September 6th

Six more days. Six more days until my due date. Six more days until I was supposed to hear you cry, hold you against my chest and look into your open eyes, “Welcome baby, I am so excited to meet you”. I have been dreaming of this day for years. Well before we officially started to try and conceive. Well before our first, and not last miscarriage. Well before medically assisted pregnancy interventions: femara, injectables, thyroid medication, metformin, progesterone supplements, exploratory surgery, polypectomy. Before admitting it is time to try IVF, before a canceled cycle and finally our transfer date, May 12th. Three days before your dad and I finally became an official couple, I graduated with my masters degree and before your dad and I got engaged. May was always a good month full of happy memories.  

I held my breath while we waited for the results of that embryo transfer; no, before that. I held my breath after the egg retrieval; while we waited for the test results on the quality of the remaining embryos. I anxiously watched you grow on an ultrasound screen just days after conception and continued to hold my breath while I waited to come back and ensure you were really settled into the lining of my womb.I held my breath while we waited to confirm a heartbeat. I anxiously waited weeks for that first OB/GYN visit, to hear your heart beating via doppler, to see you again on the 11 week scans – how you had grown already!  

We bubbled with excitement and could not contain our smiles. Nervous and apprehensive, we told ourselves we would guard our excitement, but it was too late. Covering your eyes and ears and turning away from “the camera” – just like dad; sitting cross-legged – a yogi, just like mom.  My side of the family is dangerously low on testosterone. Finally, we can start to even the scales – the first grandson. Just days after Opa (grandpa)’s birthday.

Excitement gradually grew, along with joy, plans and confidence. This is it. Finally, it is our time.  Our turn. We have watched others struggle with their fertility journeys and come out the other side. Now, we can join them. Week 19 – one week to go until I can see the details of your face on our anatomy scan.

I had no idea I should have taken the option to book it sooner. If only I had gone last week maybe this would not have happened. Maybe we would have caught the incompetent cervix in time and we could have saved you.

I noticed changes in pressure, positioning, fluids, along with flutters that came with a sense of peace and serenity, all is well, surely. All is going according to plan, right? I remember thinking back to my last OB visit where I mentioned pelvic pressure, and without even looking up from his chart the OB scoffed, “That will only get worse”. You are just over-thinking and catastrophizing; relax, take some deep breaths. Nothing develops that quickly, you’ve just been through a lot, everything is ok. You will see the doctor again soon and be reassured. Maybe I should have spoken up. Maybe I should have put “myself” first and canceled weekend plans for the holiday with family.  Who needs an over-cooked steak without a beer anyway?

That weekend we were able to introduce you to extended family – there was no hiding this growing bump any longer…and just like that, that night as we settled back in at home, I felt this tremendous pressure. Ok, it’s just gas. Let’s change positions, stretch, lay down, no…a trip to the bathroom and still, no relief. Something isn’t right. Why does it feel like something is slipping between my legs, like a loose tampon? I haven’t had to use one in months. That’s when I felt it, the amniotic sac, without a doubt. Call the OB – surely they can be of some help! We can fix this.  “We take care of high-risk pregnancies, right here at our community hospital”. But no one told us that it only applies to the first and third trimesters. A nervous voice on the other side of the receiver, “Can you help me triage? What do you see? What do you feel? Can someone else at home help you?..What do you want to do?”I thought you were the one to help me. I thought I was supposed to call you and be told how to handle this kind of situation and calm me down!

I had the option of going through the emergency department, waiting to be triaged and sent to L&D where I would likely be transferred elsewhere, or I could drive to the nearest city and be seen by a high risk OB. “I need a ride to Philly”, I told my husband.

Somehow what should have been an hour’s drive turned into a 30-minute drive, yet the longest drive into Philadelphia I have ever experienced. I remember thinking earlier in the week it would be nice to go into Philadelphia for the day, it’s been a while…But not like this.  

We settled in and we were able to see you on the ultrasound, snug and moving around with a healthy heartbeat, assured I was not losing fluid. Ok, what a relief. We were told that although you looked healthy for now, I was experiencing something called cervical funneling, and we had three options:

  1. Do nothing and wait and see – comes with increased risk of infection of mom and fetus
  2. Possibly get an emergency cerclage
  3. Take matters into our own hands and terminate the pregnancy (a.k.a. D&E, a.k.a. abortion)

I was not ready to give up and throw in the towel. We will wait and consult the OB in the morning about an emergency cerclage. In the meantime contractions had settled in. I refused any medication stronger than a tylenol. I cannot harm this fetus. I had to be wheeled in my hospital bed to another floor to our actual room for the night. My husband watched me writhe in pain while refusing additional pain management. We even tried a hail mary – the older nursing staff swooped in to assist my baby nurse put me in trendelenburg – for hours. Oops, let’s check her vitals – blood pressure 40/70?! But still, no luck.  

Man, I have to pee. I climbed out of the bed, unplugging my leg wraps, my hydroelectric heating pad, my belly monitor and taking my IV with me. I can’t do it, the pressure is too much and I will not give birth in a toilet. I chose to be catheterized instead. But still the pressure grew and grew, afraid you would just slip out of me before the doctor could even assess the situation further.

Come the early hours of the morning we took another look. But this time we saw the fluid reduced around your scrunched up body, butting up against my cervix. “You (now) have two choices…”. I repeated back my “options” but verbalized, “But really we only have one choice, don’t we?” Disheartedly, the doctor silently nodded. To continue to wait and do nothing would have to last at least three more weeks with increasing risk of infection to myself and suffering of the fetus. The image of your scrunched up body was still vivid in my mind. Best case scenario, NICU for several weeks and likely life-long complications.  

You would think the need for serious decision-making would end there, but now we had to decide on how to end the pregnancy. We could induce and wait who knows how long for my body to deliver the fetus, just to likely hold you long enough to feel your heart stop beating and likely still need a D&E to remove the placenta, and still be at increased risk of infection, bleeding out…I know this because I saw my sister go through it. Just three years before, almost to. the. day. I know the trauma she faced after that; the insomnia, the panic attacks, the PTSD when she was preparing to deliver her rainbow baby.

I did not want to take away from future attempts. I wanted to protect the opportunity to one day deliver a live, healthy baby without trauma. I wanted to protect myself. I thought choosing the D&E would help me heal faster, emotionally and physically, and allow me to try again sooner.  “I want to try again” I told my husband just hours before.

The nurse returned shortly after we decided on a plan and again asked if she could provide any pain relief. I finally agreed, much to my husband’s relief, “finally”. I could feel him exhale the stale air he had been holding onto throughout the night and feel him release his shoulders.

The relief came nearly immediate, like a warm wave spreading quickly from my brain to the bottom of my feet. Finally, in a relaxed and clouded state of mind, another clinician entered our room, but this time with legal papers. “…you have the right to give up your child to a family that is willing to care for this child…you have the right to sue your spouse for making you choose to terminate this pregnancy…” Oh, right.  We are in Pennsylvania nowDon’t they know how wanted this pregnancy was?  

“I want to still be pregnant…with this pregnancy”

I have been dreaming of this day for years. Well before we officially started to try and conceive.  Well before our first, and not last miscarriage. Well before medically assisted pregnancy interventions: femara, injectables, thyroid medication, progesterone supplements, exploratory surgery, polypectomy. Before admitting it is time to try IVF. This was supposed to be my rainbow baby.  

Waiting to go into surgery, rules were bent and the staff allowed my husband to stay by my side.  Nurses cried as they watched my husband kiss me goodbye before I was taken to the surgical theatre.  

I remember waking from the surgery, immediately feeling empty. “You did great momma” said the nurse, and I burst into tears. After a couple of hours of recovery the same nurse came in to remove my IV lines from each of my wrists. “Oops, that one was a bleeder!”. I walked out of that hospital just minutes later like it was all just a dream. “Did that just happen?”  I asked my husband, days later.  

I still have a pinprick of a scar on the inside of my left wrist. Being left-handed I am reminded of this moment every time I need to pick up a pen and write. I am reminded of you every morning when I still put on my maternity bra, my maternity pants and my now too-large new socks and shoes.  

I am still leaking from my breasts from time to time. The testing resumes. This time, a brain MRI with and without contrast. And now I grieve your due date, empty-armed, heavy-hearted, worried, yet trying to find the joy of having those few months with you. I will remember the warmth of the sun on my smiling face during our car ride home from Labor day weekend with our family while feeling you kick inside me.  

Deep breath in, deep breath out.  

Just breathe.

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