Pregnancy Loss

**TMI alert-This post includes talk (and pictures) relating to the conditions of the female body I think this kind of stuff is fascinating--I share it for those of you that share the sentiment.)**

Most people don't enter the conception process planning for a pregnancy loss.  I definitely didn't .  My mother had enjoyed excellent fertility--I was the only baby that decided I didn't feel like coming right when they wanted me--but I didn't make Mom and Dad wait too long.

As a married woman of 6 1/2 years I can now say that the majority of women I know personally have suffered a loss.  I believe official numbers say that 1 in 4 confirmed (by a doctor) pregnancies are lost, but it may be as many as 1 in 3 including pregnancies that have not yet been confirmed by a doctor. 

 Many people discount early miscarriages--stating that if it weren't for our super-sensitive modern home pregnancy tests women wouldn't even know they were pregnant and just think they had a "late, heavy period."  Sure that could be some people's experiences, but you have to accept that that isn't always the case.   I am never "late."  By body has cycled like clockwork since menarche, and 42 days is way past 29.  Additionally, "a heavy period" does not accurately describe the type of bleeding and tissue lost, even after only 6 weeks, that comes from an early miscarriage.  I found that passing the "products of conception" was a difficult thing to emotionally go through .

I studied human development in college. I understand the science behind early losses.  The reproductive system is a machine who's purpose is to create new perfect little human bodies.  This machine is intelligent enough to know when something is not going right.  When the process has started and is headed in the direction of creating  something other than a perfect human body--the body frequently aborts the process to start anew with hope of a better outcome next time.

(There can be other problems causing early miscarriages such as hormonal imbalances during the leuteal phase--if you encounter multiple miscarriages please seek the advice of a doctor trained in fertility.)

I feel I have a level-headed view of early loss accepting the biology behind it--but it's still hard on an emotional level.  Because each time you conceive there is an explosion in your mind opening up a great expanse full of infinite new possibilities for the future.   And when you experience a loss that great cavern is instantly and suddenly closed, blackened out.  It's disorienting and confusing.

Six months after my miscarriage I was pregnant again.  (We had allowed my body time to rest and heal for three months as recommended because my body had very definitely been pregnant.  Jeremy, especially, was concerned that I not overtax my body.) I had been visiting my sister and returned to our new apartment and was nauseated by the smell.  Stale cigarette stench coming into our apartment through the bathroom vent, closet, and kitchen piping--courtesy of our neighbors.  Within a week my oversensitive sense of smell was officially attributed to pregnancy.  Once again though, I already knew I was pregnant.  (I won't mention how--it's definitely TMI.)  I took a few tests, because at first it showed negative.  Officially past the date of a not-actually-expected period I finally got a faint-faint line.  I showed it to Jeremy, explaining, "You're either pregnant or not. A faint line is still a line." It was interesting looking back though, to wonder if the test didn't initially pick up the pregnancy because it wasn't developing normally.

At six weeks I started spotting.  It was happening again.  This time on insurance we went in for blood work.  I had blood drawn on cycle days 40 and 43.    My hcg levels were appropriate and doubling. But I still was spotting on and off.  We set an ultrasound for 7 weeks. ( That's usually the earliest they do it since that's when they can consistently find "something" to see on an ultrasound.) I didn't feel well that week. I remember going to a playgroup at the church and then leaving after not too long because I felt poorly.

The weekend before my ultrasound I felt really bad.  I had a lot of cramping and pain.  But I had been on mild bedrest since I began spotting.  I remember that in the hospital after the birth of Owen the nurses had explained that I needed to be up and walking around to help gas (causing cramping) to work itself out of my system.  I thought this may be similar since I'd been sitting around.  I felt like the pain was concentrated more to my right side--but I just felt horrible all over anyway. 

The next day we went in (cycle day 50) for our ultrasound at 11:00am.

The sonographer was very polite. pointed out some things on the sonogram, "There's your ovaries." etc. and then asked me about my pain--if it had been to one side or the other.  Then she said she'd go get out doctor to talk over the results.  She left the room and Jeremy and I just looked at each other.

"So what does that mean?"  Jeremy asked.

"Well she didn't show us a baby." I replied.

"Suspected ectopic pregnancy," our doctor explained.  He showed how my uterus had a thick lining suggesting my body thought it was pregnant.  But then showed us a large mass in my right fallopian tube. No real baby or anything, because in most-cases your body knows that something isn't quite right and won't let the baby develop.  He said his only doubt was that most people are in so much pain.  Well,  I was in pain--but I'm not really the go-to-the-doctor type.  Es specially when I've been reading all the worst-case-scenarios in my pregnancy books and think that I'm fabricating the symptoms like--it hurts worse on my right side.

There's a medicinal option for dealing with an ectopic pregnancy.  Methotrexate.  An anti-cancer drug that attacks growing cells.  My doctor didn't recommend it, saying there are lot's of growing cells in your body that could be adversely affected.  Now that I've met (over the internet) more women who have experienced ectopic pregnancies--I still feel good about my Doctors recommendations.  Some women had to have more courses of the medication because it wasn't enough the first time.  And there comes a point also when it's too late for methotrexate to work at all. 

So an hour and a half later I was in surgery.

Technically it was exploratory surgery to confirm the ectopic pregnancy and treat it.  The goal was to sawe my tube if we could.

This is my left tube and ovary, with my uterus on the right side.  You can see my abdominal cavity was filled with blood.

This is my right tube wrapped around the right ovary.  It's hard to tell since the tube is swollen to the size of my ovary.  The ovary is the paler one.  In the left half of the frame you can see my uterus. 

This is the adhesions that most-likely caused the ectopic pregnancy.  I had no reason to have such adhesions.  No PID, no internal bleeding, or previous abdominal surgeries.  But there is is. 

Here is the pregnancy in my tube.  There is a build-up of blood inside as well.  It wasn't possible to save the tube. 

This picture is after the tube was removed.  You can still see the pale ovary.  The gray-brown backwards "C" between the ovary and the uterus is the cauterized tissue from the removal. 

As for the surgery (technically a laproscopy and salpingectomy) for anyone reading this as a reference, it was general anesthesia.  Then they make two or three incisions mine were: belly button, bikini line, and over that right side.  The fill your abdomen with gas to puff it up so they can have a clear view.  When you wake up there is excess gas that has crept into strange places in your body.  Luckily I had warning of this from a friend who told me the shoulder pain would be very uncomfortable. --it was. And my throat was scratchy from having the anesthesia tube down it.  The pain from the surgery was managed with pain meds.  The only problems were coughing, sneezing, and laughing.  That last one proved the biggest problem because my mom came to help out.  Jeremy and my mom under the same roof--they set records for jokes and laughter. 

My doctor promised internal pinches and twinges for a good six months, and I had them.  I'd have more pain on that side with my period too. 

Happily my fertility has not been too adversely affected.  The right ovary was left behind because technically it could still contribute to my fertility.  Wyatt is proof of that--at my 7 week ultrasound the sonographer saw a happy corpus luteum on my right ovary.  Indicating I'd ovulated from that side and it hade been picked up by my left tube. 

It's been three years now, and I'd say it's mostly forgotten.  It's one of those things you think back on and say "Wow, we did that."  But you just do.  You just deal with the things that life sends your way because none of us get to choose it.  And it does help to remind us all to be sensitive of the struggles of those around us, and that every pregnancy is a miracle.

One is the Loneliest Number

In college I decided that six kids was the perfect number to have.  I come from a family with five children.  I loved the crazy party that a family with a lot of kids provides.    I decided I could never have less than 5 or it would seem like someone else was missing.  And I was willing to have more.  But there can be too many kids as well.  So I decided that six was the perfect number because you could still drive a regular mini-van and not have to go to one of those full-sized ones--or even a bus!  Yes I decided I wanted a one minivan family please.

Jeremy and I married mid February in my junior year of university.  I really only had one semester left.  We got pregnant at the end of that summer.  Owen was born when I was 22.  I was pleased with that feeling like we had a lot of options for our future little family.  (We weren't rushed by my age or anything.)  One beautiful, bouncy, baby.  Check.

When my mom was visiting earlier this year she was in the other room changing baby Wyatt's diaper and called out, "Jeanette did you realize, you've been pregnant five times in five years?" I hadn't realized it, but Wyatt was indeed my fifth pregnancy in five years.  And once I started looking at my dates it got really interesting. 

About a year after Owen was born I found myself again pregnant.  We had just moved to Kansas, and were settling into our new apartment.  I was tired and knew before taking a pregnancy test that it would-indeed show positive.  And it did.  I was pregnant.  At about 6 weeks I started spotting.  We searched the internet for information--was I definitely miscarrying?  I was in contact with an OBGYN but since I had not yet gotten on health insurance--we just let the miscarriage proceed naturally.


Six months later I was pregnant again.  I had been visiting my sister and returned to our new apartment and was nauseated by the smell.  Stale cigarette stench coming into our apartment through the bathroom vent, closet, and kitchen piping--courtesy of our downstairs neighbors.  Within a week my oversensitive sense of smell was officially attributed to pregnancy. At six weeks I started spotting.  It was happening again.  We did bloodwork --it came back fine-- we set an ultrasound for 7 weeks.The ultrasound showed a suspected ectopic pregnancy.  My ultrasound was at 11.  I was in surgery with my OBGYN at 1.  My abdomen was full of blood and I lost my right tube.  But we were given high hopes I could still be able to have (many?) children. 

We were nervous about how easy or not it would be to get pregnant again.  After three months of healing I was pregnant and deathly afraid of another ectopic.  Your chances for having a second ectopic pregnancy are as high as 12%.  And I only had one tube.  If I lost my left tube my only option would be invitro at $10,000 a pop--that would greatly diminish the number of children we could have.  I went in for bloodwork again.  My numbers did not look quite right.  I was leaving town and afraid of what might happen if I was out of state having a problem.  So I went in for an ultrasound at a mere 5 weeks.  We went in and saw a healthy yolk sac, baby Jonas was too small to even see yet, but the yolk sac was the right size and, more importantly, inside the uterus.  That night, in my parents home, we shared our news, and there were hugs and tears all around.  I gave birth to Jonas one year and one day after my Laprascopy that removed my right tube. 

Jeremy finished up his master's degree and was trying to figure out what to do next.  Fate dictated that was as good a time as any to add to our family.  Pregnant again.  I was calm at the beginning, just allowing myself to be.  But then more scares, heavy bleeding at 11 weeks.  But Wyatt was worth all the worry.  And as I recently looked back on my very first blog post about the pregnancy I miscarried, I realized that Wyatt was born on the due date I had been given for that pregnancy--just three years later.

So here we are with three kids after six years of marriage.  I don't know how many more children are in our future.  My body's been through a lot during these five pregnancies in five years. But I do hope that it has more to give.  I definitely felt like this was not my last pregnancy.  Multiple times while pregnant with Wyatt I felt like I would be pregnant again.  But I don't know if that is once more or many more times.  We're going to have to see how life treats us.  So right now we have a family of Five.  But we'll see what our family looks like in 10 years. 


**This post is a party of a blog party hosted here that my cousin participated in. I started getting into my ectopic pregnancy and decided to split the two posts up. Today is the story of my family size at present--comeback tomorrow if you want to hear more about my ectopic pregnancy (including the pictures).

Pregnancy

*This post contains frank descriptions relating to the female condition, if you get creeped out by "TMI" do not proceed*

I started this pregnancy with a lot more anxiety than when I was pregnant with Owen or Jonas. The general point being--we are not where we planned on being in our lives right now. We thought we'd be graduated and have a job, with a regular income, and our own health insurance. But we aren't.

So being pregnant without our own health insurance was frustrating to me. I was frustrated about having to apply for Medicaid.

I started considering what any other options might be. There is a Birth Center in a city about an hour away from here, where one of my friends had delivered her two babies. So I started looking in to that option.

It would cost $4,100 to deliver there. I was thinking maybe we could just pay for the delivery ourselves. We could apply for Medicaid in case we needed to be transferred to the hospital and for the baby's care, but otherwise just pay for it out of our student loans.

I'm confident that if I was committed to having a drugless birth I could. (With Jonas I went in with no plan to do so but labored naturally for hours on Pitocin, until I freaked out about "pushing" and got a spinal at what ended up being 15 minutes before Jonas was born.) But sure, I believe it is "within the power" of all women to birth without pain relief, and that many births can go fine outside the hospital setting. So I was having a serious debate with myself about the option of not going to an OB.

Then at 7 weeks I had some pink spotting. It was not red, but I know the difference between normal-colored vaginal fluids and pink. So I called my OB. He wanted me in right away.

Women who have had a past ectopic pregnancy have a 15% chance of any future pregnancy being ectopic. Due to my not having insurance yet we had not been in for any preliminary bloodwork. (Monitoring rising HCG levels to rule out a possible ectopic is common practice.) So we went in for a sonogram.

The sonogram looked good. There was a healthy yolk-sack, little fetus with a regular heartrate at 122 bpm. And my tube was clear. (Interesting medical side note: The sonographer was certain she could see a healthy corpus luteum on my right ovary. That indicates I ovulated from my right side and my left tube snatched the egg out of the air. . . or whatever my insides are filled with.)

The sonogram revealed an area of what looked like some inner-uterine bleeding, not entirely uncommon, but hopefully wouldn't cause any more real problems.

But I left that day with some very interesting thoughts going through my head. There's always the stress and trauma of thinking something's wrong to deal with, but I also felt like I had been given a sign. I felt like my Father in Heaven was telling me I needed to let go of my pride, get set up to see my doctor, and recognize that "hands off" prenatal care is not what I needed.

So I did. I put my paperwork through I made appointments.

At 11 weeks and 3 days I went in for my first appointment with the nurse. She took stats and drew blood.

That afternoon, I felt something strange and I went to the bathroom where I began bleeding. I called and got an appointment with the sonographer at the hospital in a few hours. I bled heavily until my appointment. I was not very optimistic about what the results would be at that point.

The first thing our sonographer said was, "Well, we've got a nice strong heartbeat--so lets just get that out there." She was training a younger girl, so she talked a lot and was doing a lot of angles, and kept saying what a beautiful baby it was.


I layed there in shock. I recognized that she had told me that the baby was fine--but I was seriously bleeding!

So we went down to my doctors office to talk to him about the results. He said it looks like the same issue as at the 7 week sonogram--this same area of bleeding. He said it looked promising as the area was beginning to show more mass like maybe there is a blood clot forming or something starting to heal up. He told us this bleeding usually doesn't last the whole pregnancy usually it heals up by around 13-15 weeks.

Inner-uterine bleeding is a risk-factor for miscarriage, so it is still very possible at this point, but my doctor expressed confidence that most of the time these areas of bleeding heal up ok and everything is fine. Since they can see the collection of blood in my uterus-it is probable that I will continue to have bleeding on and off until the area is totally resolved.

So after that experience I felt like I was definitely doing the right thing sticking with my doctor.

I don't have to feel like "less of a woman" because I have a moderate risk pregnancy that requires extra monitoring. Fertility is a precious gift. Some women's fertility is more fragile than others, and takes more protecting. I want to feel grateful for my opportunity to bear children, and not pressured into a birthing experience that any one else considers "ideal."

My doctor is an OB. He is a male. He is intelligent. He is capable. He is friendly. He is compassionate. He understands and respects how emotionally tied women are to their fertility.

I've been seeing him for the 4 years we've lived here. We've been together through a miscarriage, an ectopic pregnancy, laproscopic surgery, and salpingectomy. Then the pregnancy and birth of my second child and now the pregnancy of my third.

I'm grateful to be with a doctor whose judgment I trust, and I'm grateful for the personal inspiration I am entitled to that allows me to trust my own decisions.

Won-Hundred

Welcome to my one hundredth post (if you don't count my fake posts for my button, contact info, or favorites list, and if you do count the two old school posts I just imported from 2006)! Apparently a 100th post is a big deal in the blogosphere--like it's the first step to having people take you seriously as a blogger or something. I don't know, but I do like a reason for a good celebration.

So I decided to celebrate my one hundredth post by naming it a "won"-hundredth post because for one of my lucky readers--there's a prize to be won!

Yes, I'm doing my very first bloggy giveaway. To thank you, of course, for indulging me and my "musings" on life at home.

I've been feeling crafty, but not the go-out-and-spend-a-bunch-of-money crafty. Also, I decided maybe no one wants any of the crappy crafts I make. So I decided to make something that was functional to raise it's perceived value (insert double eyebrow raise here).

So here's the giveaway gift I made. It's a reusable grocery shopping tote. It helps fish to not choke and die on plastic bags. Plus the real reason I use reusable shopping bags: for each one you bring in to use at a Kroger brand store you get five cents off your order. You know that 25cents a shopping trip really adds up.

When Jeremy walked by and saw the green ribbon on it he said, "Now that's cute." So at least he thinks it's cute.

But you don't need to use reusable shopping bags because they are cute, you need to use them because it's what all the hip people are doing these days. . . I mean, because it's good for the environment, and see it's even more "green" because I made it out of an old sundress that I used for a swimsuit cover-up, but I was going to get rid of it.

So to enter this giveaway just leave a comment on this post. You have until Sunday the 21st (Fathers' Day), and I'll announce the winner on Monday, chosen through the most democratic method I can think of. Also, anyone can enter, whether I know you personally or not, as long as you aren't "one of my enemies, I hate those guys."

Good Luck!

As I mentioned before, for the sake of interested parties . . . um you with the funny sideburns, and . . . you hiding behind the curtain, I have uploaded two posts that were actually my first attempt at blogging (over on geocities) a year and a half before I started this blog. I called it Jeanette's Mommy Blog: On Life, Love and Babies. At that point the only exposure I'd had with blogs was one my brother was doing for his son. I had found out I was pregnant, but ended up miscarrying a week later. But if you are interested in a trip down my memory lane, please enjoy:

Introduction and Pregnant

Pregnant

That's right--Pregnant. 5 weeks. Also confirmed yesterday by a massive emotional breakdown! I had a reason to be crying of course, but as I was crying I was thinking to myself "This is weird, it must be the hormones." So yes, hormones are one of the first symptoms I am seeing, along with going to the bathroom more often, being tired, and a few other things I will spare you the details of.
So what is the first thing that you think of needing with a new baby on the way? Well I don't necessarily know what it is but when you see a free crib leaned up against a dumpster you take it! It is actually not a full crib. It needs a dozen or so screws, a piece of plywood or something to hold up the mattress, and of course a mattress. I don't know that I would want a second-hand mattress anyways. But still, plywood and a mattress are considerable cheaper than a crib, plywood and a mattress. So we took it. It is a worn dark wood color, so we will probably paint it. We already said that it can be our spring break project.
As for my big boy who's here already. He's all boy and we happen to live in every little boy's dream apartment. In other words we are immediately surrounded by a 12-hour a day 6-day a week construction zone. Owen's favorite pose is, as you see him in the picture, propped up over the back of the couch to watch the back-hoes out the front window. He's adorable!

Introduction

Here's Owen at Sweet tomaotes loving his ice cream cone. He is at such a cute age right now. We can really see his little brain working all the time. He is getting really good at anticipating what comes next. Like when we ask him if he wants to go outside and he runs to find his shoes. His favorite baby sign right now is "yummy" where he rubs his tummy whenever he gets something new to eat or drink. We just love Owen, and the time has come for Owen to get his very own playmate.

Yep, Owen's getting a sibling. I'm pregnant! Now comes the part where I have to defend myself from all the accusations and "I thought you weren't having any more 'till after Jeremy's first year was complete!" It's true. Jeremy and I both had made those comments. When Owen was only a month old we wondered if we would ever have any more children. (Life was tough.) As time went on I didn't get what my OB called "amnesia," in other words, I didn't forget how hard it was at the beginning, but as life after that stage continued on, I began to see what a small proportion of Owen's life that time made up. So by about 6 months I started thinking "Maybe I could do this again."

As Owen grew up we started to see his little personality as well. Owen is a social bug! He loves other kids! When we saw Owen interact with other kids, we started to think about what Owen might feel about our family planning decisions. In the end I began to think that a number of years down the road we might really regret not having a sibling closer to Owen's age.

The point is we are really happy to be pregnant. "The Internet" tells me we should be due [mid April].

So, then we're down to the question of the day: Why did I decide to start blogging? First, Jeremy has been saying for a long time that we should have a website for Owen. But with his quirky sense of humor, he wanted it to be full of links that don't work. Well here's the compromise a blog where we can put some cute pictures, tell some cute stories, and keep people generally informed. Second, blogging is the wave of the future. No actually, I just thought it would be nice for when we announce that we are pregnant for people (read: "my mother") to be able to see other things that have gone on in my pregnancy and not feel like they missed out on anything. Third, I think it will be good for me, especially when the baby does come. To have a little outlet to express my feelings. Being far away from my family I don't always get as much opportunity to just talk through my thoughts with someone, so this could help.
This is my blog, I'm going to do with it what I want, so it will be just journal-entry type things. I may take as much artistic licence as I want. You are free to read it, and use it to get to know me and some of my more personal thoughts better. If you think it's boring, don't read it. I don't mind. Anyways, here we go!