DH and I were both clinging to some sense of normalcy, so instead of going through the emergency room, DH dropped me off at the regular hospital entrance while he parked the car in the garage across the street. I trudged inside by myself, gritting my teeth and stopping every few steps to catch my breath. Surrealy, people milling in the halls smiled, assuming I was in regular labor. DH caught up with me while I was getting set up in L&D triage. A few minutes into monitoring they decided we were in trouble, and what had been a very quiet room exploded with activity as half a dozen nurses and doctors descended on my curtain area. An IV was inserted, medical history taken, consent forms signed. They feared rupture or possibly placental abruption and wanted to do a stat c section. Amazingly, despite the grimness of what they suspected, they said DH could be present in the OR. He kissed me hastily as we separated so DH could get dressed in scrubs.
"What did you say your name was again?" I sputtered to the on-call OB as she steered the gurney around several tight corners into the OR. (I'll call her Delivery Doc here.) I at least wanted to know her name, considering what she was about to do.
Delivery Doc reintroduced herself and apologized for the rush while simultaneously continuing to move rapidly around the OR, moving trays and equipment into place. Several nurses were doing the same thing. One of them helped me crouch over my big belly and hold still while anesthesiologist administered the spinal block. Soon the warm, fuzzy numbness spread up and down from the needle in my back. It felt so good to not be in pain anymore!
The anesthesiologist complimented me on being so calm under the circumstances. But I wasn't calm. Everything was happening so quickly I felt stunned and several steps behind the action. They put up a sterile drape and judging by the tugging, I knew the surgery had already begun, and that they were not waiting for DH to arrive. Then I heard Delivery Doc say, "It's a rupture. The baby's feet extrude through the top of the uterus into the abdomen. Membranes are broken."
That's when I lost it. The room spun as I craned my neck in an effort to somehow see what was going on beyond the drape. "What? What is happening??"
The anesthesiologist tried to quiet me down. He stood up from his stool near my head and looked over the drape. "Yes, I can see the baby's feet sticking through the top of the uterus. I'll have to order some blood as a precaution in case you need a transfusion," he said. "But I'm hoping we won't need to use it. The bleeding doesn't look so heavy right now, which is a good sign."
I realized DH was now at my side. "They said my scar ruptured, " I blubbered. "Can you look and tell me what's happening?"
Ever the trooper, poor DH peeked over the drape as requested. But after a few moments he turned back to me. "I have no idea what I'm looking at," he confessed.
Then, voice thick with relief, Delivery Doc announced, "Wabi your baby is kicking and screaming at me as I'm taking her out!" Suddenly there was a thin, high-pitched mew, like the littlest kitten. And a nurse popped around the edge of the drape holding a baby -- my baby!
She was red-faced and crying in perturbed little bleats. She seemed so annoyed and bewildered at being wet and naked in that cold, bright room. I instantly felt she might be all right.
"Just look at her," said DH, astounded.
The nurse took the baby across the room for cleaning and observation. After a few minutes she was deemed healthy and stable enough to be handed off to DH. In her tightly wrapped blanket, she looked tiny to me -- several pounds lighter and almost five inches shorter than Big A was at birth. But then again, Big A came into the world ten days past her due date, not five weeks early. I reminded myself that for her age, she was actually pretty big.
Since I couldn't put my arms around the baby while lying on the table, DH held her cheek to cheek with me. Her eyes were shut and she kept pursing her sweet little lips like she was trying to figure out exactly what had just happened.
"Me too," I thought, "Me too."
Delivery Doc was still working hard on the other side of the drape, trying to stop the bleeding and repair my uterus. Occasionally I'd catch part of the discussion regarding suction, irrigation, or sutures. But in a room full of strangers where I was cut down the middle and naked everywhere else save for a few drapes, I now felt like it was just me, DH, and our baby in the world. I could feel DH's hands pressed up against my shoulder as he helped me cuddle up to our little girl. Our three faces formed an intimate circle. I knew that the hell that had just broken loose would have some long-term physical and emotional costs. But I would take the costs. At that moment all I felt was elation at seeing my little girl for the first time. It was awesome to be alive and amazing to see our baby. It was the world's best day ever, as far as I was concerned.
"Let's name her A____," I said. And DH agreed.
After awhile they took Little A to the nursery for a few more tests and DH tagged along, saying he'd see me later. Things were calmer in the OR now. People began to chat. I stared up into the blue void of the sterile drape and suddenly felt kind of bored. I wondered how long it would be until I could see Little A again. I tuned back into what the nurses and the doctors were saying.
"... walked herself into the hospital with a ruptured uterus," one of them said. Another responded, "Patient must have an extremely high pain tolerance." To which I piped up with, "Oh no, it really hurt a lot." And that made Delivery Doc laugh.
.........................................................................................................................................................................
After everything we'd gone through, DH and I both felt my postpartum stay in the hospital seemed like a vacation. Sure, we were getting up every two hours around the clock for pumping and finger feedings. But in between those feedings, we could really rest for the first time in eons. The worry that stalked us for so long was gone, and in its place was the cutest little baby we'd ever seen, plus chocolate treats and baby gifts from visitors. Really, it was better than a vacation in the sense that you usually don't get handfuls of percocet every six hours on the Love Boat. Little A did have trouble breast feeding and regulating her body temperature at first, as well as some jaundice. But these were completely surmountable problems. Also, it turned out that recuperating from the c section was a lot easier than the last month of the pregnancy had been. (Thanks again, percocet!)
Still, some comments we received in the hospital left DH and I rattled. Doctors and nurses involved in our c section would stop by my room and seem so happy to see how we were doing. "I'm so glad you came in when you did," everyone said. That was nice. But quite a few also added, "Not to freak you out, but people die from what you had." Which is something that can only going to freak you out quite a lot, especially when person after person keeps saying it.
I mentioned what was happening to our beloved family pediatrician when she stopped by to see the baby one day. "This is making me a little paranoid," I admitted.
My kids' pediatrician and I have a very informal report. (For example, her reaction when she found out about my uterine rupture was "Fucking SHIT, dude!") I count on her to give me the straight story. She rolled her eyes.
"What is wrong with people? Obviously you don't need to hear that over and over," She said. "But look, to be honest, what they are saying isn't an exaggeration. I was talking to my husband about your case the other day, too. He's also a pediatrician, and we both were saying that usually the outcome is not nearly so good." She smiled at Little A and me. "But I don't think anyone wants to freak you out. People are just marveling at how lucky you are."
Lucky. Ever since we suspected something was wrong with our Trisomy 18 pregnancy the year before, nothing made me feel remotely lucky. If anything, I felt like probability's bitch, so rare and strange were the problems that kept arising as we tried to have another baby. If someone would have told me that just one week shy of my D&E anniversary (51 weeks to the day) I would again come so close to losing what is surely my last baby, in addition to nearly dying myself ... Well, I might have believed them, such was the funk I was in. But I would not have believed that both the baby and I would end up ok despite all that. Never.
This is but one of the many gifts my little daughter came bearing. The gift of lightness, the gift of hope. The gift of being lucky once again. Because I truly do feel lucky and so incredibly grateful. I really needed some sweet to go with my bitter, and now I've got it.
Friday, August 31, 2007
Tuesday, August 28, 2007
Backstory 6: Scars, Denial, and Instinct
People are supposed to honor instinct, to listen to their little voices. But the problem with instinct is that in bad times it can come off as chicken little, wings flapping and eyes bulging as it shrieks again and again of danger. In contrast, denial can seem so polite, quiet and reasonable. During crazy times, it is easy to decide that denial is your very best friend, while instincts are just plain annoying. That's what I did in Little A's pregnancy. I mixed up which voice was the right one to listen to.
For several weeks, I lived with my scar hurting in secret and waited for it to go away. When it stubbornly stayed there, I eventually blurted out the news to my OB. My doctor felt the spot. Most likely nothing, she said. But she'd consult with the perinatologist and see what he thought. Maybe we ought to have me go in for a scan or something later in the week.
I left the office kicking myself and wondering why I had to be such a drama queen. Yet while I was thinking elaborate thoughts about how I'd just blown things out of proportion, I found myself driving straight from the doctor to a toy store rather than going directly to work. Big A's birthday was a week away and suddenly it felt urgently important to get her a present right then. The doctor called me on my cell phone as I left the store. The perinatologist she consulted with wanted me to go straight back to the hospital for monitoring.
So in week 29 of the pregnancy I entered the schizoid existence that many women who struggle with infertility know too well. It was the everything is wonderful right now (but could go to shit any second!) stage. The good news: ultrasound scans and biophysical profiles showed the baby was healthy. The bad news: nobody knew if things would stay fine. Ultrasound could show if my scar was still intact or had catastrophically failed. But ultrasound couldn't tell me if the currently intact scar was holding together well or about to shred. The thing that could do that was a CT scan. Except CT scans are many Xrays layered together. Since Xraying a gravid uterus was a no no, we were flying blind. Several perinatologists debated whether an MRI might be the best course, but eventually that idea was dropped. There were no studies to fall back on regarding treatment, so everyone was making it up as they went along.
We settled into watchful waiting, a weekly regimen of extra doctor appointments, nonstress tests, and scans. DH and I told our friends about our dilemma in a very "oh, this is one of those annoying worries that will turn out to be nothing" sort of way. At first I was very worried -- my gut told me this was serious. But after the first couple weeks of living with the pain and the uncertainty , I began to ignore my freaked out feelings. It's not as though I wanted to fret. I was so busy trying to cajole contractors into finishing a kitchen renovation that had dragged on for months. I needed to finish up piles of work before I went on maternity leave in January. And God, here was Christmas looming. By the time bouts of preterm labor started in November, the whole scar issue had slid onto the back burner.
From this point on, the pregnancy really went in the crapper. I had a few bouts of strong contractions that sent me into the hospital for medication and monitoring until they could be quieted down. I was diagnosed with a sudden onset of polyhydraminos, too. They thought that the extra amniotic fluid from that probably made my uterus irritable and kept triggering contractions. As for why I suddenly had so much fluid -- well, nobody was willing to guess about that. After each episode of strong contractions, I would spend the next day on the couch, so sore and worn out I could barely move.
If I were at 36 or 37 weeks, they would likely have done a c section to get the baby out and stop the downward spiral. But in weeks 32 and 33, the best course of action for the mother and baby is not so clear cut. The baby seemed altogether happy in there, and while I was supremely ill, it didn't seem to be life threatening -- no infections or blood loss as far as we could tell. So we opted to try to leave the baby in and avoid a NICU stay if we could. I started on anti-contraction medications at home, quit work, and tried to stay off my feet. I just wanted to get past week 34, at which point most babies have mature lungs.
In retrospect I can pick out the thread of what happened each step of the way when my uterus finally gave out. The sharp jolt that woke me up one morning in the 35th week was the baby kicking through the overstretched perforation scar. I know the contractions started up right after that because my uterus was rightfully miffed about Little A poking through alien style. And that stabbing pain I felt after the contractions? It was a symptom of internal bleeding, as fluids were pooling where they ought not be. It all makes sense. It seems ludicrous that I didn't immediately call 911 and go the the hospital in an ambulance.
But when I was living through it none of these issues clearly came together in my head as related. DH and I had been side tracked by the other contraction episodes, which no one thought were related to the scar issue. I thought this was more of the same thing. And although the contractions after the rupture were much, much worse than any others I'd felt -- even full-blown labor with Big A had not felt so bad -- the preterm labor episodes with Little A had been getting progressively more painful each time I had them, so it's not like what I felt that last time didn't fit the overall pattern. Also, I saw no blood or fluid to clue me in that there was a big problem. All of that was emptying into my belly rather than draining out my cervix.
All this is my way of explaining that rather than go straight to the hospital, I stuck around my house. I popped an anti contraction pill and tried to wait it out. For several hours, I sweated, winced and shook through the pain. DH kept asking if we should go to the hospital, but I was in the crazy zone. I didn't want to go through the trouble of getting to triage only to be sent home again like I had been the other times. I wanted to wait it out.
Eventually contractions started to come back despite the medication I took. It was only then I realized this wasn't the same as before. Plus, I couldn't tell what the baby was doing anymore. She might have stopped moving entirely, or could have been tap dancing, for all I knew. There was too much agony to comprehend what was happening anymore.
I finally said I thought I needed to go to the hospital. The first people we called to take care of Big A were out enjoying their Saturday. They asked if we could wait another hour before going into the hospital so they could return from their day trip and pick up Big A. DH asked me the question, and I stared at him, unable to think, unable to decide. "No," he finally said. "We need to go now." He dropped off Big A with our neighbors and within minutes we were speeding toward the hospital.
For several weeks, I lived with my scar hurting in secret and waited for it to go away. When it stubbornly stayed there, I eventually blurted out the news to my OB. My doctor felt the spot. Most likely nothing, she said. But she'd consult with the perinatologist and see what he thought. Maybe we ought to have me go in for a scan or something later in the week.
I left the office kicking myself and wondering why I had to be such a drama queen. Yet while I was thinking elaborate thoughts about how I'd just blown things out of proportion, I found myself driving straight from the doctor to a toy store rather than going directly to work. Big A's birthday was a week away and suddenly it felt urgently important to get her a present right then. The doctor called me on my cell phone as I left the store. The perinatologist she consulted with wanted me to go straight back to the hospital for monitoring.
So in week 29 of the pregnancy I entered the schizoid existence that many women who struggle with infertility know too well. It was the everything is wonderful right now (but could go to shit any second!) stage. The good news: ultrasound scans and biophysical profiles showed the baby was healthy. The bad news: nobody knew if things would stay fine. Ultrasound could show if my scar was still intact or had catastrophically failed. But ultrasound couldn't tell me if the currently intact scar was holding together well or about to shred. The thing that could do that was a CT scan. Except CT scans are many Xrays layered together. Since Xraying a gravid uterus was a no no, we were flying blind. Several perinatologists debated whether an MRI might be the best course, but eventually that idea was dropped. There were no studies to fall back on regarding treatment, so everyone was making it up as they went along.
We settled into watchful waiting, a weekly regimen of extra doctor appointments, nonstress tests, and scans. DH and I told our friends about our dilemma in a very "oh, this is one of those annoying worries that will turn out to be nothing" sort of way. At first I was very worried -- my gut told me this was serious. But after the first couple weeks of living with the pain and the uncertainty , I began to ignore my freaked out feelings. It's not as though I wanted to fret. I was so busy trying to cajole contractors into finishing a kitchen renovation that had dragged on for months. I needed to finish up piles of work before I went on maternity leave in January. And God, here was Christmas looming. By the time bouts of preterm labor started in November, the whole scar issue had slid onto the back burner.
From this point on, the pregnancy really went in the crapper. I had a few bouts of strong contractions that sent me into the hospital for medication and monitoring until they could be quieted down. I was diagnosed with a sudden onset of polyhydraminos, too. They thought that the extra amniotic fluid from that probably made my uterus irritable and kept triggering contractions. As for why I suddenly had so much fluid -- well, nobody was willing to guess about that. After each episode of strong contractions, I would spend the next day on the couch, so sore and worn out I could barely move.
If I were at 36 or 37 weeks, they would likely have done a c section to get the baby out and stop the downward spiral. But in weeks 32 and 33, the best course of action for the mother and baby is not so clear cut. The baby seemed altogether happy in there, and while I was supremely ill, it didn't seem to be life threatening -- no infections or blood loss as far as we could tell. So we opted to try to leave the baby in and avoid a NICU stay if we could. I started on anti-contraction medications at home, quit work, and tried to stay off my feet. I just wanted to get past week 34, at which point most babies have mature lungs.
In retrospect I can pick out the thread of what happened each step of the way when my uterus finally gave out. The sharp jolt that woke me up one morning in the 35th week was the baby kicking through the overstretched perforation scar. I know the contractions started up right after that because my uterus was rightfully miffed about Little A poking through alien style. And that stabbing pain I felt after the contractions? It was a symptom of internal bleeding, as fluids were pooling where they ought not be. It all makes sense. It seems ludicrous that I didn't immediately call 911 and go the the hospital in an ambulance.
But when I was living through it none of these issues clearly came together in my head as related. DH and I had been side tracked by the other contraction episodes, which no one thought were related to the scar issue. I thought this was more of the same thing. And although the contractions after the rupture were much, much worse than any others I'd felt -- even full-blown labor with Big A had not felt so bad -- the preterm labor episodes with Little A had been getting progressively more painful each time I had them, so it's not like what I felt that last time didn't fit the overall pattern. Also, I saw no blood or fluid to clue me in that there was a big problem. All of that was emptying into my belly rather than draining out my cervix.
All this is my way of explaining that rather than go straight to the hospital, I stuck around my house. I popped an anti contraction pill and tried to wait it out. For several hours, I sweated, winced and shook through the pain. DH kept asking if we should go to the hospital, but I was in the crazy zone. I didn't want to go through the trouble of getting to triage only to be sent home again like I had been the other times. I wanted to wait it out.
Eventually contractions started to come back despite the medication I took. It was only then I realized this wasn't the same as before. Plus, I couldn't tell what the baby was doing anymore. She might have stopped moving entirely, or could have been tap dancing, for all I knew. There was too much agony to comprehend what was happening anymore.
I finally said I thought I needed to go to the hospital. The first people we called to take care of Big A were out enjoying their Saturday. They asked if we could wait another hour before going into the hospital so they could return from their day trip and pick up Big A. DH asked me the question, and I stared at him, unable to think, unable to decide. "No," he finally said. "We need to go now." He dropped off Big A with our neighbors and within minutes we were speeding toward the hospital.
Backstory 5: Tunnel of Pregnancy
I snapped this photo of Big A not long ago. She's running through a pedestrian tunnel at a bike path entrance screaming, "ECHO ... ECHO ... ECHO ... NO MORE PICTURES, MOMMY!" I was laughing when I took it. But later when it downloaded to the computer and I saw it on a bigger screen, I felt uneasy. The photo reminded me of ... something. Some other time. It was later on that I realized it brought me back to being pregnant with Little A last year.
Lots of people feel poorly in routine pregnancies. Hell, I felt shitty during Big A's ever-so-normal gestation due to nausea in the first 20 weeks and killer heartburn and leg swelling in the second 21. While not pleasant, it paled in comparison to what I experienced while carrying Little A. With her there was bronchitis that hung on for several months in the first and second trimesters. I would hack, hack, hack, and that would trigger my gag reflux so I would puke, puke, puke. And I discovered that even if you kegel like nobody's business, once you push a baby out then your pelvic floor, she ain't what she used to be. Subsequent pregnancy + violent coughing - virginal nether regions = pee on the floor (and serious mortification).
But, it was more than just a bad cough and peeing accidents. I felt so incredibly exhausted and ill even after the bronchitis finally cleared and everything was supposedly going well in the second trimester. I could hardly get dressed and take Big A to the babysitter most mornings without feeling like I needed a 48-hour nap by the time I got to work. Nights were even worse -- wrestling Big A into the car seat would expend the remainder of my daily energy reserves. I couldn't carry her upstairs from the garage when we got home, which upset Big A's toddler sensibilities greatly. She'd scream and fuss while I fought the urge to pass out as I nuked her something prepackaged for dinner. And then I would have to lie down. No choice about it, just had to. I would turn on the TV to occupy my little girl and pray for DH to come home as soon as possible. I knew I was being a terrible parent. Like in the picture, Big A was a blur of energy, of wants and needs, and she was pulling away from me so fast. I could not catch up.
I was failing her, and it pained me to see the failure so clearly yet not be able to change it.
Plus, there was another pain. It began near the end of the second trimester without any particular event having caused it. Once it began, it never went away. Still, it was not a terrible sensation. Just an ache. If there had been round ligaments or ribs near the location to blame for it, it wouldn't have even rated a blip on my pregnancy crap-o-meter. But there was only one thing the site of the pain corresponded to, and the hair stood up on the back of my neck whenever I thought about it.
It was my scar. The place where the surgeon had accidentally punctured my uterus during my botched termination surgery. Something was happening to my scar.
(Continued soon ....)
Monday, August 27, 2007
Marriage Pictures
So the shoes I wrote about falling in love with awhile back arrived in the mail, and they were as pretty and twinkly as I remembered from the actual store. Wheeee! The first time I took them out of the box Big A's eyes widened and she sighed like she was inhaling jasmine. "Oh. Marriage shoes! Are you getting married, Mommy?"
I explained to Big A that her father and I were already married for quite a long time now. Her little forehead knotted up as she tried to recall the wedding, and got even more creased when I said it happened years before she existed. Before Big A? Incomprehensible! She wanted to see pictures as proof, so I dragged the album out.
"This is mommy," I said, pointing at a shot of me in my wedding dress.
"You are NOT supposed to wear that on your head," she admonished as she pointed to my cloche. "No hats! You are supposed to wear ... " She struggled to come up with the word. "Like THAT," she said, pointing toward the sheer curtains.
"Well, I didn't want to wear a veil because it was a pretty casual wedding. See, my wedding dress isn't really a gown, so a hat was ok to wear with it. Plus, at the time my hair was only a half inch long all over, so the only way a veil would have stayed on was with staples or a headband. And I was very anti-headband when I got married."
Big A stared like I was a lunatic. She glanced at the next photo and shook her head again.
"No! That lady is NOT supposed to be with daddy here!"
"Oh, that's just daddy with his arm around his sister, baby. It's Aunt SIL. Don't you recognize her?"
"No! Only you and daddy are supposed to be together in the marriage pictures."
"Well, here I am without Daddy but with my brothers. See? At weddings, everyone takes pictures together." I turned the page and tried to change the subject. "Oh look, here's one of Daddy and Mommy kissing during the ceremony."
"No, no kissing!" She looked horrified. "Mommy, you are doing it ALL WRONG!"
I explained to Big A that her father and I were already married for quite a long time now. Her little forehead knotted up as she tried to recall the wedding, and got even more creased when I said it happened years before she existed. Before Big A? Incomprehensible! She wanted to see pictures as proof, so I dragged the album out.
"This is mommy," I said, pointing at a shot of me in my wedding dress.
"You are NOT supposed to wear that on your head," she admonished as she pointed to my cloche. "No hats! You are supposed to wear ... " She struggled to come up with the word. "Like THAT," she said, pointing toward the sheer curtains.
"Well, I didn't want to wear a veil because it was a pretty casual wedding. See, my wedding dress isn't really a gown, so a hat was ok to wear with it. Plus, at the time my hair was only a half inch long all over, so the only way a veil would have stayed on was with staples or a headband. And I was very anti-headband when I got married."
Big A stared like I was a lunatic. She glanced at the next photo and shook her head again.
"No! That lady is NOT supposed to be with daddy here!"
"Oh, that's just daddy with his arm around his sister, baby. It's Aunt SIL. Don't you recognize her?"
"No! Only you and daddy are supposed to be together in the marriage pictures."
"Well, here I am without Daddy but with my brothers. See? At weddings, everyone takes pictures together." I turned the page and tried to change the subject. "Oh look, here's one of Daddy and Mommy kissing during the ceremony."
"No, no kissing!" She looked horrified. "Mommy, you are doing it ALL WRONG!"
Wednesday, August 22, 2007
How Many? Update
DH saw my "How Many?" entry on the blog and decided to cross post it as a Daily Kos diary. He thought someone over there might have more information on how many women end pregnancies for medical reasons per year. (Thanks, DH!)
So far, there have been a couple comments worth passing on:
And also:
How big is 78,000? Well, I looked up the latest government data tracking death estimates for cancer. In 2007, breast cancer is expected to take the lives of 40,000 women. Leukemia will likely kill 22,000, while 12,000 will succumb to brain cancer. All those cancer deaths combined are still less than my estimate of the number of pregnancy terminations for medical reasons.
Once again, WHY is nobody talking about this?
So far, there have been a couple comments worth passing on:
First, my condolences for your loss. I know it is a deep grief and I'm glad to know that there is a support group for people who have made this difficult decision. My stats are completely anecdotal as a person working in an OBGYN department at an academic hospital. I ran a quick report on the CPT codes our residents use when indicating that they have performed an induced abortion for medical reasons and came up with 66 for the past year. Our hospital has about 2300 deliveries per year, so that's about 3%. Keeping in mind that we are a smaller, rural area, I don't think the 6% figure you used would be far off the mark. I know that we have a full time genetics counselor who meets with families to discuss their options and that she sees about 20 patients per week.
And also:
A 2004 study by the Guttmacher Institute shows that 12% of women report terminating because of maternal health problems and 14% report terminating because of potential problems with the health of the fetus:So, the 78,000 terminations for medical reasons estimate I came up with doesn't seem incredibly outlandish. Depending on what gets counted, it might even be on the low side.
These findings are based on self-report and include a wider array of fetal and maternal "indications" than most health restriction laws (proposed and actual) would allow: debilitating morning sickness, preclampsia, use of illicit drugs during early pregnancy (which leads to concern that fetal health has been compromised). But, unfortunately, there aren't many good stats out there about the % of abortions that started as planned or wanted pregnancies ....
How big is 78,000? Well, I looked up the latest government data tracking death estimates for cancer. In 2007, breast cancer is expected to take the lives of 40,000 women. Leukemia will likely kill 22,000, while 12,000 will succumb to brain cancer. All those cancer deaths combined are still less than my estimate of the number of pregnancy terminations for medical reasons.
Once again, WHY is nobody talking about this?
Monday, August 20, 2007
How Many?
In the early days after my loss, I joined an online support group for women who have ended a pregnancy for medical reasons. When I joined it the site was a little over a year old, and had perhaps a couple hundred members. Recently there was a sad milestone there when the 600th member joined.
The fact the site counts its members got me thinking about abortion statistics for people like me. It has always bothered me that nobody seems interested in quantifying how many people are making devastating choices regarding wanted pregnancies. If people generally don't want to talk about infertility and pregnancy loss, then the thing they most don't want to talk about within that arena of topics is termination for medical reasons. People get so, so judgy and uncomfortable about everything to do with this subject.
Yet even without any official stats, my experience online has shown me that what I initially thought was a heartbreaking fluke of an experience must not be nearly as uncommon as I thought. The stories I've heard are all different, yet eerily the same. We were overjoyed at the pregnancy, but then a grave problem was discovered. And we all did what we thought was best to deal with that unfixable tragedy after that. Second trimester procedures are unfairly represented as the last refuge of disorganized floozies who get their pregnancy dates mixed up. ("Whoops! It's December and I forgot to get that abortion two months ago!") This characterization is a huge injustice to the women caught in the crisis of trying to decide what to do when severe health issues come to light in the second trimester.
I for one would like the choice I made to be counted for what it is. And I would like to know how many other people went through that same choice. I think that number would be a very powerful picture of the true state of pregnancy in the US today. Because if six hundred people have found their way to a support website via word of mouth in the past couple years, I have to guess that this is just the tip of the iceberg, in terms of what is happening in both the US and world at large. If abortion numbers for poor prenatal diagnoses and maternal health problems were available, then people might begin to apply the risk of this to themselves. They might start talking about it in real terms, rather than cartoonish black and white scenarios.
So, back to the original question: How many of us are there who have done this? Today all I can do is make a really rough guess. The most commonly cited stat for all types of abortions occurring in the US is 1.3 million per year. Of those, I have seen statistics that report around six percent of abortions are due to a medical factor either in the mother or baby.
Six percent of 1.3 million is 78,000. Seventy-eight thousand times a year a woman opts to end a pregnancy due to some sort of medical reason. Holy crap, that's a ton of women! Why are people not talking about this more?
Has anyone else seem stats on anything related to this? If so, I'd love to see them ...
The fact the site counts its members got me thinking about abortion statistics for people like me. It has always bothered me that nobody seems interested in quantifying how many people are making devastating choices regarding wanted pregnancies. If people generally don't want to talk about infertility and pregnancy loss, then the thing they most don't want to talk about within that arena of topics is termination for medical reasons. People get so, so judgy and uncomfortable about everything to do with this subject.
Yet even without any official stats, my experience online has shown me that what I initially thought was a heartbreaking fluke of an experience must not be nearly as uncommon as I thought. The stories I've heard are all different, yet eerily the same. We were overjoyed at the pregnancy, but then a grave problem was discovered. And we all did what we thought was best to deal with that unfixable tragedy after that. Second trimester procedures are unfairly represented as the last refuge of disorganized floozies who get their pregnancy dates mixed up. ("Whoops! It's December and I forgot to get that abortion two months ago!") This characterization is a huge injustice to the women caught in the crisis of trying to decide what to do when severe health issues come to light in the second trimester.
I for one would like the choice I made to be counted for what it is. And I would like to know how many other people went through that same choice. I think that number would be a very powerful picture of the true state of pregnancy in the US today. Because if six hundred people have found their way to a support website via word of mouth in the past couple years, I have to guess that this is just the tip of the iceberg, in terms of what is happening in both the US and world at large. If abortion numbers for poor prenatal diagnoses and maternal health problems were available, then people might begin to apply the risk of this to themselves. They might start talking about it in real terms, rather than cartoonish black and white scenarios.
So, back to the original question: How many of us are there who have done this? Today all I can do is make a really rough guess. The most commonly cited stat for all types of abortions occurring in the US is 1.3 million per year. Of those, I have seen statistics that report around six percent of abortions are due to a medical factor either in the mother or baby.
Six percent of 1.3 million is 78,000. Seventy-eight thousand times a year a woman opts to end a pregnancy due to some sort of medical reason. Holy crap, that's a ton of women! Why are people not talking about this more?
Has anyone else seem stats on anything related to this? If so, I'd love to see them ...
Friday, August 17, 2007
Preschool!
Big Changes! This week Big A made the switch from in-home daycare to preschool three days a week. Some related observations:
1) Peer pressure is good. Big A has always equated pig tails with a heinous method of torture, so her hair is almost never done up. But once she saw the other girls wearing their hair pulled back, suddenly she was willing to sit still while I combed, braided, and barretted to my heart's content. Is there anything cuter than a 3 year old in pigtails? I'm in mommy heaven.
2) Peer pressure is bad. Every day as we leave school, Big A tries to slide down the banister (of DOOM!) on the long outdoor staircase that leads to the parking area. When I tell her no, she whines "But other kids are doing it!" It is the first time ever she's used that argument with me to get what she wants. Unfortunately, I suspect it won't be the last ...
3) When I asked her teacher if Big A was shy on her first day, the woman snorted and said "God, no!" So, I guess BA hasn't morphed into a wallflower, despite the newness of everything.
4) H&M rocks. Seriously, Target-esque prices but their children's clothing is just so much cuter than bargain basement.
I just wish I could pull off the adult H&M clothes. I saw a coat that seemed tasteful and not too Forever 21 on the rack, and so I tried it on during Big A's shopping spree. Imagine my surprise when I found Jerri Blank reflected in the mirror:
Yikes!
1) Peer pressure is good. Big A has always equated pig tails with a heinous method of torture, so her hair is almost never done up. But once she saw the other girls wearing their hair pulled back, suddenly she was willing to sit still while I combed, braided, and barretted to my heart's content. Is there anything cuter than a 3 year old in pigtails? I'm in mommy heaven.
2) Peer pressure is bad. Every day as we leave school, Big A tries to slide down the banister (of DOOM!) on the long outdoor staircase that leads to the parking area. When I tell her no, she whines "But other kids are doing it!" It is the first time ever she's used that argument with me to get what she wants. Unfortunately, I suspect it won't be the last ...
3) When I asked her teacher if Big A was shy on her first day, the woman snorted and said "God, no!" So, I guess BA hasn't morphed into a wallflower, despite the newness of everything.
4) H&M rocks. Seriously, Target-esque prices but their children's clothing is just so much cuter than bargain basement.
I just wish I could pull off the adult H&M clothes. I saw a coat that seemed tasteful and not too Forever 21 on the rack, and so I tried it on during Big A's shopping spree. Imagine my surprise when I found Jerri Blank reflected in the mirror:
Yikes!
Sunday, August 12, 2007
Awkward in the Neighborhood
I was volunteering recently in the local park, pulling ivy from long-neglected paths, when I ran into a woman from one street down. My neighbor gazed at Little A, who was waving her arms and bah-bah-bah-ing in the stroller while Big A spun circles around us.
"She's almost eight months old," I said, even though the woman had not asked the question I was answering. I tried to look her in the eye, but she stared at her feet and then left a few minutes later.
I don't need to be told how old her children are. Her daughter is just a few months older than Big A. Her son is just a few months older than my baby with trisomy 18 would have been, if the baby had been born on time. This neighbor and I were pregnant at the same time in 2005. We'd casually exchanged pregnancy info that fall at a block party, both of us innocent and hopeful about what lay in store for us at that moment in time.
The next time I met her was Halloween, 2006. She stood at my door, costumed baby and older daughter happily clamoring for candy. I was home alone, too ill to go out trick or treating with DH and Big A. Little A's pregnancy was kicking my ass. It was the beginning of the third trimester and I was round as a pumpkin -- exhausted, haggard, obviously pregnant.
I had not seen this neighbor in awhile. Yet I assumed she'd heard about my dead baby. It was ten months since the loss and I was no longer guarded when I ran into people on the street. Nobody offered condolences or stared at me anymore.
"Where is your little one?" The neighbor asked lightly.
I froze. God, she didn't know about the dead baby. The only words that sprang to mind were completely inappropriate to say in front of her kids. Like, can't you COUNT? If I'm very pregnant this Oct. AND was pregnant last Oct., how could that be, unless I'd lost the first baby? Are you an IDIOT?
"Oh ... Big A is out with her father trick or treating," I finally stammered.
"Yes, we just saw them. But where is the BABY?" she asked again, clearly not catching my drift.
What the fuck? Do I just look fat? Or does she think this is some kind of a costume -- tired suburban pregnant lady is now a character you dress up as?! Exasperated, I pointed at my belly. "I'm not due until January," I said firmly.
It was too dark to see if she blushed, but she finally got it. She thanked me quickly for the candy and hurried away. I leaned against the door, bowl of M&Ms propped up on my belly, feeling a whole new level of bad that night. In fact, I think that I switched off the porch light and stopped giving out candy after that.
I wonder if she'll ever actually be able to look me in the eye again?
"She's almost eight months old," I said, even though the woman had not asked the question I was answering. I tried to look her in the eye, but she stared at her feet and then left a few minutes later.
I don't need to be told how old her children are. Her daughter is just a few months older than Big A. Her son is just a few months older than my baby with trisomy 18 would have been, if the baby had been born on time. This neighbor and I were pregnant at the same time in 2005. We'd casually exchanged pregnancy info that fall at a block party, both of us innocent and hopeful about what lay in store for us at that moment in time.
The next time I met her was Halloween, 2006. She stood at my door, costumed baby and older daughter happily clamoring for candy. I was home alone, too ill to go out trick or treating with DH and Big A. Little A's pregnancy was kicking my ass. It was the beginning of the third trimester and I was round as a pumpkin -- exhausted, haggard, obviously pregnant.
I had not seen this neighbor in awhile. Yet I assumed she'd heard about my dead baby. It was ten months since the loss and I was no longer guarded when I ran into people on the street. Nobody offered condolences or stared at me anymore.
"Where is your little one?" The neighbor asked lightly.
I froze. God, she didn't know about the dead baby. The only words that sprang to mind were completely inappropriate to say in front of her kids. Like, can't you COUNT? If I'm very pregnant this Oct. AND was pregnant last Oct., how could that be, unless I'd lost the first baby? Are you an IDIOT?
"Oh ... Big A is out with her father trick or treating," I finally stammered.
"Yes, we just saw them. But where is the BABY?" she asked again, clearly not catching my drift.
What the fuck? Do I just look fat? Or does she think this is some kind of a costume -- tired suburban pregnant lady is now a character you dress up as?! Exasperated, I pointed at my belly. "I'm not due until January," I said firmly.
It was too dark to see if she blushed, but she finally got it. She thanked me quickly for the candy and hurried away. I leaned against the door, bowl of M&Ms propped up on my belly, feeling a whole new level of bad that night. In fact, I think that I switched off the porch light and stopped giving out candy after that.
I wonder if she'll ever actually be able to look me in the eye again?
Done, Part 2
This weekend SIL brought the nieces down to our house for a sleepover. Despite the fact everyone is mega tired today, it's always fun to gather the girls together. Between the two of us, SIL and I birthed four kids in three years. And that is just the successful pregnancies, as SIL miscarried once and I ended one pregnancy for medical reasons in those same years. Needless to say, SIL and I have been in the same phase of life: gestating, lactating, and trying to juggle a little bit of work with a whole lot of nose and butt wiping for the under-three set. So we usually can understand what the other one is feeling.
I told SIL how strange and sad it is for me to be done with having children. She sympathized, but when I asked her if she thought she would like another baby too, she looked horrified. Adding a second kid had really kicked her ass, she said. She hadn't expected how difficult the juggling would be, and since her first kid was easy going, she'd been shocked to learn how different the baby stage can be when you have a more demanding baby. All in all, it was a bumpy family adjustment after the second birth.
The good news is that now that niece #2 is 18 months old, life is much better for SIL. She likes that the girls are older and a smidge less dependent on a moment-to-moment basis. And she loves that she is now back to work three full days a week, in a job she enjoys, with the kids in preschool/daycare part time.
"If I had another I think I would lose myself," she said. "So I'm definitely done."
All of this made a lot of sense to me, and also jolted me out of my "no more babies" funk a little bit. It is good to be reminded of the positive things that come with being done. It's good to see SIL clearing out her old spit-up-upon clothes and trading up for modern styles that -- GASP -- sometimes might actually not be wash and wear!
Of course, I'm a long way off from being able to wear nonsensible clothing. Little A spits up if she's even in the same room as a dry-clean-only tag. But, someday I'll get there. And it'll be nice.
I told SIL how strange and sad it is for me to be done with having children. She sympathized, but when I asked her if she thought she would like another baby too, she looked horrified. Adding a second kid had really kicked her ass, she said. She hadn't expected how difficult the juggling would be, and since her first kid was easy going, she'd been shocked to learn how different the baby stage can be when you have a more demanding baby. All in all, it was a bumpy family adjustment after the second birth.
The good news is that now that niece #2 is 18 months old, life is much better for SIL. She likes that the girls are older and a smidge less dependent on a moment-to-moment basis. And she loves that she is now back to work three full days a week, in a job she enjoys, with the kids in preschool/daycare part time.
"If I had another I think I would lose myself," she said. "So I'm definitely done."
All of this made a lot of sense to me, and also jolted me out of my "no more babies" funk a little bit. It is good to be reminded of the positive things that come with being done. It's good to see SIL clearing out her old spit-up-upon clothes and trading up for modern styles that -- GASP -- sometimes might actually not be wash and wear!
Of course, I'm a long way off from being able to wear nonsensible clothing. Little A spits up if she's even in the same room as a dry-clean-only tag. But, someday I'll get there. And it'll be nice.
Thursday, August 9, 2007
Done
While I harbor definite neatnik tendencies, having two children requires a laser-focused diligence to keep the clothing, toys, and paraphernalia down to manageable levels. The baby stage is especially difficult to remain uncluttered in, because the little buggers outgrow things so rapidly that every corner of the house tends to store something recently indispensable but now obsolete. This wouldn't be a big deal if baby items were small and cute, or if I lived in a mcmansion the size of Walmart. But the gear tends to be over sized and designed by the same people responsible for casino carpets. And we are keeping it real here in Oakland, living in a tiny two-bedroom 1950s-era house that doesn't have space for extra crap.
In the past few months I have been reasonably good about dragging unused items down to the basement and garage, but quite bad about getting them completely out of the house. At first I chalked it up to lack of time -- going to Goodwill with a carload of boxes is a pain when you've got two kids to cart along. But the other day a friend said she was trying to conceive again, and I know that in her first pregnancy most of her maternity clothes were borrowed from a sister who took back her things when she recently got pregnant again herself. So here is an obvious situation where my friend could use some free maternity clothes, and hey, I've got boxes of them in the basement. While I'm at it, I should also give her the infant stuff Little A has outgrown so far. Yet in the basement everything remains. I just haven't been able to utter the words, "come pick them up" yet.
So, I guess the clutter in the basement is about lack of time, but not in the way I originally thought. I'm just not ready to let go of pregnancy and babydom. Not yet. I only just started down this path in life three and a half years ago, and now I'm done. How did that happen?
With Big A, when I finished a big stage all the related physical items that went with the era got carefully packed away. Sure, I might have felt a little misty at how fast she grew while I did it, but there wasn't anything truly sad about putting stuff away. I knew pregnancy and infant care were cycles I'd loop through again in the future. That bouncy seat was still needed someday. So were those stretchy pants. Saving everything was an affirmation of the dream of a bigger family. Saving things was fun.
But now every time a onesie is outgrown or the baby loses interest in a toy, it just reminds me that there is absolutely no need to keep those things. There will be no more babies for us, ever. Saving things under these circumstances is stupid, and yet that's what I've been doing.
Probably we would have stopped at two kids even if pursuing the second one hadn't turned into such hell. We are out of bedrooms in the house and out of money for raising more. But the fact that my uterus ruptured in Little A's pregnancy just makes accepting this more difficult. Because there isn't a choice anymore. We were told by several doctors and too many nurses to count that my rupturing at home was an amazing case of bad luck/good luck: Terrible for it to actually occur, but freakishly fortunate that Little A wasn't brain damaged from lack of oxygen, and that I didn't bleed to death. In light of that, it's just too dangerous to ever try again. In fact, DH got a vasectomy recently. Because we knew that if we accidentally got pregnant, we would want to try to keep the baby. All rational reasons regarding safety and fairness to "The As" (who deserve to keep a mom) would go out the window in a real pregnancy situation. So best to avoid all chance of it ever happening, we decided.
Oh, the heart is a greedy, irrational thing. It always wants more.
In the past few months I have been reasonably good about dragging unused items down to the basement and garage, but quite bad about getting them completely out of the house. At first I chalked it up to lack of time -- going to Goodwill with a carload of boxes is a pain when you've got two kids to cart along. But the other day a friend said she was trying to conceive again, and I know that in her first pregnancy most of her maternity clothes were borrowed from a sister who took back her things when she recently got pregnant again herself. So here is an obvious situation where my friend could use some free maternity clothes, and hey, I've got boxes of them in the basement. While I'm at it, I should also give her the infant stuff Little A has outgrown so far. Yet in the basement everything remains. I just haven't been able to utter the words, "come pick them up" yet.
So, I guess the clutter in the basement is about lack of time, but not in the way I originally thought. I'm just not ready to let go of pregnancy and babydom. Not yet. I only just started down this path in life three and a half years ago, and now I'm done. How did that happen?
With Big A, when I finished a big stage all the related physical items that went with the era got carefully packed away. Sure, I might have felt a little misty at how fast she grew while I did it, but there wasn't anything truly sad about putting stuff away. I knew pregnancy and infant care were cycles I'd loop through again in the future. That bouncy seat was still needed someday. So were those stretchy pants. Saving everything was an affirmation of the dream of a bigger family. Saving things was fun.
But now every time a onesie is outgrown or the baby loses interest in a toy, it just reminds me that there is absolutely no need to keep those things. There will be no more babies for us, ever. Saving things under these circumstances is stupid, and yet that's what I've been doing.
Probably we would have stopped at two kids even if pursuing the second one hadn't turned into such hell. We are out of bedrooms in the house and out of money for raising more. But the fact that my uterus ruptured in Little A's pregnancy just makes accepting this more difficult. Because there isn't a choice anymore. We were told by several doctors and too many nurses to count that my rupturing at home was an amazing case of bad luck/good luck: Terrible for it to actually occur, but freakishly fortunate that Little A wasn't brain damaged from lack of oxygen, and that I didn't bleed to death. In light of that, it's just too dangerous to ever try again. In fact, DH got a vasectomy recently. Because we knew that if we accidentally got pregnant, we would want to try to keep the baby. All rational reasons regarding safety and fairness to "The As" (who deserve to keep a mom) would go out the window in a real pregnancy situation. So best to avoid all chance of it ever happening, we decided.
Oh, the heart is a greedy, irrational thing. It always wants more.
Tuesday, August 7, 2007
Twinkle twinkle, little shoes
I have always been a sensible shoes kind of lady. Not only because I lived halfway up one of the innumerable hills of San Francisco for nearly nine years and wearing dainty spike heals there could send you sliding off a curb to your death (though that certainly bolstered my tastes). It's just that I've always had a finicky arch on my left foot, and wearing any sort of fancy shoe tends to give me chronic foot cramps. So I ended up with a closet full of trail sandals, hiking boots, and walking shoes. The few dress shoes I own are decidedly boring.
Which is why I can't believe that I just bought a pair of fancy shoes that I am excited about. It all started when I went to Nordstrom Rack to hunt kid clothes. These Via Spiga shoes called to me from the shelf across from the children's section. They are flats, but not dowdy. They make my ankles look skinny, and are so, so pretty. I was uncharacteristically smitten. And when I tried them on they actually felt comfy!
The only problem was that Nordstrom Rack only had one pair, and while they were my size, one of the rhinestones was missing from one shoe. But I couldn't stop thinking about those stupid shoes. They were twinkly toe stars. I am still in a state of post-baby body pudge, and so clothing doesn't do much for me these days, in terms of making me feel happy to get dressed. These shoes did, though. So last night I broke down and looked them up online. They are quite possibly the most money I have ever spent on a pair of shoes, and given that I now work part time out of the house AND hardly ever have the cash or a babysitter for a night out, it seems absolutely ridiculous to have them. But I just couldn't resist.
Ahhh, retail therapy. And I guess I can always wear them to the supermarket.
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