, was that they could definitely see daffodils all over the place (no surprise, since that's been evident for a while), but that (thank god) the water hadn't broken. In order to try to pinpoint a cause of all these daffodils, they moved our ultrasound up from next Friday, the 16th (11 days away) to THIS THURSDAY, the 8th (three days away!). She wasn't entirely happy about the change - they prefer to do the big ultrasound as close to 20 weeks as possible - but really wants to see if they can find out what's going on.

I feel like there aren't quite enough parenthesis in that paragraph.

()()()()((((()))))))((((((((((())))))))))()()()()(((())))((((())))((((((())

(()))()()()))))(((()))

(

)

Ok, done. Out of my system.

Anyway, so big ultrasound on Thursday. Praying that they can figure out where the heck all these daffodils are coming from. Hoping that Chewie is healthy and looking good. And keeping my fingers crossed that baby decides to put on a big show for us and show us that cheeseburger or, um...not cheeseburger.

13 weeks

On Monday, I'll officially be out of the first trimester, no matter which calendar you use. You'd think after ten thousand years of humanity there would be some set standard, but no...apparently every site and doctor calculates it differently. Some sites say 12 weeks, some say 13, some say 13 weeks 3 days, and some say the end of 13 weeks. One even says 14 weeks 5 days, but I'm ignoring that entirely. The standard seems to be 13 weeks 3 days, so I'm going with that calculation. So MONDAY! Monday is also a huge day for us because it's the day of our first official ultrasound. Obviously I had one at 6 weeks for the ER visit, but Chris wasn't there, and let's be honest....it was essentially a jelly bean. A jelly bean with a heartbeat, yes, but still a jelly bean. Assuming all goes well, this time we should see a baby! A miniature, three inch baby. I could not be more excited...and nervous. This ultrasound checks for chromosomal abnormalities like Down's Syndrome. While we have no history of anything like that on either side of our families (well, Chris's cousin, but that might be more of a twin complication than anything else), it's still completely nerve wracking to wait for the results. Chris and I haven't really talked too much about what we'd do if there were abnormal results. I think if the results strongly indicated that there could be an issue, we'd move forward with an amnio. And if that also indicated a problem? God forbid...but I don't know. We'll cross that bridge when (hopefully never) we come to it.

What else? I'm DEFINITELY showing. Before, I could write it off as bloat. But now...well, the top of my stomach under my chest is starting to pop out a big. There's a hard little area just above my belly button - I know it's not the baby yet, but I'm assuming that some organ has decided to come vacation under my ribs.

Lastly, on Tuesday I got to hear the heartbeat at the doctor's. I had bright red spotting (this kid is really gunning for the pony) over the weekend, and while I was initially able to reassure myself by finding the heartbeat with the doppler, on Monday night I could no longer find it. Obviously, I panicked. I'd just been able to find it that morning...what could possibly have changed in less than 12 hours that would suddenly make me not be able to hear it? The last three or four times I'd tried, I'd been able to locate it in less than five minutes. On Monday night I tried for 30 or 40 minutes and couldn't find it. I won't go into detail about the crying fits I went through that day and the next day, but needless to say there were quite a bit. I called the doctor Tuesday morning, honestly expecting to hear them reassure me that the home doppler might not be as sensitive or that the baby might have moved, but instead the nurse asked me to come in as soon as possible. Honestly, that was not the response I expected at all and it absolutely terrified me. You'd think after the pain at 6 weeks and the spotting at 8 and being reassured that everything was okay despite those issues that I'd start to be less nervous, but no. Apparently you start to get attached to the little tumor growing inside you as the days go on...who knew?

I got to the appointment and met another of the midwives, who was supposed to be Pam, but in retrospect I don't think that's what her nametag said. If only there was a way I could use my computer to look it up....too bad no one has invented a way to keep information accessible, say over a global system of networked computers, via just a few keystokes. I'll just have to use my Jedi mind power instead. A ha! Her name was Heather. I really liked her a lot. Neither Chris nor my mom could go to the appointment, so I called Carol and she was able to meet me. Thank god, because if it had been bad news, I don't think I would have been able to be by myself. Pam Heather put the doppler on my belly and after a few minutes, the room filled up with the amazing, wonderful sound of the baby's heartbeat. Holy cow, I was so relieved.

So now, I just wait until Monday to hopefully see that all is well with the little one. Keep growing, baby!

11w! ?

I'd been doing so good the last two weeks about worrying - of course it was always in the back of my head, but then suddenly today it came back full force. Slammed into me head on and knocked me flat on my back. I tried to find the heartbeat on the doppler to reassure me, but I couldn't. I know that shouldn't worry me - it's still fairly early to find it consistently - but it does. It really does.

So bean, Koopa, Bowser, Skeletor, Megatron....keep on keepin' on, okay? We're telling your family about you this weekend and they're all going to be SO thrilled to meet you and SO excited. You'll be really spoiled! You will have amazing grandmothers and aunts and uncle. Oh, sad! You only have one uncle! :( I'll yell at my parents for that. Once some of the girls get married you'll have some more, though, so don't let that stop you!

Spoiled. Rotten. I promise. So just...just keep on growing and be healthy. Ok?

UPDATE: Apparently the promise of being spoiled rotten works for this little one, because I've been able to find it consistently the past few days. Yay!

Please stop!

I am so effing* scared. All I can do is keep repeating "Please, God, please let the baby be okay" over and over. I just want this spotting to STOP. STOP STOP STOP.

*I had been trying not to cuss on this, on the off chance that I'll share this with you when you're old, litle bean, but yes...your mother cusses. Quite a lot.

8 weeks and counting!

Ok, beaner, I've about had it with your antics. I was (am) so, so, so excited to reach the 8 week milestone...and you have to temper it with spotting? Really? Baby, I don't even know you yet, but you're being kind of a jerk to your mama. Are you just preparing me for when you're a toddler and you are falling down stairs and being so contrary? Because it worked...I'm ready! Now how about smooth sailing the last 32 weeks? Please? Pretty please? I promise lenience when I catch you sneaking out at 18! A pony when you're 12. A cell phone* at 8. Ice cream every day for dessert! Just BE GOOD!

I love you, little dude or dudette. Just keep growing, all right? Do we have a deal?

* Or whatever new technology your generation is into. A teleporter device, perhaps.

Baby, this is your first warning!

Don't SCARE me like that!

Last night, I had some really sharp, stabbing pains in my lower left side yesterday. I was a little worried, but thanks to the online forums I posted in, my fears were assuaged. I finally got a hold of a midwife, and she said it was very likely absolutely nothing to be scared of, but that since I hadn't had a scan yet to 100% rule out early ectopic or anything else, that she'd like me to go to the ER for an ultrasound. Even then, I was still not too worried. Chris couldn't get off work, so I had my mama go with me. :)

Anyway, so I did all the preliminary stuff (blood pressure, blood drawn, etc) and then the doctor came in to give me a pelvic exam. During the exam he found the source of the pain (when he pressed, it was tender) but couldn't link it to anything specific. Afterward, he told me that he saw some blood up around my cervix and said he was going to be blunt - that wasn't good and that's not normal (which is contrary to some of the things I've read, but I'm sure he was trying to prepare me for the worst). The pain alone could mean nothing, and the blood alone probably upped the chances of a miscarriage by another 20% or so, but the pain with the blood probably put it closer to the 50% range.

So I still had my ultrasound left to do. After waiting what seemed FOREVER I finally got wheeled down to the ultrasound room, where the tech was super nice. She started with a belly ultrasound (I don't know the scientific name for them?) and I was actually kind of terrified, because all I saw was a big black hole. I thought I saw a second bean-looking thing inside it a couple times, but never was sure - and she never said anything like "That's your embryo!" Because it was so early in the pregnancy, she said she was also going to do an internal. With that one, she was able to point out the little bean, and....I saw the heartbeat. It was the biggest relief of my life, and I'm so glad my mom was there to see it for the first time!

When it came time to be discharged, the doctor said my bloodwork looked good and that everything was right where it should be for how far along I was (confirmed to be 6w5d, which is awesome because I was thinking I was around 7w but could have been as early as 5w). He said he's not sure what caused the pain, but not to worry too much about the blood unless I start bleeding fairly heavily. So of course at that point I felt stupid for going in, but he reassured me that with early pregnancy it's far better to be safe than sorry and he would have advised anyone to do the same - plus, the midwife took the decision out of my hands when she asked me to come in. So yay! Everything looks good and DOUBLE YAY! I got to see the little munchkin!

Good thing I was so happy when I got home, since the well-meaning but dense Chris said, "That's good! I knew you were overreacting." Darling, let me apologize for the boot that is about to be kicked up your ass. I think he was trying to make me feel better in a "I knew it was going to be okay" way, but failed miserably.

So here's the best thing I've ever seen in my life:

Six weeks! Woot woot!

The first big milestone is here! Today we're I'm six weeks pregnant. Way to go, little embryo!

I've been freaking myself out verily with online message boards, about which I can only say one thing: Stay. The. Eff. AWAY. Yes, pregnancy and childbirth is a miracle, blah blah blah, but on some of those boards, you'd think it was a miracle tantamount to the parting of the Red Sea, rather than a miracle that is performed by millions of woman (and the occasional man) each year. I realize that miscarriage is a very real possibility, but wow. On those boards you'd truly think that mankind was destined for extinction. Case in point: I asked a question, and one person replied, "Well, I had a blighted ovum at six weeks and another time I went in for my ultrasound at 12 weeks and there was no heartbeat. So enjoy your pregnancy."

Um.

Thanks?

No, really - I get that it might happen. But as someone else so perfectly put it, "No matter how you look at it, YOU HAVE A MUCH BETTER CHANCE OF HAVING A HEALTHY PREGNANCY THAN MISCARRYING."

Duh! I had convinced myself that something going wrong was the norm and that I - nor anyone! - would ever be able to have a baby. But obviously that's not the case.

But regardless, the chance of anything happening does go down a bit at the six week mark, more at the 8 week mark, and becomes virtually nil at 12 weeks. So hitting six weeks was a huge relief, though I won't be full relieved, like....ever. Did you know at the end of this there's an actual tiny helpless PERSON that I am responsible for keeping alive for a minimum of eighteen years?? Yeah. It's true. Tell me again what I was thinking??

--L