Quality over Quantity

"First comes love, then comes marriage, then comes the baby in the baby carriage..."

Remember that song from elementary school? You got married and then you had kids! That's what we expect out of life. That's what I expected anyway, and I always figured making a baby was easy. A guy and a girl get together, the egg comes out of the ovary, hooks up with sperm, and viola! You've made a person!

I grew up thinking things were that simple, and I'm guessing a lot of people think that too. I have plenty of friends who have gotten pregnant while trying NOT to get pregnant! When it's so natural and commonplace like that, I doubt many people stop and wonder about all the different processes that have to happen in order to make a baby. Well, not much beyond egg meets sperm anyway.

I wanted to bring you along on my infertility journey and part of that is understanding the miraculous things that have to happen in order to make a baby. When you learn about this stuff, you start looking at everyone as their own miracle. We are the ones that made it! We are literally one in a million!

That's because a woman starts out with one to two million eggs at birth and she will never make more than that. She will eventually run out. Supply is limited, especially when there are thousands of eggs that are growing and maturing and trying to become a viable egg on a daily basis! Yes, every day you have so many eggs at one stage or another. But they will all fall by the wayside. All but one! One lucky egg each month out of thousands that tried! And YOU are the one that made it. You, me, and everyone else on this planet. We are all miracles.

We could dig deep into just how miraculous all of this is. We could talk about DNA and cellular changes and get down into the nitty gritty of all the hormones involved. Yes, I would love to do that and open your world to just how fascinating and complex and miraculous all of this is. You could learn something new and probably come to appreciate just how amazing you are.

But I really don't want you to feel like you're reading a biology textbook.

So, I'm going to pare everything way down for your sake. But I do need to share a few important points so that you can get excited about the process and understand the terms I'll be using in future posts. Trust me, I'll be trying to make this as interesting as I can!

Follicle is a really important word. Eggs are not just floating around independently, but are actually encased in what's called a follicle. The follicle is like a housing unit for the egg, like an incubator, and it helps the egg to grow and mature. In the picture below, you can see the dark spot as the egg, and the yellow part as the follicle surrounding it.

The egg and its follicle will need to grow much larger and more complex before the egg is ready to be released and that whole process of maturation takes about three to five months. So they start out simple and small, as primordial follicles, and then become bigger and more complex, becoming primary and secondary follicles, and then eventually they become antral follicles, which are big enough to see on an ultrasound!

An antral follicle is different from younger follicles because it now has a fluid filled sac inside of it, next to the egg, and that sac will grow and grow until the egg is released. You can actually measure it on an ultrasound and when it gets to a certain size, you know it's about ready to release its egg!

If you're like me, maybe you thought there was just one egg growing and developing each month, the egg that eventually ovulates. But the ovaries are a very busy place, with thousands of eggs at all stages of this process at any given time, some growing, some dying, and only one winner in the end.

Here's a more involved diagram that you really don't need to study unless you want to. You can follow the follicle all through its growth process, a process called folliculogenesis, which is a really cool word to say. It is pretty amazing to see how big that fluid filled sac gets! By the time it releases an egg, it's about the size of a penny.

This process doesn't happen all on its own, by the way. The follicles do seem to wake up and start growing all on their own, which is pretty amazing. Somehow they just know that it's time to come out of their deep sleep, and no one knows how or why. So they start growing without any outside help. But once they become antral follicles then they are finally responsive to hormones in the body. And they need those hormones to keep going!

On the antral follicles, there are these little receptors reaching out for motivation. They need some encouragement to keep growing and get that egg ready for its big debut. What they need is called follicle-stimulating hormone, what we call FSH.

Every month, your average woman will have about 15 antral follicles that are competing for that FSH. They grab hold of it and start growing. You can actually watch this process happen on an ultrasound. The follicles appear as black dots in the ovaries. They will all be about the same size at the beginning of a menstrual cycle. But as the body releases more FSH, you will see those follicles grow over the next few weeks, sucking up that hormone. Eventually, one follicle will take the lead and become the dominant follicle. This is the one that will release its egg, that special one that made it all the way to the end.

Here's a picture of my ovary and a dominant follicle from a few years back. You can see a few other follicles there as well, the smaller black dots that got left behind. Can you see the sad face next to the dominant follicle? My poor dying follicles made a sad face! They didn't make it and got left behind. :(

This is what in vitro fertilization is all about. Instead of looking for a dominant follicle, we are going to clap like crazy for all of the follicles that are in there. We don't want one egg to win the race. We want as many of them as we can snatch! Everyone's a winner!

So we give extra amounts of that FSH, doing injections every day for about 10 days, and we keep a close eye on the progress, watching everything on ultrasound every two or three days. You can see a video here of the latter stages of that process, where my ovaries had grown lots and lots of follicles! See how big they are, and there are so many! Gavin is in one of those follicles!!

In vitro fertilization has always felt a lot like gambling to me. We drop a whole lot of money and hope we get lucky, hope that all the money and doctor visits and drugs and procedures give us a baby in the end. Every penny spent is well worth it when you get a baby, but it sure cuts deep when you spent that money on failure and heartache.

When you're gambling with that kind of money, you try to evaluate your chances of winning and decide whether the risk is worth it. Unfortunately, it's impossible to put an actual figure on your chances of success, especially since there's still so much we don't know about the reproductive process, why some things work and some things don't.

But there are a few things we can do to help us guess at our chances and that's how this whole in vitro process starts. We are trying to get an idea of how successful I will be and also trying to do whatever we can to increase those chances!

That's where those follicles and FSH and other hormones come into play!

What we're going to do is measure my hormones and take a look at my ovaries and see where we're at. What do we have to work with? Here's a little video of me heading to my first appointment, ready to get my blood work done.

I used to be pretty terrified of blood work and shots and all that. But when you do what I do, it becomes routine. I still don't look when they are doing the needle stuff. Yuck. But I don't dread it anymore.

So what are they looking for in my blood? It's pretty neat, actually. In their earlier stages of development, follicles actually have a detectable little substance they give off, called anti-mullerian hormone (AMH). Depending on that number, we can get a good idea of my egg supply. Remember that a woman has a limited egg supply and that supply starts to deplete more rapidly once you reach your mid-30s. I'm not there yet but it's coming up quick! My biological clock is ticking very loudly!

We want a good egg supply. The better the egg supply, the more likely we are to have success with in vitro fertilization. It gets much harder as you get older and you're literally running low on eggs.

Well, I got my results back and my AMH levels (my egg supply) is in the 34th percentile for women my age. That's still in the average range but it's slightly lower than I was hoping. I'm a little disappointed by that but it certainly could be worse!

But we have another way of detecting egg supply too, one that is a little more obvious. Remember those antral follicles we can see on an ultrasound? If we look at how many we have at the start, then we should have a good idea of how many we will end up with after doing the FSH injections. With those injections, we know we can stimulate those follicles, cheer them on and get them all to grow. So we can usually assume we will get about as many eggs as we have follicles.

As I mentioned, an average woman my age may have about 15 antral follicles altogether at the start of each cycle. When I went in for an ultrasound on day one, we found 33 follicles! Here is a video of my ultrasound, taken June 15th.

33 sounds like a fantastic number, right? Especially after my slightly low AMH levels, now I have a great follicle count to balance that out. This is very normal for PCOS women. They tend to have great egg quantity, with lots of eggs to choose from.

But we also tend to have poor egg quality, and quality matters a lot! In fact, even though the sperm contributes half the equation, they've found that the egg quality is a much bigger deal than the sperm quality. The eggs are the superstars of the show!

I am proof of poor egg quality. I got 27 eggs out and only ended up with one baby. That means only five percent of my eggs were really any good and that kind of stinks. Of course, Gavin ended up being such an awesome kid, we are thinking he must have hogged all that awesomeness for himself and left none for the others!

Egg and embryo quality can be broken down into three categories:

(1) Physical structure - How does the embryo look in comparison to the norm? Is it breaking apart and fragmented or is it well put together? They actually grade embryos by looking at their physical structure but that isn't always dependable. I talked to an embryologist once who told me that the perfect looking embryos - the perfect looking A+ embryos - never seem to make a baby. And guess what? Gavin was a "fair grade" embryo, the least attractive of the bunch. And look at him now! Still, we do know that physical structure can give some idea of quality.

(2) Energy - Eggs come out of the ovary with their own energy supply. Think of it like a tank full of gas. They need that fuel to keep them alive and functioning until they can embed into the uterus and start getting energy from the mom instead. But until that time, they're on their own and some eggs just don't have enough energy to get them from point A to point B. They may fertilize, but then they tucker out before they can implant. They've found this to be more of an issue in older women, who's eggs tend to have a little less fuel than younger women. Unfortunately, there's isn't a way to detect energy reserves in an embryo, as far as I know anyway.

(3) DNA - Really, this is the most important part of the whole equation. If there is an issue with the DNA, then we have an embryo that will not develop or it will likely abort at some point during the pregnancy. There is a test they can do where they take one cell from the developing embryo, very early on in its development, and look at the DNA to see whether everything is in order. That really is the best way to determine egg quality and your likelihood of success, but it is very expensive to do and can be harmful to the embryo.

Really, there isn't anything we can do right now to find out if any of my antral follicles are holding good quality eggs. When they are fertilized, we can watch them and try to make a guess at the quality based on their development, but it's still a lot of guesswork, and I'm not too inclined to do pre-genetic testing at this point since I really cannot afford the extra few thousand dollars.

All we do know is that my track record suggests poor egg quality. It is common for women with PCOS to have poor quality eggs and since only five percent of my eggs turned into a baby last time, we can expect a similar result this time around too. Also, since I miscarried three times but we found no evidence of any issue with my body or my uterus in aborting the pregnancies, then we assume the DNA was no good and the pregnancy aborted.

Thing is, I know a lot more about egg quality than I did before and I have it on my mind this time. So does my doctor. We are both hoping for quality over quantity this time. There's still a lot we don't know about egg quality and what we can do to improve it, but we do have some ideas and we are implementing those ideas now. Will it make any difference? Who knows! But we're going to do whatever we can to give me a better chance of success.

So here are the things we are trying, some of which I've already been doing!

(1) Increase circulation - Egg quality can improve when there is good blood flow into the ovaries. The best way to improve blood flow is to exercise and to drink lots of water. Luckily, I've been exercising a lot this year already, so that should help. But I do need to do better about drinking water! Massage is also supposed to help so I guess I need to recruit my husband for a few sessions a week. Hey, sacrifices need to be made!

(2) Diet - It's been difficult to identify exactly which foods are helpful and which are detrimental but we do know that increased insulin seems to decrease egg quality. That means sugar should be avoided in order to keep insulin down. In general, I've been eating better this year already but the goodies are still an issue and I need to change that. I'm also taking metformin, which helps regulate insulin levels and has been shown to improve egg quality.

(3) Hormones and supplements - Prenatal viatmins are a given and I've been taking those for months and months. Antioxidants seem to help improve egg qualityas well so I'm currently taking CoQ10 to help with that. I am also taking DHEA which can help regulate metabolism and other hormones in the body.

They've also found that stress hormones can decrease quality so I need to help regulate those on my own. One way is for me to go to bed earlier, which is hard for me to do! I love my nighttime! But it may help, not only to decrease stress hormones but to increase melatonin, which has been shown to increase success rates. At least I feel my life is generally much less stressful than it was before!

I'm also taking an amino acid that helps to increase my levels of human growth hormone. The jury is still out but they are finding it helps increase success rates. They know that there are receptors for human growth hormone on the eggs, they just don't really know what they do and how they interact! It's nothing concrete, but we figure it's worth trying. If it doesn't hurt, then let's try it!

(4) Different regimen - With my last in vitro cycle, we blasted those eggs with a lot of FSH. We went hard and fast! This time, the doctor wants to try going slow and steady. I will be taking a little bit lower of a dose of the hormone and may be on it for a little longer than last time. But they've found that slow and steady can be better at increasing quality.

This is where we stand now. We know that my quantity is pretty good. We also know there's a good chance that my egg quality is not so great. There isn't much we can do about quantity but we are doing everything we can to improve quality.

What are my chances? I'm still not sure. It's still a gamble. But I do have some hope that our efforts to improve quality will help my outcome be a little better this time around. Frankly, I'm happy to even have the same outcome. My expectations are more realistic now and I know that one baby out of four tries is not too unreasonable.

So let's keep our fingers crossed!

I hope you learned something and I hope you appreciate a little bit more how much of a miracle you are! Especially if all of this happens so perfectly inside of you, if you are able to conceive easily on your own. And remember, we just scratched the surface here! There's so much more to know!

Maybe I'll do a whole other post about hormones. Maybe.

The Journey Begins Anew

We're starting down a road. A road we've been down before. But this time is different. A lot different.

Eight years ago, I found out I had fertility issues. We'd been trying to conceive for about a year. There were a few moments where we thought things were working out and that I was pregnant. I wish I could remember how that feels - to be excited and hopeful without any of the other crap. I remember being at a baby shower and someone saying to me, "You're next!" and really believing that might be true. But I don't remember how that feels, hope without doubt, faith without cynicism.

Turns out I have polycystic ovarian syndrome (PCOS), which is really kind of a bizarre thing because it's not at all the same for every woman who has it. There are a few symptoms that put you into that category but you don't have to have them all to be labeled a PCOS patient. I barely make the cut, really. One is acne, which I definitely have! And another is insulin resistance, diabetes, and extra weight, which I do not have. Hooray!

There are some other minor symptoms but the most obvious sign of PCOS is polycystic ovaries! If you look at an ovary on an ultrasound, you will see a bunch of black spots. Some of those black spots can be cysts and some can be follicles, which I will explain in another post. They call those cysts a "string of pearls," which makes it sound like a desirable thing to have! Not the case!



Those cysts can mess you up in a number of ways. They can really mess up your hormones, and there are just SO many hormones involved in preparing and releasing an egg! Most notably, they can actually stop you from releasing an egg at all! Some women with PCOS never ovulate on their own without the help of drugs. There are women who go months and months with no period. Not only that, but women with PCOS tend to have poor egg quality. You may get an egg to release, but it's just no good.

Really, though, this isn't too terrible of a diagnosis. In fact, this is the most common form of infertility in women but most are able to go on and have a baby. My fertility doctor told me that 50% of PCOS women who just diet and exercise are able to conceive on their own. And a lot of women are able to conceive just by being on "the pill." When you are in the land of infertility, "the pill" actually means Clomid, a pill that helps you to ovulate, something that is cheap and easy to do.

Really, I was pretty lucky with my cycles considering my diagnosis. I actually ovulate on my own, even without the pill! So I am at a healthy weight, do not have diabetes or insulin issues, I ovulate on my own, and I have somewhat regular cycles!

Doesn't sound too bad, right?

But we were so very wrong.

We tried the pill but nothing happened. I was scared to be more aggressive with it, but I was getting anxious. I went on to the next step - intrauterine insemination. That's a mouthful so we call it IUI. It's all about monitoring everything and getting the timing right.  Instead of using a pill to ovulate, I gave myself shots and did a bunch of ultrasounds and watched the egg get closer and closer to being ready. Then I got a different shot - a trigger shot - at just the right time, when the egg was mature and ready to go, and that shot released the egg from my ovary. Then, using a catheter, I get the sperm deposited into my uterus about 24 hours later. The egg is there, the sperm are there. They just need to reach out and shake hands!!

But it didn't work. Again and again, it didn't work.
Why is this so hard!? It's not supposed to be this hard!

What else is there to do but in vitro fertilization (IVF)?

Never did I think I would have to go that far. I remember my first doctor visit, finding out I had PCOS, and my doctor talking to me about the IUI process. Yikes! Catheters!? Self-administered shots!?! No, thanks! Pretty sure I can work this out without getting to that point.

Oh, poor Andrea. Not a clue what's in store. Not one stinkin' clue.

Just look at her. She's so happy. She's thinking she's gonna be having kids in a few years, buying a home. Ya know, living the dream, that ideal we all set ourselves up for. Poor girl. She has absolutely no idea.

I was pretty scared of the IVF process. So many drugs and shots and doctor visits. At the same time, it felt good to be giving it everything I had. With the pill and with the IUIs, I had about a 10-20% chance of success each time. With IVF, my chances shot up to about 50%, which was very exciting.

I was totally acing the IVF experience too. They got 27 eggs out of me, which is downright epic, and I had eight go on to be viable embryos. I was on cloud nine. I figured that even if only half of those embryos turned into babies, I would get my whole family out of this one attempt!

Even better, I got pregnant on my first try! Wow, things were finally working out! After all the doubt and depression and anxiety and struggle, I completely abandoned all that and let myself rejoice - yes, that is the right word, REJOICE - in this long-awaited triumph.

But that was snuffed out and stomped on and shattered and buried deep, so very deep into the ground, in a very short amount of time.

Let me tell you, dealing with infertility is not easy. The complexity of emotions is difficult to bear. You feel helpless that you can't be in control of the process and just make it work, make it happen like everyone else does. You feel frustrated to be in a body that doesn't function the way it should, to be denied this privilege, this beautiful gift and blessing of womanhood in bearing children. Always you are asking why and trying to find some sort of silver lining where there is none. You have to be constantly reminded of how easy this is for everyone else, and how much joy everyone is experiencing in raising their adorable babies. There really is no escaping that unless you completely cut yourself off from the world, and yes, I've done that before to save myself from heartache.

For me, the loneliness was the most difficult. There are a lot of trials that you have to go through yourself in order to fully understand and empathize with them. I believe infertility is one of them. Most people can relate to financial troubles, or being disliked, or hating their job, or having family troubles, or trying to raise a difficult child. But I don't think it's so easy for people to wrap their minds and their hearts around infertility, of all that's involved in that struggle, because it is really such a huge struggle that can swallow up your whole life in anxiety, frustration, anger, bitterness, jealousy, heartache, and helplessness, not to mention the enormous financial burden that goes along with it.

So, as if all that wasn't enough of a burden to bear...

Now I had to add miscarriage on top of it!

There are many women who can relate to pregnancy loss. At least in that, I am not alone. But when you're giving everything you have - EVERYTHING - to make this baby, when you know your chances to conceive are limited and incredibly expensive, when you're praying and hoping and wondering whether you will ever be successful, whether any of this will ever amount to a baby... it makes the loss of a pregnancy so very very devastating.

And I had to go through it three times.

Blackness. That's really the best way to describe me at that time. It's almost an out of body experience. There's the normal you that's kind of on the outside, observing and analyzing the whole experience, and then there's this shell of a person lying on the ground sobbing. Part of me was feeling my heart shatter into a million pieces while another part of me was intrigued, wondering how it was possible for a heart to hurt so badly and still be beating, still be alive. I didn't know such heartache was possible, to feel like your heart is quite literally being torn apart. It really is a wonder it keeps beating, though I admit I sometimes wished it would stop if only to escape the horrible pain.

I never learned why I'd had all the failures, though I did all I could to find answers on my own. To make matters worse, I hated my doctor as he was completely unhelpful. He was very clinical, devoid of compassion, and seemed to have no interest at all in trying to find answers. If I had questions, he made me feel stupid for asking them. Not only that, but we were living in Hawaii and had no family around to help shoulder our sorrows. I was public about our struggles and we had many friends who expressed their condolences but ... well, as I said, this is a trial few really understand. I was alone. In every way, I was so very alone.

Things are so much different now.

I had two embryos left, having lost six of eight. We were moving to Utah - hooray for family nearby - and I stayed behind in Hawaii to put in those last two embryos. At that point, my hope was pretty much non-existent. Hope had become a risk, a liability. The more you hoped, the more it hurt when it all fell apart, the harder the slap in the face. My heart just couldn't handle any more yearning or expectations. My heart was not even really functioning anymore. Not only was it in pieces, but those pieces were like petrified wood, hardened, immobilized, and numb, no longer able to feel because feeling was just bad.

I didn't ask God for anything anymore. I'd asked for bread and He'd given me a stone again and again and again (Matthew 7). All I could muster was, "Thy will be done."

I was pregnant again, which surprised me since I figured getting pregnant four out of four tries seemed pretty lucky. But then all I had was anxiety. All I could do was try my best not to think about it, what could or couldn't happen. Sad, really. Most women are just thrilled when they find out they're pregnant. Me, I had to try to put it out of my mind because I didn't want to worry and I didn't want to hope either. I just wanted to stay in the safety of the void.

One ultrasound led to another. I would look for that heartbeat and breath a huge sigh of relief. Each day brought a little bit more hope and a little bit more anxiety too. What if I lost it now? Oh, my heart! How could I live through it? It's like walking along the edge of a cliff, wondering how badly your body will be maimed if you fall. But you're not worrying about your body. You're scared to death of the damage to your heart. Very real long-term damage.

Then there was this point where I knew it was all going to work out. I think it's when I found out we were having a boy. He was so active and strong and it became so much more real to me that there was a living being inside of me. A LIVING BEING! That was the first time, at about 18 weeks, that I finally let go of all the anxiety and fear and let myself be happy and hopeful. I finally let myself cry for joy. I asked my husband if he thought there was a spirit in that little body. He said yes and I felt the same. God had given me a very special spirit and he was here to stay.

I can't tell you what an unreal experience it was to have an adorable baby boy. As soon as I delivered him and saw him and held him for the first time, I wanted to do it all over again, right then and there! There is nothing in this world more magical, more close to heaven, than a brand new baby.

You can read my previous blog post all about the delivery of our baby boy, Gavin, or you can watch my youtube video about it here. https://www.youtube.com/watch?v=I_yI2k6ggjM

Or you can just look at this ridiculous picture of our long-awaited miracle baby who turned out to be much more adorable and enjoyable than I ever even imagined:

Two years ago, I found out I was pregnant with Gavin and started down a new path. Instead of heartache and disappointment, we had joy and success.

Now we're starting all over again and are scheduled to do IVF this July.

A lot of people ask me if things will be easier this time, if we'll be able to have success without so much heartache and loss. I wish I knew. One thing I've learned is that your past experience has very little bearing on what will happen next, at least if you're thinking in terms of what's fair. After my second miscarriage, I thought it'd be fair for me to finally have a baby on my third try. But that's not what happened. Instead, I miscarried a third time. But I was thinking in terms of "paying my dues" and in my mind, my dues had been paid. I'd gone through the heartache, now I deserved to be healed. But that didn't matter. Just because you flip a coin and get heads twice, that doesn't mean it's any less likely for you to get heads on that third flip. It's still a 50/50 chance and I figure my chances should still be about the same, no matter my past experience.

Of course, it's not that simple. The reproductive process is so complex and there's really so very little we understand about it because it's just so darn difficult to study. There are so many factors, known and unknown, and it's not an exact science because women's bodies are not all the same! For all I know, I could be infertile because I just stay up too late all the time! Maybe something I eat just messes up my eggs and we have no clue what it is or what it's doing! We just really don't know and unfortunately there's not much we CAN know. As I said, you just flip that coin and bite your nails waiting to see what you get.

So that's how I look at it. We're flipping coins again. It may be easier. It may be harder. We won't know until it happens.

But things are definitely different this time.

First, we have Gavin. No longer do I have to worry and wonder and cry about whether it will ever happen for me. It may never be easy, it may require a whole lot of patience and money and perseverance, but I know that I can conceive and carry a baby.

Not only that, but Gavin is there to fill the deafening silence of an empty family. It was so difficult to come home and feel the emptiness where you know your children should be. To go to social gatherings where everyone has their little ones and it's just you and your husband, year after year. To sit in church and see moms and dads struggle with their wiggling children while you weep silently in your pew, year after year after year. Now we have our own monkey in church, our own babbling baby in the home. If we fail again, it won't hurt so deeply because our lives are not empty anymore. In fact, our lives are very full. :)

Second, I have a new doctor at a new facility and he is so much more trustworthy and supportive and attentive and compassionate than Dr. Loser in Hawaii. Finally I feel like I have someone who is really hoping and fighting for my success. I brought him a huge stack of my medical records and he was thrilled to have it, and told me he had homework to do to look over my history and see how best to help me. And I have full confidence that he did just that! When I brought my medical records to my doctor in Hawaii, he didn't even want them!

It is a whole new experience to be in the care of someone CARING and it gives me a little bit more hope that things will be successful knowing I have someone so attentive on my side. Unlike my previous doctor, he enjoys my questions - he even told me that I ask very good questions and that I know a lot about the subject, which is what happens when you have to do all your own research because your doctor tells you nothing - and he answers my questions thoroughly. I'm so much more comfortable and confident and excited to work with this new doctor and have a positive experience with him instead of all the stress and frustration I had before. Even if things don't work out, it's such a comfort to know you're in good hands.

Lastly, we have family here and a much bigger support system now. It's a lot less stressful to start down this road and know that you're not alone anymore. There's never much anyone can do in hard times. But family does help.

As I said, this is a difficult journey full of so many emotions and I think many people are not able to grasp that experience. I first became public with my infertility journey because I wanted the support of others and for them to rejoice with me when I would have my success. But my journey turned out to be so much more difficult than I ever anticipated and as I struggled through so many terrible emotions, my focus shifted. I still welcome the support of friends and family and hope to share my joys and successes with others. But my primary focus is to give a little more depth of understanding on the journey of infertility and all it entails. It's not necessarily that I believe infertility to be a more important trial than others, if you can really place varying levels of importance on trials anyway. I just believe there are few things that bring people closer together than compassion and understanding and the best way to get to that place is to walk a mile in someone else's shoes, to see and feel things from their perspective.

And so we start on this journey again and I've decided to document the process and keep this blog updated. I've put out my shoes and it's up to you if you want to walk in them. But I can't make you any promises on what kind of a journey it will be. I'm hoping for a leisurely stroll, of course. A walk through the neighborhood park would be nice, or an easy trail through the forest. Something calm, enjoyable, peaceful. Hmmm, yes, that sounds absolutely lovely.

But if there ends up being a snake on the trail, or a wall of brambles, or few steep sections, or a whole bunch of mud, or a dangerous cliff ... well, don't say I didn't warn you!

If you choose to join me, thank you. It's a lot to ask of others, to take on your burdens and your sorrows along with the joys. I've found that most people aren't keen to do it. But it's what draws us closer together, what separates the acquaintance from the friend.

I can't make any promises about the trail, but I can promise you one thing about the shoes. They are well-worn and broken in! Good luck to us both! :)

The Story of Baby Gavin

Diagnosis of Pre-Eclampsia

Our fourth IVF attempt was a surprising success, and we were expecting our son on February 20^th, 2014.  After living with my brother for a while, we moved into an apartment in Murray and got to work getting everything settled for our new arrival.  We found a new obstetrician and hospital nearby and I had my first appointment with Dr. Gravelle in mid-December when I was 30 weeks along.  She asked me how I was feeling and I said, “I feel awesome.  I don’t feel pregnant at all!”  It was true.  I was having a pretty easy pregnancy.  I felt like my normal self and thought it was great.

Boy did I ever pay for that comment.

Soon after that appointment, I had a few issues pop up.  I started seeing stars, the kind you see when you get up too fast and are about to pass out.  This would happen from time to time for no apparent reason.  I also started to feel a bit larger than before.  Well, duh, I’m pregnant.  But it wasn’t all baby and it wasn’t all fat either, though all the holiday treats weren’t helping.  Some of it was swelling too.

On Christmas Eve, my mom noticed my swollen ankles and feet.  Oh no!  She and my sister-in-law, Amber, talked about how swelling can be normal in pregnancy but it can also get pretty bad and be an indicator for other issues.  Amber specifically mentioned pre-eclampsia but I didn’t really worry about it.  This was probably nothing more than your normal pregnancy symptoms.

My swelling did get worse that day, to the point where I was aching.  That’s what I get for being on my feet all afternoon cooking our special Christmas Eve meal.  We cancelled our outing to Temple Square that night and instead spent the evening rubbing my feet, which did help.  My swelling continued to go up and down over the next few days.  I was hardly worried but figured I would bring it up at my next appointment.

On Friday, December 27^th, I went in for a gestational diabetes test and a regular checkup with Dr. Gravelle.  After drinking the lovely glucose juice, I had my appointment with the doctor.  They told me I had high blood pressure and protein in my urine too (not to mention a lot of weight gain)!  High blood pressure was definitely a new one for me!  I told the doctor about the stars and the swelling too.  She said I was retaining a lot of water.  She wanted to do more testing to make sure, but it was all sounding a lot like pre-eclampsia.

Pre-eclampsia is a strange condition.  No one really knows why women get it but we know the only cure is the delivery of the placenta.  For whatever reason, the placenta begins to have a negative impact on your body and the only way to stop it is to get it out, which obviously means the delivery of the baby.  Pre-eclampsia can lead to eclampsia, which causes seizures in the mother and can be fatal for her and the baby.  So it can be serious, but they take measures to monitor everything and make sure the mother doesn't get to that point.

I asked her what would happen if I did have pre-eclampsia.  She told me it all depended on how well I did.  If I had severe pre-eclampsia, they would deliver the baby right away.  But as long as it was mild and stayed that way, they would deliver the baby at 37 weeks, which is considered far enough along for baby to be good and healthy. 

I honestly had no worry whatsoever that things would get severe.  I couldn’t picture it happening, especially when I felt pretty good and knew the baby was fine.  I didn’t have any inkling it would happen and didn’t worry myself over it either.  My only real concern was the due date.  If he was delivered at 37 weeks, that would be the end of January!  Darn it, I really wanted a February baby!  And how was I supposed to prepare myself when I had all these maybes and what ifs!  Ugh!

So we did some more blood work for the pre-eclampsia and they wanted to collect my urine for 24 hours just to get a good reading on the protein levels.  I also did a non-stress test, where they strapped some monitors to my belly to track the baby’s heart rate.  Whenever he moved, his heart rate was supposed to go up to let us know the placenta is doing its job.

I was initially worried he wouldn’t move at all but instead he danced around so much that we kept losing his heart rate!  He kept moving out from underneath the doppler!  Once we finally pinned him down, the nurse said, “I need this baby to give me a baseline!”  We knew his heart rate was up with his movements because that’s all he was doing was moving around!  Calm down, buddy!  So what began as a twenty minute tests ran over an hour instead.  But he eventually calmed down, we got the baseline heart rate, and he passed with flying colors.

I felt fine.  The baby was fine.  I wasn’t worried in the slightest.

I called about my results on Monday, December 30^th, and the nurse said I did have mild pre-eclampsia and would need extra monitoring.  I would be coming in twice a week for more of those non-stress tests and to check my blood pressure.  I would also do labs and a doctor visit every Friday.  Sounded busy but I was actually excited to keep a closer eye on everything.  I love to monitor my baby!

They wanted me to come in that day and the next for two shots of betamethasone, a steroid that is supposed to help the baby develop a little more quickly and helps prevent pre-term labor.  I remember coming in on Tuesday, December 31^st, for my final shot.  It was so busy that they took nearly an hour just to get to me and do the shot.  Everyone was there having babies, trying to claim them on their 2013 taxes!  I was feeling glad I was not having the baby right then, right around the new year, which I know can be hard as a birthday.

That night, I was over at my brother’s house to celebrate New Year’s Eve with him and his family.  I started feeling kind of crappy as the night wore on.  I had had a really big dinner and quite a few snacks so I figured I’d just eaten too much.  I’d actually gotten a blood pressure monitor from a friend just a few hours before so I checked it and my blood pressure was pretty high.  So I decided to just lay back on the couch, take it easy, and wait for midnight.  As soon as midnight came and I muttered a weak “Happy New Year,” I found a bed and went right to sleep.

From Bad to Worse - Can't Breathe!

I heard some very strange sounds the next morning, January 1^st,, as I was lying in bed.  I thought it was a squeaky toy or little bubbles popping, almost like when you pour milk into your Rice Krispies.  I had no idea what those sounds were until later that night when I was desperately trying to get to sleep.  Those sounds were coming from me!  Whenever I exhaled, I heard that squeaky popping sound!  What was going on?

Throughout that day, New Years Day of 2014, it had become more and more difficult for me to breathe.  I figured the baby must have been really cramping me now that he was getting bigger.  There had been times when I’d felt him move pretty close to my ribs so I knew it was a possibility and a normal part of pregnancy to be short of breath. 

But as I tried to sleep that night, I felt was my labored breathing was a little over the top!  It was hard to breathe deeply.  I remember telling Nick I felt like I had an iron band tied around my chest, constricting my breathing.  And each breath felt like I just wasn’t getting enough oxygen, like I was trying to climb Mt. Everest!  So I was basically panting, which is not conducive to sleep, let me tell you!  When I would start to fall asleep, my breathing would slow down, which would make me feel even more deprived of oxygen, to the point that my chest would start hurting and it would wake me right back up!  It felt like I was drowning, with that pain in your chest you get when holding your breath underwater for too long!

It was a very rough night.  I looked up tips on getting better sleep with a baby cramping your lungs.  Nothing worked.  I got very suspicious that this was not just the baby.  I typed in my symptoms and it almost sounded like I had asthma!  Can you even develop that later in life?  Can you suddenly get that while pregnant?  I tried home remedies for asthma too but nothing worked.  I was getting frustrated and desperate, not only to be deprived of sleep but to have to work so hard to do something as basic (and non-stop) as breathing!

Nick woke up in the middle of the night hearing me pant next to him.  He was very concerned.  He got up and gave me a back rub.  It felt fantastic but, unfortunately, sleep never came.

After a night of no sleep, I had determined this was way too horrible to not be addressed.  I had an appointment with Dr. Gravelle the next day but could not wait that long if it meant another night of no sleep.  After anxiously watching the clock all morning, I called and talked to a nurse.  She told me to go ahead and check in at labor and delivery.  Then she called me right back and said she had talked to labor and delivery and they just wanted me to go to the emergency room.  I had no clue whether this breathing problem was related to the pregnancy or not so when they sent me over to the ER instead, I figured it must be a separate issue.  Either that or they were too busy to deal with me.

My Day at the Emergency Room

My mother-in-law, Angie, took me to the emergency room around 10am, Thursday, January 2^nd.  Luckily we found the place mostly empty and were able to get checked in quickly, though that was no hint of what the rest of my day would look like!  After changing into a lovely hospital gown and getting my own room, a doctor came in and listened to my breathing.  He said he didn’t hear anything out of the ordinary but that I could have a blood clot in my lungs.  Because that can be fatal, he said we should run some tests to rule that out.

They hooked me up to a bunch of monitors, put an IV in, and had someone come from labor and delivery to monitor the baby.  Sheesh, what an operation.  Then they did blood work which did show a possibility of a blood clot.  But the doctor said pregnancy nearly always complicates the readings for that test.  What does that mean?  More testing!  Lots more!

I had a chest x-ray done, a CT scan, and this horrid breathing test to monitor my oxygen intake.  While lying on this thin hard table, this technician put one of those oxygen masks over me.  I was excited to get the mask, thinking it would feel a whole lot nicer to get some supplemental oxygen!  Instead I felt like I’d had a pillow strapped to my face!  It was even harder to breath than before and I told the technician that.  But he assured me that air was coming through this little hole in the top just above my mouth, just a quarter-sized window to the room air I guess.  Gee, thanks!

To do the test, he asked me to take a deep breath and hold it for five seconds.  He counted the seconds but they were very slow seconds so it was more like ten or fifteen, not five.  It was hard enough for me to even take a deep breath, let alone hold it for that long when I was struggling to breathe so badly!  At his signal, I let my breath out and started gasping for air.  I had that pain in my chest from lack of air and was feeling a desperate need for oxygen!  But I felt like I wasn’t getting any air through that stupid mask and started to panic!  It felt like I was suffocating!

I cried out a little and tried reaching for the mask to rip it off but the technician held it onto my face!  Seriously, dude, this is scary!  But he assured me I was getting air!  That may be so, you dolt, but I feel like I’m dying here!  Really! 

Because my mouth was gaping open, desperate to draw in as much oxygen as possible, it was creating a little gap between the mask and my face.  I could feel some of the room air coming in through that little gap, giving me just enough oxygen to keep me going (meanwhile that stupid hole in the mask seemed more like a plug than an opening).  So I focused on that leak of air and tried to calm myself and slow my breathing.  Overall, it was a horrible experience and I now know how terrifying it would be to die from drowning or suffocating.

By this time, I had been at the emergency room for about five hours, with all the testing and all the wait time in between.  Angie had gone to work around noon and Nick had come to take her place and be with me.  Besides the suffocation test, I was really very calm throughout all of this, not at all suspecting that I had a blood clot in my lungs.  I was really hoping we would find some cause for my labored breathing, however.  If we found nothing wrong and pinned it all on the baby cramming me, I was afraid to face another month of sleepless nights panting in my bed with no remedy or relief!

So I was very relieved when they came in and told me I had no blood clot but that they did find fluid in my lungs!  Alright!  We have a reason for this craziness!  The doctor said my heart looked a little enlarged and they needed to figure out if the fluid in my lungs was from a heart under stress.  If I was having a heart issue then they would admit me to the hospital.  If not, they would deal with the fluid and send me home.

I remained unworried.  Honestly, the one and only thing that was on my mind was sleep.  Whether I got sleep at home or was admitted to the hospital and got some sleep there, I didn’t care.

I updated everyone on my status and asked my sister-in-law if they could be on standby to take my dog in case I needed to get admitted to the hospital.  Nick had already gone to take care of him since Marley had been in the crate all day long during all my testing.  Instead, my brother, Brett, was anxious to come down to the emergency room and be with me.  I thought it was a little too soon to be worrying but I couldn’t convince him otherwise.

In the meantime, they gave me this fantastic shot through my IV!  They told me it would clear the fluid from my lungs and I would pee it all out.  What?  We know how to do that with a shot?  Wow, high five to whoever figured that out!  I was pretty skeptical of this magical shot but man oh man did it ever work!  Over the next few hours, the floodgates opened.  I was visiting the bathroom every ten minutes and peeing the Nile into their toilets there!  I was started to get self-conscious that the nurses were laughing about this robed woman dancing through the halls to the bathroom again and again.  I’m sure it was comical to anyone who noticed. 

But the best part?  I could breathe again!  After about an hour, I started to notice it didn’t hurt so much to breathe and I felt a lot more satisfied with each breath.  I called my mom and she could tell things were getting better because I wasn’t panting through my sentences.  Wow, it really worked!

They did an ultrasound on my heart to see if they could find any issues there.  But everything looked just fine.  Since my heart checked out and I could breathe again, I was ready to go home and hit the hay!  I feel great guys!  Thanks!  See ya!  But no.  The doctor came in again to talk to me.  He told me that my heart checked out fine but he had called down to labor and delivery and they wanted to check me out over there.  Ugh, okay, more checking and testing.  Really, I feel fine!  Can I just go?

The doctor said there could be a connection between my pre-eclampsia and the fluid in my lungs, which they called pulmonary edema.  If there was a connection, he said they may deliver the baby now.  I thought that was laughable.  I hadn’t heard of labored breathing as a symptom of pre-eclampsia, and considering the fact that the baby and I were feeling fine, I didn’t see why this would turn into an emergency delivery.  And, by the way, if these were related then why on Earth did they send me to the emergency room in the first place!?

My Shocking Plunge into Labor

My brother and husband were there and they followed behind as they wheeled me through the hospital over to labor and delivery.  It was going on 7pm now and I had already been at the hospital for nine hours now!  I was hoping this would be a quick check and I could go home soon.

They took me into one of the labor rooms and I sat on the bed there.  Brett asked me if I was nervous and I said no.  I didn’t see any reason to get worked up over something that hadn’t happened yet and probably wouldn’t.

The on-call doctor came in, Dr. Brown, a lady I had heard wonderful things about.  I had hoped to have her as my obstetrician but she was already booked up.  She lived up to her reputation and was nothing but easy-going, fun, and compassionate.  She sat down on the bed next to me and said, “Well, the good news is that you don’t have a blood clot in your lungs.  The bad news is that you've now graduated to severe pre-eclampsia and we need to deliver this baby now.”

Excuse me?

Sometimes you hear something so outrageous that it takes a moment for the information to grind through all the gears in your head and get processed as a reality.  My first reaction was to somehow find a way to get out of this.  Can’t I go home, sleep, and come back to do this in the morning!?

Part of it was the timing.  No one wants to deliver a baby seven weeks early, of course, and I was still unhappy with the date itself.  It’s hard to have a birthday around the new year and this was way too close to that!  But I was mostly wanting to get out of it because of how tired I was.  After being up for 36 hours, I felt extremely exhausted and had a horrible headache.  I didn’t see how I could face a night of labor and a birthing too!  But the doctor said it with such finality, I knew I had no choice.  I knew they would never risk delaying delivery with severe pre-eclampsia.  I was stuck with this new reality.  I would be having this baby very early and would be exhausted doing it!

Once I accepted that (though I would be shaking my head in disbelief for days to come), I just tuned out all my other concerns and focused on preparing myself to have this baby.  I asked Brett to take our dog for me and asked Nick to run home and get a few things for our stay at the hospital.  Brett left a little emotional, crying and telling me he loved me, which was very sweet.

The doctor told me we’d have to do quite a few things to get my body ready for this baby to come.  Then she checked me and said, “Oh, change of plans, you’re already at a two and he’s head down!”  Okay then, I guess my body wants to be rid of this baby!  Or maybe the baby is done with my body?  Which one, I don’t know.

She came in a little bit later to break my water.  I was a little afraid of that long hook but it didn’t hurt at all.  It was a very bizarre experience though.  It was Niagara Falls all over again and we were all oohing and ahing at all the fluid.  I told the doctor and the nurse, “It feels like I’m throwing up out the wrong end!” and they laughed at that.  Thankfully the fluid looked normal and everything checked out.  Now there was no turning back.  I would be having this baby within the next 24 hours!

Before starting me on the Pitocin to induce labor, they needed to start magnesium sulfate treatments, which helps to prevent seizures.  This is a risk with pre-eclampsia so it needs to be addressed.  I’d heard nasty things about the magnesium and was worried I would face a night of nausea or dizziness.  To my great relief, my only reaction was feeling hot.  Poor Nick spent the night wrapped up in his coat and some blankets while I had the temperature turned down and a fan going, plus a cold wet washcloth on my head for the heat and the headache.

We had one other issue that needed addressing sooner than later.  With my already weak bladder and that shot still working its magic, I was needing a bathroom visit a little too often.  I probably went three times within an hour and the nurse was beginning to be exasperated.  With all my monitors and IVs, it was quite a process just to get across the room and go pee.  The nurse recommended we put a catheter in and I was all for it.  If I didn’t have to go to the bathroom then I could rest a whole lot easier, and rest was still my number one priority.

I had no idea what I was signing up for.  I had never had a catheter in and had no clue they actually shove the thing up your urethra!  Did you just cross your legs, clench up and squirm?  Because I did for days after whenever I revisited that experience!  Part of it was the pain, but part of it was just the shock of what she was actually doing!  I gasped and cried out and was mad at myself for okaying this horrible process.  The worst part was, I now felt extreme discomfort down there.  It felt like I had to pee really bad!  Wasn’t that the point was for me to get rid of that full-bladder feeling and now I was feeling it all the time!?  Wow, this thing is of the devil!

After all that was taken care of, they started me on the Pitocin sometime around 10 or 11pm.  After about a half hour, I started feeling some contractions.  It was painful, like a very bad menstrual cramp.  If that was all there was to it, I could have endured.  But I knew that the pain would get much much worse.  I had no desire to experience that and my exhaustion ruled out any possibility for me to take this on anyway.  What I needed more than anything was rest, not a display of bravery!  So I called the nurse and asked her to bring on that epidural!

Whoever invented the epidural also gets a high five from me.  That thing took away all my discomfort, including that horrid catheter and the restlessness and aching I felt from laying on a stupid hospital bed all day long.  All I felt was relaxation.  I might actually get some rest tonight after all!  The anesthesiologist was a bit of a goofy looking guy but he did an excellent job.  I told him, “No need to be too descriptive!”  A few weeks earlier, I had nearly passed out when learning how an epidural works.  He told me, “I will just tell you what you will feel, not what I am doing.”  It worked out fine, with a few unpleasant sensations along the way, but nothing as horrible as that catheter!

We finally got settled in around midnight and I was excited for the long-awaited possibility of sleep.  I did have a few obstacles though.  Of course, the nurse would come in and check on me from time to time, waking me up each time.  They also had a blood pressure monitor on my arm which was set to inflate and check on me every hour.  Thanks for that.  I was incredibly thirsty too, probably dehydrated from that magical shot leaking everything out of me, so I woke up binging on ice chips every so often to satisfy my dire thirst.  And I had that darn headache from lack of sleep.  I had my washcloth to provide some relief to my head but was really hoping some sleep would help get rid of it.

And I did sleep all throughout the night, which is really incredible.  I never thought I could sleep through labor!  The interruptions were frequent and I didn’t get the restful sleep I really needed.  It just felt like a series of light naps, over and over again.  By the time morning came, I was glad for the rest but not feeling much better overall.  I still felt that I had pulled two all-nighters in a row and was worried to have to deliver a baby in that condition!

The Delivery of Our Baby Boy

At around 6am, they checked me again and said I was at a 7.5 and that things would be moving along quickly now.  I had Nick text everyone and let them know I would probably be having this baby between 7am and 9am.  Sure enough, I was at a 10 when they checked me 7am.  They wanted to wait just a bit longer for his head to descend more and also for Dr. Gravelle to come in and deliver the baby.

During the final waiting period, my exhaustion peaked and I finally fell into a deeper sleep.  This felt wonderful except that it was cut very short once I was wheeled into the delivery room and was needing to prepare for delivery.  By this point, I was so incredibly exhausted that my eyelids would simply not stay open.  It was awful.  Here I was at this epic, long-awaited, hard-earned moment, and I felt like I’d swallowed a whole bottle of sleeping pills!  I was prying my eyelids open with my hands, slapping my face, and doing whatever I could to be present, even though I had an overwhelming desire to just lie back and let sleep overtake me.

Of course, once I was required to start pushing then I woke up, barely.  Nick was there by my side, holding up my leg, and I had a nurse on the other side with the other leg.  My doctor, who I’d only met twice at that point, was there to deliver the baby.  I was concerned that the epidural would make it hard for me to push, but it had worn off just enough for me to feel the contractions and to feel enough down there to focus my efforts on pushing the baby out, without having to guess whether I was being effective or not.  I was really very happy for that, to feel enough to be effective and more involved but not enough for it to be unbearably painful.  That and the fact that I could deliver this baby vaginally are two of the greatest blessings of my sudden delivery.

They told me to push for ten seconds whenever I had a contraction.  Pushing the baby out was actually not too difficult, though the small baby and the pain medications made everything much easier, I’m sure.  He even started out facing the wrong way but my first few pushes turned him the right direction, face up.  Bam, I am that good!  My only difficulty in pushing was that my face felt more pressure than was comfortable.  They told me to hold my breath when pushing (not a huge fan of holding my breath after the suffocation test), but it seemed like that made my face red and hot like I was going to pop a vein in the process.  Still not sure if I was doing something wrong there but I’m happy to report that all my veins are still intact (I think).  The doctor was impressed with my progress with each push and that’s what mattered most.

The doctor was busy working to massage everything and stretch me out so the head could make its way out.  But she said I was very tight and would probably tear.  She was concerned I would tear upward into my urethra, which would have been very painful and hard to repair.  So she made a very small incision downward to allow me to tear in the right direction.  I was concerned I would feel her do the deed, but I was blessed once again to have the pain relief working.  I felt nothing.

Nick was really enjoying the whole process.  I asked how he was doing and he said he was doing great and that this was a beautiful thing.  He was anxious for me to watch it too.  I thought I would give it a go, though I wasn’t too keen on the mirror thing.  They wheeled out the mirror and I got a good look at the whole birthing process.  After that first look, I told them I was about done with that.  Yes, it was very cool, if it wasn’t me, right now.  In retrospect, I actually wish I had stuck with it.  I think it would have been neat to see him come all the way out.

I was awake for the pushing, of course, but I would lie back in between contractions and nearly fall asleep each time.  I was still very groggy and drained, and still parched too.  Nick had those very-unsatisfying ice chips nearby and I would have him feed me some in between contractions.  I couldn’t wait to fall asleep when this was done and get a nice tall glass of water too, not necessarily in that order but I’ll take whatever comes first!

At 8:39am, the baby was born.  Of course, I cried.  The greatest emotion I had was actually a sense of loss.  I had no idea that I had developed such a strong bond with this baby while he was a part of me.  I felt that separation once he left me and it was kind of sad, like I’d just lost my privilege to be a part of this sacred process of life and this miraculous little being.  I also cried from relief that the hard part was over, and also from the magic of the whole birthing experience itself.

Much to my relief, everyone had a great reaction when he came out.  At 33 weeks, I had no idea how he would look or how we would do.  I also had that worry that he may not be perfectly healthy and may have Downs Syndrome or some other issue.  I had tried to prepare myself for that in case it happened, mentally and emotionally.  So I was happy to hear when everyone said he looked really good, had great skin tone, and even gave out a little cry, all very good signs. 

I sat up to see my baby but they whisked him away to the NICU and all I saw was a foot!  I was very disappointed in that.  I knew they would take him quickly to the NICU but had been told the doctor would hold him up for us to see.  But Nick was able to see him and said he was beautiful and the nurses and doctor agreed.  At least I had that assurance that he was looking great.

After they took him away, we had this little bit of time to rest and admire our baby.  They gave me a cold cup of apple juice, which I downed, then brought in a picture of him just a few minutes after he was born.  I was so happy with what I saw.  He really did look amazing for being so young and for having just been born!  I didn't have any expectations, really, but I was not anticipating him to look so great.

Complications, Pain, and Blood Loss

My rest time was over quickly.  Without saying a word, the doctor suddenly began pressing firmly all over my abdomen, which felt very painful.  I knew what she was doing.  We still needed the placenta to come out.  She also started reaching up inside of me.  I don’t know what she was doing exactly, but I know it added quite a bit to the pain.  It hurt so badly, I laid back and gasped and cried out, just hoping this would be over soon so the pain would end.  Why was this taking so long?  Doesn’t the placenta just come on out after the baby?

This went on for quite some time.  I lost all awareness of anything else but the pain and how it went on and on.  After ten or fifteen minutes, the doctor told me that the placenta would not detach and they would need to go in and get it out.  My mother had had a similar complication after I was born where her placenta had come out in pieces and the doctor had had to do a manual sweep on the inside of her uterus to make sure there was nothing left inside!  Yes, he reached his fist up through her cervix and felt around in there.  To this day, she gets faint just mentioning it and describes it as the worst experience of her life, worse than child birth.  Knowing how horrible it felt for my mom, it was the LAST thing I ever wanted to hear.  And there I was, hearing that very thing!  My main reaction was, “Well, go figure.”  Frankly, I thought she had already been all the way up just because of the pain I felt and how far she was searching around in there.  To think she would be going deeper was beyond what I could comprehend.

I was already spent before any of this craziness began and this new development took me to the final level of exhaustion.  Though I still cried out in pain, I was beginning to fade.  I remember hearing them say, “Should we give her something for the pain?”  What!?  Hello!  If I could have had some drugs, why did we not do this ten minutes ago!?  The goofy looking anesthesiologist came in and told me he was going to give me something fast acting.  Nick said he gave me a shot and that I calmed down within thirty seconds, thank goodness.  Once I was rid of the pain, I phased out.  Bye, everyone!  Sorry to birth and run, but I’m done with all this!

Who knows how long I was out and I still am in awe that I could even sleep through something like that.  Turns out I was losing a heck of a whole lot of blood, however, so perhaps I was blacking out too, not just sleeping.  The placenta had finally detached but there were pieces left inside that were hemorrhaging, still connected to my body and getting a blood flow.  So I was basically bleeding internally from these stubborn placenta pieces.  Nick said it was amazing how much blood I lost while all this was going on.  I guess it was quite a scene.

Needless to say, there was a team of people around me at that point, all working to get this out and keep me stabilized.  I came out of my stupor for a moment and felt my heart pounding.  “I feel like my heart is beating really fast,” I said.  “That’s because it is,” one nurse told me.  Seeing all these people around me and feeling my heart racing, I suddenly felt very sick.  I shamelessly threw up all that wonderful apple juice.  Nick laughs about how unabashedly I vomited all over everything but I was too dazed and too concerned about this placenta crisis to care about making a mess.  And I knew it would just be apple juice anyway.  Not like I was throwing back some Mexican food or something.  He said they were completely unfazed by it, threw some rags on the floor, and just continued on in their work.

I wish Nick had been nearby.  I was concerned that he was worried for me and I couldn’t see him past all the nurses by my bed.  I asked for him and then could see him sitting in the corner watching this blood bath.  There was no room for him by the bed with all the nurses around me.  There was a little room by my head though so I imagined him holding my head or touching my face and how comforting that would be.  But I knew he wouldn’t come and be in the way of everyone.  So I laid back and faded out again.

This went on for a good thirty minutes.  They transferred me to another bed and I remember feeling incredibly weak as they picked me up and scooted me over, like I had no strength in any of my limbs.  They wheeled me back into the labor room but I have no memory of that.  I was already gone.

Meeting my Baby and Recovering

Though I probably could have slept all day and all night after that, I was awake enough to hear a quick conversation shortly after arriving back at the labor room.  I heard them ask Nick if he wanted to go and see the baby in the NICU and he said yes.  Though I lay there half asleep, I wanted to cry out and demand that he wait for me.  I was jealous he could go and see him first and that he’d see the baby without me.  Seeing as I was pretty incapacitated, however, I didn’t see how fair it would be for him to wait for me.  Besides, he had already seen the baby be born so he had kind of already crossed that bridge.  And I was too weak to protest even if I wanted to! 

Nick later told me that he was anxious to see the baby but also didn’t like the thought of him spending his first few hours of life all alone.  I agree and would have done the same thing, though we were both picturing him alone inside of an incubator and were surprised to find he was not!  Hooray!

I woke up at about 11:00am, after resting for just 90 minutes.  Nick was there looking at his phone with tears streaming down his face.  He told me he was looking at pictures of the baby and just coming to realize the relationship there, that this was his son and he was the daddy.  It was really sweet and I felt so happy for him, for this moment he’d been anxious for all the way back when we were dating 10 years ago!

Nick had been in charge of keeping everyone informed and I was wondering what he had relayed about the pregnancy and the craziness with the placenta.  He said he had just told everyone there had been slight complications but we were all okay.  Good man.  I wanted people to know, but not enough for anyone to worry too much.

He then told me that my parents were on their way!  What!?  I was shocked and felt really happy and flattered.  With this whole thing being a complete surprise, I had no expectation for my parents to come.  But now they were both coming and coming right now!  How cool!  Soon after he told me, my dad walked in with my brother, Brett.  Wow!  This is neat!  Though I desperately wanted to go back to sleep, I was happy for the visitors, to feel the support and share in the excitement of everything.

The nurses came in shortly after they arrived and said it was time to move me to recovery.  On the way, we would stop by the NICU and I would get to see the baby!

They wheeled me in, bed and all, and I got my first look at this beautiful baby boy.  I don’t remember all the emotions I had at that moment, only that I was very emotional.  I think I felt a lot of relief and gratitude that he was finally here, he looked very healthy, and everything had turned out okay.  I also felt love and awe for this little being who had been inside of me just hours before.  How amazing.  There was a lot of crying.  He was getting help breathing so he had his face covered with the CPAP machine and I was only really able to admire his limbs.  I rubbed his feet and his legs and his hands and just appreciated how great he looked.

Later on, Nick told me how meaningful of a moment this was.  He was there with me last March (2013), when we had gone in to the fertility doctor and been told we were having our third miscarriage.  I had felt hopeful that the pregnancy would work out, though it was already on the rocks.  But we did an ultrasound and I could see that things were not looking right.  The doctor told me the news and that’s when things broke inside of me.  That’s when I’d been asked to take on more than I could bear.  My heart broke, my spirit broke, my faith broke, and the last shreds of hope I’d been clinging to were completely destroyed.  Nick saw this all happen on my stone cold face as I sat in that room at the fertility center, a room that had come to mean nothing but pain and heartbreak for me.  I was beaten.

Ten months later, Nick would see a different face.  Here I was seeing my baby for the first time, something I had not dared to ever hope in again.  He said it meant so much to see my face then, to see me have happiness and joy instead of pain and devastation.  This was a big step toward something brighter for the both of us, toward healing in our hearts and spirits.

Recovery was an interesting experience, fun and exhausting and a little challenging.  I had a stream of visitors over the next few days, including my mom and dad and my brother and sister-in-law, my mother-in-law, and a few cousins.  While I was stuck in bed trying to recover, Nick had the job of escorting everyone to see baby Gavin, a job he did not mind at all.  He loved to watch him, take pictures, and just admire.  So did everyone else.  I was glad I had a picture of him to put by my bed since I was missing out on all the fun.  I would look at it often and feel love and pride and happiness.  What a gem.

Besides seeing the baby again, what I wanted more than anything was just to rest!  But with all the visitors during the day and the nurses checking in all night long, rest consisted of short naps here and there and never any restful sleep, a little torturous after the lack of sleep I’d already had the past few nights.  I suppose that’s what a baby does to you anyway so we might as well start now!  At night, I put a cold washcloth over my eyelids because my eyes (and my whole head) felt so burnt out from everything.  That helped to soothe them a little.

Luckily I had great nurses who took really good care of me.  I found that I was experiencing very little pain, surprisingly, though I’m sure the drugs were helping.  They still had me hooked up to the magnesium treatments to avoid any post-delivery seizures and I also had these bands massaging my legs the whole time, supposedly to avoid blood clots.  I was still very swollen too, in my hands and arms, my face and chest, and my ankles and feet!  What a hottie!  You can just call me Bloatie.  Sitting or standing would cause my ankles and feet to swell up any more and they would ache badly.  I was thrilled to get all this excess fluid out of me in the days following.  It’s almost like my body was retaining so much water, it had nowhere else to go but into my lungs, which is what started my sudden delivery!  Who knows?

Really, the biggest issue was the blood loss, which I felt any time I attempted to get up.  Just sitting up in bed made me feel woozy.  The nurses tried to help me to the bathroom once and I nearly fainted when I stood up, even with them both supporting me.  My vision was going and my hearing was too, so we aborted that mission and I got right back on the bed.  We tried again a little bit later and although I made it to the bathroom this time, I was still shaken by the whole experience of walking a whopping five steps to the toilet!  I had to hold on to the bar on the wall while sitting on the toilet, just to steady myself and not pass out.  I felt so weak, as if I were a 90 year old woman.  Clearly I’d had some serious blood loss.

Because of all that, I was not able to see the baby again for quite a while, since I couldn’t even get myself into a wheelchair.  Saturday morning they decided to do a blood transfusion and I was all for it so that I could heal up and see my baby again.  Once that was done, I began to feel more able.  Finally I could go and see Gavin again and hold him for the first time!

The nurse handed him over to me and cuddled his tiny body to my bare chest.  I was overwhelmed with emotion and began sobbing.  Finally, after so much work, so many trials, so many losses, so many doctor visits and prayers and perseverance, I was a mother.  This tiny little being was mine to have, to hold, to care for and raise up.  I felt an overwhelming desire to love and protect this little person, to let him know that he was safe with me and that all I wanted was for him to be happy.  I stroked his back and his fuzzy little head.  I felt like I was holding a bunny because of how small and soft he was!  Oh how I loved this precious little boy, this gift and miracle we had!  My cup runneth over.

It was a wonderful visit.  You can only have four people in the room at a time, so all my visitors came in at different times to see me with the baby.  My parents were there first, then the grandmas, then my brother and sister-in-law.  Everyone was in tears from all the emotion of the moment.

I was discharged Sunday evening, after four days of tests, labor, delivery, visitors, and extreme shock, emotion, and exhaustion.  That night, I rubbed my belly and missed his presence there.  At the same time, Nick turned to me and said, “I miss him.”  We held each other and cried, partly because of the difficulty in leaving him behind but mostly because we felt so overwhelmingly blessed and in awe of all that had happened.  We now had a son, a healthy and adorable baby boy. 

As we held each other, Nick said, “I never thought I could love anyone as much as I love you.”  It was one of the sweetest moments of my life.