Back on the Roller Coaster

It has now been two full months, or about 9 weeks, since my (2nd) miscarriage.  I’ve honestly been pretty numb to it all… except the last few days.

It’s a very different experience, having a 1st trimester loss after (1) a previous 2nd trimester loss, and (2) the birth of a living child.  Everyone’s experience of grief is different, and I know that if I hadn’t experienced those two key events in my life, this event would have been much, much harder for me to process.  As it is, I’ve mostly just been able to write it off as bad luck.  This is my 1 in 4 pregnancies that probably had some chromosomal defect that my body rejected.  We’ll move on and try again.  That’s that.

Until the last few days.

I’ve had highly significant ovulation pain every cycle since the birth of my son, so I’ve been able to tell pretty clearly when I’m ovulating.  I knew that I had ovulated about two weeks ago.  But as the days ticked by and my period didn’t arrive, I started feeling that roller coaster of TTC emotions that I remember so well.  It’s like there’s a constant subprocess looping in the back of my brain:

Could I be pregnant?  It’s too early to tell.  I could take a test!  No, that’s a waste of money — if I still don’t have my period by Monday, then I’ll be pretty sure and I can just take the test to confirm.  Let’s google when your period returns after a miscarriage.  Mine sure seems late!  But I think I know when I ovulated, and that was less than two weeks ago.  Let’s google about getting pregnant before you get your period after a miscarriage.  It’s a thing that happens to people!  But it probably won’t happen to me, because we don’t tend to get pregnant easily.  But we did this last time.  But I really shouldn’t get my hopes up.  Chances are I’m not pregnant.  But could I be pregnant?

And repeat, with increasing intensity, for three days.  UGH.

I won’t keep you hanging any longer — I got my period yesterday.  I’m not pregnant.  I didn’t really think I was.  But boy, did I hope!  I was so mad at myself for hoping, too — or really, for caring so much.  It was so nice after my son was born to just not obsess about my cycle endlessly, and I’m annoyed that now I’m back to doing it even though I really don’t want to.  I guess it’s a good thing that I got my period, since it hopefully means my hormones are back to normal (or my body’s best approximation thereof) and now we can really start TTC again in earnest.  But it’s also a reminder of just how much time it’s taken to go through this miscarriage — this is my first period since March.  Four months of lost time, and another lost baby (albeit a very small one).

Well, I knew that getting pregnant again was likely to be a long haul, so it’s good that we started trying early.  And we’re still in the zone of inconvenient timing relative to my tenure clock, so from that perspective it’s OK if this takes another 6 months or so.  Just not much more than that, please.  I’m not sure I can handle the emotional roller coaster for another two years.

Hopefully the approaching onslaught of teaching and advising and committees and meetings will distract me from the TTC roller coaster.  Hopefully I can just turn that subprocess down to a dull roar in the back of my mind while we keep pushing on with our quest for another living child.  Hopefully it won’t eat up too many more years of our lives and hopefully there won’t be too much more disappointment and heartbreak to come.  Hopefully it’ll be a smooth journey and another uneventful pregnancy.  That’s a lot to hope for, but hopefully at least some of my hopes will come to pass.

Talking about Family Planning with Students

Last week the senior faculty member in my department hosted his annual 4th of July barbecue for our department — all the faculty, their families, and all the students who are here doing research for the summer were invited.  It was quite a crew (for a liberal arts college), with 30 or more people hanging out in his backyard, munching hot dogs and (veggie) burgers, and splashing in the pool.  It was a beautiful day with some really great people, and I love that my department is such a welcoming and family-friendly place (this is one of several regular events throughout the year at which partners and children are explicitly encouraged to attend).

I was sitting on the grass with my son on my lap.  He was contemplatively munching on a veggie burger.  We were surrounded by students.  They were commenting on how much he’s grown since the last time they saw him, how long his hair is (it’s in these amazing platinum-blond ringlets right now since we haven’t cut it yet), asking what new things he can do, etc.  Then, one student busted out with “Are you going to have more kids?”

I gave my stock response: “We’ll see!”

Another (perceptive) student said: “It sounds like maybe you say that a lot.”

I laughed and said, “You’re right!  A lot of people are curious.  Almost as much now as when my husband and I first got married and we got lots of questions about when we were going to have kids.”

Another student said, “It’s kind of a personal question, isn’t it?”

I said, “Yes, it’s personal.”

The student who asked in the first place apologized.  I told her I didn’t mind, that I was also very curious about things like that when I was her age.

It was a brief twinge of discomfort in an otherwise lovely day.  I kept turning it over in my head.  I almost wanted to tell them why it was personal — to tell them about the daughter we lost before our son was born, or the fact that I’ve been pregnant three times with only my son to show for it, but I didn’t want to spoil the festive mood.  On the other hand, I feel that we generally do our young people a disservice by being so closed-mouthed about the realities of pregnancy loss and infertility.  I teach my students lots of things, and sometimes they learn from me whether I want them to or not — I know that the students have been keenly interested in my life since I revealed that I was pregnant with S (the students were also keenly interested when I was pregnant with his big sister, although that generation has all graduated by now).  I also know that for all the young women, I am the sole example they have of a female professor in our field, which can feel like a heavy responsibility.  I want them to be encouraged by my example, not daunted.  But I also want to prepare them for challenges they are likely to face.  There were about 8 students sitting with me on the grass during this conversation — odds are that several of them will experience miscarriage sometime in their lives, and probably one of them will experience infertility.  Is it better to prepare them, or to let them find out for themselves?  I made a choice in the moment, a choice that felt right to me at the time, but I could imagine having handled it a different way.

For now, I educated them that asking questions about fertility plans is personal.  I’ll save the conversation about pregnancy loss for another time.

Slow-Motion Miscarriage

I really wanted medical management of my miscarriage, i.e., to take medication to speed it along.  I wound up not having that option, since my indicators last week were not great, but also not totally inconsistent with a healthy pregnancy.  Since my doctors weren’t sure, they didn’t want to intervene with medication or surgery (a decision I certainly understand and agree with), which meant that I wound up undergoing a slow-motion miscarriage as, over the course of the week, I slowly went from spotting to bleeding to passing tissue and knew that it was over.  An ultrasound this morning confirmed that my body passed the tissue on its own (even though I am still bleeding), so I have officially miscarried.  Gravida 3, para 1.

The strange thing about going through a slow-motion miscarriage is that you can’t just curl up at home with a pint of Ben & Jerry’s and wait for it to pass.  I mean, I guess you could (perks of the flexibility of an academic job?), but mine has gone on for at least a week, and that would require more pints of Ben & Jerry’s than I am really comfortable consuming.  So, as a result, I wound up doing a lot of things that I never imagined I might do while having a miscarriage:

• Having a miscarriage during research meetings with my students and postdoc
• Having a miscarriage while talking with my department chair
• Having a miscarriage while writing an invited major review article on recent advances in my field
• Having a miscarriage while sitting on the grass and listening to a student folk music concert with my toddler
• Having a miscarriage at my department’s end-of-year party
• Having a miscarriage while baking cookies and playing board games with my old college roommate, visiting from New York City
• Having a miscarriage during an ice cream fundraiser for my son’s daycare

I mean, on the one hand, if you have to have a slow-motion miscarriage, many of these things are quite pleasant ways to pass an otherwise depressing time.  On the other hand, I’ve felt weirdly disconnected from my life this week, and it’s bizarre to be engaged in some other activity and then have the intrusive thought “wow, isn’t it weird that I’m doing this while having a miscarriage?”  It also feels strange, and somehow dishonest, to interact with other people when they have no idea that you’re having a miscarriage during the interaction — but not quite enough that I really felt like telling them about it (I did tell the two close friends who happened to call this week, and my visiting college roommate).

It’s also frustrating because my son seems to be old enough now that people feel comfortable asking me if we’re planning to have another baby.  Twice this week alone, I got the question, and not from people that I’m particularly close to.  I wanted to yell at them that I was having a miscarriage, and they really shouldn’t ask questions about people’s reproductive plans (or at least point them to this amusing flow chart).  Instead, I just gave my stock answer of “we’ll see!”

One thing I found both disturbing and reassuring this week was a recent study on 2nd and 3rd trimester loss that was published in 2016.  I wasn’t aware of it until this week, since it wasn’t published yet when I was scouring the literature after we lost our daughter in September 2014.  I thought it was such a great study that I emailed the author to thank her for doing the work, particularly since there seems to be so little research on 2nd trimester loss.  You can read the full article here, but these are the two main takeaways for me:

• Second and third trimester pregnancy losses are strongly correlated, indicating similar etiologies.  Once you have had a 2nd or 3rd trimester loss (including before 20 weeks), you are about an order of magnitude more likely than a typical woman to have another one.  The overall probability is about 4%, with recurrence more likely if the cause of your first loss was placental or maternal, and less likely if the cause was fetal or unexplained.  (This was the disturbing part — my first loss was placental/maternal, which puts me in the higher risk category of ~8% recurrence.  I sort of knew that already, but this was the first time I’d seen the probabilities broken down in that way.)
• First trimester miscarriage is not correlated with 2nd or 3rd trimester loss, including recurrent 2nd or 3rd trimester loss.  Roughly a quarter of previous pregnancies ended in first-trimester loss for all the women in the study, regardless of the number of previous 2nd or 3rd trimester losses, which is not significantly higher than the general population.  (This was the reassuring part — it makes it more likely that my current miscarriage was just run-of-the-mill bad luck.)

So, anyway, here I am, just waiting again.  Waiting for the bleeding to taper off, waiting for my cycles to reestablish themselves, waiting to see if we can get pregnant on our own again.  The OBGYN had me make a follow-up appointment for August, mostly as a chance to check in and come up with a plan if necessary.  She half-suggested that I could go for an infertility evaluation at the local big state hospital system if I wanted, but since I’m already being followed by an RE at the other major hospital system in the state I figured it wasn’t necessary, at least not yet.  As I discussed with her, while it’s great that we spontaneously conceived (and so quickly!), it does make it hard to know how long to wait before going back to the RE again.  I did put in a note through the electronic messaging system to my RE to update her about this pregnancy and ask if she had any suggestions moving forward, and her one suggestion was: stop breastfeeding.  I’m not quite ready to do that yet, and it seems pointless to go back to her before I am.  So I guess the plan is to wait a few months, see what my cycles are up to, and then reevaluate.  I think I’m OK with that plan for now.

My Blog Title is Apt Again

Well, whaddya know.  I’m pregnant.

It has never taken us less than 8 months to conceive before.  This time, first try.  We are thrilled and a little stunned.  I’ve always been a little skeptical of the stories you read of how people who have experienced infertility/loss often get pregnant quickly after a full-term, healthy pregnancy — I mean, maybe it happens to some people, but I was sure it wouldn’t happen to me.  Well, here I am!

For now, of course.  I know as well as anyone that first trimester miscarriage is a distinct possibility, as are losses at later stages of pregnancy, as are all manner of other health problems (I’m still at elevated risk for ectopic pregnancy and placental abruption, for example).  But for now I’m pregnant, and that’s a very, very good thing.

We’re a little shocked at the timing — I mean, we were trying to get pregnant, obviously, but we just didn’t expect it to happen this quickly.  Of course our minds started jumping to the possible reality of having a new baby join our family in January.  Two under two — yikes!  It would also throw a monkey wrench into my tenure plans (I’d been on track to submit my materials a year and a half from now), but… we’ll deal with that.  Our family is more important than my tenure case, and if I wind up using both my clock extensions and spending nine years on the tenure clock, so be it.

I was also just starting to cut back on pumping at work this week, but for the moment I’m still breastfeeding/pumping four times a day, which is going to start feeling like a lot as I get more pregnant.  But… what if I wean, and then miscarry?  I’ll be mourning the loss of a baby simultaneously to mourning the loss of a wonderful breastfeeding relationship.  I suppose I’ll just keep doing what I’m doing (i.e., weaning from the pump during the day, since I would never mourn the loss of a relationship with my pump!) and see how things go over the next few weeks.  I’ve got a viability scan scheduled for a week from Monday, after which we’ll know a little more (and, if all goes well, I’ll start back on Lovenox).

What a weird and wonderful week it’s been.  Pregnant again.  Holy cow.  Here’s hoping this little bean sticks around!

Dragging My Feet on Trying Again

I’m curious whether any of you have ever felt this way.  Before we were pregnant with our daughter, and then again after her death, I was laser-focused on getting pregnant as quickly as possible.  I was temping, I was charting, I was using OPKs, I was doing everything I could to time things properly and maximize chances of conception.  This time around feels… different.

I want another living baby, very much.  Therefore, I want to be pregnant again.  And rationally, I realize it makes sense to start trying now.  It has never been easy for us to get pregnant, and it probably won’t be this time either.  I’m 34, so Advanced Maternal Age is staring me in the face.  If we want another kid, there’s no time like the present, clearly.

But… our son is still so little.  Our breastfeeding relationship is still going strong.  He’s only just started reliably sleeping through the night.  I’m enjoying the mommy-daddy-baby triad and am not eager to upset it with another little one, even though it’s absolutely what we want for all three of us in the longer run.  Starting over with a newborn sounds exhausting.  Being pregnant again sounds exhausting.  Heck, even getting pregnant again sounds exhausting — getting pregnant with my son was an exhausting and heartbreaking almost-2-year-long haul, counting everything we went through with my daughter.   That’s part of what makes me eager to get started sooner rather than later, but it’s also a big part of what’s making me reluctant.  I just can’t imagine going through it all again.

So, I’ve been dragging my feet a bit.  Just last night my husband asked… isn’t this the week?  And I was surprised to realize that it was, and I just hadn’t really been on top of keeping track.  But he’s keeping track, apparently!

Are we really ready to get back on this roller coaster?  I know that another living baby in our family will be more than worth it in the long run.  But it’s been a LONG run to get to where we are now with our son, and it’s daunting to think about going through it all again.  There’s also my tenure clock lurking in the back of my mind.  If all goes as planned, I’ll submit my materials about a year and a half from now.  Another baby between now and then would practically require me to push back that clock.  But since it’s probably going to take us a while, it still makes sense to start now so that ideally our pregnancy will be timed (ha!) so that my due date would be shortly after I submit my materials.  So there’s the gamble about trying to time it so that it’s soon… but not too soon.  But I also fully subscribe to the mantra that there is no good time for a baby, and that the potential pitfalls of waiting too long are far more dire than the pitfalls of moving back my tenure clock a bit… or even than not getting tenure at all.

Maybe it’ll be easier this time.  Maybe we’ll surprise ourselves and get pregnant quickly without intervention (unlikely, but possible).  Maybe I won’t lose another pregnancy.  Maybe the Lovenox will just inject itself every day.  Maybe we’ll get a magical easy newborn (ha).  Right now, it just looks like a lot to handle, and I’m tired (but not newborn tired, thankfully!), and I want to enjoy my son, whom I love to the very depths of my soul and with whom I never feel like I get to spend enough time.  I’m sure this ambivalence is normal.  But I’d love to hear any thoughts about how to get past it.

In other news, S continues to delight.  He’s walking and climbing all over the place these days, and starting to communicate.  No clear words yet, but definitely several expressive gestures that he uses in different contexts (I won’t call them “signs” because they’re not the official ones that I’ve been using with him, but he has clearly developed his own signs — instead of “all done,” for example, he’ll grab the front of his high chair tray with two hands, and just this morning he also did it when he wanted to get out of his jumparoo.  It was very clearly the same communicative gesture in a different context, and it was so cool to see that he is actually putting together the pieces for communicating with other humans!).  He’s big into blocks and wheels and gets delighted whenever he manages to balance a thing on top of another thing.  He’s very snuggly and pretty social and loves to hang out with our friends and family members, or walk outside and just look at the world and touch the bushes and trees.  I simply can’t get enough of him these days!  Having another little one to watch grow up has to be just as great… right?

Half a Year

Working in academia means that the year has a distinct rhythm.  Last week the students moved into their dorms again, a fresh batch of misty-eyed parents unloaded minivans full of stuff and left their precious children to their own devices, and this week I got up in front of a classroom for the first time since last December, before my son was born.  As the start-of-school milestone passes yet again, it makes me think back on our journey, and how our quest for a living child has ticked against the start of classes during my time on the tenure track.

Three years ago we were just starting to realize that getting pregnant might not be easy for us.

Two years ago I was four and a half months pregnant and deliriously happy; I had no idea that on September 11 we’d find out that our daughter had died.

Last year I was four months pregnant and completely freaked out but hopeful.  The other faculty knew, but I waited to tell the students until it was obvious.  I was juggling an academic schedule with frequent prenatal visits and trying not to lose my mind as the anniversary of our daughter’s death approached.

This year I have a six-month-old bundle of snuggles and love.  He has ten fingers, ten toes, blue eyes and blond hair like his daddy, two teeth(!), and an intense desire to crawl.  He’s now been in full-time daycare for one week, and I miss my little sidekick, but he’s doing great.  He just started drinking from a sippy cup (after adamantly refusing a bottle his entire life), which means I have a little more freedom and my baby is a little more grown up.  We’ve survived his first two illnesses (the first a week-long epic fever followed by ear infection followed by full-body rash from antibiotics, the second a plague that swept our household and left me delirious with my first fever in a decade and left our poor little guy a drippy-nosed, coughing mess for a couple of weeks).  Completely disordered sleep suddenly seems to have resolved this week into once-a-night wakeups (knock on wood!).  He sits, he laughs, he explores his world.  Our baby is growing up.

And still, I teach.  I love being back in the classroom, talking about physics, prompting discussion, fielding my students’ intense questions about our place in the cosmos and how it all fits together.  My first class of freshman majors are graduating this year, and the amount of growing they’ve done since I first welcomed them into a college classroom is staggering.  In a seminar I’m teaching this fall (packed to capacity), during introductions the first day several students mentioned that they’re taking the class because I brought them into the field with my introductory course, and even though they ultimately chose majors in other subjects they wanted to keep taking classes in my subject because they loved my class so much.

Brown-nosers, the lot of them. 🙂

I’m in a very happy place now, but the start of the school year reminds me that it’s been a long time in the making.  Seeing the students arrive on campus also reminds me that my hopes for my son involve him leaving me to join a similar tree-lined, ivy-covered campus about 18 years from now.  As he started full-day daycare last week I sobbed to my husband, “Today it’s daycare, tomorrow it’s kindergarten, the next day it’ll be college and we’ll never see him again!”  Possibly an exaggeration, but the feeling of time passing is inescapable.  I love his emerging personality and his increasing independence, just as much as I love having my tiny baby to snuggle and hold and nurse while he lets me.

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.