Archive for the 'Miscarriage' Category

Why I am not planning on trying for any more children

19 May 2012

—Want to pay very close attention to the children I already have.
—Really, really enjoy sleeping.
—Not all that sure I would do a decent job with more children.
—Don’t desire the all-consuming, maniacal worry of pregnancy.
—Husband doesn’t want any more.
—Enjoy occasional kid-free time, don’t want it to diminish further.
—Don’t want to go through any more miscarriages.
—Like not giving two shits about my fertility anymore.
—Feels risky, asking fate for another perfect and healthy child.
—Travel gets harder the more children involved.
—Not psyched about the idea of a third c-section.
—I only have two arms.
—Feel very fulfilled with my two special little people.

Reproduction from a four-year-old’s perspective

18 January 2011

Little Girl happened upon me when I was reading a pregnancy guidebook recently and subsequently has developed a full-on obsession with the subject. I let her look at all the graphic photographs in the book, and you know which one she kept going back to with questions? Not the head emerging from the vagina, not the breastfeeding, not the waterbirth (though she thought that was pretty wild), but the one of the pregnant lady heading to the car to go birth in the hospital. “Why is she making that face?”

Overall she has had a LOT of questions, but nothing about what starts off the whole show to begin with, so thank goodness for that. And not being a crazy person, I haven’t told her I myself am pregnant. I certainly wouldn’t want to have to discuss a miscarriage with her (especially since it would be ad nauseum, since she is four), and if I do continue to be pregnant, it would be quite a few long months of constant queries on the order of if the baby was coming NOW? What about NOW? How big is it NOW? What is it doing NOW? If I keep on being pregnant, there will be plenty of time for that when I’m showing. I don’t want it to begin quite yet.

But due to her curiosity, we are still talking all the time about how babies grow and how do they eat in there and how they are born and how they drink milk, some of it general and some about her own case, some of it starkly factual and some of it rather glossed over. Little Girl frequently acts various aspects out with her toys (yesterday her llama had eight babies on the landing of the stairs!). And today when I was dressing her, she tried to drink from her own nipples. I told her you have to be a mommy who had a baby come out of your tummy to have milk in your breasts, and then she wanted to know if I still had any milk, in that case. But I explained that when the baby is done needing milk, the milk goes away, so I didn’t have any anymore. Then Little Girl had an idea. What about if I married a new husband and had a new baby that could be her sister and then I would have some milk?

Never before had she entertained the notion of my having another child or her having any siblings (though she has had for a year now an imaginary brother named Key from China, but he has different parents). I did ask her once if she would like another kiddo to live in our house, but she said, “No, because then there would be too many.” (And honestly she doesn’t seem to like babies all that much when we have spent time with them. They try to pull her hair and touch her stuff and make weird noises.) Now I see she was under the impression there was a one-child-per-marriage policy. There are a lot of only children on my side of the family, but she certainly knows lots of people with siblings, so I’m not sure where she got that.

And she’s adamant you have to be married to have a baby, despite my examples to the contrary. We had lunch the other day with my Japanese friend from school, who’s in her late twenties and having trouble getting her Swedish boyfriend to marry her (Swedish people are typically much more comfortable with just living together indefinitely) because she wants to have a baby. Little Girl agreed. “You need to get married before you have a baby.” I had no idea I was raising such a conservative!

These days she’s more interested in my pregnancy books than I am. Pretty much everything about pregnancy stresses me out and/or worries me so I try not to dwell on it overmuch (ha, like I am successful there). I will never understand those people for whom pregnancy is an easy state of joy and hopefulness. But still it’s enjoyable to experience Little Girl’s inquisitiveness these days. She’s so clever and curious and verbal. Despite all the talking about babies, though, she says she doesn’t want one herself. Instead, she’s going to be an astronaut, then a teacher, and then come live again with mommy and daddy and tell us what she saw. I guess she doesn’t think motherhood and career can mix. (I need to get back to work so she can see that they can!)

Distractions

7 January 2011

I’m not really interested in keeping a mopey diary about my pregnancy worries so I’m not going to recount the good news and then the bad news and all my related obsessing. If there is something definitive to say, I’ll do that. Let me, instead, catch you up on some facts to oppose all my uncomfortable internal uncertainties. Internal in both senses.

+++

Remember my dog’s cancer scare? He seems to be fine! Some temporary meds and a change of diet and his symptoms are all gone. Something simple for once!

+++

Occasionally Little Girl can’t put her finger on the word she wants to use so she’ll make something else up. “Christmas” was “Santa Claus Day.” “Dinner” was “night lunch.”

+++

Mayonnaise totally icks me out, so it’s a wonderful feature of Sweden that they, instead, rely on butter in sandwiches. In fact, the literal definition of the Swedish word for “sandwich” is “smörgås”, is “butter goose.” yes, as in the “smörgåsbord.” Anyway, sandwiches are big here and seem to be normal for both breakfast and lunch. They are usually open-faced, with butter, cheese, maybe some sliced ham, cucumber, tomato, pepper. I prefer to order a “double” sandwich so that I get two pieces of bread in the American style, but at any rate I am eating more sandwiches than ever before. Hooray for butter.

+++

We have been planning for some time to renovate our kitchen, which was last overhauled in the 70s and is 100% decrepit pine paneling from ceiling to cabinetry. We’ve spent hours with the poor man at the Danish kitchen design place with me constantly asking about the availability of typical American features of which he has never heard and Husband and me making fun of each other for whatever dumb thing we have fixated on. (We’re not at IKEA since there’s not one close to us.)

But we just can’t settle on what to do. Move the wall? Roll-out pantry? We had finally hammered out two good possibilities, when we suddenly became caught up on the idea to put the kitchen in another room entirely! Let’s swap the kitchen with the formal dining room! Genius! Then we can do XYZ and avoid ABC! Oh, but what about LMNOP? I have no idea what we’ll eventually do, but it’s exciting anyway. My father-in-law is all, “Not have the kitchen in the northwest portion of the house? What insanity is this?” But we did some crazy shit (by Swedish standards) when we renovated the bathroom and it turned out great. I guess we are sort of assuming we’ll be in Sweden for a good long while to do such daring, complex house stuff.

+++

Is there no end to the reasons a four-year-old can imagine for avoiding bedtime? There are the dubiously needs to pee, eat a snack, drink some milk, drink some water, read another story, tell us a story, tell us a secret, tell us about a scary thought she is having, ask for suggestions for nice thoughts and/or dreams she could have instead, discuss monsters, tell us a joke, and ask us to tell her a joke. We can get her to quiet down eventually, but she’s both creative and persistent! I just don’t know what she has against going to sleep. I love bedtime!

Sigh

30 December 2010

I had been hoping to share some happy news with you all. Pregnancy! But I had a very Bad Ultrasound today. Not 100% definitely Bad, where the doctor tells you she’s sorry and outlines your options. Just one where she gets subdued and keeps saying “it’s very early” and “we’ll see what happens” and stops mentioning your next appointment. I’ve had enough Bad Ultrasounds to know what all that means, and I also know what an ultrasound at this stage is supposed to show, and what it showed even earlier with Little Girl, and that we didn’t see it.

My pregnancy-to-baby ratio is pretty bad, with two previous miscarriages and one kiddo, so there’s no surprise here. Just disappointment. And since I’ve had a missed miscarriage before, I can’t even be sure I’ll find out for sure before my next ultrasound appointment (four weeks). I guess things could turn out okay, but, well. Though I suppose I have a higher chance of having a baby than if I hadn’t gotten pregnant to begin with, so that’s something. (This is me attempting optimism.)

Swedish medicine takes pregnancy pretty seriously. Normal pregnancies are cared for by midwives and you just get (in my city) one ultrasound. But of course with my complicated history I’ve already had two doctors’ visits and I’m only six weeks. Consults with the midwife, dietitian, and another OB are already scheduled (every time they schedule something I make sure to get the phone number to cancel, should I cease to be pregnant by then. I should stop telling the scheduler why I am asking for these numbers because they seem to think I am rather morbid).

We have been discussing my continuing my metformin during pregnancy, which the maternal-fetal specialists I saw in the US with my second pregnancy wanted me to do (at a lower dose). Here they insist I stop it immediately, even during the first trimester, which I am absolutely not on board with. The US doctors said it would help prevent my borderline gestational diabetes and severe milk supply issues I had with Little Girl (I took metformin until 20 weeks pregnant with her). The doctors here and I have not come to an agreement. (Well, the current status is that they know I don’t want to stop it, they won’t write a prescription for it, and I won’t tell them I have an active prescription I can use back in the US.) It was a really stressful OB visit, partly because the doctor didn’t speak English and it’s really hard to argue in a language you’re new to, and then of course there was the Bad Ultrasound.

Of course, maybe what medicines I take during pregnancy don’t really matter if I’m not going to be pregnant all that long. I keep arguing with doctors in early pregnancy about things (like due dates and VBACs) and then those issues stop mattering. We’ll see, I guess. I wish I could know for sure if I could drink. Will have to settle for ice cream. Not that Sweden has my favorite flavor.

Dear 2009 and 2010,

4 October 2010

What is y’all’s deal? First a missed miscarriage, then a surgery to un-miss the miscarriage, which was not altogether successful, leading to labor and another hospitalization, all during a rather rushed move. Then we sold our house at a huge loss, Husband spent more than half of the time in other states and/or countries for work, our cats died, and we inexplicably moved away from a beautiful house by the sea and all our friends to the Land of Perpetual Rain. Next, my grandmother and shortly thereafter my grandfather died. And now you tell me my dog, Loki, might have cancer? Well, fuck you, too!

Age

13 August 2010

Last night Husband and I had a date in a nearby big European city: we went to a concert, to see Leonard Cohen. We’re in Europe all the time, of course, but still, something about crossing a cobblestone street, arm in arm, with the sound of European ambulances in the distance, in the evening, dressed up, with no small child, felt especially sophisticated and exotic.

And then we ate at McDonald’s, which kind of ruined the effect.

The concert was great. I believe I was the youngest person there, though, which surprised me; surely I am not the only non-retired person to like Leonard Cohen (by contrast, I was one of the oldest people to go see Lady Gaga). But I’m a big fan; I’ve even read a novel of his. But as good (and long!) as the concert was, the themes of the music–love, suffering, growing older–cut a bit close for me. And Cohen’s age; he kept reminding me of my grandfather. But he was so spry, hopping up from kneeling, dancing onto the stage. Such a contrast to the exhausted and broken man looking out at me from the mug shot in the papers with my grandfather’s name on it.

+++

I have a birthday coming up in November. I’ll be 30 and I’m not at all looking forward to it. No longer will I be able to say, pointedly, to Husband that I’m “in my twenties.” I’ll be a total grown-up. It’s funny; ever since I was a kid, I always tried to seem older than I was, and avoided telling people my age. Now I can’t seem to stop mentioning it–“I’m still in my twenties,” I assured the neighbor; what were we even talking about that I needed to bring it up? Will I never experience some sweet spot where my age and the age I want people to think I am coincide?

+++

Next week Little Girl will be four. Good for her! I think I am not that happy for me about it, though. How did she get so old? Where did that baby go? And so fast? And I remember once saying I wanted, insofar it was possible, to have my children four years apart. I guess that’s definitely not happening. We were going to start trying soon, but everything feels so uncertain now, my emotions so raw and variable, that I think it would be unduly stressful for anybody we might create. And with two miscarriages behind me, and such complex pregnancy issues, I’m just not sure I can rustle up too much enthusiasm. Why create more trouble for myself? But I’m only going to get older, which won’t make things easier. That’s just how time works.

Evil socialist medicine

22 June 2010

Remind me, what’s supposed to be so bad about socialist medicine? Something about long wait times and useless, uncaring doctors? Because so far I am completely pleased with the medical care I’ve gotten here in Sweden.

It all started with my never-ending yeast infection. I had needed some Diflucan, and I needed my metformin (insulin regulating med) refilled sometime, as well as my hormonal birth control. After calling the local doctor’s office (you are assigned a medical center, though you can change it if you want to) and leaving a message, a nurse called back and then we set an appointment for three business days later. Not amazing but not at all bad.

When the day came, I had to take a number to talk to the receptionist. Swedes love taking a number anytime you might need to wait in any kind of line. When it was my turn, I had to pay my copay of about 12 dollars. You have a max of 100 dollars out of pocket a year for medical care, and some other, similar amount for prescriptions. Then we were told to go to another waiting area (Husband was there for interpretation if needed, which he wasn’t really, and Little Girl came as well) and soon after the doctor herself came out and got me and took me to her office, which was a relaxed room with her desk and papers and an examining table off in the corner. Nobody ever checked my pee or my weight or anything. Nobody asked for my family’s medical history. I filled out no forms.

After talking to me a bit, she only then checked my blood pressure since I mentioned I’d had some high readings over the last few months. It was still high. She said after the nurse’s vacation, in August, I should wear a blood pressure monitor for 24 hours to see what is going on. We talked some more about my various health issues (I had brought all my records and lab results dating from the late nineties documenting my liver, endocrinologic, blood-clotting, obstetric, etc. anomalies), and she saw how complex it all was. She said she was see about getting that BP check done sooner and suggested, with my history of infertility and problematic pregnancies, in light of the fact that we are thinking about trying to conceive again soon, that I should contact the local hospital and let them know, basically, to expect trouble. I would either be infertile or I would have another high-risk pregnancy. (Typically pregnancies here are mostly hands-off and cared for by midwives, but that’s not likely for me.)

The next morning a nurse called and asked if I could come in that very day to get fitted with the BP monitor, and since nobody is employed or really all that busy, we could. I wore a cuff on my arm attached to a black, medical-device looking box that I wore on a type of belt. Peopled looked at my funny. It went off every 30 minutes for 24 hours, and then we dropped it off back at the medical center along with the log they’d asked me to keep of my activities. Pretty easy.

The next business day the doctor called Husband on his cell phone and told him the monitor said my blood pressure is actually totally fine. It only spikes when I am stressed: my high readings were when we were attending my first get-together with the club for American women in the nearby big city (more on that later) and at the doctor’s office. Apparently, interacting with other human beings really freaks me out. Or maybe just strangers? At any rate it’s such a relief to know I don’t have a new physical ailment, just the same old anxiety. What concerns me more is I felt like I was enjoying meeting those people. Am I so un-self-aware?

The doctor also said she was going to go ahead and write a letter to the women’s clinic asking them to see me for a consultation with the closest thing they’d have to a reproductive endocrinologist or a maternal-fetal specialist (these were my kinds of caregivers in the US, but the doctor seemed to think that a gynecologist interested in endocrinology was probably the most I could expect) in preparation for thinking about trying again for another baby. She also apologized for not having been more prepared for me when I came in–not having known I didn’t speak Swedish, or that there was quite so much to my medical story. But we assured her we were quite happy with her care.

So far the Swedish medical system has been quite satisfactory. Fast, easy, and kind. Sweden has the lowest infant mortality rate in the world so I am optimistic about the next set of doctors I will met.

Hooray! We can come back to America!

22 March 2010

Sweden has delightfully socialized medicine, of course. Which is nice when you are in Sweden. But if you are coming back to the US and will be a consultant buying your own health insurance plan for your family, like we would be, having been without US coverage while may make you seem like you had a gap in coverage, to insurance companies looking for such a gap. Not to mention the fact that some of us (ahem, me) have oh so many serious pre-existing conditions (my liver is crappy, I have something akin to diabetes, and way more) that insurance companies wouldn’t have to look for a dumb one (e.g. acne) to deny us.

This health care situation is one reason I was worried that a move to Sweden may necessarily be permanent. If we couldn’t have insurance in the US, I wouldn’t come back. But if this new health care bill works as it should (as I understand it, not that I fully do) these worries should not loom so large four years from now. Which is wonderful. I won’t be trapped in Europe by American insurance companies!

Now, I really like the idea that Sweden and some other countries have, that health care coverage is a human right they wish to provide for their citizens along with, for example, education. This seems eminently reasonable to me. Sweden is much smaller in population and somewhat less diverse than the US, so perhaps the same system wouldn’t quite work here, but I’d say their perspective on health care is something we should emulate. One role of government that we can hopefully all agree on is its responsibility to look out for the welfare of its citizenry, and health is the starting point for all well-being.

Our health insurance coverage in the US has just gotten worse and worse over the years. Example: In 2006 I had a high-risk complicated pregnancy ending in preeclampsia and a c-section; we paid about 2k for it, including several hospital stays. But with my next pregnancy in 2009, also high-risk and complicated, which lasted less than 12 weeks, we paid more than FIVE THOUSAND DOLLARS out of pocket. And we didn’t even get a baby out of it. Total rip-off, I have to say.

So while I find no fault with the health care I have received–I love the responsiveness of doctors here, how I can make an appointment for just when and where I want it and receive just the care I want and need–it’s pretty disgusting and nonsensical that our health care coverage now doesn’t actually provide us with any health care coverage. It’s still getting worse: Recently Husband’s workplace started on a new plan that is so horrible (10k deductible!) that I have not even bothered using it; instead I’ve been self-paying at doctors’ offices and it’s been quite a savings over what we’d pay if we went through insurance, since, with the upcoming move, we’ll never meet that deductible. And of course we’re still paying for coverage, as well. It’s just gross, really.

So I’m happy about the passage of the bill, both because I appreciate its ideals and because it looks like it’ll perhaps make our possible return to the US more practicable. I do hope it works out. Dubious, it must be said. But we need change, and this looks like the right direction to me.

Replay

2 February 2010

Well. It’s so disappointing to learn, after a stressful two-week-late-period-with-multiple-negative-pregnancy-tests-and-subsequent-OB/GYN-visit, that my ovaries are all fucked up again, despite years of behaving themselves on my insulin medication. My formerly very orderly cycles let me know I was healthy, hormonally, and suddenly, for no clear reason, I’m not. My last cycle was a very normal 30 days. But today on the ultrasound my ovaries looked just like they did when I first went to a reproductive endocrinologist for infertility, years ago–filled with useless cysts.

Polycystic ovary syndrome. So we meet again.

I feel like I’m back where I was five, six years ago. No, I’m not actually trying to conceive right now, but we were going to try this year, I think, and I thought I was, perhaps, no longer reproductively-challenged. After all, I got pregnant last January on my first try. I thought I could count on my ovaries. But now I guess I’m definitely infertile.

And if my medicine is no longer working–what then? It’s not exactly good for you to have too much insulin running around in your body. It freaks me out, too, the prospect of going through infertility and treatment in a brand-new country. It was hard enough the first time, when I spoke the language and knew the system. I don’t even have a clue what kind of services they provide in that arena in Sweden, though Husband’s theory is that, with one of the world’s lowest birth rates, they’re probably happy to help people reproduce. Even so, what I want is not to be infertile–and my particular kind of infertility has serious health implications which are also worrisome–in the first place.

The doctor wants me on hormonal contraception for a few months, at least, to calm my ovaries down. (I chose the NuvaRing as it has the lowest amount of hormones.) I’m going to have some blood tests. She doesn’t think it was weird that my ovaries all of a sudden freaked out, didn’t think it was related to the miscarriage, and told me that, coming off the hormones, conception should be easier.

In the past I would be scouring the internet, now, second-guessing the physician, but I’ve spent years really enjoying not reading PCOS and infertility sites. I don’t want to be here again. I’m so over it–but evidently I’m actually not.

Planning

5 January 2010

Good news! It’s been a year now since I last got pregnant, not that that worked out, and I think I may actually finally be mildly interested in getting pregnant again! After the miscarriage I was stunned, then overwhelmed with the move, then apathetic and frankly too busy at the beach to care, then in a bit of denial, and now a little ready.

Not that it matters, since I won’t. I mean, hello, we’re in the middle of an international move. Sweden’s national health plan also won’t cover your pregnancy if it starts before you get enrolled. And just a few months after getting there I’d like to start an intensive year-long course in Swedish, after which I’ll need to go through the teaching (re)certification process. And then there’s the renovations we want to do. And passing the Swedish driving exam. Plus learning how to drive manual. That last one’s like a full-time job. Not really a good time to see about creating new life to care for.

But Little Girl’s three-and-a-half already. And let’s see, we wait another year-and-a-half or so to try, I get pregnant in a reasonable time-frame, I actually stay pregnant and don’t have to start over, then the baby’s born…I don’t know, that’s a lot of math, but that’s a really long time from now! Little girl’s car seat will totally have expired by then. I don’t want to buy a new one! I don’t think you realize how expensive that thing was.

And I’m starting to like babies a little bit (blame our one friend here; she has a two-week-old that never cries! It just gurgles and grabs your finger! Aww!). I’ve looked at old videos of Little Girl, too. She was so cute! If you leave breastfeeding out of it, maybe babies aren’t so bad! They can’t run away when you want to cuddle them!

Even if I decided not to do such a hardcore Swedish language program, which is my main mental obstacle to getting pregnant in the next year-and-a-half, Husband isn’t anxious to have babies. He wasn’t with Little Girl, either–it wasn’t an unbearable need for him like it was for me–though of course she’s the absolute center of his life now. Her fleeting preschool whim is his command. I’m not worried about that. He’d get on board.

But there are a lot of potential pitfalls here. The isolation of a new baby (not that I had that with Little Girl, but I have no idea about Sweden) wouldn’t be a good combo with a new country with a foreign language. Hello, postpartum depression! And Husband is having a hard time finding a job there (he’s been looking) that doesn’t require a lot of travel. Can you imagine–winter dark and cold, preschooler with cabin fever, no friends, stupid incomprehensible language, can’t drive, half-finished kitchen, bathroom with no bathing apparatus, all alone in the countryside, fussy newborn who fears and loathes my breasts? Holy shit.

That’s the worst-cast scenario. Maybe things could go differently. It’ll be a while before it makes any sense to roll the dice on this one, anyway. But it feels a little healing to want to hold a baby, even if I still have to hand it back immediately if it starts to even look like it might want to fuss.

Year of Suck

31 December 2009

2009 has been rather dramatically unpleasant for us. I even kept a list of reasons why:

high-risk and expensive pregnancy
extended and expensive miscarriage
weird and expensive horseback-riding situation
moved
moved really quickly
got rid of most possessions
left friends
left good teaching job
Husband traveling all the damn time to Europe
Husband commuting five hours every week
Husband work stress
my work stress
realtor problems
lost lots of money selling house
cat Tang died
Husband car accident
moving to Sweden stress and worry
roofing scam
lemon dishwasher
driveway problems
lost my glasses
constant construction/yardwork etc. noise in neighborhood
beach house living weirdness with mom
chronic arthritis pain
grandmother’s Alzheimer’s decline
granddaddy’s strokes and decline
money continually going away
two speeding tickets
broken washing machine, useless dryer

Nothing on here about Little Girl, though. So that’s good. On to 2010! It has its own massive set of risk factors, but I guess it might be okay.

Oh right

10 October 2009

By the way, today was supposed to have been my due date. Though if past experience is anything to go by I’d have actually had a baby weeks ago. Anyway, feel okay about it–I’d had some heightened awareness of the date for the past little while, but when today came, it wasn’t until the afternoon that I realized. Did awesome things (besides clean) like body surf in a roiling ocean and drink a nice Riesling at a good restaurant that I would have been too, let’s see, altered to do otherwise. For that matter, we wouldn’t be having this totally awesome Year of the Perpetual Beach Vacation if I had continued being pregnant. I understand that sometimes the distress from a miscarriage comes up more strongly during a subsequent pregnancy, but for now, for the life we have currently, for the limbo we are in, the miscarriage feels less like a loss than fact about my life, like so many others.