Evelyn's Birth Story

All of the difficult times and effort to get here have paid off. We have a lovely baby girl! She is so sweet and laid back. As if all the difficulty of trying to get her here was a down payment on the difficulty of parenting. We're reaping the rewards with a very good and easy baby! I'm not sure how long that's going to last, but we are enjoying a happy baby girl so much right now!

You've read the story of conceiving this angel, here's the story of her birth.

Perhaps because we spent a year trying at a viable pregnancy, I was so sure this baby was going to come early. I was ready to have her in my arms, and I was sure this meant that she was coming around 38 weeks. Also, my birth with Adelyn, her older sister, had gone so perfectly and quickly that I felt this was further evidence that things would happen early.
Because of the easy birth with Adelyn, we did not take a refresher birthing class, and we really gave very little thought to a birth plan. I think Jordan and I both assumed I would go into labor, and then we would labor at home until we had to go to the hospital to have a baby. But babies have a way of asserting their independence even from the womb!
At 37 weeks I found out that I was GBS positive. Not a huge deal, but it meant we would not be able to labor at home as long as I had thought we would. This brought up a lot of concerns for me about how we would know when it was time to go to the hospital. I was worried that things would happen quickly enough that I wouldn't get the two rounds of antibiotics I needed, four hours apart, in order to prevent Evie from having to have IV antibiotics after she was born. While this was on my mind, I still didn't figure it was going to make much difference, we were just going to have to be a little more careful about timing once I went into labor.

Happy Due Date!

My pregnancy continued. I was having periodic Braxton Hicks contractions. Sometimes so regular that I was sure it was the real thing, but eventually they would taper off and that would be it.
I got to my due date and my doctor, Dr. Melissa Crochet, sat down with me to talk about what we needed to do. Having been through four miscarriages with me, she was also invested in getting me a healthy baby in my arms. We discussed that if things didn't happen, I would be induced, 2/10, 9 days after my due date.  I really didn't want to be induced. I was worried it would mean a natural childbirth was impossible, and might even put me at higher risk for an eventual C-section. However, this was still so far away, I was sure it wouldn't be an issue. Still, having this end date in my mind made me start to really focus on trying to have a baby.
My friend, Carrie, was also pregnant and had had the same due date as me. Magically, she was still pregnant as well! On 2/5, the Wednesday after our due date, I played hooky from work and met her to spend the day together. We had lunch and coffee and did some walking and shopping for craft items. Still, no labor for either of us. So I went to work the next day.
On Friday morning, 2/7, Carrie texted me that she thought labor was starting, but she probably had a ways to go yet. This lit a fire under me. Something about contemplating the last days of pregnancy as the most pregnant person in the world! I threw in the towel at work and declared I had worked my last day before my leave. That day I went to the mall and walked miles with another friend, Christine. Then I went and had a chiropractic adjustment of my hips to see if we could help the baby descend. This really helped me being able to walk comfortably, but didn't seem to get contractions going. Still, I felt I was doing something, and I still had three days until the dreaded induction!
Saturday I was exhausted and sore from all the walking the day before. I went to a professional conference and sat all day, still with periodic contractions, but nothing regular. Carrie had her baby in the wee hours of the morning on Saturday. On Sunday, I started taking cohosh, an herbal supplement that is supposed to stimulate labor. Still nothing. I cried buckets that night.

So we arrive at 2/10, Monday morning. While induction wasn't what I wanted, at least I knew I would be having a baby that day. We did toy around with not showing up for the induction, but really, at 9 days past my due date, I was terribly uncomfortable and I had been thinking labor and birth were imminent for about four weeks! So, we showed up, but a half hour late. It was really important to me to get to take Adelyn to school that morning. We had breakfast first as a family at Einsteins and then dropped Addie off together. I cried in the car the whole way to the hospital.
When we got there, they checked us in and checked me to see where we were starting from. I was dilated to a 3. Our doula, Shannon, arrived around 10am and shortly after that, they started the first round of antibiotics contiguous with the pitocin. Dr. Crochet said the plan was to continue the pitocin throughout the course of two rounds of antibiotics, four hours apart. We would increase the pitocin every 30 minutes during that time. Since each round of antibiotics took 30 minutes to drip in, that put me on pitocin for at least five hours. After that we would see where things were and break my water.
While I was on the pitocin I had to be on continuous monitoring, so I wasn't allowed to move around much. We did what we could, but really the contractions were irregular and not very strong. Certainly nothing that was going to lead to having a baby.

Three hours in, around 1pm, I thought I felt a pop, indicating my water had broken. However there was no gush of water, not even a drip, so I assumed I must have been mistaken.  Dr. Crochet came in shortly after, around 2pm to check me. I had dilated to a 4 over the four hours that I had been there on the pitocin. Dr. Crochet went ahead and broke my water, though when she went to do it, she mentioned that there was fluid, indicating it had likely broken sometime earlier, just not fully.
I was nervous to let her break my water, considering that I hadn't made much progress and I still wasn't having regular contractions. She assured me that this was really the best thing and it would get things going. In addition, if she broke my water, we could discontinue pitocin and see how things progressed over the four hours until I needed the next round of antibiotics. I agreed, as this would mean we could have my poorly placed IV removed and then replaced in a better location in four hours. But I would be IV and heplock free for four hours, with the freedom to walk around the hospital.
We went walking around. We toured the hand museum, the gift shop, and tried to do some stair walks. Unfortunately, the door at the top of the stairs was locked, so we had to get the attention of the ICU nurse to escape the stairwell.
We had to go back to my room every 30 minutes to check on baby's heart rate, but otherwise, it was a blissful free four hours. I did start having regular contractions, but still not very intense until around 5pm. I was checked again at this point and was at 6cm. We continued walking, but stayed on our floor.

Things were definitely picking up. I began vocalizing through contractions and really needed counter pressure on my lower back through each one. At one point Jordan began to let the pressure off a little too early and I told him, "If you stop right now, I'm gonna kill you." I really preferred to be standing for this part of the labor, so we didn't experiment with different positions much, mostly just walked laps around our floor, stopping to lean against the wall or on Jordan's shoulders during each contraction.

I was still in good spirits though, and handling the contractions well, so when Addie finished up with school and gymnastics class, we gave the go ahead for her to come in for a visit. She got there around 5:30/6. At first she was so shy and quite, not at all normal for her. She had a lot of questions about everything.

While she was there, I had a few contractions. I was vocalizing through them, so she wanted to know what I was doing. I told her that it helps to "sing" through them and she asked if she could help. I told her sure, so she came over the wall where I was working through a contraction and stood next to me making the same low vocalization I was making, so that she could help.

She wanted to be a part of it, so when I was leaning on Jordan to get through another contraction, she put herself between our feet, head between our bellies.
I had really wanted Addie to be able to be a part of the delivery, but I didn't want her to be scared. I was so glad that she was able to come for a little bit and be with us. It really warmed my heart!
After Addie left, it was time to restart the IV and get the next, and hopefully last, round of antibiotics. Once that was finished, I was free to move around again, but the heplock was kept in place.
Around 7:15 I began to feel like things were getting close and I might need to push soon. I said this and Shannon went to get the nurse. She checked me to see if it would be ok to push, but said I was still only at a 6. I couldn't really believe this, considering how I felt, but I began to think about what it would be like to endure this more intense labor for several more hours.
They thought perhaps the baby was positioned posterior, which is why I needed so much counter pressure on my lower back. This would make it difficult for her head to dilate my cervix completely. We moved to the bed where I labored on my knees, leaning over the birthing ball while Shannon used the rebozo through a few contractions. I tried to breathe through the urge to push, blowing raspberries, but it was very difficult, and I knew that another few hours of this was not an option.
In between contractions I told Jordan and Shannon that it might help if I used the restroom. I didn't think I really needed to pee, but I knew that if there was anything in my bladder, the urge to push might be less if I emptied it.

So we made our way to the restroom, no more than 5 feet from the bed, but so hard to get to in this stage of labor. I had two contractions in the restroom because they were coming so fast, and the urge to push was only getting more intense. On my way out of the restroom, I wasn't able to make it all the way to the bed before I was overcome by another contraction. I leaned against the wall as I had through earlier contractions, but the urge to push was so incredibly strong I couldn't hold it off. As the contraction subsided, I growled to Jordan and Shannon that I didn't believe the nurse about my progress, the baby was coming NOW! Another contraction started immediately and Shannon raced out of the room to get the nurse. Jordan stayed with me, providing counter pressure, and a hand below me, just in case the baby came before anyone could make it in.
About 10 nurses came running into the room, one of them asking me if I could make my way to the bed so she could check me, but there was no moving mid-contraction. And even after that one tapered off and I stood upright and began to turn to go to the bed, there wasn't enough time to take a single step that direction before another contraction began. With that contraction, there was no stopping the pushing. The head was out, and moments later, I was holding Evelyn in my arms.
Evelyn was born at 8:20, about 50 minutes after I was checked and was only at 6cm.  I had fewer than 10 contractions between then and her birth. Dr. Crochet didn't make it for the delivery. She came in a few minutes later. Evelyn was caught by a first year resident on duty at the time. She only had time to put on gloves before she was thrown into the fray, probably her first solo delivery. Definitely her first standing delivery! Come to find out afterwards, when she caught Evelyn, she had one hand on either side of one of my legs, so once the baby was out, she wasn't able to maneuver to get her to my arms. Luckily there were enough nurses to help with that and twisting Evelyn around to free her of her double nuchal cord. She weighed 8lbs 10oz, exactly the same as Adelyn.
Despite all my misgivings about the antibiotics, being induced with pitocin, and having my water broken, it was a perfect birth. I couldn't have asked for better. I feel so blessed to have had two amazing birth experiences. While childbirth is definitely painful, I have so thoroughly enjoyed both of my births.
I can't say enough for how professional and considerate Dr. Crochet was through the whole process. She wasn't annoyed at me for not blindly trusting her. She calmly assured me that this was the right thing to do and that it was going to be ok. And she was so right. I also can't say enough for the help of Shannon, our doula. She did an amazing job through the delivery and the photos that she managed to capture of the birth, even with all of the frenzy going on in the room, are just spectacular. And the cherry on top, is little Evie. Perfect from head to toe, loved immensely by me, her dad, and her big sister!

20 week ultrasound

Our anatomy scan ultrasound is tomorrow. I know people must go into this with excitement, happy to see their baby and maybe find out the gender. I feel like that's the normal way to feel. I'd be lying if I said I was approaching the appointment with anything other than anxiety and dread. Is it my job, my history of pregnancy loss, or just a pessimistic nature? Probably a combination.
When I think about the appointment, I imagine myself on the table looking at the screen. The room is full of a thick silence while the sonographer takes a closer look. It's obvious there's a problem. From there my imagination brings me to wondering what type of problem? Is it something serious or just concerning for a possible problem? I'm already imagining the follow up level two sonogram or fetal MRI or fetal echo.
With all of that going on in my head, there's not a piece of me that can be excited. I try to tell myself I'm being crazy. I will myself to imagine everything going well, but the daydream where everything goes well seems so much less realistic than the one where there's a problem. The best I can do today is just stop the daydream when I realize its getting started. Just avoid thinking about it.
At least once it's over, there won't be this anxiety to contend with. How long do you think until my head comes up with something else to worry about?

Pregnancy after multiple miscarriages

After four miscarriages, being pregnant again kind of makes me crazy. I mean, at 12DPO, I had already taken four pregnancy tests. But I think even normal people do that... maybe. Once I was sure I was pregnant is when it really went off the chain! The best way I can think to describe it is that I needed every possible reassurance that the pregnancy was still going on. I knew from experience that the longer the pregnancy went on before I knew I was going to miscarry, the more difficult it was. So everything I did from here was to reassure myself that things were going well.
11 DPO - I called my doctor to tell them I wanted to come in the next day, a Friday, to have an HCG level checked. They reminded me of false positive home pregnancy tests and that it was too early really, but let me come in anyways
12 DPO - Pregnancy test that morning before going in to get my HCG level measured, faint but definitely present line. HCG reported back to me that afternoon as 28. While this is an early positive, one HCG level doesn't mean anything, it's the doubling time that counts. This is when I discovered betabase.info. This is a magical website where thousands of women have put in their beta HCGs at different stages of pregnancy, so you can get a good comparison with lots of women. My level at 12 DPO was lower than the median for a singleton pregnancy. I was sure this was the first sign of doom. We were told to come back on Tuesday (it was Memorial Day weekend) for another HCG level.
15 DPO - It's Memorial Day and I can't wait any more to know how things are going. So, I take another pregnancy test, just to make sure that the line is getting stronger. Adding to my crazy, I make sure I do this with a small, dilute sample. The line is definitely stronger. Just so you really understand how crazy I am: I took this test in a gas station on the way home from our weekend trip to Lake Charles. I also had the previous test from 12 DPO in my purse (all weekend!!!) so that I would be able to compare them when I decided it was time to take another one.
16 DPO - Return for HCG level in the morning. This time, I'm so sick with nerves waiting for the call that I can't even eat lunch. They call me that afternoon, and the level is 315. I'm not kidding, I cried. That is an amazing level. I put it into beta base and it's a better doubling time than the median as well as a better level than the median level for a singleton pregnancy...in fact it's approaching the median for twin pregnancy??? I'm told to come back for another level on the following Monday. Oh crap, almost a whole week. What am I going to do?!?!
21 DPO - take a pregnancy test... obviously. This time it's like three drops in the middle of the day. The pregnant line is bright pink and the control line is barely present...that's how dilute the sample was. At this point pregnancy tests really can't tell me anything more... boo!
22 DPO - HCG 4434!! Now my level is between the median for twins and triplets. I'm remembering the three mature follicles they saw before my trigger, and I start to think, just a little, that I might have other things to worry about. But the worry of whether or not the pregnancy is going to stick is enough for me for now. We did put our plans to buy a new car on hold at this point. Can't go buying a 5 seater if we're gonna have triplets! The plan was for a sono in a week and three days.
26 DPO - I told myself I could wait, but I couldn't. I started having cramping, which was the first sign of miscarriage with my most recent pregnancy. I called the doctor and asked if I could come in for blood work. They were very understanding and agreed. My HCG was 15,111. The median for twins is around 10,000. Triplets is 17,000. EEK! But at least the pregnancy is going well. That afternoon I started to experience nausea! YAY!!! At this point, HCG levels can't even tell me anything. Beta base only goes to 30 DPO.
31 DPO - Our first sono. I was wreck the whole day. Through all of these miscarriages I have had three sonos. Two of them were bad news and the third, was a lie. My most recent miscarriage I went in at 6 weeks and saw a perfect heart beat, and then at 7 weeks, it was gone. I was expecting bad news. Even with all the good HCG levels. On top of that there was the possibility we would learn the life changing news that we were having multiples. A wreck!!
The sono
6 weeks (because DPOs are getting ridiculous now) - The first thing I see is only one sack. Phew! Also that is amazing news because it means my HCG levels are that much better!! Then the search for the flickering heart. Yes, it is there. The heart rate is 118. She says I'm 6 weeks and 3 days. At the end of the 6th week, they expect the heart rate to be 120, so we're right on track. Slow heart rates are a first sign of possible miscarriage. She told us that the sack is nice and round, a good sign. She and the doctor both tell us that if they didn't know our history, they would say this was a home run, perfect pregnancy. 
But there is my history. And I still don't know how this ends. Last time we were here, the next sono showed us a miscarriage. The first time, it was 9 weeks before there was a problem. For now, everything looks good. But part of my crazy is that I can't hold on to that. On the way home from the sono I was already planning how I would react when the next sono didn't show a heart beat. I already know I will have a D&C, not a natural miscarriage. I know we will probably stop trying, at least for awhile... this is too hard. I stop myself from day dreaming about all of the fun things, like telling Addie and like actually having a baby. After a year and a half and four miscarriages, it doesn't matter that I'm six weeks pregnant and nauseous and exhausted or that I've been reassured that things are going well 8 different times. I can't believe it. In the words of a friend, it's like every piece of good news is another step out onto a precarious ledge, and any minute the whole thing is just going to collapse. Jordan says that we should make that image into a bridge, so that there's at least the possibility of crossing... I can't even get there.
They are going to let us come back every week for sonos. I wonder when I will start to believe we're going to have a baby. There's some positive thinking. Even wondering when I will start to believe it implies that at least somewhere in my head I think there's the possibility that things may continue long enough for me to start to believe it. That also means there's a lot more crazy to come. I hate that now the only thing I have for reassurance is the sonograms... Oh, and my temperatures. Yes, I'm still temping. I now have 34 days of temps above my coverline. I think I'll keep temping until I run out of paper; that should be in another month and a half. We'll see how I feel then though. I do realize that the sono would probably show me a problem before my temp dropped. At this point my progesterone levels are so high, I'm sure it would take a couple of weeks after the baby died for my temp to drop. Still... it's something I can do.

BBTs and Fertility Drugs

BBT
For those of you who don't know, this stands for basal body temperature. Kind of on a whim, when I wasn't allowed to start trying yet in February, I decided to start measuring my basal body temperature. This is your temperature immediately upon waking after at least 3 hours of uninterrupted sleep. I borrowed a book from a friend and did some reading about it. I hoped "temping", as I've come to lovingly refer to it, might give me some information to help in our baby quest. Temping really tells you one main thing, when you ovulated. Your temp is down (mine is around 97.7) before you ovulate and then it magically rises the day after you ovulate (mine goes to around 98.3). Not a huge difference, but if you graph it every day, it's certainly a big enough spike that there's an obvious difference. I knew I ovulated, but I wanted to know more about my cycle. One of my main theories was that I had a luteal phase defect. This means the time between ovulation and the start of menstruation isn't long enough. An average luteal phase is 14 days, a "sufficient" luteal phase is 10-11, sources vary. Anything less than 10 is very unlikely to produce a successful pregnancy. Well, I knew I had a short cycle, 25 days on average instead of 28 like most people, but I wasn't sure if those three days were shaved off the pre-ovulatory phase or the luteal phase. So, I started temping.
This was very inconvenient in our lives, because we also happen to have a two year old who really didn't want to stay in bed. For the first two months of temping, she was up in the middle of the night, coming into our room and requiring "someone" (husband) to get up and bring her back to bed. If I got out of bed to help her, it would mess up my temp. So we divided into shifts, anything before 2am, I would handle, that would allow me 3 hours consecutive sleep before temp time. Anything after would be him. Conveniently, Adelyn really only woke up around 5am, so all the duty fell to my dear husband! Luckily we have all of that sorted out now (we put a gate on her door, works even if we don't close it!!), but I thought I would throw something in here about what a pain this was for us. It also means no sleeping in, ever (not that we could with a two year old around).
Even with all the difficulties, I found the information very useful. My luteal phase was 9 days the first cycle, and 11 days the second. Borderline for a luteal phase defect, but I also noticed that my temp wasn't stable in the luteal phase. It would regularly dip down below my cover line (the line that indicates your highest pre-ovulatory temp). I definitely thought something was fishy.
Fertility Drugs
In March we went back to the reproductive endocrinologist for a sonogram to see if we could start our first cycle of fertility treatments. We were finally cleared and good to go, so I met with the nurse to learn how to give myself injections (!!!) and how to order these drugs. The trick to this is timing. The timing starts from the first day of your period. Once you start your period, you have to go in for a sono to make sure the ovaries are ready to go (no cysts). This can be on day two or three of the cycle depending on when they're able to schedule you. If everything is ok, my treatment plan was to start taking clomid on day 3 (possibly the same day you just got told you were ok to start treatment) and then you start taking the injections on day 5. The injections are only available from a specialty pharmacy, and obviously each time I needed them was on the weekend. Both treatment cycles I ordered drugs Friday with Saturday delivery so I could start taking them Sunday night. Jeesh! One of them was the Friday before PKU camp, so I was rushing around trying to procure some clomid to take that night and arrange for my drugs to be delivered while I was away for the weekend. Ridiculous!
My first treatment cycle was and wasn't a success. I didn't end up pregnant, so big fail there. But my luteal phase was better. That cycle it was 11 days, with each and every day above my coverline. None of the bouncing around I had seen with the un-medicated cycles. I was pleased enough with that that I was only moderately disappointed with not being pregnant. So, I started my period, and back in the doctors office for a sono to see about another treatment cycle. This time, no dice. Cysts all over. I think there were 8 in total. This is apparently a normal reaction to fertility drug stimulation. Still, let me again say how much it SUCKS to want to be pregnant and have to use birth control!! I think most couples going through fertility treatments don't use birth control the months that they aren't on treatment. Perhaps the chance of getting pregnant is less, but hey, any chance is a chance right? Not for us. I just knew we would get pregnant, we had every other time. And I just knew that would mean another miscarriage. It was awful, but each and ever time we were tempted to throw caution to the wind, I would remember my New Year's resolution - no more miscarriages!!!
So we sat out a month, and I went to grief class and my luteal phase was erratic. Every one around me in the whole world was pregnant. I was sad. And by the way, ovarian cysts HURT!
I went back with my period again, and this time, no cysts. So we raced around (this was the pre-PKU camp treatment cycle) and got the drugs and did the treatment.  So to walk you through the end of a treatment cycle. I started injections on day five, continued with clomid days 3-8, then injections through day 10. Then into the office for a sono to see how the follicles are coming along. I went in on Friday, May 10th and had three mature follicles. This means ready to trigger. So that night I gave myself the HCG shot, which is used to trigger ovulation. We scheduled our intrauterine insemination (IUI) for May 12th. Mother's Day. We hadn't tried the IUI with the first cycle, but the drugs are expensive, and we decided the chance for success was better with the IUI, so we would go for it and throw all of our eggs in one basket so to speak. IUI is not a romantic procedure, but we went in together, so at least we were both in the room. And then we were sent on our way for the two week wait.
Everyone talks about this two week wait. That's the time between ovulation and when you're supposed to start your period if you're not pregnant (a luteal phase if you remember). For me, it's really only ever been 11 days at most. All the while, I'm temping. I was glad to see my temps well above the coverline and even a few spiking up to 98.7, higher than I had EVER seen my temp before. I just knew I was pregnant. So, 9 days past ovulation (DPO) I took a pregnancy test. I swear there was the faintest second pink line. It was so faint though that if I blinked it was gone. Also, because the trigger shot is HCG, you run the risk of a false positive pregnancy test if you take one too early. So, obviously, I took one at 10 DPO - still too faint to be sure my eyes aren't playing tricks on me. At 11 DPO, the line is still very faint, faint enough I can't even get a picture of it to send to my husband who is out of town, but I swear it is there. And it can't be a false positive if it's getting stronger right!?!! The pregnancy test at 12 DPO was positive enough for a pic, and I was sure by then. 12 days was longer than any of my luteal phases previously.
Yay hooray! We are pregnant. So now begins the obsession that only someone with multiple miscarriages can really commiserate with, but I thought I would invite you to share some of my insanity in the next post.

Coping

Getting Ready to Try Again
Recovering from my fourth miscarriage, I knew we still had things to do before we could start trying again. And in all honesty, I needed a break. A chance to get grounded again and stop the trying and crying. I think about these four months now as a time of healing and really trying to understand what I had been through. Until now, we were full steam ahead trying without looking back. I coped with every miscarriage by racing forward until I could try again. After a year, it was clear that this might take much longer than I had anticipated, and perhaps it might not even happen at all. I needed some time to think about that.
We still had some imaging studies to complete with the reproductive endocrinologist, so I waited until my next period after the miscarriage and then went in. The imaging was normal, except for some retained tissue from the miscarriage. He sent me to get my HCG levels checked to see what was going on. Everything was normal, HCG of zero. He thought that meant I was going to pass it, but didn't think it was a good idea to try with this cycle, given the tissue. I was told to come back in March, with my next period. Just a word here about how frustrating it is to want to be pregnant with every fiber of your being, but still have to be using birth control!!!
In the meantime, one of my very close friends at work informed me that she was pregnant. She knew everything I had been going through and disclosed this news to me in the most sensitive manner possible. It still broke my heart. Her due date and mine were days apart. She waited as long as possible to tell me, trying to let me heal a little. This hurt a little, because of how open I had been with her about what I was going through, but looking back, and imagining being her, I can't figure out when else would've been a good time. Waiting so long to tell me meant that she started showing very soon thereafter. For a bit, every day was a challenge to maintain my composure at work and not lose it.
I was having such a difficult time, and I knew I needed some help. Our church started offering a class called "Navigating Grief." I waffled on it, thinking for sure I would get pregnant during the 8 week course, and then I wouldn't need it. In the end, with everything at work, and feeling like I had lost one of my main confidants, Jordan and I signed up for the course. For 8 weeks I went every Monday night and cried with a room full of a dozen heart broken people for an hour and a half. The first night, I had to share my story, and it was one of the first times I had said the whole thing out loud. I bawled through it. One of the other almost impossible assignments was to write a letter to our loss, and then read it aloud to the class. I'm not the only one who presented with body-shaking sobs. Finally, we had to bring a memento, something that reminded us of our loss, and share it with the class. This was hard. I had very little from everything I had been through. I had intentionally gotten rid of all of my positive pregnancy tests and even the only ultrasound picture I had from my most recent miscarriage. I did have an ultrasound pic from the first miscarriage. I pulled it out...and cried. I brought that and a song that my friend mentioned above had shared with me...about multiple miscarriages. You can hear it here...
http://mirandadodson.bandcamp.com/track/try-again
More sobbing during class. I have never been so close to people I really hardly know.
By the end of the series, I could listen to that song without crying - a big accomplishment - and I can talk about my experience. It still brings tears to my eyes, but not the body-shaking sobs that accompanied the telling the first time through. The class taught me that we really need to talk about our grief. It's not comfortable for me to say or for you to hear, but it helps to process the experience. I can't believe so many people in my life have no idea what I went through that year. It's ridiculous that I thought I was protecting myself and my friends from something by not sharing my experience. The class made me decide that I would go public with everything... when I was ready. So here it is!

Our Long Journey

So I haven't posted since Adelyn was a baby. Last post was about teaching her how to clap her hands. Amazing what going back to work will do to your motivation to keep up with a blog! Well, Adelyn is wonderful, but this is a baby blog, and while she will always be my baby, at almost 3 years old, I'm not sure she qualifies that way to most people. So I didn't really come to talk about her. I came to talk about our quest over the last year and a half to further expand our family with baby number 2.

We got pregnant with Adelyn fairly quickly and really expected it to go the same way the second go around, which it did... and didn't.
Our First Pregnancy After Addie
In December 2011, we found ourselves pregnant, almost by accident. We were almost ready to start trying again, so we were a little nervous, but excited. Time plugged along, we were getting used to the idea, but I guess given my profession we didn't "go public." I had some kind of idea in my head that if there was a problem, I wasn't sure I wanted to air my dirty laundry for the world to see. So, we shared with family and close friends, but nothing more.
My first sono was scheduled for February 13th, I think. But Jordan was going to be out of town. I called a friend and my mom to see if I could find someone to go with me, but after thinking through the reason I wanted someone with me in the first place (in case something awful happened), I decided it was best to reschedule for the next day, when Jordan would be back. This happened to be Valentine's Day. I was 9 weeks pregnant.
The minute they pulled the image up on the screen I started searching for the fluttering heart beat... nothing. No movement either. The tech confirms the date of my last period (making sure I'm as far along as I think I am). She measures the little bean that's in there...it measured 9 weeks, but no heart beat. At 9 weeks, there should be a heart beat. The doctor comes in and explains that we are having a miscarriage. The baby is dead. There isn't anything that can be done about it. The whole thing was as awful and painful as you might imagine. I was far enough along they recommended a D&C rather than waiting for it to pass on it's own, which could be painful and take many weeks. We were scheduled for the procedure in the next week or two. This followed by blood tests to make sure everything cleared. We met with the doctor again and she showed us sono pictures and explained that the nuchal translucency (thickness at the back of the neck) was larger than you would expect, likely the baby had some kind of chromosomal defect. I knew all of this. Miscarriage is common. It happens in 30% or more of pregnancies. I wasn't surprised, even if I was sad. I was mostly wanting to move away from the whole terrible experience and start trying again.
Our Second Pregnancy After Addie
We were told to wait two regular periods before trying again. This took two and a half to three months. Then we were pregnant right away. This time they brought me in for early beta HCG levels to monitor my progress. We found out pretty quickly, around 6 weeks that my levels weren't doubling like they should. While this was a much less devastating way to find out about an impending miscarriage, the shock of having two in a row added a whole new layer of sadness. I could see my self becoming a statistic. We miscarried beginning of June, after 7 or 8 weeks of pregnancy. Luckily this time we were early enough into the pregnancy that I didn't need to do a D&C. Natural miscarriage wasn't so bad... like they say, an intense period... except with heart break. 
Testing
After two miscarriages, my OB wanted to do some basic lab tests just to make sure that there weren't any obvious and fixable problems. These tests can't be done when you still have HCG in your system, so we waited a month and then went in. Several weeks later, the results are in and everything is normal. I'm a carrier for an MTHFR mutation, but who isn't really. With just one, that shouldn't increase risks. Still, she says she wants me to take progesterone and aspirin with my next pregnancy. Just in case.
Our Third Pregnancy After Addie
Since we didn't have to have a D&C and with waiting for all of the tests, we were cleared to start trying again. Again, we got pregnant quickly. I went in immediately for blood tests, and knew immediately it was no good. The pregnancy was non-viable at 5 weeks and I miscarried at 6 weeks.
Three consecutive miscarriages is multiple miscarriage. 1% of people have multiple miscarriages. We are the statistic all of a sudden. We were referred to a reproductive endocrinologist, my OB said this was beyond the scope of what she could manage.
More Testing
We met with the reproductive endocrinologist (RE) at the end of October. It was an hour long appointment, and he basically spoke with us about multiple miscarriages. He said that if you think about how common miscarriages are, you would expect people to have three in a row just by chance, and shared the statistic of 1% of all people having multiple miscarriages and how, that's really a lot of people. He's right. If it was a genetic variant in 1% of the population, we would call it a benign polymorphism. Given my age and that two of the pregnancies were "only chemical pregnancies" (I could've punched him in the face for how he diminished my experience like that) I should expect to be able to have a live birth even with everything we'd been through. Still, he wanted to do some other testing. He sent some blood work that day, and told me to schedule some uterine imaging with my next period. They called me with results in a week, mostly normal. Maybe I have low ovarian reserve, but basically normal. Oh, and your progesterone was high, so maybe you were ovulating. No, actually, I was pregnant!
Our Fourth Pregnancy After Addie
Since they hadn't really done anything at the RE office, they said we could monitor the pregnancy there or with my OB, our choice. I was more comfortable with my OB, so we held our breath and got my HCG levels...everything was good. They scheduled an early sono for 7 weeks. But 6 weeks in I started experiencing some cramping and panicked. My wonderful OB worked me in and did the sono herself with me in tears through the whole thing. There was a flickering heart beat. Everything was fine. I was measuring a few days later than I thought I should, but everything seemed fine. I was elated... and began to actually hope that this would be the one. I kept the scheduled sono appointment for the next week, because I'm a panicked freak of nature at this point. My mom went with me as Jordan was again out of town. I thought I was safe with the normal sono the week before. Alas, no. No heart beat this time... not even a recognizable fetal pole... just a mess. I met with the doctor to talk options. It was the week before Christmas, so if we were going to do a D&C, it really had to be the next day. I really didn't want to go through that again and my other two natural miscarriages hadn't been so bad, so I decided to just deal with it.
It was the most awful Christmas. I got the flu on Christmas Eve and ran a fever until December 27th. We then went to Beaumont as I was beginning to recover, to see my family. I began to miscarry on December 30th. It was awful. Nothing like the other two. It was miniature labor. I was having actual contractions. **Warning, this is graphic** At my grandfather's house I went to the bathroom...and passed the baby. I couldn't see anything, there was too much blood. But I felt it pass. And then there wasn't anything to do but flush it down the toilet. So. Awful.
I continued to have contractions and intense pain for the next few days. I had pain medication, but it was really just awful. After the flu, I was exhausted. I think I spent the whole Christmas break curled up in a ball in all the guest bedrooms of everyone in our family. I went back to work on January 3rd and felt mostly back to normal. I was seeing patients and went to the bathroom. **Warning, this is also graphic** I had still been bleeding, but nothing more than a period. When I went to the bathroom I passed a clot, and then the blood started gushing. This was one of the things they told me to be worried about...continuous and unrelenting bleeding. I couldn't even leave the bathroom I was bleeding so heavily. I freaked out. Thank goodness I had my cell phone with me. I called Jordan and he navigated getting me in urgently to see my OB. He came to pick me up, by which time the bleeding had slowed enough that I thought there was a possibility I might not bleed out onto the floor. Thank goodness my OB is close to my work. She examined me. I had passed a clot. I guess what happens is your uterus works on passing the clot by squeezing and contracting and squeezing and contracting. If it passes, great, but if not, it just keeps trying. This amounts to squeezing a cut and making it bleed and bleed...except inside your uterus...behind a giant clot. When the clot passed, all of the blood that had built up behind it for the last couple of days came rushing out. Scary! I still had a few clots. She prescribed me something that should help with passing them (makes your uterus contact stronger) and told me if I bled again like I had, I needed to go straight to the ER. It's too much blood to lose twice like that.
**Safe for squeamish again** Luckily there were no further incidents. I finished having the miscarriage, but did retain some tissue that took months to pass. We went back to the reproductive endocrinologist and he did his imaging, nothing abnormal (except the tissue from that miscarriage).
He sat there and told us that they had come up dry. No answers. No cause. No idea what the problem is. Four miscarriages in a year, and no reason. He said we could either keep trying without intervention and we would likely get pregnant and eventually succeed in carrying to term. The only other option had limited evidence of utility, but he offered to do fertility treatments, with the idea that if the problem is poor egg quality (something you can't really test) then the fertility treatments will beef up the quality of my eggs and hopefully give us a better chance at success. Well, we were done trying naturally. My New Years resolution for 2013 was no more miscarriages. So, after being pregnant four times in one year, we entered into the realm of fertility treatments!
 

Clap Your Hands

The most amazing thing!!! Adelyn claps her hands on command. I know I must have taught her things before now, things that she just picks up from being around me. This is the first thing I feel like I actively taught her. The first thing that I thought, "I bet she could learn to clap her hands", and then she did learn it. I know it's not a big thing, probably not even really that impressive, but somehow I am astonished by it. I'm amazed that she understands the words, that she can make the movements to actually clap her hands, and then that 2/3 of the time, she actually wants to do it when you ask her to. It's amazing and pretty much the cutest thing I've ever seen!
It seems like Adelyn is pretty amazed by her new ability as well. She claps a lot even when she isn't asked to. She always watches the people around her when she's doing it, and I think she realizes that she has discovered this universal form of communication. Everyone knows about "clap your hands"! All the strangers at the grocery store, all the moms and older kids at play group, and all the people that go to baby bounce at Northpark. I can only imagine what's going on in her mind, but I think she is SO happy to have a way to make everyone clap their hands back at her. Because of course that's the first thing that happens. If a baby claps their hands at you at the grocery store, of course you clap back!
We recently started working in "touch your head". Once she had "clap your hands" down, I wanted to add to her list of tricks, and she already seems somewhat fascinated by being able to touch the top of her head...so I started telling her that she was touching her head when she chose to touch it. Then I would ask her to touch her head and take her hand and pat her head with it. She isn't as consistent with this one, but in the last two days, she touches her head probably half of the time that I ask her to. Now we're working on "wave goodbye". Then, I think we'll do "point your finger". I think she's going to be disappointed that some of these things aren't quite as universally used to communicate, but I'm pretty sure she'll still get grins of approval from random strangers when she touches her head on command.

I'll post video when we get it...of course whenever we put the camera in front of her face all thoughts of clapping evaporate!