thoughts on telling

I’ve gotten to the part in my pregnancy books (my darling husband gave me another, figuring that it’d be too hard to read the one on twins he gave me back then) when the question turns to when to tell. Last time I had a deal with myself of only telling one person per day. I was so afraid something would go wrong, that I’d have to tell people we wouldn’t have a baby (or babies) after all. Well, and then we got to the point where I thought it was safe to tell (and hard to hide), and then things did go wrong and we didn’t get to take home our babies… and emailed everyone we had told, as we couldn’t face the idea of running into people and having to explain it in person. But I digress.

By only telling once we’re out of the trimester, while I understand the reasons so well, sometimes I think we’re not doing ourselves and other women or couples a favor. At that point, the majority of pregnancies do end well, so anyone who has never been in this unfortunate position will assume that announcement equals baby. Sometimes I wish for a society where I could make a cautious announcement earlier, with the knowledge that things are not “safe” yet (as if they ever were), but that I could use some support and understanding already.

I’m not planning any big announcements this time. I can’t stomach the thought. But I have mentioned this new pregnancy to a few people already, when the opportunity came up. Everyone is so excited for us. FIL, who has no medical education but loves commenting on such topics, thinks that my body is now used to being pregnant so everything should be fine. The cynical part of my mind wonders if my cervix is also used to opening… A colleague had seen many Japanese moms around and excitedly suggested that our kid could learn Japanes, while I just hope to make it to 24, 26, 28 weeks. It is very sweet, but at the same time I wonder if they cannot see how we worry that something might go wrong again. But perhaps they cannot stomach that thought.

With the girls, I often felt like an imposter when I said I was pregnant. Not sure why this was, and perhaps it is common after infertility. This time, I don’t. I’m owning this experience, despite all the concerns. In what might have been a spike of exuberant hope (in combination with the fact that I never quite lost some of the weight I put on with the girls, so that I’m already out of pants that fit) I have even ordered maternity yoga pants. And a scarf to hide the bump when desired, or simply protect against windchill. Because it was called rainbow scarf.

sleep

Thanks for all your good wishes! My poor husband basically didn’t sleep last night, getting a panic attack whenever he was about to fall asleep. Which is probably a fairly normal reaction after being told that there might, possibly, be something wrong with one’s heart, but not helpful for getting the much-needed rest. I’m sure he also has some unresolved sadness about losing the girls; who wouldn’t, 5 short months out. And probably the fact that I’m pregnant again, while wonderful, also raises all sorts of worries in him. (I recently got an email about “7 fears of expectant fathers”, and thought like, I’m fairly sure his main fear isn’t listed in there…)

I stayed home with him today (luckily my job lets me do that) to be there just in case, and for moral support. When we took a nap in the afternoon, he still struggled to fall asleep, while I slept soundly for 2.5h… but he did get some sleep, so I hope we are on a path to improvement.

then and now

Tuesday was bittersweet. We feel incredibly lucky and blessed that our embryos and my uterus get along so well, of course, but when we went for celebratory sushi we ended up also talking a lot about A and C. How happy we were to be expecting them, how sad we are that we didn’t get to keep them, and how we worry about the second trimester with Strawberry Baby (on top of the first trimester that everyone worries about).

It may seem like we dwell on the past, but I think it is necessary for us. This all happened less than a year ago, it was our very first pregnancy and we were so excited. Now, excited, but cautiously. But we do have a lot of hope for this baby, and push our doctors harder to take any concerns seriously – although given my history, I think they will do that anyway.

It was my husband who coined the term “Strawberry Baby”: during the 2ww, he said he hoped we’d get another Strawberry Baby. When I inquired, he explained that one of our daughters had looked like a little strawberry on the first ultrasound (which I think to this day remains his favorite ultrasound).^* In our native language, strawberry starts with an E, so it’s even consistent. Once he noticed that I picked up the term enthusiastically, he was quick to point out that of course he hoped this little one would stay with us much, much longer than the strawberry stage.

And at the same time, we are embracing this pregnancy and celebrating every day. Reading about what Strawberry Baby is doing in the pregnancy book he gave me last year. We have told a few friends and family members as well as my boss (who has been incredibly supportive through everything) and a good mentor. I want serious weekly pregnancy photos (H is a good photographer, but somehow last time wasn’t too interested early on as he figured that’d have time…). I’m still working on a theme though and might pick something else than what I tried yesterday.

^* I thought about including that picture here, but decided it’d be too confusing.

Strawberry Baby

Thanks for all your wonderful wishes! It really warms my heart and makes me even happier than I already am.

Beta rose nicely to 644 – “Everything looks very good” were the words from my nurse. If I wasn’t so tired I’d tell you why we call it strawberry baby. But tired is probably good and normal and all, so I just need to sleep more and tell you tomorrow.

Pink

To pass the time waiting for my nurse to call, I did a routine experiment. And in the second-to-last step, the solution turned pink – which it never had before.*

Hours (hours) after this, my nurse finally got the results and immediately called: 215. A great, solid beta 14d3dt. I almost feel guilty as so many fellow bloggers have had chemical pregnancies lately, and at the same time I know this was only the first hurdle. But for today, I will celebrate having made it thus far.

* After some random guesswork, my colleagues suspect it was just from the marker I used – but I prefer to think it was my baby saying “relax, Mom”

what I want to remember

So happy.
That’s the thing my husband keeps saying about when I was pregnant. He loved seeing me so happy.

The picture was taken in August, on my birthday, 14 weeks pregnant. And so happy.
I’ll probably remove it later for the sake of pseudo-anonymity, but wanted to share it with you. One of my best memories from 2013. Thank you for being here with me.

ruptured

I was getting used to my mostly-couch routine, and the babies seemed to be hanging in there. Then yesterday I suddenly felt as if something was weird, and then there was a big gush of fluid. More fluid when I got to the bathroom, and even more.
We went to L&D, who confirmed that my membranes had indeed ruptured, and saw that baby A had very little fluid. We had hoped that they’d be able to save at least one baby, but apparently that’s really difficult – the main risk now is infection, both for the babies and for me. At 20 weeks, they’re much too young to survive. The options we were presented are “expectant management”, also known as wait-and-see, and termination. Gulp. We certainly weren’t able to chose the latter, not after all these steps it took to get here.
They offered to keep me in for the night for observation, but H said he’d much rather have me home with him, unless there was a risk. Hospital germs tend to be worse than homegrown ones, so they don’t want me to stay for long anyway. My cervix was still at 1.5cm, and no contractions, so it didn’t seem as if labor was imminent. After being explained the risks three times over, we went home and cried. I have never seen my husband cry like this. That alone was heartbreaking.
The good news is that I haven’t had any more leaking or gushing of fluid since coming home. Resealing of membranes is rare, but possible. My cervix went into mucus overproduction mode, which I hope also is a good sign – maybe it is trying to regenerate the mucus plug?
Basically we now need a miracle: no infection, no contractions, resealed membranes and refilling fluid. We have an ultrasound tomorrow to see how things are going. If you have good thoughts to spare for us, or stories from other PPROM survivors, please share.

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”.

firsts

• I didn’t realize it until talking to my family about our plans for when the babies are here, but I’m in the first generation to not stay home until the kids are, like, in middle school (which is quite common where I’m from, in fact the entire tax system is built around a family of one parent earning significantly more than the other). I think they’re all horrified that I won’t/can’t stay home for more than a few months (am still in the process of trying to figure out the details). This probably warrants one or more dedicated posts, but honestly I find it hard enough to juggle the “how much time off can I afford” question after trying so hard to get pregnant that making me feel like a bad mother before the babies are even here doesn’t help.
• I must officially look pregnant by now. Which is funny because I thought I wasn’t changing – although the main criterion, “my pants don’t fit”, probably isn’t that useful of an indicator any more. At the airport I was kindly asked to go through the business class check and the family security lane, but I though they were just being nice. But when one of the stewards asked when the baby is due, well, there was no mistaking it. He couldn’t believe that there are “two babies in this tiny belly” – it certainly doesn’t feel tiny, though it’s more “wide” than “protruding”, if that makes sense. I’m 17 weeks now, and read somewhere that the uterus size for twin pregnancies is as that of singleton pregnancies 6-8 weeks further along, which would be 23-25 weeks. Probably clearly pregnant-looking. Must upload new pictures soon.
• As I said, I didn’t think I changed. Well, I gained 6 pounds in 2 weeks. Which certainly is fine for a twin pregnancy, and probably for anyone on a visit home with lots of good food ;) but still surprising given that I thought everything was the same.
• I bought two tiny toys for the babies. I wasn’t exactly looking for something, but MIL dragged me into stores to “see what kind of things I liked” (which is a nice thought, though it’d be even nicer if she had also asked whether I was ready for this) and there were these tiny toys I really liked. After checking with H, who can be very picky with just about anything, I went back and bought them. I hesitated for a bit – what if, God forbid, something were to go wrong? But even then, these are our babies. The toys now sit on my nightstand (which really is a chair) and make me smile every time.
• I need to pee all the time. Wasn’t that supposed to be a first- and third-trimester thing?
• The “first” I’m still waiting for is movement, or maybe rather movement I can clearly recognize as such. I sometimes feel bubbling in unexpected places, but have no idea if this is a kick or just gas – and as just about anything is in unexpected places now, it’s hard to tell. Most of these bubbles are rather lateral though, while I thought I’d feel the babies more in the center… ?