Pregnancy After Miscarriages

We’ve had support and love and prayers and positive thoughts from so many as we’ve gone through our pregnancy journey. Strangers and acquaintances have extended unexpected kindness; family and friends have shared in our heartache. I’ve connected with people from across the globe, literally, as a result of sharing our experiences. And there have been questions by many who are following our story. How is the pregnancy going? Are you doing anything differently? How do you feel? What are they [medical team]  doing for you?

Time to write and capture it all seems impossible some days but I know I’ll regret it if I don’t. So with less than 12 weeks until our due date, I’m committing to writing more. For therapy, for my children, and for those that may be helped as a result.

The photo attached to this post captures 21 months of trying, planning, losing, hoping… of joys and heartaches and faith. I asked my friend and photographer to take this image during our recent session–an image that displayed my bracelet, necklace, and healthy baby belly. The jewelry contains charms/birthstones for three babies, though we have only one living child. Losing James at 17 weeks and then Morgan at 9 weeks was the journey that brought us here–pregnant for the fourth time and experiencing a healthy and happy (while worrisome) pregnancy. I can’t help but wonder about the heartache, its purpose, and who this new life will be and their profound role in our lives.

Every milestone during this pregnancy has given me reassurance that we will be blessed again with a healthy pregnancy, a full term of nurture and that we will hold this child full of life and opportunity in December. The first trimester was the hardest. I nearly wished it over because I wanted it to pass quickly and be beyond the ‘iffy’ stage where miscarriage risk was at its highest. Then there were the meetings with the specialist, genetic counselor, and ultrasound techs. I held my breath each time and partially prepared myself for bad news or intervention. In a past post, I wrote about the feeling of waiting for the bottom to fall out… that is what it felt like. Once I began approaching the 20-week mark and after confirming ultrasound images, I gained confidence and affirmation that we would welcome this child as we intended.

During this pregnancy, I have been reminded by several people more than once that I’ve experienced miscarriages, I may do so again, I need to be careful, and my favorite, I’m of an “advanced maternal age.” Some would even have me believe that my body was broken and without intervention, I’d experience heartache again. I followed precautions and had faith that my body that once carried a child to full term, and delivered that baby without complication, could so again.

I want to do everything possible to protect this child and provide them a full term of nurture but I want to do so as naturally as possible. For the most part, that is a contradicting statement. I could have elected to do more. I found a balance that worked for me. Each person has to find their own harmony, trust their gut, and have faith. So here is what pregnancy, at age 37, after two miscarriages looks like for a mama who opts to let nature and God control as much as possible.

We conceived in late March/early April and I got confirmation via home pregnancy test on April 14.  The result of that test filled me with joy and fear simultaneously. I’ve kept that positive pregnancy test in my bathroom cabinet. Every time I take my vitamins, there it is, still beaming “PREGNANT.” Not as much now, but in the early weeks, I would look to that for confirmation and assurance that I was carrying a viable life.

The same day I went to the clinic for lab work to check my progesterone levels. They were not as low as they were with Morgan but lower than where my midwife wanted them to be so she ordered a prescription of progesterone via Crinone 90 mg. Each evening I would administer this via vaginal suppository and was told I’d need to continue to do so through the first 15 weeks until the placenta was established enough and could produce progesterone on its own for the baby. Due to the concern of another miscarriage and being on Crinon, pelvic rest was also ordered as well as limiting any strenuous activity or heavy lifting. Easier said than done with a toddler.

On May 25, I met with my midwife again. She was unable to find the heartbeat so she sent me to ultrasound. I fought back emotions as best I could and when the tech revealed there was a baby, with a heartbeat, I wept. I was referred to a specialist and began co-management at my local clinic with an OB. So essentially, I had three doctors to report to.

In late, June I met with the specialist who took images of my cervix and determined the images could not rule out an incompetent cervix and that losing my son at 17 weeks was likely the result of said cervix. She discussed surgery and intervention that would result in an automatic c-section delivery and require me to go under anesthesia. Both of which I felt was too invasive. She then persuaded me to meet with a genetic counselor which was another roller coaster ride. I had blood drawn to run the test–I opted for the minimum, the check of chromosomes 13, 18 and 21. There was an ala carte of options, however, so many to choose from. I didn’t want any of them, I didn’t want to know. The process of discussing these potentially life-threatening diseases or mutations was enough to cause me nausea and concern. I can’t image getting positive results and carrying that throughout the pregnancy.

In early July, those results came back. No abnormalities. At that same time, I went back in for new images. This time with much better success. The images revealed a closed cervix measuring about 3cm. Shorter than they would have liked but long enough to take surgery off the table for immediate consideration. Instead, ultrasounds every two weeks to monitor the cervix for funneling, shortening or thinning. They also wanted to adjust my progesterone supplement from a 90 mg suppository to a 250 mg muscular injection form. I did some research and wasn’t comfortable with that–in short, the concept of injecting progesterone into my buttock muscle once per week didn’t make logical sense. If it’s needed at the cervix, wouldn’t administering it there be a better method? I convinced the specialist that continuing that route was best and what I was most comfortable with. She agreed but increased the dose from 90 to 200 mg. And what originally was supposed to last 15 weeks was extended to 36.

Each ultrasound revealed a strong cervix doing exactly what it was designed to do. As the weeks went on, the window on surgery closed and soon, we required no further meetings with the specialist. There was nothing more they could do–it was all on me and the babe. At this point, we were nearly 25 weeks along.

A work trip was scheduled for September which was strongly advised against by my providers. With the help of web conferencing, I was able to participate virtually.

_L3A1672_1 copyToday we are 28 weeks, 5 days into pregnancy. I still check for blood every single time I go to the bathroom. I still have the worry. I question every symptom or lack of symptom and analyze the meaning. I embraced nausea and pregnancy symptoms. Waiting to feel the baby’s movements seemed torturous at times. But with each passing day and week, they lessen and more focus is placed on the day I hold this child in my arms. And now I find myself wanting time to slow down again. This is my last pregnancy and I love being pregnant. Our babe is very active and I’m so grateful for their movements and health. I’ll miss this. I video record my belly as it moves from the activity below it. I bare my belly in the privacy of our home every chance I can. I’m sharing name ideas with my husband. And I’m involving my daughter in this pregnancy as much as I can. At nearly two-and-a-half, there is only so much she comprehends but I think she is grasping it pretty well. “I’m a Big Sister” is a new favorite book that she picks out most nights to read (a book we got for her just before her first birthday with the anticipation of her becoming a big sister to James in October 2016). I’ve been grateful for this time with her and for the awesome blessing of being her mama.

Philippians 4:6-7 “Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus.”

Psalm 56:3 “When I am afraid, I will trust in you”.

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