Birth Plans: Flexibility vs. Failure

Our birth story…

The nurse put her arm around my shoulders and said, “That’s why you don’t have a birth plan, Sweetie. They always fail, especially your first time around., but she’s totally worth it. She’s so beautiful.” I wasn’t sure how to react so I just grinned and forced a fake laugh (more of a grunt).

“Fail” – I didn’t like my child’s birth being described that way. It didn’t go the way I hoped. My labor was much harder and longer than I expected it to be, but I wouldn’t call it a fail. We went through Hell just to get pregnant, did everything we possibly could to ensure a healthy pregnancy, and I am sitting here holding a perfectly healthy baby girl who everyone says is the most beautiful baby they’ve ever seen. How is that a fail? After the nurse left my room I let one tear roll down my cheek. Looking down at that perfect little soul I couldn’t stay sad; however, the nurse’s words really burned. My birth plan had failed? Just because my child’s birth didn’t go the way I hoped, did that make it a failure? If it had failed, did that mean I had failed?

Our birth plan in a nutshell involved a “soft induction” at 39 weeks, using a Cytotec insert to ripen my cervix and hopefully coax my body to go into labor on its own, then a natural labor from there. It wasn’t something we just slapped together. We did a lot of research, consulted our midwife, and hired a doula. I have a narrow(ish) pelvis and the baby was already measuring around seven pounds at 37 weeks so we were concerned waiting much longer would mean a certain c-section. We took seven prenatal/birthing classes between our doula, midwife, and the one-time class offered at the hospital. The recurring theme in all of them was a birth plan is less about an actual “plan” and more about making the hospital staff aware of anything you want that might be outside the hospital’s standard operating procedure. Everyone said we were the most prepared first-time parents they had ever met. I felt (almost) totally confident going in. I provided a typed copy of our birth plan to the nurses so if things didn’t go as planned, or if I couldn’t communicate my wishes for some reason, they would know what to do. I had faith the plan would be the guiding voice in my care.

The Cytotec did its job. My water broke on its own about 2.75 hours after the Cytotec dose was administered.

(Side note: The nurse had short, fat sausage fingers. We called her “Gherkin Fingers” behind her back. When she inserted the Cytotec and/or checked my cervix it felt like she was shoving her fist through my perineum. While we did go through three shift changes during my labor, I ended up with Nurse Gherkin TWICE – 24 of the 36-hour labor.)

My contractions started on their own just as planned shortly after my water broke. I didn’t want any Pitocin (to advance contractions) or pain medication. However, we had agreed (along with our midwife and doula) to a “progressive” plan, meaning we would start with Cytotec only to induce and see how it went. In the event something wasn’t working we would take the least invasive next step available- including Pitocin if needed, and all the way up to an epidural. We would avoid a c-section at all costs. It was a simple but mostly natural plan we were all comfortable with, leaving room for change along the way if needed.

(IMPORTANT NOTE: Every hospital, provider, and/or facility is different. Know what options will be presented to you ahead of time. Research those options and make your birth plan based on what your delivery facility/provider offers. There is no sense in asking for something that’s not available, or using a facility or provider who doesn’t offer what you want.)

When my contractions were not productive (I wasn’t dilating quickly enough) my midwife suggested a very small dose of Pitocin. I wasn’t thrilled with that idea but most hospitals will force a c-section if labor goes longer than 24 hours. I was aware of this and adamant that I WOULD NOT have a c-section. At 18 hours I agreed to the Pitocin. Well, all that did was make my contractions more painful, and they got really sporadic after that, but they weren’t productive and I wasn’t dilating properly. They said it was because the dose of Pitocin was too low but I don’t know if I agree, especially since I later discovered the Pitocin was increased without my knowledge. I’m not sure what others’ experience might be but Pitocin contractions hurt FAR worse than natural contractions! They were excruciating! By increasing the Pitocin without telling me I couldn’t prepare for the increased pain, which was nearly debilitating. It was so bad I couldn’t breathe at times. Had I been warned I might have been able to adjust my coping mechanisms but as it was I felt like I was just along for the ride. I think my body just wasn’t ready, or that my water broke too early. What I do know is Ol’ Gherkin Fingers was the one calling the shots while making me believe she had confided in my midwife when she hadn’t. Believe me when I tell you I spoke to the midwife about it. (#pissed)

Around 30 hours the midwife came to see me (after my doula insisted the nurse call her in) and said she would not let me have a c-section but we needed to get the baby out as I was getting too weak, my blood pressure was dropping, and I was losing too much blood. I still wasn’t dilating properly so she recommended a low-dose epidural that would allow me to move, feel pressure, and maybe a small amount of pain but would block the extra pain of a rapid, full dose of Pitocin. She said it was my best bet to avoid a c-section if we could hit it with a full dose and get me fully dilated. I agreed to the new plan reluctantly. I looked at T and my doula and said, “I just can’t do this anymore you guys.” I had endured 33 hours of labor, could barely walk to the bathroom, and could literally feel my torn ovarian ligament that plagued my entire pregnancy getting worse.

I had to argue with the nurse that she was NOT increasing the Pitocin until after the epidural had been administered. She tried to fight me on it and I told her she could call my midwife again and we could wait for her to come back before moving forward or she could hold off on the Pitocin to allow time for the epidural to be administered. She agreed to hold off. It literally took less than 30 minutes for the epidural, which was fairly easy. Take that with a grain of salt because I was a med tech for years and actually used to assist with epidurals at a neurology clinic. It might seem less traumatic for me than someone else. However, it really wasn’t bad at all, and the damn nurse didn’t even “hold” me like they’re supposed to. (I’m kind of glad actually because she was dripping sweat like a pig in a smokehouse.) I chatted with the anesthesiologist while he did it.

Once we did the epidural and increased the Pitocin I got to a “9” within an hour. I honestly think the added pain from the Pitocin without any pain medication was what stalled my dilation. Once I got the epidural and could focus on the contractions without the pain I progressed really quickly. Just as I was getting really confident and felt ready to push they came and told me to “hold it” because another mom next door was pushing and they couldn’t deliver us both at the same time. (#eyeroll) I had been in labor for 34 hours and was SO CLOSE! She had only been there five hours. Why couldn’t she hold it? A little over an hour later my midwife appeared and asked if I was ready to push. I was BEYOND ready. I had the baby out in about 30 minutes.

I knew not to expect a crying baby to slip from my vagina the way they do in the movies, but I sensed a sudden change in the room when Addy came out. A couple of the nurses held their breath so I held mine too. The room was silent. I looked down. They were clamping the cord, but I remembered my midwife telling me they practiced delayed cord clamping. Why were they clamping it? My doula had said probably 100 times that as long as the cord was attached and unclamped the baby was breathing. Why would they clamp it? Then I saw the midwife unwrap the umbilical cord from the baby’s neck. Addy was purple and not breathing, dangling limp in the midwife’s hand. I panicked. I couldn’t breathe at all. My breath was stuck in my chest, like I had swallowed a bowling ball. They told T if he wanted to cut the cord he would need to do it quickly. I watched him cut it and the whole time I was thinking “No, no, no. You can’t cut the cord! She needs the cord because she’s not breathing on her own,” but no words would come out. I couldn’t speak. My eyes went wild. I freaked out. All I could do was stare at her tiny, limp, blue body.

They swept Addy off to the warming table about eight feet away. They were rubbing and patting her hard all over her body. Maybe six people were working on her doing God knows what. One of the nurses rushed out into the hallway. I heard someone say she was looking for a doctor.

I wasn’t aware at all what was going on down between my legs. I vaguely remember pushing out the placenta and seeing it plop into a bowl. I heard my midwife say there was a small tear, then something about a blood clot, and then she said I lost 700-something of blood. I had no idea what was really going on. I wasn’t processing anything. All I could do was stare at Addy while a swarm of people in scrubs poked, patted, rubbed, and suctioned her.

In my head I was begging, “Please, Addy girl, please breathe, baby. Just breathe. Come on, Addy.” Someone told me later that I was speaking out loud. Another doctor (not the pediatrician we chose in advance) came in right as Addy started crying. I heard her saying “Oh, good. Good.” Addy’s cry was shrill, almost blood-curdling, but it was the most beautiful noise I’ve ever heard in my life. Her color started turning pink almost immediately and I felt myself take a breath for the first time in five minutes. (She literally didn’t breathe for five minutes!) I remember the midwife arguing with them about her APGAR score but I didn’t really register what was happening. They wiped the baby off a little and laid her on my chest. All I could do was cry. T was pushing my hair back off my face while he rubbed her little back and kissed my forehead. I’ve never been so scared or so relieved ever in my life. Then, I suddenly felt this very sharp pain in my vagina. I realized I could feel my midwife stitching me up. I told her I could feel it and she said, “Just one more stitch”. A quick, sharp pain and it was done.

Once the room cleared out a little the midwife explained Addy was just fine. She said they should have given her more time once she started breathing before they did her APGAR score. She encouraged me to ignore whatever score the hospital gave her because it was really not correct and not important anyway. No one ever even told me what it was. It’s been over two weeks and I haven’t looked or asked for it. Her chosen pediatrician came to our room that night and said she was perfect and there was nothing to worry about. Maybe I should care more about the numbers but I really couldn’t care less. All her vitals were perfect and the pediatrician seemed pleased. She was eating and doing all the things newborns should do, so who cares about the damn APGAR score? The baby had a bit of a cone head (which went away in about two days). There was absolutely nothing else that kept her from being 100%, absolutely perfect.

Part of me felt foolish. If I had skipped making a birth plan would her birth have gone smoother or faster? Would her APGAR score have been higher? Would she still have come out blue and not breathing? If I hadn’t asked for Cytotec would it have gone differently? If I had waited for my labor to accelerate on its own would my contractions have synced up better and allowed me to dilate completely naturally? I really didn’t want Pitocin and ended up not having a choice but to take it to force contractions because I was facing a c-section. If I had been more patient could I have avoided drugs altogether? Some women go all the way to 42 weeks. Should I have waited longer – or should I have taken Pitocin and/or the epidural sooner? Did my desire to go “as natural as possible” (but as early as possible) make my birth plan an overall failure?

I had been telling myself I wouldn’t feel guilty if I couldn’t go naturally, and that I wouldn’t let anyone tell me I did anything wrong – particularly if my baby was healthy, and she was. So, why was I letting it bother me? Well, because these nurses are supposed to be the people supporting me through and immediately following my labor and I felt more scolded than supported. They were shaming me for wanting something different from their “set in stone” method for handling childbirth. The hospital’s “business as usual”, run-of-the-mill birth plan doesn’t work for everyone and NO ONE should just have to accept it as their individual path. Every mother has options, and they should be allowed to create a birth plan which works best for them, even if that plan has to change along the way.

I wish I could say I fared as well as Addy. I lost a LOT of blood. My blood pressure dropped really low. I ended up with six stitches because I tore all the way down between my labias minor and major on the left side. One stitch popped two days after labor and was poking me in my clitoris until it fell out about 9 days after birth.(#ouch) Two weeks later I still have horrible hemorrhoids. I became severely anemic. My hemoglobin was 6.7!!! (They usually do a blood transfusion if it drops below an 8.) To avoid a transfusion my midwife prescribed weekly iron infusions. We are hoping the one I did this week is the last one. I’ll do blood-work again at my next OB appointment in May. Two weeks after birth I weigh almost 10 pounds less than I did before I got pregnant. Losing weight that quickly is not encouraged, but I just can’t keep weight on right now between caring for a newborn, breastfeeding, and trying to stick to a healthy diet for breast milk quality. It has NOT been an easy recovery for me, but Addy is doing SO great.

Personally, I don’t think our birth plan failed. We stuck to it as much as we could considering it was being sabotaged by some of the people meant to help us. I don’t think ANY birth goes exactly as planned. In fact, I would love to hear from someone whose birth went exactly the way they expected. From what I experienced I think some hospitals try to force all births to go THEIR way, unless the mother speaks up for herself, KNOWS what her options are, and enforces what she wants. Even with a birth plan I felt bullied by some of the nurses into making decisions I might not have made otherwise. I think most women go in not knowing what to expect, without a plan, and that’s the way the nurses like it so it can go the way they’re used to doing it. While I do wish it had gone differently, I don’t believe I failed at a damn thing. If we decide to do this again (that’s a big IF), I will still make a birth plan, and I will do a better job of enforcing it. I totally encourage every other mom to do the same!

Advertisements

Gain a Baby, Lose a Friend (or two)

I’m not completely sure what I hope to accomplish with this post. I just need to sort something out and I don’t really know what to do. (Maybe one of you can advise me.) As usual, I have allowed the customary four-to-six weeks to pass between posts. (I imagine it will only get worse once Baby A gets here.) The last month has just been really overwhelming! Besides the stress of last-minute preparations for baby and all the crazy crap going on with my body in the last month of pregnancy, I’ve had to deal with some Class A bullshit and it has me feeling totally lost.

Another surprise no one really warned me of was the sometimes extreme effect pregnancy can have on friendships. I’ve decided it might have even ended a friendship for me. As any of my readers will know (and as should be indicated by the blog’s name), I have strived to maintain a positive attitude as best I can through all of this – infertility, treatments, and now pregnancy. We really have been through SO MUCH. T is way better at knowing how to handle these things, particularly dealing with other people. It’s as if this type of thing doesn’t even bother him! On the other hand, I’m neurotic and overly-assertive and rarely handle things the way I probably should. I guess that’s why we work together, and there are times I wish I had consulted him before doing something (or opening my mouth). I’m definitely feeling that way now.

I’ve never had a baby before (duh). I don’t know the ins and outs of “pregnancy etiquette”. I am not even sure I knew pregnancy etiquette was a real thing. If this is the first time you’ve heard of it I am telling you right now – there really IS such a thing as pregnancy etiquette and you will want to try to understand it before you find yourself in a social disaster. Pregnancy etiquette covers everything from when/how to tell people you are pregnant, to what is acceptable to put on your baby registry, to who you should notify when you go into labor. They really should offer an 8-week course on this shit!

As you may know I am in human services. I wasn’t sure how to tell my clients I was pregnant. I didn’t really feel like it was any of their business but many of them smoke or have hazards in their home I didn’t want to be exposed to. I didn’t know when to tell my family I was pregnant. None of my friends were chomping at the bit to throw a baby shower for me so I didn’t know how to go about having one if there were no volunteers. My mom thought it was perfectly okay for her to finance and throw my baby shower while some people found it inappropriate and tacky. I didn’t know how to explain I didn’t like my belly touched without warning, or how to avoid some of the more uncomfortable questions/comments so I was just kind of open and honest about it. When people said or did something I was uncomfortable with I asked them to stop. Some of my friends (one in particular) publicly criticized me over this. She asked exactly how she is expected to prove that she’s supportive and excited for me if she isn’t allowed to touch me or talk to me. First of all, she never once called to ask how I was feeling or if I needed anything so I’m not so sure she honestly cared enough in the first place. Sigh…

I was kind of under the impression pregnant women automatically receive a certain level of grace and respect in that their needs and comfort suddenly become a priority to the people in their lives. I didn’t want to be made uncomfortable, upset, or feel violated. I wanted my pregnancy to be as positive an experience as possible and people were doing and saying things that made me uncomfortable and/or unhappy. I didn’t lash out at anyone and NEVER singled anyone out. I just made my wishes widely known and expected people to be respectful. I guess some people didn’t see it that way. Again, I just didn’t know any better, and I didn’t have anyone around to offer guidance.

I had one friend who I thought understood all this stuff and would help me, but she kind of abandoned me when I finally got pregnant. She was BEYOND supportive throughout the fertility process but once we got pregnant she took a huge step back (more like 10 steps back). She had some fertility issues in the past but chose a career over a family. I had hoped she would be supportive and involved, but she has openly criticized every single thing I’ve done from day one. She volunteered for things and then when it came time for her to step up she blew me off. I wanted her to be involved SO BADLY, and I understood it might be uncomfortable for her, but I thought we were good enough friends that she could TELL ME if she was uncomfortable. She never said a word. She just started blowing me off and publicly criticizing everything I did. She booked a venue for my shower without giving me the total price (which my mom was paying) before booking. When I told her to cancel due to the extreme cost she got upset, even though no contracts had been signed and it wasn’t costing her anything. I cried for days because she was mad, and I felt it was all MY fault that I wasn’t getting the venue I wanted.

When this friend’s birthday came around some of her other friends purposely excluded me from her surprise birthday party and used my pregnancy as an excuse to do so. I didn’t even know a party was planned at all. If that isn’t a clear indication of the value (or lack thereof) in our friendship I don’t know what is. She has made it clear to everyone else that our friendship is SO unimportant that her other friends felt perfectly comfortable excluding me ON PURPOSE. They said since alcohol was involved they felt it would be inappropriate and didn’t want ME to be uncomfortable. I don’t believe for one second they were considering MY feelings. I mean, they didn’t even give me (a grown adult) the option to decide what I was comfortable with, or at least warn me a party was being planned and explain why they were excluding me. That would be the courteous, adult thing to do! I’ve seen baby showers and weddings held at the same venue. I’m convinced it had nothing to do with my being pregnant and more to do with how she portrays our friendship to others. It’s kind of devastating to find out your friendship isn’t as valuable to someone as you thought.

The final blow was our maternity photos. When we first announced our pregnancy this same friend offered to pay for maternity photos, but the catch was she would choose the photographer – a friend of hers. It’s a very long story, but that photographer just was not going to work out. At 36 weeks we still didn’t even have a date set for phots. I told the photographer myself that we were going to have to go a different route. My friend was out of town the weekend this happened so I planned to call her when she returned in a few days to explain. In the meantime I started looking for a new photographer who could get us in ASAP. Before I could call her my friend sent me a long text saying I hurt “a lot of people” and calling me “thoughtless and ungrateful”. She said I slandered the photographer (when I never even told anyone who she was). I apologized for handling it poorly and tried to explain. I also asked her to explain why she was calling me names and had been so distant and cold toward me since I became pregnant. She didn’t even acknowledge my questions. She said she wasn’t looking for an explanation, that she wanted me to understand what I had done wrong, and it was my choice if I chose to accept it or not. That’s the last time we spoke.

I feel like she wants this to be all my fault. I’ll admit I should have declined her offer to begin with, or talked to her about the photographer long before we were so short on time. I should have talked to her about it before I started looking for someone new, too. However, I don’t think this is all on me. It’s easy to see my responsibility in this, but isn’t she responsible too? I started thinking about her behavior, my being excluded from her surprise party, and how she refused to even address MY concerns and focused only on making ME feel shitty. She wasn’t looking for a resolution. Her objective was not to understand our issues and repair our friendship. It seems to me her objective was to hurt me and to “put me in my place” so that SHE has the upper hand. I’m not sure it ever was a mutual friendship. I have no idea what to do.

Walking away entirely is not an option, not just because I don’t want to lose her friendship entirely, but we share some of the same friends and her significant other is T’s best friend. We live in a rural area. We need to be able to co-exist, at the very least. I’m certain she feels the ball is in my court, that she expects something out of me to “fix” this but I have no clue what that is. I apologized and that doesn’t seem to be good enough. Quite frankly, I don’t have the energy for this, and I have far more important things to worry about. My baby and family are more important to me than this petty bullshit. She abandoned me, called me names, insulted some of my friends and family, and publicly criticized me. She accused me of all this shit with no suggestions for how I’m supposed to make it right, and I’m expected to repair our friendship all on my own as if this is all MY fault? I’m at a total loss, and I am grieving it genuinely. I just don’t know what to do next. Doing nothing means there will always be this awkwardness. Addressing it only gives me the opportunity to fuck it up even more. She definitely has the upper hand. Sigh…

Third Trimester: The Throat Punch Diaries

I’m 34 weeks today. Up to this point the weeks have just flown by. I’ve wanted it to slow down, and honestly I think I still do. This could be my ONLY pregnancy and I just want to cling to it. Part of me is also freaking out because we still have SO MUCH to do. Then, there’s the part of me that’s still waiting for something to go wrong. When you’ve lost 5 babies that fear something could go terribly wrong never leaves you, and the third trimester brings on a whole new set of aches, pains, risks, anxieties, and MOOD SWINGS!!! (#psychomama)

My best friend only made it to 28 weeks with her first baby. Sadly, he didn’t make it. When I made it beyond 28 weeks I secretly took a huge sigh of relief. Just like every other notable point along the way, that was another milestone for me, to make it past 28 weeks. (My God, that’s so morbid. I’m glad my friends don’t read this!) My mother only made it to 33 weeks with me. I was due July 4th and was born May 15th. Now I can take another deep breath because making to 34 weeks is just another reassurance that everything will be fine. Next, I want to make it to 36 weeks. My midwife won’t even consider “letting” me go early before 36 weeks. If something happens before then she will try to stop labor.

I’m going for monitoring every week, the baby is bigger than average (a little over 5 pounds already), and I’ve had mobility issues. I’m concerned about missing work before she’s born, bedrest, c-sections, and getting prepared for her arrival. We still need a pediatrician, a daycare, to pack hospital bags, to get T’s shit out of her closet, and I just feel like we will NEVER have enough stuff (or space for all the stuff)! Suddenly, it feels as if time is passing at a much faster rate than it was, and that was too fast to begin with!! I just have to keep telling myself it will all be fine.

Believe it or not I’ve had some people try convincing me everything is not fine. Can you believe that? A friend who is only about a week ahead of me in her pregnancy has told me as long as I’ve known her how much she hated her first pregnancy and how she never wished to be pregnant again, and yet she decided to purposely get pregnant with her second child. She had her IUD taken out and was pregnant within a week! (If you’ve struggled as I have I know this totally pisses you off as much as it does me.) She has bitched the ENTIRE time – since Day 1 – about her pregnancy, and God forbid anyone remind her of how much she has always said she hates being pregnant, or that she made this choice. Worse yet, she seems determined to make me hate it, too. Every single time she sees me (which is about once a week) she asks me, “Do you hate it yet? Are you over it? Are you miserable?” (#eyeroll). Somedays I am in so much pain I almost can’t stand it. There really are days I am ready for this to be over, but then Addy will kick or roll over or give me a little nudge as if to say, “I just wanna hang out with you a little bit longer, Mama. I like it in here,” and I forget that my hip is basically out of place, I can barely walk, and that third trimester heartburn and morning sickness have come back with a vengeance.

I also had a client tell me my baby was a “problem”, and another say I would be lucky if my baby lived since I’m “so old”, and considering all the trouble I’ve had in the past. Even after I reminded her I’m only (almost) 37, I’ve had a really healthy pregnancy, and asked her to stop saying negative things about my pregnancy and baby, she kept it up. I was so pissed I just had to leave. I walked out of an appointment! It was better than throat-punching that 93-year-old crackerjack across the room! My boss would probably flip if he knew I walked out like that, but I am SO SICK of the negativity. What gives other people the right to steal even a little bit of my joy? Who the hell do they think they are?

I honestly thought I would get more flack from people about Addy being an IVF baby. I do get questions, but they seem to be from people who mostly are just curious or genuinely interested in what we went through. I’ve had to explain that IVF can be done in several different ways. For instance, not all IVF embryos are genetically tested. Ours weren’t. I guess we’ve been lucky in that not many people have said ignorant things to us about our embryos being “test tube babies”, us playing God, or any other stupid crap, but I know a lot of people do get those comments. I belong to a couple of online support groups and have heard some horrible stories. Someone told one of my IVF sisters her baby was a “program baby”. I’m not even sure what that MEANS, but my response was if someone called my kid a “program baby” I would give them a progesterone injection in their eyeball. I know, that’s pretty violent, but you can google ANYTHING these days. Know what you’re talking about before you open your damn mouth! NO ONE in their right mind WANTS to go through IVF. It is painful, expensive, traumatic, invasive, and exhausting. Calling IVF babies “program babies” makes it sound like the mother just followed a booklet or set of rules- like Weight Watchers or something. It diminishes what we went through! I don’t know anyone who didn’t try everything else they possibly could before going to IVF. To act as if we took the “easy way out”, or cheated somehow, that we just bought our babies to avoid suffering a “natural” process is the most ignorant idea, and anyone who tries to make us feel less than who and what we are or to downplay what we’ve been through can just go to Hell. (Yes. I WILL tell you how I really feel.)

Being in social work during the third trimester brings along its own set of challenges. My hormones are in full-blown chaos mode. One minute I’m manic, the next pissed off, and later I’m bawling because I can’t see my crotch (which I haven’t seen in at least three months anyway). I don’t understand. I can’t feel an emotional transition “coming on”, and I definitely can’t explain any of it. Controlling it is certainly a must, at LEAST at work, but sometimes I just can’t, and I have no valid excuse for it when I lose my cool. So, I have to curb my desire to strangle people on the regular, I mean like every couple of hours, every single day. Today I had a guy tell me the reason he has missed the last TWO appointments is because his aunt won’t hand deliver his mail to him at his mom’s house. He’s 47 fucking years old! Seriously, dude! Get your shit together! I had to force myself not to tell him to grow the fuck up. Instead, I used phrases like “self-advocate”, “taking initiative”, and “displaced blame”. Another client has stood me up twice because she just “didn’t have time for it” when I drive 30 minutes one-way to HELP her! I mean, are you fucking serious? I’m so entrenched in the hormonal muck that I can’t even remember how I used to deal with these people pre-pregnancy, and I’m scrambling to keep my shit together. I’m almost certain I chipped a tooth the other day gritting my teeth in an attempt to keep my thoughts to myself and my mouth SHUT. I mean, in my current mental state that’s really the only option. Amazingly, my blood pressure hasn’t gone higher than 120/80. I think that’s pretty fucking amazing, folks. (#deepbreaths)

Third trimester has not been kind to me. I’m physically and mentally exhausted. I don’t sleep, I’m in some kind of discomfort every moment, my heartburn has come back with a fury, and it is insanely difficult to move – in any way. I can’t turn in bed, walk, or bend over without incredible effort. I worry I will have to take off work before we deliver, which will cut into my maternity leave. Again, I’m SO happy to be pregnant, but I hate I can’t enjoy it much right now.

With all the aches and pains, I can’t really do much physically, which has definitely affected how I am able to show affection. Poor T hasn’t received much attention in months! It’s not that I don’t want to be intimate. I just CAN’T. It’s physically impossible, aside from a hand job now and then. I feel like an overweight, un-groomed cocker spaniel, not exactly sexy, but I still fix my hair and makeup every day. I try to look nice but T doesn’t seem interested in even touching me. He barely even kisses me. He still tells me I look nice. In fact, he tells me I’m beautiful, but he doesn’t hold me, rub my back, or even touch my belly. I try to tell him when Addy is moving, which seems to please him, but he never reaches over to feel. I had hoped pregnancy would make us closer, but I feel kind of on my own a lot. He’s encouraging, supportive, and does SO much for us, but I just want him to hold me, kiss me, and pay some attention to me, even if he won’t get sex out of it. I would just come out and tell him bluntly, but he’s sensitive. If I told him I felt physically neglected he would see it as me pointing out his “failures” or “mistakes”, as opposed to me just asking for something I need. So, I sick it up and PRAY that time will fix it after the baby comes.

I usually try to sprinkle some positivity into each post but I think I am just not capable. I’m too tired. I haven’t been sleeping, and I’m feeling a little overwhelmed with all the aches, memory loss, clumsiness, and just utter exhaustion. So, I’m sorry this is not a happy post. I’ll do better next time. Thanks for reading!

Second Trimester: Clinging to Joy

This pregnancy is going by way too quickly. I’m already 26 weeks, 3 days! I’m not sure where the time has gone. Every milestone is so exciting, but then comes another, and another, and before you know it you’re nearing the third trimester and didn’t even see it coming. That’s not to say the second trimester has not presented its own set of challenges, but rather that I just want it to slow down a bit. I want the whole thing to just… slow… down.

 …

You might recall from two posts ago that I started having some hip pain near the end of the first trimester. That pain has progressed to a state of consistency that has been more than just an aggravation. I am at least in minor pain 24/7, but usually moderate or severe depending on what I’m doing. Being pregnant has been the most miraculous experiences of my entire life. However, this pain is stealing some of my joy. I cannot get beyond the pain some days, and it has robbed me of my sleep. I haven’t slept more than a few hours a day since probably 25 weeks. The second trimester is supposed to be the “easiest”, the best, the one all mothers enjoy the most, but I’ve been miserable for much of it. I am so disappointed that I’ve allowed this hip thing to rob me of even a small bit of my joy but I just can’t get over it. It’s a constant cloud that hangs over me. When it first started the chiropractor was able to relieve the pain for 5-6 days and I would see him once a week. Now, the pain comes back later that night, the next day, or two days later if I am lucky. I just don’t know WHAT to do. Two of the massage therapists at the chiropractor’s office have been pregnant recently and they both took prescription pain meds while pregnant for similar pain, but I absolutely refuse. I can’t take that kind of risk after what I’ve gone through to get pregnant, and since I’m seeing a midwife she wouldn’t likely suggest it. I guess I just have to live with it, but some days are worse than others. Everyone says, “Get as much sleep as you can now before the baby comes”. First of all, if that is not the most ridiculous thing I’ve ever heard I don’t know what is! Being pregnant does not give me the super power to “reserve” sleep. I can’t sleep extra in January and save it up for April. Furthermore, that thing where we are genetically geared to forget what pregnancy is like so we will continue to reproduce must really do a number on some women’s brains because the “symptoms” of pregnancy make it almost impossible to sleep sometimes, much less when there is pain involved. I could say it’s Nature’s way of preparing me for the sleep I will be losing after the baby gets here, but I think I will just complain about it and accept that I can’t fix it. Since this is MY blog I guess it is the ONE place I am allowed to complain maybe a little bit.

 …

Addy is doing great. They measure my belly at every visit and I’m told we measure only a few days ahead. Her heartbeat is strong, and we will get an ultrasound for the first time in two months on January 22nd. We will do a 4D ultrasound and growth scan that day. As you might recall from previous posts we decided to skip genetic testing after our anatomy scan came back okay. This was because our insurance won’t cover it and it won’t tell us anything that can be fixed anyway. Since then we haven’t had another ultrasound so we are VERY excited!!! In the meantime Addy has been EXTREMELY active. She moves almost any time I’m not moving, and sometimes when I am. A couple of weeks ago I’m pretty sure she wedged her head against my ribcage and I couldn’t sit up or bend. I had to lie flat until I could get her to move, and she’s quite stubborn. (She gets that from both her parents.) Since then, the midwife seems to think she has turned head-down, but I think she is face-up. It feels like little knees (or maybe elbows) are always rubbing back and forth around the area of my sternum, and sometimes I feel nudges down lower. I am assuming those nudges are from tiny fists. Every so often it feels like she flips over, but she always moves back to that primary position. She seems to sleep okay at night, or at least she hasn’t moved enough to wake me up much (yet). I’ve only gained 13 pounds, which is less than “average” but still in the “safe zone” so I guess that’s a good thing too.

 …

I have felt a little depressed lately about how few friends I seem to have. When I was married to my ex-husband he didn’t really let me socialize outside of family and a very small group of trusted friends. After my divorce many of those friends disappeared, like I had the plague, and then 4-5 of them moved out of state. I am so very thankful for the few who stood by me, but it left me with slim pickings when it comes to people to plan a baby shower. Traditional etiquette says immediate family should not throw or fund a baby shower. It also says a mommy-to-be shouldn’t have much of a hand in planning the shower or doing any work for it. Well, no one whole-heartedly volunteered, and I’m not one to ask. I almost thought I might not even HAVE a shower but the thought made me absolutely depressed. My one friend is pregnant herself and recently lost her job. My best friend since Kindergarten lives in Florida – eight hours away. My only real friend in the town where I live is very “important” around town – too busy and important to actually “do” anything. She would rather throw money at it and make it go away. (Side-note: I think she’s a bit jealous because she never had kids and isn’t used to someone else being the center of attention.) ONE of my friends from high school volunteered to “pitch in” and she has done more work than anyone. She has designed and printed the invitations and any other paper stuff needed for the shower (games, signs, etc.). She’s a graphic designer, her family owns a print shop, and she dabbles in event planning so she’s been an angel! She didn’t even charge us for anything. My mom secured the venue and paid for it. I picked the theme, the games, the cake, ordered the cake, and am in the process of deciding on food and party favors. I have NO idea who will pay for any of it, probably my mother. I feel bad because my mom has already done SO MUCH for us, but what choice do I have? I want a baby shower, even if it is full of people who couldn’t even bother to help. I want to celebrate this miracle that is happening to us, our precious Addy. Also, this could be the last chance I ever have in my life that I’ll get to be the center of attention. I know that sounds shallow, but I have endured HELL to get here and I feel like I deserve a little fun. I was really bummed at first that T’s family had not even asked about a shower, much less volunteered to help. I even asked his mom if there was anything special I should include in the shower and she just replied “Let me think on it and I’ll get back to you after I return from Mexico.” Well, she won’t be back until the 22nd and I want to mail invitations by then so I guess if she adds anyone or makes a suggestion that cannot be added I will cross that bridge when we get to it. It made me feel kind of… unimportant. I already don’t have many friends willing or able to help. My mom has spent FAR more money on this baby than his mom has, and they got her a bunch of “Daddy’s girl” stuff for Christmas, which is cute but made me feel cruddy. I was starting to feel more like a vessel for T’s baby than a valued member of the family. However, his mom, sister, and grandma have since volunteered to help any way they can so that made me feel a bit better, and quite relieved actually. I just want to have a nice shower and enjoy celebrating our little miracle. I don’t think that’s too much to ask.

 …

I recently discovered there are no “real” prenatal classes offered anywhere near my area. My OB clinic offers one 2-hour class taught by my midwife. I don’t know how we could possibly get beyond “natural versus medicated birth” in just two hours. The situation is similar at the local hospital. It’s a brand new, state-of-the-art hospital built just a few years ago but they don’t offer prenatal or birthing classes, not really anyway. They offer a tour of the hospital OB wing, which must be scheduled. While you’re at the tour you’ll sign up for one class that lasts a few hours, usually about a month prior to your due date. Then, AFTER the baby is born they’ll send a lactation specialist to your hospital room to give you a crash course in breast feeding. I am sure many women have done it this way. I know many around here who have, but every book I’ve read set me up for disappointment – even the one given to me by our OB clinic! I thought we would be taking hours-long classes once or twice a week for at least a few weeks. It was almost devastating to find out the only thing available to us is a “crash course” and a hospital tour. So, I went looking for additional resources. An acquaintance of mine from my home town just 20 miles away is a doula. She was the first person I thought to ask. She told me she is contracted with my insurance, gave me a list of the many services offered in their birthing package (including 5 weeks of prenatal classes among other things), and the out-of-pocket cost if my insurance should not cover it. So, I called Blue Cross Blue Shield and they told me it’s not covered unless they bill the services a very specific way. I have a background in medical billing, particularly with BCBS, so I called the doula to ask questions and it turns out their insurance biller is the only one who might even come close to helping me. The cost is about $1100, and if my insurance won’t cover at least PART of it, we can’t afford it. Just another wall to climb in what has been quite a struggle to become parents! It just kind of blows my mind that they expect women who have never experienced childbirth to just walk into the hospital completely uneducated and bring a child into the world without a clue as to what her options are or what to do. And don’t give me that crap about women dropping babies in rice patties, cotton fields, and apple orchards for generations. This is the 21st fucking Century. I want a god-damned birthing class for fuck’s sake!

 …

We did the dreaded gestational diabetes test last Thursday, three business days ago (5 days total). I was insanely nervous because even though we eat a fairly healthy diet there is a strong history of diabetes in my father’s family. My biological grandmother died from diabetes apparently. It’s easy to understand why I might be concerned. The midwife, however, didn’t seem worried at all. (She never seems worried.) I was surprised that the act of drinking the glucola (my sister calls it “the orange death”) was not as disgusting as I thought it would be. It was insanely sweet because it has 55 grams of sugar in it; however, I was able to get it down in the five-minute time frame given without gagging or puking. (BONUS!) After the drink was another story. We don’t eat a ton of sugar, not much at all actually, and we maintain a whole grain, high-protein diet. My body is not accustomed to taking in that much sugar. I started getting a headache and feeling funny so I decided to leave work early (where I had finished the drink) and went to the doctor’s office. I sat in a sweltering waiting room that was absolutely packed for over an hour. I was literally sweating and thought I might actually pass out. Just as I was about to ask if I could go lie down the lab called me back. My favorite lab tech was working. Her name is Sara and she is amazing! I’ve had her most of my visits to their lab, even back when we first started seeking help with our fertility, and I just love her! She said we should get the results by Monday at the latest. Monday came and went and I heard nothing from my midwife. I gave them an extra day because we’ve had terrible ice storms and Monday was MLK Jr. Day. I hadn’t heard from them by 2 pm today so I decided to call. The receptionist answered instead of the “phone Nazi” (aka heifer) – thank God, and informed me that my midwife was out of town this entire week at a conference and she wouldn’t receive my results until she returned a week from today. I was pretty pissed because no one bothered telling us when we scheduled the test, or when we were there Thursday, that she would be gone. I felt it was a little unprofessional for SOMEONE not to make sure her patients knew she would be gone. I asked if they could please try to reach her and get back to me with the results as soon as possible, and they did call me back within an hour. I breathed a HUGE sigh of relief when the nurse said everything was normal, which made my irritation with their lack of organization seem slight. It is just one more milestone and one test closer to the finish line, and that is also a huge comfort!

 …

When I weigh the pros and cons of my own second trimester I would say it has been overall enjoyable, maybe even blissful. I can feel my baby, which is by far the most blissful and amazing thing I’ve ever felt. Nothing trumps lying there with my hand on my belly feeling Addy move, turn, kick, and bounce. I just can’t even describe how amazing it is. (By the way I think it feels less like gas and more like little thumps.) It has not been as grand as so many other women, books, and even doctors might describe it. I’ve had my share of aches, pains, and obstacles – certainly more than anyone warned me to expect. However, I supposed I should have learned by now to expect the unexpected. I’ve encountered many unpleasantries through this whole IVF and pregnancy process that no one bothered warning me about. I should learn not to be surprised. But like I said, the good FAR outweighs the bad, a million times over. I only wish it would slow down just a bit so I could hang onto those moments of joy just a smidge longer.

Thank you for reading…

Pregnancy Brain is Real

I know I haven’t posted in a long time. Sorry. Life has been a little nuts, and I honestly keep forgetting. Right now I am sitting on my lunch break (which I didn’t expect to get) using the free WiFi at my favorite coffee shop, in my least favorite town. I’m preparing to see clients 3, 4, and 5 for the day – one of them at the local behavioral health center. Ah! The glamorous life, eh? The last couple of months have just been a whirlwind. Between exhaustion, health problems, the holidays, and just LIFE I feel like I’m constantly falling behind. When I do get a free moment I try to write in my pregnancy journal, but most of the time I just really want a beer and a nap. The nap I can get occasionally, but the beer, well nope!

Did you know “Pregnancy Brain” is a REAL THING? I thought it was just a wives tale, something pregnant women made up as an excuse to be forgetful, simply because they’re too exhausted or achy to possibly remember everything. Well, the exhaustion does play a role, but our midwife informed us it is a clinically-diagnosed, medical condition caused by a change in our brain chemistry, stress, exhaustion, the increase in hormones, and the decrease in coordination. Who’d have thought!!! I have tried VERY hard to NEVER complain about being pregnant. After all, I’ve waited 11 fucking years to have all these aches, pains, fatigue, farts, burps, sleepless nights, sleepy days, anxieties, and pregnancy brain. So, please don’t take it the wrong way if I describe my “symptoms”. It’s just me putting it down on writing that I’M PREGNANT, YA’LL!!! I’m STILL freaking pregnant – at 22 weeks, 3 days even!!! BOOM! Take that, Aunt Flo, Mother Nature, and all those quacks who told me I would never make it this far. And yet, I’m cautious to get too excited or confident. In the back of my head rests that persistent whisper, “Something could still go wrong.”

Anyway, where was I? Oh, pregnancy brain. Yup. It’s real. I drop absolutely everything I touch. (And I seriously debate the value in picking it back up.) I forget to put primer on before doing my makeup. I put dirty dishes in with the clean ones in the dishwasher this morning. I thought today was Wednesday. (Damnit, only Tuesday). I forgot to add my father-in-law to the Christmas card list. I’m suddenly late to work on occasion, which is a HUGE no-no in my book. I drove to the gas station for gas and pulled up to the door instead of the gas pump and then got out and couldn’t remember why I was there. I said something to my doctor and she just laughed at me, as if everyone should know this pregnancy brain thing was not a myth. Boy, did I feel dumb, which is a general state of mind for me these days. In fact, I just forgot what I was going to say next.

So… um… Oh well, on to something else… As I haven’t written since first trimester I guess there’s plenty to tell. We’re having a GIRL!!! We are naming her Addyson Grace, Addy for short, but she will always be “Baby A”. She’s such a little miracle!! She’s almost 13 ounces now, and VERY long. Her legs are insanely long, like her dad’s long-ass frog legs. She already has a spunky little personality, and I’ve been able to feel her move for about 3 weeks. She moves a TON. She’s moving right now, in fact. Her anatomy scan came back great so no expensive genetic testing, which is NOT covered by my insurance. (A whole other story.) We figure we can’t change anything even if we do get a positive, and about 19% of positives are false anyway. Why stress ourselves out? We are taking the road less travelled. (Go figure.)

My mom got us a (practically) brand new crib and changing table for cheap and isn’t asking us to pay her back, even though she had already spent a small fortune on quilts, bibs, clothes, etc. At the rate she’s going we won’t need anything by the time the shower gets here. She still insisted on spending a small fortune on us for Christmas as well. I’m not complaining but I swear she never saves a dime for herself. She’s not a Spring chicken anymore and her health is not great. I wish she would slow down. She says she works 50-70 hours per week so she CAN give whatever she wants to her “babies”. I’m almost 37 and she still says I’m her baby, in public… She says it to everyone. She’s so excited. When I texted her we were having a girl she called me while I was waiting to see the doctor and literally everyone in the waiting room could hear her screaming over the phone. The whole crowd turned to look at me. I just lipped “I’m so sorry!” at them while she carried on. Lol. She’s so crazy, but I love her.

Okay, I have to save my battery, and I think A is standing on my small intestine. I’ll leave it here for now. This time I won’t wait over two months to come back, promise. Happy holidays, everyone!

Love, peace, and Poise liners!

~~ HappilyCautious ~~

Post IVF: Weeks 9-13

We had our 9-week checkup on September 13th. I know, that was over a month ago. Historically, I post about once a month. I’m not trying to make excuses, but I do work full-time, T has been working 7 days a week, and almost all the housework, shopping, and other errands fall on me. So, I apologize for the delay in updates. (Not that anyone cares. Only two people liked my last post. I don’t know who I’m kidding.) Anyway, I am 13 weeks today and our next ultrasound is Monday, but several changes have occurred so I figure it’s time for an update…Since our fertility clinic usually graduates patients between 9-10 weeks and I was very close to nine weeks on September 13th, I made sure our appointment was scheduled with our main doctor, Dr. Peter Ahlering. If we were going to discuss graduating from the fertility clinic we wanted to discuss it with him directly, not the partner RE or NP. Of course, just as with every previous appointment, we started right off with a trans-vaginal ultrasound. Dr. A came in with his signature tap on my knee and a “Hey guys!” He is always so excited to see each patient, and laid back. It’s like hanging out with a friend, except that friend is poking around in your lady parts.  

I was really nervous, but of course Dr. A chatted to keep me calm. Two little sacs popped up on the screen. Twin A was doing “her” little dance, just as before, but something wasn’t right with B. It looked like the sac had moved and it hadn’t grown since the last ultrasound. A’s heartbeat was great, over 150. When we searched for B’s it just wasn’t there. B was gone. We were prepared for it, or we thought we were. I mean, we didn’t get into this for twins, and we were honestly a little scared about the idea, but once we “had” them, and saw their little hearts beating…. Well, it was kind of hard to say goodbye. Dr. A was comforting and visibly disappointed for us, but he said we knew this could happen, and we had to think about Twin A. He was right, of course. He checked me out and all results came back with flying colors. Twin A was looking strong. He would have loved to see us one or two more weeks, but since we live two hours away he recommended we be released to our local OB. He said he would let us talk to our nurse coordinator and decide if we wanted to set up anymore future appointments with MCRM. It was all very emotional for me. In just the matter of an hour we found out one baby was doing amazing but the other had passed, and I was very healthy and safe to graduate from the clinic but that meant leaving Dr. A and his amazing staff.  

We tracked down our coordinator. She was sad to see us leave. She reiterated her wish that we lived closer. She asked if we wanted to come back for one more week, just for our own comfort, but when we looked at our schedules and budget it seemed like just an added expense. I cried (again) because Dr. A and the MCRM staff are like family to us. They gave us a little MCRM onesie – our first baby gift. It says “I survived the ice age as a frozen embryo”. This is not really accurate since we did a fresh transfer, but 90% of the people we know have no idea it doesn’t apply to us. I did suggest, however, that they should change the saying to something more universal like, “Made with a lot of love and a little science.” Leaving MCRM was so bittersweet. I cried all the way to the car, and part of the way home. I think it was just all the feelings welling up – losing B and knowing I’ll still see his little bubble on my ultrasounds for a while, leaving the clinic, seeing how great little A is doing, and knowing we made it far enough to graduate from the clinic. I was completely overwhelmed. It took me a few days to adjust.

Transitioning back to my OB’s office has not been without its frustrations. That heifer of a receptionist has continued to be a thorn in my side. (I call her a heifer because she is stubborn and rude, not because she’s fat or anything like that. She’s just hateful.) I complained to both my midwife and the nurse. The nurse’s response was, “Yeah, we’ve been really busy lately”. She may well be very busy but I can’t stand the way she speaks to me and treats concerns I consider important like minor, insignificant irritations. To me, that’s just an excuse to allow the person answering the phone to make your patients feel unimportant.

Other than the issue with the receptionist everything is going pretty well. I had some spotting for two weeks after we tried to have sex for the first time since July. That was scary, but the baby is doing great. (And I’m refraining from sex until further notice!) We’ve taken to calling the baby “A” or “Baby A” because we can’t bear to say “it” when describing our baby. I now have a love-hate relationship with ultrasounds. They’re just regular external scans now. (NO MORE trans-V ultrasounds!!! – THANK GOD!!!) That definitely helps, but I hate that we can still see B’s sac. Remember how I said my midwife doesn’t do the scans herself at the OB’s office? Well, the ultrasound tech wasn’t informed that we had lost a twin so she kind of freaked out for a split second at our first scan, until I told her what happened. This is the kind of thing that would never happen at MCRM. Communication is key, and they get that. My midwife is amazing, and the head doctor who founded our OB clinic is a great doctor, but his staff is not as phenomenal as MCRM’s. I don’t know that there is any other staff like theirs. I guess they set the bar and I will just have to deal with being disappointed from now on. In the meantime, the midwife can’t really tell us how long we should expect to see B’s sac. She said when this happens the second sac usually “resorbs” and eventually just stops being visible, but sometimes it stays the whole pregnancy. Other times it passes at some point during pregnancy. We thought that might be happening when I had the post-sex spotting but I never passed anything other than some brown blood. The only real “complication” we have had since losing B is that I am having a LOT of hip and lower back pain. I had connective tissue problems in my hips before getting pregnant so this is not a surprise, but my chiropractor won’t let me do anything about it until around 14 weeks. I got a note from the midwife and go for a massage and adjustment on Monday! (I can NOT freaking wait!)

I have this thing with the number 13. A lot of people do, I know, but it just keeps popping up. I lost my grandma in 2013, on January 13th. My first pregnancy to make it past three weeks would have been due in 2013. By the time A gets here I will have been trying for a baby for 13 years. We had our first specialist appointment last year on April 13th. We had our LAST appointment with MCRM on September 13th. That day, when we were driving home my grandma’s favorite song came on, “Home” by Phillip Phillips. It played at her funeral. All these little things just keep happening that tell me everything will be okay. Now, on the first day of our 13th week I feel like I can FINALLY breathe.  

I’m increasingly optimistic. I am [this] close to my second trimester, AND I have not thrown up even ONCE since transfer!!! (I can’t believe it!) The powers that be were watching over me these last three months because I am DEATHLY afraid of vomiting. I have no idea why I’m so afraid of it, but I can’t tell you how thankful I am to be puke-free and entering my second trimester! Oh! And no more Progesterone! Whooohooo! I am SO SO blessed, and I can’t wait to make our official pregnancy announcement. In fact, I need to buy a pumpkin and carving kit today because I want to do a Halloween announcement and that’s only two weeks away! (EEK!). I feel like I am FINALLY allowed to be excited. 

IVF: The Post-Transfer Rollercoaster 

Note: I apologize in advance for another dreadfully-long post but hope you get something from it….
If you think you’re anxious while “stimming” in the early stages of IVF, just wait until after transfer. You’ll have the most precious investment(s) of your life nestled gently into your uterus. You will want to believe you can relax at that point. You’re almost done – halfway there at least (you hope). This was a HUGE milestone to check off your list. Now, you just wait, and “relax”. Everyone tells you the “most important” thing you can do is relax, and you’ll want to. You’ve been stabbing yourself for weeks, and are likely still taking progesterone in some form. You’ve endured the dreaded two-week wait and concurred the hazards of post-retrieval embryo die-off. (At least half your embryos probably didn’t make it.) Now, whether you’ve waited a month to do a frozen transfer or did a fresh transfer just a few short days after retrieval, you’re tired and want a break. You DESERVE a break, and everyone who knows what you’ve been through will tell you to take one, especially the nurses and doctors helping you through this journey.  Well, that’s pretty ironic. Some relaxation sounds nice, but it’s not very realistic. Even if you’re lucky enough to have time off work following transfer, the “what if” factor will make you nuts! 
The day of our fresh transfer I was still in a lot of pain from retrieval (and that surprise pulled ovarian ligament I’ve written about before). If you’re doing a frozen transfer you probably won’t have that, but I can only testify to my experience. I was still in quite a bit of pain. The lab brought a little tube into the transfer room carrying my precious babies. The doc slid them in, no sweat. We watched it all on a monitor – two seemingly glowing grains of rice moved slowly toward the top of my uterus and just stuck with no problems. The doc said it went beautifully. I told him at least that part was easy. (I joked it was easier than doing it naturally.) After, I looked at my nurse and asked, “Now what?” She gave a reassuring smile and (basically) said, “Nothing changes”. They set me up for two beta blood tests – one about 6 days after transfer and the other two days after that. “That’s it,” she said, “Until we get lab results we do nothing different.”
Needless to say that was a bit anti-climatic. I am not sure what I expected – fireworks maybe? There were no fireworks. There was no party, not even a card from anyone – not that a lot of people knew what was happening. T didn’t even seem too impressed. He just focused on keeping his road rage in check for the drive home. After all of the turmoil and excitement in the weeks (years really) leading up to transfer I just felt kind of deflated. I was doing 2ml progesterone injections every other day. If you’re not familiar with “PIO” (progesterone in oil), these injections are not fun. I have done several other shots in my rump over the years – B12, among others. They aren’t that bad. Mostly I didn’t even feel them. I definitely feel the PIO shots!! They bruise and burn. Many days I cry when doing them. I did ALL of my stim shots on my own, but after a couple of mishaps when I bruised myself really badly I started having T do the PIO shots. (Don’t tell him I said this but he’s better at it than me.)
I’m a member of a few online IVF support groups. One is an international group. I can’t BELIEVE many clinics (both foreign and stateside) don’t do an ultrasound until 8-10 weeks, even with IVF! Get this – some don’t even do beta blood tests AT ALL! They NEVER check HCG levels. That absolutely blows my mind!!! I’m lucky. My first beta was supposed to be at 7dpt but was going to fall on a Thursday, which would put my second 48 hours later on a Saturday. Well, no lab anywhere within 100 miles does same day results on Saturdays, and my doc wouldn’t get them until Monday regardless. So, they let me draw my first beta at 6 days on a Wednesday so I could do my second comparative beta on Friday. My levels almost quadrupled – FABULOUS! Then they said they won’t do anymore HCG tests. My OB, knowing I was at risk for loss, would draw betas every week until a heartbeat could be detected. That doesn’t happen at my fertility clinic. You wait for an ultrasound around six weeks instead. 
I was excited about my labs but couldn’t enjoy the excitement much. My mind and body just wouldn’t let me. At 8 days past transfer when my labs came back I was only 3 weeks, 6 days (3w6d) along. Three of my four previous pregnancies ended in miscarriage right about 3-5 weeks along, and I was having cramps. NO ONE told me you can have period-like cramps your ENTIRE pregnancy!!!Talk about traumatic. Apparently this is especially in the first trimester. I was freaking out. My nurse said it was normal. I didn’t really feel much reassurance from that. I was a nervous wreck, and I knew I would be until the first ultrasound, which was almost two weeks away. 
Those two weeks dragged by. I felt like Moses traversing the desert. I was miserable. Every cramp, pain, or “feeling” in my “area” sent me flying to the restroom to check for blood. I just knew I would start bleeding before I even got to see my baby. I debated calling my OB to see if she would do a scan just to ease my nerves, but I didn’t want to be that person, and my OB doesn’t do them herself. She uses a tech. I wanted a doctor to tell me everything was fine. No offense to US techs or nurses. Some of my dearest friends and family members do those jobs, but I was feeling very anxious and just needed a doctor’s reassurance. I was trying not to drive everyone nuts or show how edgy I was but even people who have no clue what we are doing asked if I was okay or pointed out my “attitude”. One friend who has been aware since day one said, “Sounds to me like you’re complaining and I thought you said you weren’t going to complain.” (Ouch!)
Ultrasound day finally came. I was a nervous wreck. T drove most of the way to the clinic (two hours away). I was grateful. I was worried I wouldn’t be able to drive. My whole body shook. We were 20 minutes late for the appointment because we hit bad traffic on the expressway. We called ahead to tell them there was traffic and no one answered. I checked the clock and it wasn’t even 8am yet. They don’t open until then so I left a message. (More anxiety) We got there and had to wait. (More anxiety) We almost always have to wait. They’re an amazing clinic. Everyone wants to go there. (Take note: If your clinic’s waiting room isn’t full at least half the time you’re there I would bet you can find a better clinic. Otherwise, your clinic staff is perfect and I want to know where you go!) I never complain when we have to wait, and we were late getting there, but I was a basket case! I chewed my lip and jiggled my legs the whole time. 
When we finally got to the US table I couldn’t see anything on the screen but a little black bubble. I panicked until the RE showed us not one but two, tiny, black sacs on the black and white screen. The image was grainy. Then, she said she found the yolk sacs and pointed them out, and OH! Did that sac split? Is that a triplet? OH. MY. GOD!!!! We were already struggling with transferring two embryos because our RE never said that’s what we were doing for sure. I think he thought that’s what we asked for. I’m not certain. We showed up for transfer and were just sort of told we were transferring two so we went with it. The idea of THREE babies almost gave me a heart attack. The RE said not to worry. (Note: This was the partner RE, not our regular doctor. I am sure she is completely competent but I wanted my OWN doctor to tell me what was happening.) She said it could just be an “embryonic bleed”, which happens in 70% of pregnancies. She would mark the twins as “Twin A” and “Twin B” arbitrarily and the anomaly would be marked with a “?”, for now. She printed out some pictures and gave them to us. She told us to come back in a week. 
T couldn’t go with me for the next US. I was 6w3d. I hoped to hear a heartbeat (or two), but didn’t really want to hear them without T there. It’s weird. You want to know your baby is/babies are healthy but you also want to share all the really special moments with your SO (significant other). Also, I was still pretty nervous. The cramps seemed to be getting worse. My anxiety was less, but still noticeable. The worry of losing my babies was almost always at the forefront of my mind. It still is. I went alone because my mom and best friend were working and T’s Mom was out of town. I stared into that weird, grainy screen again, begging for a sign. The NP was doing the scan this time. She wasn’t as handy with the tool as the RE’s. She poked and pulled at me for a long time before I finally saw the little black spots I was longing to see. Two little flickers of white light just barely glinted on the screen and she said it was a heartbeat. Twin A had a heartbeat!!! (Sigh of relief) What about B? Well, B was being illusive. Finally, we found Twin B and got her (or him) centered enough to see the yolk sac. Then we saw a second little flicker, Twin B’s heartbeat. Thank God! The NP tried to turn the sound on to hear them but their little hearts were too small at just 6w3d. She said we would most likely hear them next week when we go back. Good! T will be with me then! 
After each ultrasound I have felt kind of momentarily invincible. After the first one T and I both said it was like a cool breeze wafted over us and peace just surrounded us just as we were walking into the exam room. My BP then had been 120/80, which is pretty high for me. At the second ultrasound it was 90/70, which is darn near perfect (again, for me). 
Following the 6-week ultrasound I couldn’t shake a bad cramping feeling. I had been having cramps all along, but these cramps were far more intense, almost a stabbing pain, and constant. Three days following the ultrasound I was traveling for work  when I had a very sharp, stabbing pain shoot from my belly button to my vagina. I’m not trying to be graphic or overdramatic, but it really did feel as if I was being stabbed in the vagina. I was exiting my car when it happened. I had to steady myself against the car. I took deep breaths and the pain eased slightly. I grabbed my satchel and walked across the street to the library where I had a meeting scheduled. I went straight to the restroom and found a quarter-sized spot of blood on my pantyliner. I sat on the stool a few seconds and felt another sharp stab. Simultaneously, I felt a big gush. I peered into the toilet and it looked like the stool was filled with cherry Kool-aid. I freaked. I changed my pantyliner to a pad and went back out to my car to call the nurse at my clinic. The nurse said not to worry. Bleeding was normal. Normal? That much blood was normal? She said to check my pad in an hour and if I was filling a pad within an hour I needed medical attention. If that was the case, I had the choice of driving two hours to my fertility clinic or going to my local emergency room. 
I endured an hour-long meeting with a consumer and went straight to the bathroom. There were only two, small drops of dark blood but no clots or anything. The cramps had eased up a little, but I decided to cancel my afternoon and called my boss to let him know. I drove over an hour home and texted T about what was happening. I asked if he could leave work early. He said he could. I wanted him to take me either to my local OB’s office or the E.R.
The more time passed the worse the cramps seemed to get. I started feeling hot and sticky. I was still bleeding just slightly. I attempted to reach out to my OB’s office but  one of the receptionists refused to let me speak to a nurse or practitioner (heifer). I had hoped they would bring me in and do an ultrasound and/or labs. I knew if I could get hold of the midwife she would get me in if she could. I didn’t fancy the idea of going to the E.R. if I could avoid it. The receptionist was being a bitch so I asked that she get a message to my midwife to let her know what was happening. She agreed. When T came home we decided to go to the E.R. (Side note: We didn’t hear from the OB until we had already been in the ER almost four hours.) 
We waited almost two hours for a bay at the emergency room. They ordered STAT labs, a urine sample, and an ultrasound once we finally got a room. Everything came back fine. (The US tech was amazing!) There was no explanation for the bleeding and pain. THEN, I suffered through the MOST horrific pelvic exam I have ever had in my life. I imagine it was similar to how they might do it in a third world country. They apparently don’t have obstetrics tables in the E.R. In order to push the cervix forward for exam, they flipped a metal bed pan on its top, covered it with a towel, and had me balance my ass on it. Meanwhile, the nurse took AGES to find the supplies they needed. (Why they weren’t already out is beyond me.) Then, I grasped the rails on the hospital gurney to keep from falling over, or beating the doctor to death while she dug a massive blood clot from my cervix. She called it a sub-chorionic bleed. She said it was totally normal. Once the clot was removed the bleeding and cramping stopped (mostly). She sent me home with instructions to see an OB within 3 days. Since I had a follow up with my specialist in four days (and three days would have landed on Labor Day) I just decided to keep the specialist appointment. I felt so stupid, as if I had overreacted, and everyone in the E.R. seemed to nod in agreement, as if they could read my mind. I was so embarrassed, and annoyed with the whole thing. 

We had our 7-8 weeks ultrasound yesterday. I was 7w4d. The NP immediately said she is glad I went to the E.R., even if it did turn out to be something “normal”. During the ultrasound Twin A showed up right away. She looked like a Teenage Mutant Ninja Turtle, like she wore a little mask. (I say “she” because her heartbeat was fast at 135, and she seems like kind of a diva.) She had to be right in front, grasping everyone’s attention. She showed up perfectly. Twin B was more stubborn, as he has proven to be all along. (I say “he” because his heartbeat is always slower than A’s. This week it was around 115, and since B is stubborn, just like his dad, it seems appropriate that B could be a boy.) We couldn’t get a clean enough image to measure B, and his heartbeat had to be measured manually because the machine couldn’t pick it up. In fact, we could hear A’s heartbeat just fine – loud and clear, but B was just not having it. The nurse practitioner said not to worry just yet. She has to go around A to get to B and it could just be making it harder to see B. We will just keep an eye on him. Also, the “triplet” or “anomaly” we saw in previous ultrasounds was gone. We are guessing that’s what the E.R. doctor extracted from my cervix. 
It seems like the weekend following an ultrasound is when something always goes wrong. This Friday (yesterday) I accompanied T to the laundromat to help fold laundry. (Our dryer is broken.) I am restricted from lifting so I just folded. About 10 minutes before we left I started having stabbing pains again, but this time in my left ovary, hip, and lower back areas. It hurts to walk or move much, and it hurts to pee sometimes. My ovaries are still somewhat swollen from retrieval so it could be that my left ovarian ligament is doing what the right did after retrieval, or it could also be round ligament pain, especially with twins. We don’t know. I’m on bed rest for the second weekend in a row. Heating pad on low for the back pain and Tylenol every few hours is all I can do according to the nurse. (Thank GOD she answers emails on the weekend!) I can tell you one thing – I’d better be dying before anyone tries taking me to our local E.R. again!!!
I have another ultrasound September 13th. I will be almost 9 weeks and might get released to my OB’s office. I have really missed them, but I worry I will miss my fertility clinic more. My nurse coordinator is so amazing. She has even said she wishes we lived closer so we could see them longer. (I think I love her!) My doctor is beyond amazing. He just KNOWS what to do, always. He’s soft spoken, gentle, encouraging, and responsive. He gives you his email and encourages you to use it, and if you do he responds. Not that my OB isn’t great. She’s amazing, but her staff kind of sucks, and she’s no doctor Ahlering!
I feel mostly confident that everything is going to be just fine. There is still that nagging fear in the back of my mind, but it’s mostly just a whisper. I’m a little worried about B. He might be struggling a little. They’re both still in the “danger zone” as long as they are still considered embryos instead of “fetuses”. (Just a few more weeks!) I guess there’s nothing to do but wait and see…