Tag Archives: second-trimester pregnancy loss

Miscarrying and Hypothesizing

Well, I opted for medical management of this miscarriage, and it’s proceeding slowly.  I took the first round of medication Friday night, and not much happened, so I took another round Sunday morning, and finally things are moving.  I don’t think I’ve passed the main pregnancy tissue yet, but hopefully soon (I was so afraid it was going to happen in the middle of my lecture yesterday!).  I’ve got another week before they’ll start pushing a D&C on me, which I’d like to avoid if possible since I have adhesions from my first pregnancy.

In the meantime, I’ve started to do some research on causes of recurrent pregnancy loss.  I’ve already been tested for clotting factors and some of the immunological stuff, and other than being heterozygous for Factor V Leiden it all came back normal.  But it’s hard for me to believe that FVL is the only culprit, since it’s not associated with an increased risk of 1st trimester loss.  The main thing I haven’t really been evaluated for is heritable chromosomal issues, like a balanced translocation in my husband and me — but I find it hard to believe that that could be the source of our woes, since we know that two of our four pregnancies at least have been chromosomally normal, including the daughter we lost in the 2nd trimester.  It’s also not particularly associated with 2nd trimester loss.

There are actually very few issues that are associated with increased risk of both 1st and 2nd trimester loss.  But one thing that I read about immediately clicked for me, and now I am anxious to talk about it with my doctor on Tuesday.  You’d think that with everyone looking at my uterus in every which way over the past four years someone would have brought it up before now, but I’m about 95% certain that on one of my recent ultrasounds the tech noted a slight septum that she didn’t think was clinically relevant.  But anatomical abnormalities like a uterine septum are one of the most common — and most treatable — causes of recurrent pregnancy loss.  They are also one of the few etiologies that causes both 1st and 2nd trimester loss.  The ASRM guidelines on recurrent pregnancy loss note that the likely mediating factor causing 2nd trimester loss is abnormal placentation, which was the leading hypothesis for our daughter’s death.  It just all makes so much sense!  If I have a slight septum that isn’t bad enough to cause total infertility, but is enough to cause poor blood flow to the embryo/fetus, it would explain why I keep getting pregnant but keep losing the pregnancy, sometimes early and sometimes late, even in the absence of chromosomal issues.  It at least seems worth asking about, since the prognosis for treatment is really, really good — there are some studies where the live birth rate jumps up to like 85% (normal!!!) after surgery to correct a septum.  I would love to have an 85% chance of a live birth, instead of the 75% chance of miscarriage that I seem to have had in my pregnancies so far.  Maybe my doctor will tell me I’m nuts and that this slight septum can’t possibly be causing my problems… but I feel like I have to at least bring it up.  And if my regular OB doesn’t listen, I have an appointment with the RE on the 28th and will bring it up again then. And again and again until someone listens and has a real conversation with me about it.

I’m just ready for someone to take this problem seriously and stop telling me it’s just bad luck — it seems so clear that whatever is going on, it’s more than just bad luck.  One 2nd trimester loss… maybe?  But that’s already really bad luck, since it happens in only ~1% of pregnancies.  Two losses?  OK, fine, a single first-trimester loss out of three pregnancies does seem within the realm of normal.  But three losses out of four pregnancies, including a loss in the middle of the 2nd trimester?  How can people keep attributing this stuff to bad luck?  I mean, I know it’s not always possible to find a cause, but it would be so much more helpful if someone would say, “Look, your history is crappy and indicates a problem.  We don’t always know what the problem is or how to solve it, but here are the things we can check for and here’s why I do or don’t think that each of them might be a problem for you specifically.”  That’s what I want.  Why is it so hard for doctors to talk to patients that way?

Anyway, that’s where I am now.  Waiting to finish miscarrying this pregnancy, walking around, acting like everything’s normal in the meantime, diving back into the literature on pregnancy loss to try to find some answers about what’s happening to me.  This semester has just been so hard, with my dad dying the first week of the semester and my third miscarriage happening in the middle of the semester.  I’m kind of amazed that I’m still functioning, but at the same time I really don’t think I can take any more, and I’m having to bite back yelling at people or bursting into tears all the time.  I have very little patience for anything even a little bit trivial right now, which is really not the frame of mind I should be in during advising week for our freshmen, who are freaking out about their schedules for next semester.  I also can’t handle any kid-related stress, and when my toddler was clinging to me at daycare dropoff yesterday I actually started crying right in the middle of the toddler room.  I don’t think the teachers noticed, and I got myself out and to the car before I really let loose, but I wanted to cling to my son as much as he wanted to cling to me!  You’d think I’d be used to pregnancy loss by now, but I don’t think you really ever get used to it.  Having a living child makes it easier, for sure, but it’s still awfully hard.

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Still Trying… With Some Perspective

After four cycles of trying, still no luck.  I know that especially since my tubes are crap this is still well within the range of normal, but I’m starting to contemplate when to go back to the RE.  The decision is complicated by the fact that my ovulation pain reached new heights of awful this month and sent me back to my OBGYN basically asking “This is not normal, right? Is there anything I can do about it?”

To give you an idea, this month for five days leading up to ovulation I experienced pressure and abdominal pain.  For the ~2 days around ovulation, everything hurt.  It hurt to sit down, it hurt to walk, it hurt to have sex (which is just adding insult to injury), and the pain was so bad that it woke me up in the middle of the night.  I mean, I know some level of ovulation pain is normal, but this just seems beyond normal.  I had brought up ovulation pain at my last annual visit and my doctor brushed it off, but it was so bad this month that I decided to go back.  So I made an appointment, which wound up being with their midwife who I haven’t met before (I thought someone told me she had retired, but apparently she’s back).

I ran through my symptoms and she basically said that she’d be happy to order an ultrasound but didn’t think she’d see anything — I agreed that she was probably right, particularly since I just had two ultrasounds in May/June during my miscarriage, which also didn’t show anything weird about my ovaries.  She said it’s probably either endometriosis or adhesions — I know I have some scarring from the first pregnancy when we lost our daughter at 18 weeks and I developed an infection that I later found out had scarred my fallopian tubes (worse on the left than the right, which is probably why my two subsequent pregnancies have both been on the right).  She said that there’s basically nothing they can do about those things: “Well, I mean, there’s surgery, but…” she said with a little laugh.  I was sitting there thinking: why are you laughing about surgery?  It was as though she thought it was ridiculous that I might consider surgery for pain bad enough that it affects me for a whole week of every month and wakes me up in the middle of the night.  I mean, that’s bad, right?  So the upshot of the appointment was that I declined another ultrasound, and she told me that my best option was going back to the RE — she thought maybe another HSG would help break up some of the adhesions and relieve the pain a little (which sounds sketchy to me, but what do I know?).  I left totally down in the dumps, wondering when I can finally put this phase of life behind me, because it’s just so unrelentingly awful (except for my son, who is the best thing in the Universe, which is the only reason I am willing to keep putting myself through this crap to try to have another one).

Fast forward two weeks to today, and my period arrives.  I’m feeling like crap, thinking I’ll never get pregnant again, or if I do, the baby will probably die again.  Then I had a meeting with our colloquium speaker.

This colloquium speaker and I have known each other on and off through meetings, talks, and conferences for a number of years.  I think we have sort of a little mutual admiration society going on. I remember meeting her for the first time when she was a grad student and I was visiting her university as a postdoc to give the colloquium.  She had just had a baby a few weeks before, but came to campus specifically to meet with me.  I was equally as interested in her science as in what it was like to have a newborn — we had a ton to talk about.  She just seemed so put together, was doing such awesome science, was interested in science education, was thoughtful, and appeared to be super-mom on top of it.  My career was a little farther ahead than hers, but she was a little older because she’s a non-traditional student who started her PhD a little later in life.  So, we kept tabs on each other a bit, as we both bounced around and wound up in our dream jobs as physical scientists at liberal arts colleges only an hour’s drive apart in New England. I started my job four years before she did, which means that she just started her job in January of this year.  I had a kid about three years after she had her first.  She invited me up to give a colloquium her first semester on campus, and this semester I invited her down to give a colloquium at our campus.  Today she’s visiting, and we started off our meeting with the usual excited back-and-forth about what we’re both up to — how her first year of teaching is going, how my approach to tenure material submission is going, etc.  Then, she changed the subject.  She mentioned that she was 22 weeks pregnant.  I congratulated her, quite genuinely, but couldn’t help feeling a small pang of self-pity that she was pregnant and I had just gotten my period for the fourth time after miscarrying, seven months into the journey to conceive our second living child.

But then, she kept going.  She remembered a conversation we’d had a while ago — she had shared that she had two miscarriages in a row, and I had shared about the loss of our daughter in the second trimester.  Well, it turns out that two weeks ago, at their 20 week anatomy scan, she got some bad news that their baby is much smaller than expected.  She is in that heartbreaking waiting phase where they’re trying to figure out how bad it is and whether they will be able to make it to viability, but there is much talk of early delivery and long NICU stays and potential long-term health issues.  Apparently they can’t yet tell whether it’s a placental issue or a chromosomal issue, but neither outlook is good.  She won’t know more until her next ultrasound in two weeks, but she’s been thinking a lot about how to handle it.  She wanted to know if I had any advice based on what I’d been through before (with weirdly similar timing relative to my tenure clock — we are truly living parallel lives in some ways).

My eyes immediately filled with tears for her.  And I silently kicked myself for allowing that earlier pang of self-pity.  It was an important reminder that we never, ever know what other pregnant women are going through, even when it looks from the outside like everything is perfect.  Advice.  What advice do I have?  None, really.  I don’t think I handled my 2nd trimester loss particularly well, but I also don’t think there is a good way to handle it.  I told her a few things:

  • Please accept offers of help.  I didn’t and I made things unnecessarily difficult for myself.  This is a huge life event, and it’s a small fraction of your time on the tenure clock and your life overall, so be kind to yourself while it’s happening.
  • If doing work feels therapeutic to you, go with it.  I couldn’t function for my own sake while I was going through our loss, but I could force myself to function for my students’ sake.  So if it feels right to work, work.  If it doesn’t, don’t.  You need to do whatever you can to get through this.
  • She wanted to know if I had thoughts about when she should tell her department — should she tell them soon so they could plan for the possibility that she might need to take medical leave?  I don’t know if this is the right answer, but I said no.  She doesn’t know what will happen.  Possibly nothing will happen, and she’ll be able to get through the rest of the semester without any issues.  Nobody can plan for this right now, so she has no responsibility to tell other people if she doesn’t want to.  They will figure it out.  They will not blame her for not telling them the news sooner.  There is really nothing to tell right now other than that her baby is sick and she doesn’t know what’s going to happen.  I advised her to wait until she knows what she needs so that she can ask for what she needs.  Unless she wants them to know for emotional support purposes, but my experience was that people really don’t understand pregnancy loss, especially in the second trimester, and having everyone know is often just a higher emotional load to deal with.

That was pretty much all I could think of.  I also told her that I am so, so sorry, and that I am here to help or if she just wants to talk — I told her that when our daughter died, I was just desperate to talk to people who had had second trimester losses, especially those who had gone on to have healthy pregnancies afterward, so if she has the same desire I am absolutely here for her.  I just wish she didn’t have to go through it, especially not this tortuous period of not knowing what’s going to happen.  She sounds pretty pessimistic about having a healthy baby at the end, but I will be hoping upon hope that it’s another case of unreliable ultrasound and that everything will be fine.

These childbearing years are the hardest thing I’ve ever been through, and it breaks my heart the more I learn how awful they are for so many women.  I wish there were a better way.  I wish it were easier.  I wish people talked about it more and were better at supporting each other through it.  I wish we could just wish children into our lives.  When they do come, they’re amazing, but it doesn’t seem like we should have to endure so much suffering to get there.  I will be holding this friend in my thoughts, and checking in with her in two weeks to see if she needs anything after their next ultrasound.

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.

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.

Not My First Mother’s Day

I’m sure that anyone reading my blog is highly attuned to the fact that Mother’s Day is this Sunday.  Already, well-meaning people have started gushing about how this is my first Mother’s Day as a mother.

It’s not.

This Mother’s Day is very bittersweet.  My feelings are still quite fresh from last Mother’s Day, which was 8 long months after our daughter’s death and just a few weeks before we found out that I was pregnant with Soren.  My feelings are also still fresh from two Mother’s Days ago, when we were just about to start infertility treatment, again just a few weeks before we found out that I was pregnant with our daughter.  Those two painful Mother’s Days are very much in my mind as I also reflect on the joy that it has been to be Soren’s mother for the last 2.5 months — finally, mother to the living child that I dreamed of for so long.

This Mother’s Day, I send love and strength to the invisible mothers.  The mothers who have experienced miscarriage, stillbirth, and infant death.  The women who are mothers in their hearts as they toil through infertility tests and treatment.  I also send love and strength to the women who lost their own mothers far too soon, especially the women who will never experience the loving sandwich of having a living mother while also being a mother to a living child.  It’s a beautiful and wonderful time of life, and something that I will never, ever take for granted.

While this isn’t my first Mother’s Day, it’s by far my best Mother’s Day.  I am surrounded by love, and my love surrounds my newborn son.

Early Days

IMG_0237We are so lucky.

Our son, Soren, is now three weeks old.  It simultaneously feels as if he’s been here forever, and also that he is this amazing and magical new creature of a human who can’t possibly be with us on this earth for real and forever.

I don’t want to minimize the very real difficulties of labor and delivery and life with a newborn, but so far (knocking crazily on wood as I say this) the start of his life feels charmed — it’s all gone as smoothly as I think it possibly could have.  The contrast with our first pregnancy is jarring, but having had that experience where everything went wrong has paved the way for me to appreciate how very right everything has gone so far this time around.

I hope I’ll find time to write up my birth story on the blog eventually, but the short version is that a membrane sweep sent me into labor the day before I was scheduled to be induced, and Soren was born the next day.  Since my water had broken and since I was positive for Group B Strep, they did have to augment my labor with Pitocin, but everything progressed smoothly despite the intervention.  Eventually I opted for an epidural, which is a decision I was immediately happy with, and after an hour and a half of pushing and some quick suctioning to get rid of his meconium-laced fluid, Soren was in my arms (while I sobbed tears of joy and relief).  I had two second-degree tears, which were stitched up quickly, and I was up and walking around only a few hours later.  Soren’s heart rate never faltered, he was born alert and latched on to my breast like it was the most natural thing in the world (and he’s hardly been off since!).  My milk was a bit slow coming in, but a few days later he was pooping and peeing like crazy and he’s been gaining almost a pound a week since then.

Amazingly, the recovery from this full-term delivery has been easier than the recovery from the delivery of my daughter at 4.5 months.  Two days after delivering my daughter I tried to go walking with my husband and our dog, and I was so dizzy that I had to sit by the side of the road until he could come pick me up in the car.  Two days after delivering our son, we all went for a long walk and it felt so good to stretch my legs.  I couldn’t believe it at first, but then I realized that last time around I didn’t know it yet, but I was dealing with both hemorrhaging from a retained placenta and a raging infection, not to mention the emotional impact of the loss of our daughter, whereas this time around everything was healthy and normal.  I didn’t even worry about whether or not I was healing normally, because I already knew what abnormal healing felt like.  This just felt a thousand times better.  And let me tell you, engorgement is SO much easier to deal with, both physically and emotionally, when you have an adorable baby to feed.  It wasn’t as painful and didn’t last as long, and I LOVE knowing that I am providing nourishment for my son — it made the (milder) soreness totally worthwhile.  Knowing how amazing I felt compared to the first time around — again, both physically and emotionally — just sent me into an emotional high those first few days after his birth.  Having a supportive husband and mom around helped too.  We decided that having three adults to care for one newborn was just about the right ratio!

And I know that putting this in writing is probably going to jinx me forever, but… I’m pretty sure we won the easy baby lottery.  No newborn is truly easy to live with, but we seem to have gotten it about as easy as it gets.  Sure, he fusses occasionally, but we can always calm him down with some combination of the 5 S’s (swaddling, swaying, shushing, sucking, side-lying).  And while we’ve had a few tough nights here and there, most of the time he sleeps in two- to four-hour chunks at night, and will wake for a diaper change and feed and then go straight back to sleep.  I keep waiting for the other shoe to drop — I’m convinced that there’s going to be some disaster, or he’ll get sick before six weeks and need a spinal tap and be up crying all night, or that he’s sleeping too much and it’s a sign of developmental delays to come, or he’ll suddenly get colicky in week four and we’ll be miserable for the next couple of months.  I guess this is just the beginning of a lifetime of parenting worries.  But in the meantime, I will enjoy this magical baby that we have been given!

After she went home, my mom commented to me about how healing it was for her to see everything going so well with my delivery and postpartum recovery.  She felt like it was healing for her as well as for me, since her experience giving birth and caring for me in the first weeks was also extremely difficult — she wound up with an emergency C-section, and I was colicky, and my dad was not supportive.  She’s seen a lot of deliveries since then in her work as a women’s health nurse practitioner, but it’s different when it’s your daughter, and when you stick around after the birth is over.  She said that watching me going through a healthy and normal delivery and recovery, and caring for a healthy newborn with a supportive partner showed her just how good things could be — how right it was possible for everything to go.  After being with me for the horrible end of my first pregnancy, she said it was so wonderful to see things finally going right and well and to see me finally getting to be a mother to a living baby as I’ve wanted to do for so long.  It really has been amazing, and I feel so extremely fortunate to be here at last.

This isn’t the end of our story.  I know there will be challenges ahead with Soren, and I know there will be challenges as we start to work towards conceiving our next baby (we very much want a younger sibling for Soren).  But these early days have been so very beautiful — yes, sleep deprived, and yes, full of the exquisite boredom and dull busy-ness of caring for a newborn… but also astonishing and full of truly momentous love and the incredible process of watching our son’s life unfold.  I feel that I will never tire of kissing his soft cheeks and watching his enormous blue eyes take in the world.

We are so very lucky.

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!