Tag Archives: anxiety

Full term, and the end is in sight!

Hard to believe, but here I am at 39w1d — officially full term!  I just had what is looking like my last prenatal appointment this morning — one more NST and ultrasound, and then the midwife checked my cervix which is looking like it’s starting to do things (2cm, 60% effaced, medium, soft, and -1, for those who like the stats).

I’ve been talking about the possibility of induction with my providers for the past few weeks — my favorite doctor in the practice is on call next Friday, and L&D had openings, so we went ahead and scheduled an induction for next Friday.  I’m a little nervous about induction, but I’m more nervous about going too late and risking the complications that come with that.  I feel good about being induced at 40w2d — my dating is extremely precise (was tracking ovulation and had several ultrasounds around 6-8w that all agreed with ovulation) so there’s no chance of accidental prematurity, baby was measuring 76th %ile as of last week (bigger than my first son), and since my first son was born at 40w5d (after labor at 40w4d) and my cervix is already ripening I think the chances of my body not being ready for induction are pretty low.  I found some great statistics online, and with a Bishop score of 8 (or more by next week) and a previous vaginal delivery, it looks like my odds of needing a C-section with induction are about 6% or less.  Plus it’ll be good to have a date when I know I can stop taking the Lovenox — I just hope I don’t jump into spontaneous labor an hour after my dose sometime in the next week!  (I actually skipped it this morning, just in case the cervical exam got things moving — last pregnancy a doctor did a membrane sweep at 40w4d without warning me, and I had my first contractions within an hour after that appointment!)

It’s so hard to believe that by next week we’ll almost certainly be meeting our second son.  I mean actually hard to believe — it just doesn’t feel real yet, somehow.  We’re as ready as we can be, and now I’m just hoping for no surprises, no emergencies, and maybe even a similar textbook labor and delivery as we had with S.  It’s so helpful to have the memory of S’s birth to ground me — I feel much less fearful about going back to the labor and delivery ward of our local hospital than I did last time, when my only association with that place was the awful delivery of our daughter.  I now know that things can go well, and I even have an expectation that they might go well, rather than feeling like I’m constantly in emergency mode.  Part of me wonders if my more even-keeled emotional state in this pregnancy will affect the baby.  Maybe this baby will be more laid-back than his big brother?  We can hope!  (S was actually a pretty great newborn — he’s mostly just a bit more clingy and anxious than the average toddler, I think.  But if I got another like him, I’d be thrilled!)  Wish me luck!

 

Tenure/Pregnancy update: End-of-summer edition

30 weeks pregnant and all was well at our monthly ultrasound this week.  Little guy is bopping around in there, currently lying sideways across my belly.  My husband and I have settled on a default name (unless we come up with something we like better by the time he is born) and are setting up the nursery.  I don’t remember at what point we did all this with S, but I think it was later.  I do remember that this was the point in my pregnancy with S at which our dear friends offered to throw us a shower, and I broke down in tears and just couldn’t handle the idea of planning for a living baby (the upshot was that we agreed on a “sip-and-see” a few months after S was born, which was a lovely compromise).  Some days I still can’t handle the idea of planning for another living baby (how lucky can we possibly hope to be???), and some days that’s all I can think about.  I still feel plenty of pregnancy impostor syndrome — like, this pregnancy isn’t actually going to last, there’s not actually going to be a new baby, it could all come crashing down at any moment.  But I’m at least able to act more normal this time around, mostly not responding weirdly to people’s innocent inquiries about whether this is our first (standard answer: “No.  We have a 2.5-year-old at home”) or jibes about how we’ll have our hands full with two boys (standard answer: “I sure hope so!”).

On the tenure side, I submitted my materials to my department today!  Hooray!  Now comes a long, long wait.  If I’m lucky, I’ll have a final answer by May 2019, and if I’m not lucky, I’ll have a final answer by December 2019.  The big steps in the process are:

  • This fall the department solicits letters from experts in my field around the country/world who can comment on my research portfolio.  This process typically takes a couple of months, as I understand — it happens in two stages, the first of which involves sending letters asking people if they will agree to write letters, and the second of which involves sending letters asking them to actually write the letters and then waiting for the responses.
  • Hopefully by the end of fall, but possibly later if there are delays, my department will have collected all of the external letters and will meet to go over all of my materials and vote on my case.
  • After my department has made its recommendation, presumably sometime in the spring, my case will go to a university-wide faculty committee for evaluation.  This committee currently includes members from the departments of English, Music, Gender and Sexuality Studies, Economics, Sociology, Chemistry, and Biology — there’s also one from Earth and Environmental Sciences, but she can’t vote on my case (unfortunately, since she’s the most qualified to evaluate it) because she’s officially my faculty mentor.  I go to the end of the line for the university-wide committee this year, since most faculty start at the university in the fall, but I started in the spring, so I’m on a one-semester-late review schedule.  This is the main reason for uncertainty in when I’ll get an answer about my tenure case — they will review my case in the spring if they have time, but if they are overwhelmed with fall cases they aren’t obligated to review it until next fall semester.
  • After the university-wide committee votes on my case (if the vote is positive), it goes to the Board of Trustees, and then the university president.  If I’ve gotten positive reviews at each stage up until this point, it’s usually a rubber stamp at the upper levels, but there was a case in recent memory that was positive at the department and university level but was overturned by the president, so there’s always the possibility that something weird will happen.  Since the Board of Trustees meets only a few times per year, this is another potential source of delay, depending on when the university-wide committee reviews my case.

After all of this, I’ll get a yes or no answer: either yes, I can keep my job essentially forever (barring unlikely circumstances like a major failure to meet my duties or major reorganization of the academic structure like eliminating my department), or no, I’m fired and I have to go look for another job.

It’s a long time to be in limbo, and many faculty find the uncertainty torturous.  My goal is just to try to relax and let the process play itself out, and allow myself to be distracted by the hopeful new addition to our family in November.  It’s the sort of setup that could either be really great (because I’ll be so busy with a new baby that I won’t have time to fret about tenure) or really awful (because being home with a new baby is psychologically challenging and so is waiting for news about your tenure case).

But either way, both of these big projects are looking like they’re in good shape at the moment, so I have to focus on that.  And now that I’ve turned in my materials, they have something else in common too: there’s essentially nothing I can do to change the outcome of either at this point.  The work I’m submitting for tenure has been done and documented, and this baby is baking away and the only thing I can do is to take care of myself and wait to see what happens.  I should avoid doing stupid things, like starting a feud in my department or suddenly becoming a binge drinker, but otherwise I have to accept that I have little to no control over the outcomes of either my pregnancy or my tenure case at this point.  And that’s hard for someone who likes to plan and act!  But if nothing else, my experience with pregnancy loss and infertility have given me plenty of practice at waiting, accepting lack of control, and dealing with difficult outcomes.  So, I’m pretty sure that whatever happens, we’ll make it through.

Baby and Tenure Update

Baby and tenure packet are both cooking along, so I thought I’d post a brief update.

Today I’m 28w pregnant and therefore officially in the third trimester.  While I do feel much more relaxed with this pregnancy, I had my first significant baby freak-out earlier this week — I had just been feeling off, and woke up with a sort of painful burning in my lower abdomen and then had two bouts of super-intense sharp pain over about an hour in the morning that freaked me out and sent me running to my OB worried about a repeat abruption.  She very calmly told me she didn’t think I was having an abruption, and that it sounded more like something GI-related, but if it would reassure me they’d check on ultrasound, which they did (just a quick, unofficial ultrasound).  Everything looked fine with the placenta, and baby has been kicking up a storm ever since, so I’m just left feeling a little sheepish.  I’m still glad I went in instead of stewing in worry, though.  While I am significantly more relaxed in this pregnancy than in my pregnancy with S, that’s like saying that my wind speeds have dropped from hurricane level to tropical storm level — I am still very, very far from the carefree blissful assumption of a healthy baby that I experienced for the first 18w of my first pregnancy.  But objectively, everything is fine.  I’m starting to drag a little and feel the achy pelvis and lower back that I remember from my pregnancy with S, but it’s still not bad, and I’m still immensely grateful for every day that I’m pregnant with a healthy, squirmy baby.

On the tenure side, I’ve drafted my research and teaching statements, gotten some feedback on them from my PhD advisor and my faculty mentor outside my department (who has served three times on our university tenure committee), updated my annotated CV, and am now revising everything and preparing to submit at the end of the month.  While my materials aren’t technically due until early November, I’ve obviously got another big deadline looming at the same time (i.e., my baby’s due date!) so don’t want to leave it any later than I have to.  I had discussed with my chair turning everything early and he’s totally on board with it.  So, my goal is to get my packet submitted by the end of August, before the semester starts, and then just allow myself to be distracted by teaching and the new baby while the process goes forward over the course of the year.

I am facing one tricky decision that I need to make in the next few weeks, which is whether or not to ask my department to solicit letters from former students as part of my tenure packet.  There’s a little bit of explanation required here: it’s not a standard thing that my department does, but other departments around the university do include it as a standard component of the tenure packet.  The only universally standard metric of teaching effectiveness at my university is the end-of-semester evaluations filled out by students in my classes.  Mine are good — consistently above average numerically, with lots of positive comments and relatively minor gripes.  But I’m also philosophically opposed to having my teaching evaluated only on the basis of those student evaluations, since there’s a ton of research showing that they are biased and not good indicators of teaching effectiveness.

So I’ve wanted to include multiple metrics of teaching effectiveness in my tenure packet.  I already asked my department to send faculty to observe some of my classes (which they’ve sort of done… last semester my chair visited one of my classes and had a really great conversation with me afterwards about his observations, and then another faculty member visited the last 12 minutes of one of my classes and said he thought he got a pretty good sampling of my teaching, blargh).  While I’m glad that I’ll be including peer evaluations to some extent in my packet (another component that is standard in many other departments at my university), the dimension that I think is missing is any sort of measurement of the longitudinal impact of my teaching/mentoring, including the work I do with research students (which falls under the category of teaching at my university).  So, I had discussed with my chair the possibility of soliciting letters from former students.  Apparently my department had their first meeting about my tenure case last week and discussed that they’d be happy to do it, and it’s basically up to me (1) whether or not I want them to do it and (2) what sample of students I want them to ask.

For example, I could ask them to solicit letters from only my former research students, or I could ask them to solicit letters from every student I’ve ever had in class, or I could ask them to solicit letters from only former majors in our department.  Whatever I choose, they will all get the same prompt (which my chair already drafted and shared with me), which is basically a letter from the chair saying that I am being considered for promotion to associate professor with tenure and asking them for any reflections they have on the quality of my teaching and mentorship, and how their experiences with me may have impacted their subsequent career development.  So, a pretty generic prompt, with no carrot or stick to encourage them to reply.

Philosophically, it seems like a great thing to do to assess a dimension of my pedagogy that is not otherwise reflected in my materials.  I suspect I might get some really strong letters — I think I have had a pretty significant positive impact on a number of our students (and I don’t think I’m being delusional about it — certainly I’ve had students tell me that they have felt that way).  But… part of me wonders if I should just leave well enough alone and not introduce an extra dimension of randomness.  My teaching evaluations are good, and on that basis alone I’d probably get tenure, so why rock the boat?  It’s certainly possible that I could get negative letters (though I can’t think of any former students who are out to get me), but the thing I’m more worried about is getting weird letters from students who don’t understand the tenure process and therefore say things in a way that they might think is positive but that might raise questions for the tenure committee.  Basically, the more data the tenure committee has in its hands, the higher the probability that there will be something a little odd for them to fixate on.

So, anyway, I’m thinking about it this week, and planning to talk to my aforementioned outside-the-department faculty mentor to see what her experience has been reading student letters as part of the university tenure committee.  My inclination at the moment is to ask my department to go ahead and solicit the letters, and for the sample to be all of our former majors.  My reasoning is both the principle that I would like my tenure packet to reflect the long-term impact of my teaching/mentoring as a dimension of my teaching effectiveness, and also that I think it’s likely that it will be an overall strength of my packet rather than a weakness (I just don’t think I’ve made any of our students mad enough that they’d be motivated to write and complain about what a horrible professor I am, and I know that I’ve had a significant positive impact on a number of our former students that isn’t reflected in my end-of-semester evaluations and would likely be reflected by these letters).  So, that’s the last big decision I need to make before I turn in my packet.

Overall, this is an exciting and busy time as I prepare for so many new things: a new semester, a new baby, and a new stage of my job.  It’s always easy to love life in August as a university professor, but I’m really feeling the gratitude this year for all of the wonderful things I have in my life.  My anxiety about the tenure process has been kept at a minimum both because I’m actually able to do something about it at this stage (e.g., work on my tenure statements) and because I have had the perspective of expecting a new baby and watching my friend land on her feet after her tenure denial last year — both of those have grounded me and reminded me that whatever the outcome of this case, I’m going to be fine, and in fact, much better than fine.  I’ve also had the wonderful distraction of preparing for the new baby.  My husband and I took most of last week off from work and had a lovely staycation — we did fun stuff with S that we don’t usually have time to do (like taking him on longer trips to the zoo and the aquarium and the beach), and we also kept him in daycare a few days so that we could get stuff done around the house (newborn and 0-3mo clothes are out of storage, washed, and folded, expired infant carseat has been replaced, and my baby to-do list has gotten longer since I finally had time to sit down and think about all the things we need to do).  The big-kid bed transition is officially a success, and I loved having the opportunity to spend more quality time together last week as a family of three — we have a really great family right now, and so much to look forward to.

Update: End of the second trimester

Well, here we are, past that oh-so-arbitrary point of “viability” (not that I’m eager to test it!).  I’m about 25.5 weeks now, and the time remaining feels both short and long.  If all goes well, living child #2 will be here before we know it, although when I think about everything I need to do between now and then it seems like a lot.

It’s been an eventful few weeks for our family: my husband’s parents visited for two weeks, in the middle of which I went to two conferences for a week.  Then, we transitioned S out of his crib and into a big-kid bed (so that we wouldn’t have to buy another crib), and this week he has his first case of croup.  Poor little munchkin’s life is all topsy-turvy.  But he’s recovering this weekend, and hopefully will be back to normal soon.  I missed him like crazy while I was away at the conferences, and I’m glad I won’t have to go on any more long (>1-night) trips before the new baby arrives.

I think that it’s pretty common to feel this way, but my husband and I are both feeling the bittersweet nature of the coming transition: eager to meet the new baby, but also worrying about having less time for S and disrupting what has been a really, really fun stage of his young little life.  Despite what everyone says about the terrible twos (and despite the occasional tantrum), we are still finding every age more fun than the last, and it’s hard to imagine giving up our wonderful little family of three — especially thinking about going back to the difficulties of the newborn days.  Even though it’s clearly what my husband and I both want, quite strongly, and even though we want our son to have a sibling.  One thing that made me feel better about this ambivalence was reading this article about how your first child fills your whole heart, and your second child makes you grow a new heart.  Kind of corny, but there are lots of corny things that speak to me during pregnancy and parenting.

The good news is that this pregnancy has definitely been easier than my pregnancy with S, anxiety-wise.  When I think back to my emotional state during that pregnancy, I think I must have scarred S for life somehow (presumably cortisol-mediated) — I was in a constant state of panic and worry.  This time around, even though three of my previous four pregnancies have ended poorly, I have at least one normal, healthy pregnancy under my belt, which makes me more relaxed.  Unlike my pregnancy with S, I now have a much better sense of what’s normal and what’s not — when I was pregnant with S, I only had the one train wreck of a pregnancy with my daughter to compare with, so everything that happened during that pregnancy, normal or not, was suspect.  This time, if it happened during my pregnancy with S, I figure it’s probably fine.  I definitely have my moments of worrying that making it this far in the pregnancy will mean that it’ll be all the harder if it all comes crashing down the way my first pregnancy did, as well as moments of remembering my daughter and wondering why she had to die, but overall I’m just much more even-keeled this time around than I ever was during my pregnancy with S.

And oh, is S ever a great distraction!  I feel like I should be writing down more of the adorable things he does.  Some of them are already gone — for example, he used to call our dog “Bubba” (her real name is Goldie), which was one of his first jokes, but now he just calls her Goldie.  I love his babyish pronunciations, like “Naka-WEEN” instead of “nectarine.”  He has such a great sense of humor, and is really into knock-knock jokes (his favorite is: Knock knock.  Who’s there?  Boo.  Boo who?  Don’t cry, it’s only a joke!).  He has picked up some adorable expressions like “No way, Jose!” and “Oh dear!” and one of his favorite words is “cockeyed” (courtesy of his grandpa).  He’s also been really into song mashups, and will often launch into epic renditions of “Rain, rain, go away, Old McDonald had an itsy-bitsy spider E-I-E-I-O!” and then laugh himself silly.

Anyway, he is a riot, and he’s also a total mama’s boy right now.  I feel a bit bad for my husband, who handles it really well despite clearly having to hide his frustration once in a while, but it’s definitely a double-edged sword being the preferred parent.  I get more of the “Mama, mama, mama!” and more of the “I wuv you mama” endearments, but I am also required to carry him around all the time, can’t take a shower some days without wailing outside the bathroom door, can’t drop him off at daycare without a meltdown most days, and often have a toddler on top of me half the night if he’s had a bad dream or just needs snuggles (like he did when he had croup this week).  My body is his happy place, clearly.  I have no complaints, and I am generally happy to savor the snuggles while they last (it already makes me teary imagining when he’s a teenager and wants nothing to do with me), but I do worry that it’s only going to make things more difficult when he has to start sharing me with his little brother.  Yesterday, out of the blue, he said “Baby sleep in S’s crib?” which we thought was very generous of him since he just transitioned to a big-kid bed last week and still clearly has mixed feelings about the situation.  Those were also the first words out of his mouth this morning, so it’s already on his mind.  I hope he doesn’t have too much trouble adjusting to his new sibling — my mama guilt is already pretty strong.

And that’s the rambling update on where we are right now.  There’s a lot to do in the next three months, from replacing our expired infant car seat to moving my husband’s home office and converting the room into the new nursery — we’re planning to tackle some of it during our week of August vacation, since I’d like to get as much done as possible before classes start in the fall.  There’s still the part of me that fears assuming that everything is going to turn out OK, but the practical part of me says that it’s better to get it all done while I’m still relatively mobile and not drowning in teaching, and also that we’ve been through the worst once and will deal with it if it happens again (although I really, really hope that it doesn’t).  So, onwards!  Even if it doesn’t seem possible, I can feel this baby kicking away inside me, getting ready to meet his new family.  It’ll be a whole new ball game come November.

Second place is a good place to be

Two big pieces of news this week: (1) We had a normal anatomy scan, and (2) as of today, this pregnancy officially moves into second place of my five pregnancies in terms of how long it has lasted.

The anatomy scan on Tuesday morning was blessedly uneventful.  It was my husband’s first time seeing the baby on ultrasound, which was pretty special for him (he came to every single prenatal appointment for my first two pregnancies, but when you have a toddler somehow all our time disappears and “divide and conquer” becomes a survival strategy).  This baby moves around a lot (which was also commented on at the 13-week NT scan), but apparently is more cooperative than S, because they didn’t have to tilt me upside-down or make me walk around and they still got all the views they needed — unlike with S, who was so stubborn that we had to wait four more weeks to get a decent view of his aortic arch.  The ultrasonographer was quick and efficient, not chatty, but that was fine — she just kept snapping pictures, saying “looks perfect,” and moving on.

The doctor who came in afterwards was fine, but could really work on his bedside manner.  Basically his job was to tell us that the scan was normal, but that of course a normal anatomy scan doesn’t guarantee a problem-free pregnancy or birth.  Instead, he delivered the message in such a way that it sounded basically like he was saying, “There are SO MANY ways a pregnancy can go wrong!  I mean, you’ve already had a normal NIPT, but that’s only really good at detecting Down Syndrome, and of course the anatomy scan is normal, but it doesn’t pick up everything and you could still do an amniocentesis if you’re really worried about catching every uncommon chromosomal abnormality, but even that doesn’t rule out a whole host of other birth defects!”  Luckily, my husband and I weren’t too fazed by it, since we do already understand the limitations of the tests and the probabilities that go along with them, but this doctor must freak out a whole lot of families — and he’s in an MFM practice, so you’d think he’d know better!

Otherwise, 18w is feeling OK so far.  It is hugely reassuring to have the normal anatomy scan under our belts (a milestone I never had in my pregnancy with my daughter).  S’s sleep has been a little rocky lately which means I feel the pregnancy fatigue a little more acutely, but my anxiety level is MUCH lower in this pregnancy than it was with S.  I mean, I’m still far more anxious than I was in my first pregnancy, and I assume more anxious than someone who has never experienced loss and maybe particularly late loss, but I do not have the acute panic with every minor twinge that I had during my pregnancy with S, which is a huge relief.  I think the big difference is that when I was pregnant with S, I had no experience with what a normal pregnancy was like, since our daughter had died, so even stuff that I had experienced in my first pregnancy (because it was totally normal) freaked me out in my second pregnancy because I didn’t know if that was a sign that whatever happened to my daughter might be happening again.  Now I have one normal, full-term pregnancy under my belt, which gives me a much better sense of what’s normal vs. what I actually need to freak out about.

And this week is another big milestone in the sense that this pregnancy is now officially my second-longest-lasting of my five pregnancies so far.  I think second place is a great place to be, and in my ideal scenario (healthy live birth within days of my due date) it would stay there until the end, since I don’t really want to go a week past my due date again!  The milestone of a normal anatomy scan has also opened us up more to starting to think about logistics: names (boy names are hard!), rearranging our house (relocating my husband’s home office as we turn the current room into the new nursery), figuring out what furniture we need (e.g., are we going to try to do the transition to a big-kid bed, or buy another crib?  Do we need a second glider?), and all of the other things we’ve been studiously ignoring up until now.  There’s a lot to think about, but it’s fun to plan, and it feels good to be able to believe in this pregnancy enough to start actually making plans.

Another piece of ultimately good news is that our little campus daycare seems as though it should have a spot for our baby in March, which is when we really need it.  They’ve been horrible at communication (first they told us yes, then they told us no, then today the director emailed that we’re in again), but ultimately it looks like they’ve worked out a solution that should be reasonable.  The problem is that our daycare is so small that it only has four infant slots, but they rigidly age-group the kids by fiscal year so having an infant starting in March means that if they reserve an infant slot for our baby next year they are essentially only able to have three infants the first eight months of the fiscal year, which is a loss of about $10k in tuition for them.  The director was going to save us the spot anyway (which is why she originally told us yes), but then the “executive board” (two parents who are now on my blacklist) decided that the cost was going to be too high so they were just going to ignore the fact that we had top priority on the wait list and not offer us a spot until the new fiscal year in July 2019.  I mean, there are all kinds of dumb things going on there, including the fact that $10k is a miniscule fraction of what our family will be paying the daycare to send two kids all the way through from infant to preschool, and also compared to what they’d lose if we pulled our our older kid before he switched to preschool, since they have a lot of pressure on infant slots but usually have trouble filling all the preschool slots — and if we had to find another daycare for our second baby, the probability that we’d pull S out is actually quite high, since he’d be transitioning to preschool anyway and it’s better to make that transition a bigger one for him than to totally disrupt an infant’s routine four months into daycare to get them in the same place.

So anyway, the upshot is that the infant/toddler teachers were apparently just like, “Um, why can’t we just move S to preschool a few months before his age-mates to free up a spot for one of the older infants to officially become a toddler and then we’ll be able to open a new infant spot in March?”  So, it looks like S will move upstairs to the preschool about a month after his third birthday (which I think will be mostly a good thing — being the oldest in his age group means he’s occasionally seemed bored and frustrated at the end of the year when he’s ready for big-kid things and gets barred from them because of the arbitrary age grouping).  His age-group buddies will join him in July, but since he’s currently in the same classroom as the group who will be moving up to preschool this year and therefore he already knows them, I’m not too worried about the social aspect of moving rooms a few months before his age-mates.

So anyway, the point is that things are good, and we’re thinking about the future and starting to plan for a new family member, which is a nice place to be.  There’s always that part of me that fears making plans or telling people (like my students) about my pregnancy, because what if…?  But I’m mostly able to accept that those fears will always be there, that the possibility of another loss will always be there, but that it’s OK to be optimistic and hope and plan in the meantime.  In a way, having faced the worst in the past makes the worst seem at least hypothetically more manageable this time around.  I hope beyond hope that it won’t happen again, but I know that if it does, we’ll get through it, because we’ve done it before.

Good betas

Well, I’ve got good betas.  Friday’s number: 926.  Monday’s number: 2500-something.  Doubling time: just under 48 hours.  Right on the money.

Of course, I’ve been here before.  At least three times, to be precise (we didn’t have betas drawn for the fourth pregnancy, so I don’t know if they were good or bad).  One of those times resulted in a live birth, and the others didn’t.  So, while this is an encouraging development, I’m not exactly counting any chickens just yet.

I also wanted to record a conversation that has been bugging me all day.  I was walking to a faculty meeting in a different building with my department chair, who also happens to be the closest member of my department to me in age, and with whom I am friendly.  He is currently the only person in the department who knows that I have had three miscarriages, including two since S’s birth.  As we headed over to lunch he said: “Oh, I just sent you an email about this, but remember my recent postdoc X and his wife Y?  Well, X just sent me the news that Y is 9 weeks pregnant and wanted me to share it with everyone!”

I said, “That’s great. [pause] Wow, 9 weeks… oh, to be that optimistic… But, good for them.  I’m happy for them.”

And he just kept talking, as though it was nothing.

Now, I know and like this guy.  I don’t think he meant to upset me.  But it was upsetting.  I was able to handle it OK in the moment, I think… I only expressed the twinge of wistfulness about feeling confident enough to announce a pregnancy to an entire department of your former mentors and colleagues at 9 weeks(!).  But… I would much rather have gotten the news by email, in the privacy of my office, where I could work through my feelings without needing to respond in the moment.  There was no reason for him to bring it up with me in person, other than general cluelessness surrounding my feelings about early pregnancy.  I get that he was excited for his former mentee — my colleague is a father of three young kids, and just loves babies and little kids.  I just wish he had been even a little bit sensitive to the fact of my previous losses, when clearly it didn’t even occur to him that this news might hit a nerve for me.  It made me feel lonely, and reinforced the reality that most people, perhaps especially men, don’t understand the emotional impact of pregnancy loss, particularly recurrent pregnancy loss, on women.  What it communicated to me was that he doesn’t see my losses as a big deal, and doesn’t even understand that they might be a big deal for me.

Of course, it helped that I was able to hear the news while I was pregnant, rather than two weeks ago when the testing and treatment seemed to be dragging out interminably.  It’s amazing what an emotional roller coaster every pregnancy is for me, even the fifth one.  You can bet I wasn’t in the mood to tell my chair that I was pregnant (I mean, 5 weeks is basically like 9 weeks, amirite?!), but at least I was able to feel a little bit hopeful, and then getting the news of good betas later in the day helped me feel even more hopeful.

Now I have to wait two weeks for that all-important heartbeat ultrasound, since I’ll be traveling from the 12th to the 16th of the month.  Please keep sending good wishes, especially until then!

The two-week wait after the two-week wait

I’ve gotten pretty good at the two-week wait over the years.  I am a model of patience and restraint: I never test before a missed period anymore (why would I?  It’s just a waste of a pregnancy test that I most likely wouldn’t need if I just waited for my period to come in its own time).  I’ve been pregnant five times, which means a heck of a lot of two-week waits, so I guess I’ve finally worn down my anticipation.

But the two-week wait after the two-week wait?  That’s a whole different story.

In my four previous pregnancies, I’ve always had an ultrasound at 6 weeks.  In our first pregnancy it was because we’d had some difficulty conceiving and were being followed by the RE, and after that it was because I was supposed to start Lovenox at the first sign of viability.

That first six-week ultrasound was magical.  We saw a heartbeat right away.  There was a living creature.  Inside of me!  It was amazing!  I was elated!  I cried!  I fell in love at first sight.  It was just incredible.  Later we found out it was a daughter, and that was a magical moment as well.  There was so much anticipation in that pregnancy.  Which probably made it all that much harder when it ended at 18 weeks.

Since then, the six-week ultrasound has been a different story.  I am more wary, guarded, less attached to that little bean, less surprised whether I see a heartbeat or not, more clinical as I interrogate the ultrasound tech.  In my fourth pregnancy, I warned the ultrasound tech before she started that pregnancy didn’t tend to go well for me, so I wasn’t expecting good news.  Why did I feel like I needed to warn her?  Indeed, when she had nothing but bad news to give me after that ultrasound, she was fine.  I was the one who held it together until my doctor asked how I wanted to end the pregnancy, and then I lost it.  The six-week ultrasound has gone well for me twice, and poorly for me twice, and even in the cases where it has gone well, only half of the outcomes (i.e., one) were positive.

Same with betas.  I’ve had betas drawn in three pregnancies: my first, second, and fourth.  They’ve always been great — I’ve never had a bad hCG draw.  (I say, knocking on wood, waiting anxiously for the second round of betas for my current pregnancy.)  Yet 2/3 of the pregnancies with good betas have ended poorly.  So you’d think I’d be over them by now.  But here I sit, the night after my 2nd hCG draw in my 5th pregnancy, unable to concentrate on putting together my lecture for tomorrow because I’m wondering what’s going on with my betas.

After everything that’s happened, I don’t trust betas, and I don’t trust the six-week ultrasound.  But… I still get so obsessed with waiting for the results!  I’ve been thinking and worrying about them all day.  The two weeks after the two-week wait, while I wait for blood test results and ultrasound results, feel like the longest weeks of the whole pregnancy.  (Except for the days after my due date in my pregnancy with my son — those were truly the longest days of the entire pregnancy.  Each one felt like a week!)  I torture myself: have they not called yet because the news is bad, and they want to wait to deliver bad news tomorrow?  Even if everything’s fine with the betas, it’ll be two weeks before I can have the ultrasound, due to some poorly-timed travel… how will I make it that long???

At least if the news is bad, I won’t have to wait long to find out what’s going to happen in this pregnancy.  The only way I was able to make it through my pregnancy with my son was through continuous distraction.  So I’m just going to try to distract myself like crazy for the next two weeks.  Traveling to the conference next week will help.  Afternoons with a toddler who demands all of my attention will help.  What else will help?  How do you survive the two-week wait after the two-week wait?

Healed

I finally felt it this week.

I was walking the dog in the sunset of a beautiful June evening, down the road to our house with the fields of wildflowers that feed our neighbors’ apiary in full bloom, with my husband and son walking to meet us for the last few minutes of our journey.

I felt happy and satisfied with life.  I felt happy about our family, about the growing bonds between my husband, son, and me.  I remembered our daughter, and was glad to have the memory.  I felt satisfaction about being back at work, about the science education and research that I do.

And then I realized that it was the first time I’d felt that way since before our daughter died.  It took almost two years, but I finally feel healed.

Part of the shift comes as my son (four months old this week!) has grown out of the newborn phase and into a giggly, chubby infant with an emerging personality of his very own.  When I was pregnant with him I spent the whole pregnancy in a haze of anxiety and fear that our terrible experience of loss might repeat itself.  Once he was born I feared infection, SIDS, and developmental delays.  I know I’ll never move past the fear entirely, and that worry is part of parenthood, but I’ve realized recently that it’s no longer the dominant way I think about his life.  I’ve started to see our son in every facet of our future, which is something I couldn’t allow myself to do for a long time.  I’m invested in raising a child, a child who will hopefully be part of our lives for a very long time.  I suddenly believe that he’s here to stay with us for a long while.  And that belief has largely filled the empty place left by our daughter and allowed me to feel happy and satisfied with my life again.

God, I’ve missed this.

Pregnancy loss takes such a toll, physically, mentally, emotionally.  Part of me is amazed that it has taken this long to feel that I’ve healed, and part of me is amazed that I’ve gotten here at all.

Soren is growing and changing every day, and his big blue eyes seem to just swallow up the world and all the new things he sees.  What an amazing experience it is to be his mother.  What a life we have to look forward to.

cent

A Plan

Today we had our last scheduled appointment with our local OBGYN group, two days before my due date.  We got the full workup (ultrasound, NST, exam) and discussed The Plan from here on out.

The results of the full workup are that baby is looking great, positioned in the same optimal birth position he’s been in for a few weeks now (lying with his head square on my cervix, facing my back), and my cervix is starting to change, but is not yet considered “ripe.”  (For those who like numbers: 1.5cm dilated, 40% effaced, -3 station.)  Of course, cervical info like this is nearly meaningless — it’s entirely possible that left to my own devices I’d stay at the same numbers for weeks, and it’s also entirely possible that I could go into spontaneous labor tomorrow.  But it was encouraging to hear that something is happening.

Then came the talk about The Plan.  I didn’t really know what to expect, but the doctor just came out and said, “OK, I know you have a preference for Dr. X in our practice.  She’s on call next Wednesday, when you’ll be 40w6d.  What if we start cervical ripening Tuesday night and plan to induce on Wednesday?”  I agreed, they scheduled it, and it’s on the calendar.

It all happened so fast I didn’t really feel like I could think it through in the moment, but now I have some very mixed feelings, probably because I feel like this is a problem that just has no correct answer.

It’s a little earlier than I’d wanted, but only by about two days — I’d been ready to ask for cervical ripening to start at 41w0d, followed by induction, so this is two days earlier.  Two days isn’t a lot, but given where I am in pregnancy, it could very well be the difference between spontaneous and induced labor.  Or not — the problem is, there’s just no way to know.  Since two days is unlikely to make a substantive difference, maybe it’s worth it to have the doctor we prefer… but not if induction winds up leading to an otherwise avoidable C-section (not that there’s any evidence that this would be the case — the best recent studies indicate that induction at 41w does not increase the risk of C-section even with an unripe cervix).

In my ideal world, I’d rather go into labor spontaneously.  But there’s no guarantee that that will happen, or even that it’s what’s best for my baby and me.  After all, my mom waited, wound up going past 42 weeks, needed an emergency C-section, and I almost died.  So it’s not like waiting for spontaneous labor necessarily gives me a get-out-of-jail-free card for poor labor outcomes.  Waiting until 41 weeks seems like the best compromise according to the data — so one or two days earlier is probably negligibly different.

Another thing on my mind, of course, is the anxiety.  I’ve woken up in the middle of the night three times in the last week in tears with worry about my baby.  My nightmare (literally) is that I’ll wake up one day, won’t feel him move, and we’ll go in and he’ll be dead.  I know he’s alive and healthy now, and I want him out while he’s still OK.  I’m already in the regime where stillbirth risk is rising, and even though it’s still small overall, having had a baby die inside me with no warning once means that I just don’t want to take any unnecessary risk, even a tiny one, of having it happen again.

As I’ve been thinking about it today, I realized there may be a middle ground.  I know that the risks of induction leading to C-section are higher with an unripe cervix.  Given the slight dilation I have already and the excellent positioning of the baby, I’m hoping I’ll make progress by next week, but I just don’t know at this point.  So my slightly revised plan is to ask to go in for a cervical check Monday or Tuesday before they start the cervical ripening, to find out if my cervical status has changed.  If it has, I’ll feel much better about going forward with the induction.  If it hasn’t, maybe I’ll check on the call schedule and see if one of the other doctors I’ve felt reasonably comfortable with would be on call if I waited a couple of days.  There’s one doctor I definitely don’t want, and another that I probably don’t want, but either of the other two would be fine with me.  The only problem with this plan is that I think (although I haven’t confirmed) that they will not want to induce me on the weekend, which only gives me a couple of days of wiggle room unless I wanted to wait until Monday (which I’m not sure I do, and which my husband has already said makes him a little nervous). But getting to ask the questions would be reassuring.

At least for now, I’m happy to have a date on the calendar, and to know that there is a plan that everyone is OK with that would involve me holding a baby by late next week (fun fact: if all goes according to The Plan, it’s very likely that my son would share his birthday with his father!).  I’m also happy to feel like there’s some flexibility in the plan — the doctors I talked to today emphasized that I can call and ask questions anytime in the next week, and that changes in the plan were possible.  So for the moment I’m reasonably content to sit back and wait to see what happens.  Who knows… maybe I’ll go into labor in a few days and all of this will be moot anyway!  Point is, my son will be here soon, in a matter of days, not weeks.  And when I put it that way, it’s a pretty amazing place to be.

Birth Day

Don’t get too excited by the title — baby is still on the inside!

Tomorrow is my birthday.  It’s also the anniversary of my daughter’s due date.  It’s also the official “full term” 39-week mark in my pregnancy with my son.  Quite the triple-whammy of extremely mixed emotions.

Last time I wrote, I said I was mostly relaxed, content to wait for a while to meet my son.  Well, that equanimity has gone out the window this week, I can tell you!  Two of the last three nights, I’ve woken myself up crying in the middle of the night, the first time because I had a dream about delivering my daughter last year, and the second time because I was worrying about my son being stillborn.  The anxiety about wanting to KNOW that he’s arrived safely is starting to get to me, especially since I know that I’ve reached the upward slope of the U-shaped curve of stillbirth — even though the absolute odds of stillbirth are still low (about 0.5%), they’re increasing with every week that he stays inside, and will approximately double over the next two weeks.  I want to be patient and wait for spontaneous labor, but I also want to induce and get him out while I know he’s still OK.  A lot of my anxiety is coming from the fact that I never did settle with my doctors when we would induce if I don’t go into spontaneous labor (which I so far show no signs of doing, although obviously it’s still early). I find myself fearing that they’ll try to make me go to 42 weeks, and I just don’t want to do that.

I want to induce no later than 41w0d, which I think is backed up by good science.  I would probably chill out even more if the induction date were set a few days earlier, but at least right now I feel that I will completely panic if they try to make me go later.  Not only am I worried about stillbirth, but I’m also worried because my mom went more than two weeks overdue when I was born, and I went into fetal distress and almost died after her emergency C-section (it’s not clear why, but might have had to do with an aging placenta).  And when I say I almost died, it’s not an exaggeration — my mom was a labor and delivery nurse at the time (now she’s an OB/GYN nurse practitioner), so she knew that what was happening was truly scary.  It involved Apgar scores of 1, 2, and 2 (as my mom likes to say, it was the only standardized test I ever flunked).  Apparently I was the giantess of the NICU for a few days (since the NICU is mostly full of preemies, and I was the one huge post-term baby).  The very fact that my mom went late with me means that I’m more at risk for going late with my baby, and the fact that I have a history of placental abruption means that I’m at higher risk for placenta-related problems in this pregnancy.  Taken together, these things mean that I want this baby OUT before something really bad has a chance to happen.  Not to mention that I feel that giving birth to one dead baby is more than enough for one lifetime, thank you very much, and I’m happy to accept the risks of induction (which at this stage do not include an increased risk of C-section, it turns out) in exchange for a lower risk of stillbirth.

Phew.  OK, now that I’ve got that off my chest…

I’m trying to relax and enjoy these last few weeks of pregnancy, but it’s really, really hard as my anxiety ratchets up.  It’s also poignant to experience the anniversary of my daughter’s due date and my birthday in my hugely pregnant state.  It makes me think about where I am in life: tomorrow, I turn 33.  I would also be celebrating my daughter’s first birthday this month (probably this week) if she hadn’t died.  But of course, she did, so I’m not — even though I consider myself her mother, I’m still “childless” in the eyes of the rest of the world.  I’m finally on the brink of giving birth to a living baby, but he’s not actually here and safely in my arms.  Yet because birthdays make me think about life in a broader sense, I can’t help thinking ahead to my next pregnancy (if there is a next one) — my husband and I have always hoped to have at least two children, and IF our son is born healthy, we plan to start trying for #2 around his first birthday, since it took us 2.5 years to get to this point with him and I have known tubal scarring that will make conceiving again tricky.  That means that in all likelihood, I’ll be at least 35 by the time our second baby is born (if, indeed, we are lucky enough to get there at all).  When we first started talking about kids, back before I turned 30, we said we wanted two or three, and we were going to start having them right away.  We planned, and God laughed.  Now, as I turn 33, my biggest hope and dream is that our baby boy will finally join our family sometime in the next two weeks… it seems like too much to hope that he might have a little sibling in the next couple of years, but I can’t help but dream about it and hope that things don’t get too much more complicated as I get older.

So, in the meantime, I wait.  I will say that my birthday tomorrow is looking very exciting!  First, I am planning to submit the paper I’ve been working on to the journal — it will feel so good to get that done before the baby arrives!  My coauthors have been really great about doing their share of the last-minute work to make sure it’s ready for submission, and it feels like a nice, solid piece of work.  I’m really quite happy with it. Tomorrow is also a big day in science because of the expected announcement of the first-ever detection of gravitational waves!  This is huge news, guys — extremely likely to be awarded the Nobel Prize in physics over the next few years.  I’m planning to watch the press conference live at 10:30am EST, and I invited the rest of my department to come watch it projected on the big screen in our library along with me.  Assuming the rumors are true, it’s going to be a pretty spectacular scientific birthday present!  Then, of course, I officially hit “full term” in my pregnancy tomorrow, which is exciting in its own way.  In the afternoon, my husband and I get to go talk to lawyers to do the super-fun job of drawing up a will (we’re being responsible future parents!).  And then my husband is cooking me my traditional birthday cake, the same one I’ve requested for three years running.

In the meantime, I’m trying to take a deep breath and coast through these last days (please, let it only be days!) of pregnancy.  I’m still feeling fine physically, still capable of tying my shoes and walking my dog two miles a day, and more or less able to sleep at night.  I mention this not to gloat, but rather because I only seem to read about how physically miserable all women are at the end of pregnancy — I’m not, and I want to make sure my own positive story is out there in case it makes anyone feel less apprehensive!  My main discomfort is just that I’m slightly obsessed with poking my baby all the time to make sure he’s still kicking.  Poor kid.  Hopefully I’ll be able to update you soon with pictures of him on the outside!