it’s complicated

Glow in the Woods had a post about trust in our bodies after babyloss. Like so many others, I’ve had ups and downs. Infertility is a major down – it’s hard to accept not being able to get pregnant “naturally”, even though given my history it wasn’t all that surprising.

But for some reason I thought I’d be good at pregnancy. I even thought, after completing our family, I could be a surrogate for friends in case they turned out to need this. That’s how convinced I was my body could do this.

We transferred two embryos, and both implanted. I’m so thankful for this. It gave me some confidence in my body back. Then there were the bleeding episodes – scary, but fortunately the babies were always fine. We made it into the second trimester, the supposedly safe zone.

I had this weird pelvic pressure, for weeks. The first doctor thought it wasn’t a concern. And then it was almost too late. I’m trying not to dwell on the what-ifs, but sometimes it is hard to resist… what if I had insisted on being checked earlier? Would there have been any way to keep the babies inside, C’s amniotic sac intact for longer?

The extra post-partum bleeding didn’t help, though I don’t think it hurt my relationship with my body much, either. The thing is, I think my body fairly reliably tells me when something is wrong. The pain I had before my endometriosis was discovered, the pelvic pressure that may have had to do with the shortening cervix… It knows, my body. It may not be able to perform all those tasks I’d want it to, but it tells me when things are off. And I am amazed that it can produce eggs that make such beautiful babies together with H’s sperm. And carry them for quite a while. I hope I’ll learn to listen to it even more, and I hope that my doctors will listen, and that they will actually be able to do something in case things start to slide.

But of course we first need to get there. I was so proud when it started making cervical mucus again (yes, proud may seem an odd feeling, but it is what it is), and glad when my period returned. On Monday I had a saline sonogram to check my uterine cavity for anything from scars to polyps that might be detrimental to implantation. They found a tiny thing, in fact, they’re not sure it’s anything at all – we’re still waiting for my main RE’s verdict. And while I didn’t have the painful cramps I had after my last saline sonogram, I started bleeding yesterday. More today, like a period. Of course I don’t even know if this has anything to do with the procedure, or if my body is simply still trying to get back on track. It’s just not exactly helping my confidence. And yet, after reading Suzanne’s post, I feel like I should be grateful that everything is most-likely-okay. And I am. I’d just have it rather all be great, for all of us.

PS: WordPress says this was my 100th post. The title seems fitting.

can we just skip October?

And maybe November too, while we’re at it. I’d so much rather wake up just shy of 24 or 28 weeks, respectively, instead of the 19 I will be tomorrow. Not that 19 weeks per se would be a bad thing, but as my cervix measured 1.5cm today, half of what it was on Wednesday, I’m getting rather worried that we might not even make it to viability. I found the measurement particularly mean as I was feeling better – on Thursday through Saturday I took it really easy, and I think that helped. On Saturday I passed quite a bit of brown, almost solid mucus, which I found terribly scary, but my doctors thought likely came from the internal exam. On Sunday we had friends visiting, and I wanted to do some cleaning. Yeah, stupid me. I really hope the shortening was from that (or some other transient cause) and that it’s not too late to reverse it. (Otherwise, it was lovely to have them over, and really they cannot be blamed for my stupidity.)

The rest of the scan went well. It looks like we have two little girls in there! I’m kind of suspicious with one of the pictures, whether there’s really nothing between the legs… but either way, we’re so happy that they are doing well and still unaffected by the situation around them. And now so scared of losing them. It is a heartbreaking feeling that my body might fail my precious babies.

Unfortunately, according to my doctors, there’s not really much they can do at this point in a twin pregnancy. Apparently there’s no scientific evidence that a cerclage or bed rest would help, and that they may actually be harmful. I know that there’s many stories out there of women who made it, often with these – but I’m also a scientist. There is some data that progesterone may help, not enough for significance in twin pregnancies, but it seems fairly clear for singletons, so I think we’ll try that. Because it seems awful to do nothing. And then we have to try and get to 23 weeks and change, re-measure, and consider steroid shots if my cervix is still short. We have a long month ahead of us.

18 weeks: L&D

You didn’t think that was the appropriate way of celebrating 18 weeks? I kept thinking “but that was for 38 weeks!”, too. But I’ve felt pelvic pressure for a while now, sometimes better, sometimes worse, and yesterday it was so much that even a short walk (like, to the bathroom) wasn’t fun anymore and so I decided to call the office.
(Spoiler if this is too stressful: the babies are fine, and for the moment everything else seems to be ok, too)

Not that I’d completely ignored it before: at my last appointment I asked the doctor, but she said not to worry. It’s a bit hard to say now, but I’m fairly sure I was less uncomfortable then. Well, and then I went halfway around the world, and between jet-lag and being pregnant and getting a cold I was rather tired anyway. But back in my normal life, I thought this wasn’t developing in the normal direction at all. Dr. Google found several cases of this where it was just the pressure from the babies, which obviously gets more as they keep growing. And then there were some cases where it was actually preterm labor… I grew concerned and just plain uncomfortable. The on-call doctor said that this should be evaluated, and whether now or at my next appointment was up to me, so I decided for the better-safe-than-sorry plan and went in. After a bit of confusion because I got a “visitor” sticker initially, I was given a room and the usual parameters (urine, oxygen, temperature, blood pressure) were checked. A young doctor came in to go over my symptoms and history. Then she checked the most important part, the babies — they’re fine, as usual unperturbed by the weird stuff my body does. First breath of relief. Then she proceeded to check my cervix, and as promised that wasn’t exactly comfortable. It was also a tad dilated “but long”, which nevertheless didn’t sound too reassuring. She went off to find her more senior colleague for the cervix length measurement. Senior Doctor wanted to repeat the manual cervix check (much less uncomfortable) and declared it a tad open at the top, but then closed. The ultrasound measurement (with a wand that was supposed to remain sterile, have never seen anyone handle this thing with so much care) came to 3-3.3cm. Which they told me was ok, but the threshold for worrisome, 2.5cm, is close enough to keep me somewhat concerned. I have my anatomy scan on Monday, and they shall re-measure my cervix then, and if it shortens we’ll talk about the options. If it stays at this length we’re fine. Then they put on a contraction monitor for good measure, but it wasn’t showing anything (and I haven’t felt any either). So I was discharged and told to come back if anything got worse. At home I did far too many searches on cervical length (CL) issues and possible treatments, learning that “normal” would be 3-5cm, concern starts at 2.5cm and serious concern at 1.5cm. Eventually I decided that, while knowledge may be power, sleep was important too, and went to bed. Am feeling much less pressure today, though I have no idea what causes these changes.

A few scattered thoughts:

• In general (well, aside from having to go to L&D at 18 weeks) this was a quite positive experience. Everyone was kind and caring and tried to make me as comfortable as possible and answer all my questions. I had the feeling of being in good hands.
• 18 weeks is scarily far from viability, let along a gestational age where one can reasonably hope for the babies to be fine.
• I’ve begun to think that individual CL measures are like individual betas — they tell you something, but the development over time seems much more important. Although it can also be quite erratic, going back and forth…
• I’ve had these symptoms for almost a month now. So either my cervix started out veeery long, or this is largely discomfort and not actually doing much. I’m kind of hoping for the latter. We may know more on Monday.
• Nevertheless I decided to take it easier, in particular, less walking around (that’s when the discomfort is worst) and ideally an after-lunch break of half an hour or so where I can actually lie down.

So, here I was thinking about when and how to announce my pregnancy on facebook, and suddenly my new mantra is “long and closed”.