About unfertilized

Navigating the infertility jungle as I make my way on this crazy, seemingly never-ending, baby making journey. TTC#1 since June 08. Success through FET in September 2011, due in June 2012..

Of Milestones and Healing

This blog has not died, it’s just been in some serious hibernation mode! Once again I find myself in the familiar place of having several blog posts half written in my head and not enough time to sit down and compose my thoughts in an orderly enough manner to post online.

While my own infertility struggle has been resolved, infertility continues to be part of my life through involvement in online infertility communities (particularly twitter), my volunteer role with an infertility charity, and of course by seeing the toll it continues to take on people I know who still walk this difficult path.

My own healing process is also ongoing as I continue to gain (often surprising and unexpected) insight into my own experience with infertility, even from my current privileged vantage point. I am a numbers person –  numbers are a natural way for me to make sense of the world – and infertility lends itself well to being reduced to a numerical shorthand. Anyone versed in this shorthand can understand notations such as: TTC 32 months, 4 IUI’s, 2 IVF’s, 3 mc’s (just an example, not my story). But at its most basic, the weight of another month or year passing with seemingly no end in sight is an experience that those facing infertility can relate to.

While I thought that my infertility story had been written, I am surprised to find myself facing yet another milestone. My husband and I first started trying for  baby in June 2008. I got pregnant with my first son in September 2011, or after 3 years and 3 months of trying to conceive. Now, in a few weeks, it will be 3 years and 3 months since that beautiful little embryo first snuggled into my uterine lining to become a part of my life forever. In other words, the amount of time that has passed since I conceived my first son will soon be longer than the amount of time that it took to conceive him.

Over the last 3 years and 3 months the process of shedding the psychic weight of infertility has been gradual, and like any weight shedding exercise, filled with periods of sudden weight loss, followed by plateaus, and continuing slow and steady drops. After giving birth to my second healthy son, I thought that I was finally done.

However, I now find myself with pent up anticipation of welcoming this new milestone. I remember back in my dating days, that once a relationship ended, I felt like I could only have true closure once enough time had passed to cancel out the effects of the time spent in the relationship. I now look forward to taking this next step in my relationship with infertility.


Perpetuating the Infertility Taboo

As I mentioned in a recent post, I will soon take on a more public and impactful role in the wider infertility community through volunteer efforts with an organization whose mission  is focused on infertility awareness, support and advocacy.

Outwardly, my volunteer efforts will focus on helping other people who are experiencing infertility, however, my motivation for taking on this role is not  purely altruistic. Aside from all of the usual benefits that people get from volunteering their time, I am hoping that this more public role will force me out of my comfort zone and get me talking more about infertility, and my own experience with it in my day to day life.

While living with infertility, I did not like to share many details about what was going on with friends and family. I was always honest when people asked if I wanted kids, and would freely share that we were trying, but that was usually the extent of it. As I have written in earlier posts on this blog, the reluctance to share many details extended even to other people in my social circle who were also experiencing infertility (though in this case, the reasons for not wanting to share were much more complex).

The sad thing is that I think at the time, my instincts were correct, and I was emotionally better off by not sharing. Even now, when I am sharing my experiences with others who are in the midst of their own infertility struggles, if the topic of being more open with their broader social circle comes up, I generally advise that the less said the better. Instead, I give them ideas of how they can connect with other people also experiencing infertility, or steps they can take to protect their emotions from the repeated painful reminders that being infertile in a fertile world can bring.

Unfortunately, infertility remains one of the last taboos. Probably the closest analogy I can think of is the perception of mental illness, yet I think even mental illness has come a long way in the last ten to twenty years in terms of public awareness, and acceptance of the mentally ill.

All of these factors lead to a vicious cycle: the general public has many misconceptions about infertility; as a result, infertiles who choose to share their struggles find themselves facing ill timed or intrusive questions, or receiving unsolicited advice from caring friends and family who are trying to be supportive (not to mention much worse from others who may not be as well meaning); leading to infertiles deciding they are safer to keep quiet about their struggles; resulting in an uninformed public and the continuing taboo.

There is the odd person who has the emotional and mental make-up to take on the role of advocate while in the midst of their own struggles, however for most people, I think it is more realistic to advocate once their own infertility is resolved (however that resolution may happen). Therefore, I strongly believe that in order to break the vicious cycle, and properly educate the public about infertility, it is up to those (like myself) whose emotional resources are no longer drained by infertility.

And yet, despite promising myself that once I had Baby Boy I would be more open about what we went through and share my experiences with friends and strangers alike, to date I  think I have failed miserably. The reasons for this failure are many.

I am generally at peace with my own experience with infertility. Yes (as I explained in a recent post), the scars are there, but they are just that – scars. Infertility is no longer a gaping, weeping wound, nor even a fresh scab that can easily be picked to bleed again. It depends on the day, but I would guess that it has an impact of 5% to 10% of what it used to (and much of this is actually due to the positive after effects of infertility, which I also described in the aforementioned post). Therefore, I think I am in an excellent position to advocate and share my story every chance I get.

However, the reality is very different. When I do bring my experiences up in conversation, I tend to keep it vague – I say that “it took us a long time”, or maybe (the odd, odd time), I admit to doing “fertility treatments”. And while I wish that I took every available opportunity to share even this amount of information, I usually only bring this up when I suspect that the person in front of me may also have experienced (or be currently experiencing) infertility. And when I share even these fairly neutral statements (from behind my current shield of motherhood, and growing pregnancy belly no less!), my stomach is clenched and my heart is racing, and I feel completely naked and exposed.

Therefore,  I completely understand why infertility remains a taboo topic, because despite my best efforts so far I have not been very successful in doing my small part to change things. I am looking forward to what I hope will be growth and healing as I take on my new role, and slowly, step by step become the advocate I’d always hoped I could be.

Infertility by the Numbers – Drugs, Drugs, and More Drugs Part 2

This post starts off where my last one left off. If you haven’t read it, good to at least go back and read the intro paragraphs where I explain the reason for these posts. In this post, I’ll talk about other drugs that I took while undergoing IUIs.

4. Prometrium

Prometrium is a progesterone supplement that comes in round little balls. Its most common use is as hormone replacement therapy for post menopausal women, but it is often used to supplement progesterone in fertility treatments.

I first started using prometrium as part of my IUI protocol – taking it several times a day between the procedure date and the pregnancy test date. The fun part about the prometrium was that I had to insert the little balls vaginally, which was a whole new experience for me.

Prometrium’s most common side effects are deceptively similar to early pregnancy syptoms – fatigue and sore, tender breasts, which of course makes for an interesting two weeks while waiting to find out if you’re pregnant or not!

5. HCG trigger shot

The HCG trigger was a shot that I took before the actual IUI procedure (for IVF, which is more fresh in my mind, it is taken 12 hours before the egg retrieval; I believe for IUI it’s more like 24-36 hours beforehand, and in any case the precision of the timing is not as critical).

HCG is the hormone that your body produces when pregnant (it’s what shows up on pregnancy tests), and for fertility treatments, it is often used to “release” the eggs once ultrasounds show that they are big (and therefore mature) enough. For IUIs, the trigger shot results in ovulation, while IVF is timed such that the eggs are retrieved just before you would ovulate on your own.

Initially, the Dr. would do the shot himself, but for my injectable IUI cycle and my IVF, I administered it myself, since I was already giving myself other shots.

The somewhat crazy thing with the HCG trigger shot is that you have to mix it up yourself – there’s a powder and a liquid and you mix them up together and then inject. This extra step adds to the stress of the treatments (not to mention that, unlike most of the other drugs, the shot needs to be precisely timed with the timing of your procedure, so I spent lots of time worrying that I would miss my window).

6. Femara (letrozole)

Now that I’ve discussed some “ancillary” drugs, it’s time to get back to the good stuff! After three rounds of clomid, I was ready to move on to other fertility drugs. My Dr. suggested that for my next IUI we’d do femara, and if need be, add some injectable medication.

Femara is similar to clomid in that its a little white pill, and I took it for several days at the start of my cycle. It can also be used to induce/enhance ovulation, however people tend to have fewer side effects from it (most importantly, it is not known to thin your uterine lining like clomid can).

The catch is that (in Canada at least), femara is not approved for use in fertility treatments – rather it is a drug used to treat breast cancer. Therefore, before being able to take it, I had to sign a release with my Dr. that I understood this. Femara also came with the reassuring warnings that it should not be taken if you are trying to, or suspect you may be pregnant (?!), but my Dr. reassured me that since I was only taking it early in the cycle, it would be long gone from my system by the time I may become pregnant.

My Dr. had me come in for an ultrasound several days after taking the femara, and based on what he saw, decided that we would add injectable drugs to complement the femara.

7. Puregon (Follistim)

Puregon (also known as Follistim) is an injectable fertility drug. I first took it in small doses in my femara/injectable cycle, and later also took it as part of my IVF.

Once you move onto injectables you feel like you’re in the big time – no more little white pills, bring on the needles! The other thing you notice right away is the big time cost. While a cycle of clomid or femara will cost about $100 (give or take), injectables for an IVF cycle will set you back thousands of dollars (less for an IUI, as you don’t want to grow as many eggs, but still much more expensive than pills).

And then there’s the injectable side of it – yes now you (or your partner) have to give yourself needles. The nice thing about Puregon is that it comes in a great delivery system – you inject cartridges into something that looks like a pen, you set the dial to how much you need to take, and in it goes. It’s pretty fool proof, and the needle is super thin so once you finally get the courage to jab yourself, it goes in like butter and you barely feel it.

Doing those first few shots though is difficult. I had heard that it hurts less to do the shot yourself, so since I am a wimp when it comes to pain, and my husband is squeamish, we decided that I would do all of my injections myself. In order for my husband to feel like part of the process, he would sit with me in the room, help me get everything set up, and then look away when I actually did the shot.

This is one of the difficult things about fertility treatments – no matter what the underlying source of the infertility is, except in rare cases, it is the woman who has to take all the medication, and go through the actual procedures, so I found it helpful to involve my husband wherever possible to keep him as invested in the process as I was.

8. Orgalutran 

This is another injectable medication that I took as part of my last IUI. At one of my early ultrasounds, the Dr. noted that I had one follicle that was much bigger than the others. Therefore, the risk was that I could ovulate from this follicle too early in the cycle. The orgalutran was supposed to prevent ovulation from happening, so that the other follicles could catch up. If I remember correctly, I had to take it two nights in a row. It came in a pre filled syringe, but I was supposed to only inject half of it each night, which of course was another thing to stress and worry about.

This last IUI cycle again yielded two eggs for me, and again resulted in a negative pregnancy test. At this point, after 6 IUI’s, we decided that it was time to move onto IVF. My last post in this series will explain all of the drugs I took in preparation for, during, and after my IVF cycles.

New Beginnings

Lotus Flower, Innisfree Garden, Millbrook, NY

The experience of infertility has been on my mind a lot lately. There are a number of reasons for this – a big reason is that I am on the verge of stepping up my involvement in the infertility community in a big way through a volunteer role with an organization whose mission is to educate people about infertility, and advocate for, and provide support for people who are infertile. Needless to say, I am super excited about this opportunity.

Something else that I am super excited about is that I am pregnant again! I haven’t blogged since I found out (on either of my blogs), for all of the usual reasons, but at 21 weeks along, I am more than halfway through this pregnancy (I just updated the details on my “TTC Journey” page). Once again, I am enjoying an uncomplicated, fairly symptom free pregnancy, and am looking forward to welcoming Baby Boy’s little brother into our family.

While my husband and I are not committing to “never again”, the reality is that in all likelihood, our family will be complete once this baby arrives. This means that after six years where trying to conceive, infertility, and pregnancy were such a big part of our lives (at times overshadowing everything else that was going on), we will be closing the door on our reproductive years.

This is, of course a wonderful place to be. After having lived through the anguish and uncertainty that infertility brings, both personally, and through the stories of the hundreds of infertile people I’ve connected with (online and also in person), I know how incredibly lucky we are to get the “happily ever after” ending.

And yet, the last six years are so imprinted in my mind, that it’s still hard for me to see ahead to the time where something that was so front and center in my life will no longer matter. I cannot get my head around never again worrying about the ins and outs of my menstrual cycle, never buying another ovulation prediction test, nor needing any more fertility clinic appointments. Even something as matter of fact for most people as taking birth control after this baby arrives has me torn and confused, as it is diametrically opposed to everything I’ve been working towards these past six years.

For better or worse, infertility (and everything reproduction related) seems to have seeped into my identity and affected my world view to such an extent that in order to move forward beyond infertility, I find myself fighting a version of stockholm syndrome now that I will soon no longer be a hostage.

Before I  wrap up, I feel the need to point out that I have seen posts similar to this one be misinterpreted by those still in the trenches.

What I have touched on here is the coming need (and hopefully) eventual ability for me to move beyond MY infertility. I do not wish to forget or erase the past, nor do I plan to ignore what infertility means to millions of other people who continue to live with that reality every day. Moving on personally does not mean that I will stop supporting other infertiles (and in fact, as I mentioned at the start of this post, I hope that in the coming years I will be able to make a discernible, positive impact on the lives of people who continue to struggle with infertility). Arriving at a healing place, and continuing to be supportive of others are not mutually inclusive.

Lastly, despite all the negative aspects of infertility, the experience has taught me a lot:

– it has opened my eyes to the many amazing advances in science and medicine that have taken place just in my lifetime, while also teaching me that all of our advanced knowledge and tools can still only go so far;

– it has tested me in a way that nothing else in my life has, and as a result taught me about my level of resilience;

– it has increased my empathy towards others who are dealing with hardship (including any number of medical conditions) in their lives; and (more to the point)

– it has taught me to never, ever take for granted the ability to conceive, carry a pregnancy, deliver a healthy baby, and be able to build your family in the way that you had planned.

Crossing the Great Divide

This is another post that I wrote on my other blog, however as much of it deals with the experience of infertility, I thought it may be of interest on here as well.

Baby Boy turned one recently, which means that it’s been just over a year since I became a mother. There is an argument to be made that I was already a mother to the babies that started developing in my womb but did not make it, or to the embryoes created during our IVF, but in this post I want to focus on motherhood in the traditionally understood sense of the word: a woman with a child. As someone who struggled with infertility before becoming a parent, it has been interesting for me to explore over the last year to what extent my experience of infertility impacts my identity as a parent, and vice versa.

While we were trying to conceive, as the months and then the years passed by, I found myself detach more and more from the world around me. The experience of infertility is very isolating, and sometimes it felt like every day brought fresh reminders of how different our reality was from that of our friends, colleagues, and society in general.

When you are first trying to conceive, the initial months are unremarkable: you have sex at the “right time of month”; you read the first chapter of pregnancy books to make sure you’re doing all the right things to conceive; you imagine how your life will change when you have a baby; and then you wait to see if your period will arrive on schedule or not. It is very easy to find community and common ground with friends and strangers alike when you are in this stage.

As the months go by, you start to get discouraged, but it still feels like pregnancy is just around the corner. You did not get pregnant the first month trying, or even the second or third, but your experience continues to be unremarkable. At some point though (and this point is different for everyone), you start to notice a divide between your experience and what you have read or heard about. As you go further and further down the road, the divide becomes greater. Key events that signify that your experience is no longer “normal” may  include trying for over a year (and realizing you are now considered infertile), experiencing pregnancy loss, and the initial visit to a fertility clinic. Suddenly, you realize that you do not know anyone who shares these experiences (or maybe you do, but they have kept their struggles to themselves).

Realizing that you have to rely on a fertility clinic to help you conceive is a difficult thing to deal with, as is having to go through the testing and investigations required to narrow down what the problem is, and once identified, learning to accept the problem. Lying in bed after having sex, as you think of baby names for your likely newly conceived baby is a distant memory. There is another divide once you start fertility treatment, and then a further one when you move on to IVF, with each step leading to further isolation and loneliness as your story becomes more and more removed from the typical narrative (there are further divides, but I will stop there, because that is where my experience stops).

Once you become pregnant, the struggles do not stop. You are now part of a sisterhood that you have been yearning to join, and you are closer than ever to achieving what has often felt like a distant dream.  But, even though you are ridiculously happy, the divide is still there. While from the outside you look like any other pregnant woman, as soon as you speak to other pregnant women, or parents of young children, you are reminded of how different you still are. While they are complaining of the normal pregnancy aches and pains, you are terrified that there is something wrong with your baby, and are closely watching for pregnancy complications that could impact your baby’s health. You cannot relate to the experiences described on pregnancy websites.  Even though you are pregnant, you are still infertile.

And then you give birth to a healthy baby. You take your baby home, and your new concerns become feeding your baby, sleep (theirs and yours), and making sure baby is reaching their developmental milestones. You learn about teething, fevers in babies and starting solids. Perhaps you struggle with going back to work, and how to find childcare for when you do.

You find community with other new parents and find that they have all the same concerns. It does not matter how their babies got there; you are all in the same boat now. Sometimes you think you love your baby more because of how much you fought to bring them into the world, but then you see how they look at their babies, and how tenderly they hold them and you realize that they love their babies just as much.

And this is where I find myself today. I am first and foremost a parent. Whether I am talking to my friends who also had babies in the past year (without the experience of infertility), or whether I am reading my twitter feed filled with tweets from women parenting after infertility, the concerns are the same. We all want what’s best for our babies.

When politicians speak of family friendly policies, they are now speaking to me. At work, or at social gatherings, I can finally contribute to the conversations about the joys and challenges of having children. The huge weight that was on my shoulders has been lifted. The feelings of isolation, of “otherness”, of feeling different are gone. I have crossed the great divide.

This Time Will be Different

I published this post on my other blog, but I figured it had some relevance here too…

Sometime this year, my husband and I will start the process of trying to conceive baby #2. This moment is still months away, as there are a number of moving pieces that have to fall into place before we can reasonably attempt any baby making. At minimum, I need to wean, get my chicken pox vaccine, and get my period back. Since we have five frozen embryos from our IVF cycle, we are planning on jumping right into doing a frozen transfer as soon as we are in a position to do so, therefore there will also be the various tests and procedures that our clinic requires before proceeding with a transfer, not to mention coordinating our schedules with both the clinic where our embryos are, and the clinic where we will do our monitoring for the cycle. The many joys of procreating by committee will soon be upon us.

While I have tried hard not to speculate about what trying to conceive will be like this go around until the time comes, in the last few weeks I’ve often found my mind spinning as I try to process the ramifications of what getting back on the baby making train will mean for us. This is due partly to the fact that we are starting to have preliminary discussions about what our timing is going to look like, and that I am getting close to weaning Baby Boy (I had planned to breastfeed him to a year, which is another two months away, but based on his lack of interest over the last few weeks I suspect our wean date will come sooner than that). I have also recently read a lot of blog and twitter posts that touch on some of the issues I have been struggling to get my head around, related to life after infertility, secondary infertility, and infertility amnesia.

I have no idea if or when we will have another baby. If we do have another baby, I don’t know if we will get pregnant via frozen transfer, natural conception (ha – sounds like immaculate conception to me!), or through further fertility treatments. I don’t know if it will happen on our first try, or after multiple attempts. But despite all of the uncertainty, rather than feel panic at the thought of climbing back on the roller coaster, I am at peace with whatever our outcome may be. I am at peace, because I know that the worst is behind us.

The experience of infertility while trying to conceive Baby Boy was akin to falling down a deep chasm, and having no idea how far you had left to fall, or what sort of landing you would have. Along the way, we were willing to grasp at anything that would help us achieve a quick and safe landing – in the six months before we conceived Baby Boy, my husband and I agreed that we would pursue donor eggs, donor sperm, or surrogacy if we got any indication that any of those would resolve our infertility (unexplained infertility is its own deep chasm, but that’s another story).

I am a planner by nature, and while trying to conceive Baby Boy, having a plan gave me some semblance of control over an uncontrollable process. I was always two steps ahead: if the current cycle/treatment option failed, I had a plan A, and then a plan B if plan A failed. At the time we conceived Baby Boy, I had my plan A and plan B all set, and my husband and I had the resources (financial, emotional, physical) to keep going balls to the wall until we achieved our goal. We were not at the point where we had an end date (whether fixed on the calendar, or based on a number of things happening, or not) at which point we would change course to pursue adoption (when we had last discussed it, this was an option my husband was not interested in), or living permanently child free.

While overall, our mindset was that given enough time and treatments, we would eventually be successful, not knowing how our story would end was still terrifying. The future held so much uncertainty, and there was no way of knowing how much more heartbreak in terms of failed cycles, pregnancy loss, or even just the cruel passage of time we would have to endure before we held our baby in our arms.

This brings me back to my original point about starting the process of trying to conceive again. No matter how many times I turn the idea of it around in my head, I come to the same conclusion: this time will be different.

This time will be different because we are not starting at zero: not only do we know way more than we should about all the ways that conception can go wrong and therefore are intimately familiar with how difficult it can be; but the existence of our five frozen embryos (that paradoxically only exist due to the extent of our struggles first time around), mean that we are starting out ahead of the game.

This time will be different because we are no longer in a chasm of unknown depth. I can look ahead and know with certainty that I will not have to endure multiple fresh IVF cycles in order to bring my baby home (I am not ruling out the possibility of doing another fresh cycle if none of our current embryos take, but I don’t see a scenario where I would do more than one more fresh cycle). I know that if we are to have another child, it will take us less time to conceive this time around than the 3+ years it took us the first time, for the simple reason that due to my age it has to (I’ll be between 37 and 38 when we start trying again).

This time,  there are limits to what we will go through in order to conceive. I know that we will transfer each of our existing embryos until one sticks, but if we are not successful, we are not going to go to heroic efforts to have another baby. Lastly, knowing that we had the strength to survive failed cycles and pregnancy loss the first time around gives me comfort that if needed, we have the strength to survive again. All of these factors mean that when we start trying again, we will be able to feel, or at the very least, see the ground below our feet. We will be able to reach our hands out and find something sturdy to hold on to, rather than grasping at air as it slips through our fingers.

This time will be different because no matter what happens, I will never forget that even our “worst case scenario” of being parents to one healthy, amazing baby boy is many people’s dream.

Wrapping Up

I did not expect so much time to go by since I last wrote! I do have some unfinished business on here, which I will try to mostly wrap up with this post.

I did start writing a Part 3 to the delivery story which wrapped up a few loose ends and described the rest of our hospital stay. It feels like so long ago now, and I feel like it’s a little late to do a blow by blow at this point, so I’ll try to keep this part brief….

As I wrote in my last post, Baby Boy, while healthy overall, was not in good shape when he was first born. His hospital discharge papers describe him as being born “flat” – limp and not breathing, with an initial apgar score a whopping 2 out of 10.

It took two minutes for the staff to get him breathing. He also had to be intubated as he’d swallowed meconium that was floating around in my amniotic fluid. The doctors said that the meconium was a recent occurrence, and while he had swallowed some, it had only made it as far as his vocal chords and thankfully not into his lungs. His five minute apgar score was a respectable 7 out of 10.

Once things calmed down, the Dr. told us that upon seeing the shape Baby Boy was in when he was delivered, we definitely made the right decision to deliver when we did and that it was a good thing we did not wait a few more hours. Even now, three months later, writing this makes me emotional.

Since the pregnancy had gone so long, it’s likely that my placenta was starting to shut down, resulting in the problems that we saw. It scares me to write this and put it out there, but in a different time and place, without the medical assistance that we had, we would not have had a happy outcome.

[On a related note, the phrase “Babies come when they’re ready” which many people seem to throw around lightly infuriates me. Even while pregnant, when I heard/read this phrase, my first thought was always “except when they don’t”. I could write an entire blog post/rant about this (and maybe I will one day). In the meantime, let’s just say that my baby was definitely ready, and yet there was no way he was coming on his own. Somewhere along the way, either he or my body, or both did not get the memo that it was time. Okay, back to the rest of the story.]

Once I was moved to the recovery room, I finally got to see Baby Boy in person and hold him for the first time. I did some skin to skin contact and breastfed briefly, however he was pretty stuffed up which made breathing through his nose difficult, so the breastfeeding didn’t last long.

Shortly afterwards, we found out that Baby Boy had a fever, so he was admitted to the NICU as a precaution. As I wrote in my last post, I was group B strep positive, however due to things going quicker than expected, I did not receive the full dose of antibiotics before he was born. Therefore, Baby Boy’s fever was a concern as it could mean that he had contracted the infection, so he was put on a round of antibiotics for 48 hours until his blood test results came back confirming that there was no infection. In addition to receiving the antibiotics, he was also under observation in the NICU. Thankfully there were no issues and he was out in two days.

Throughout the last few months of my pregnancy, every indication was that Baby Boy was going to be big. This did not come as a surprise to me, as big babies ran in my family. I was 8.5 pounds when I was born, and my little sister was close to 10, and my Dr. told me to expect Baby Boy to be between 8 and 10 pounds. Sure enough, Baby Boy came through, with a birthweight of  9 pounds 2 ounces.

After seeing Baby Boy, the staff in the delivery room commented on his size, and in particular on his really big and round head. The consensus was that if things had turned out differently and I had actually gone into labour, a vaginal delivery would have been somewhere along the spectrum of very difficult to impossible. While Baby Boy got his high birthweight from my side of the family, he also got a giant head from my husband’s side (my husband was only 7.5 pounds at birth). Once the pediatrician measured Baby Boy’s head size, it turned out to be in the 95%.

So much for a quick wrap up, that took way longer than I expected!

As I mentioned in a previous post, I will not be blogging about Baby Boy or motherhood on this site, however I have started another blog for that purpose. For any of you who are interested, you can follow or check out at: frostymomma.wordpress.com. I have written a few posts there, but I admit that so far, the blog is just limping along.

I do have a few final thoughts on the infertility journey that I would like to post here, so expect a few more posts on this blog from time to time.

Birth Story Part 2 – the Delivery

Picking up where the previous post left off….

June 22nd (41w, 5d) – 11PM

After lots of waiting around the last few days, once we get moved back to labour and delivery to start the pitocin, things start to move quickly. As soon as we get into the room, the mood feels electric and purposeful, and there is a real sense that this is going to be it, and that the baby would be coming soon.

I am pleased to find that the nurse assigned to me is the same nurse who I met in triage the night before and really liked. She also remembers me, and I am really happy to have her on my team. Since the idea of the pitocin still freaks me out, I mention to her that I will want an epidural sooner rather than later, and she reassures me that I can have it at any time.

I’d been monitored for the baby’s heartbeat and contractions every few hours since being admitted, but now that the pitocin was going to be administered, I would be constantly hooked up to the monitor. I was Group B strep positive, so in addition to the monitor, I got an IV put in to administer an antibiotic to clear up the infection, and protect the baby from contracting it.

June 22nd (41w, 5d) – shortly after 11PM

The nurse hooks me up to the monitor, which immediately shows that I am having a contraction! I am feeling a little crampy in my lower pelvis, but it does not feel anything like what I expected a contraction to be. “Are you sure it’s a contraction?” I ask the nurse.

She feels the top of my uterus, and since it is really hard, she confirms that it is, in fact a contraction.  The news of an actual contraction, even before the pitocin is administered is a good sign. There is a festive, celebratory feeling in the air, however it is short lived.

The nurse frowns at the monitor. “That’s not good.” We learn that once the contraction was over, the baby’s heart rate took a dip. The nurse explains that while it is not unusual (and okay) for a baby’s heart rate to dip during a contraction, a dip right after is not a good sign as it means that the baby is not handling labour well. So, we watch to see if the same thing happens with the next contraction.

The nurse is pleased to see that the next contraction does not end with a dip in baby’s heart rate, however, before we can relax, the heart rate goes flat. As I mentioned in my last post, the baby’s heart rate should be within a certain range, and also fluctuating within the range (with peaks and valleys). In our case, while the baby’s heart rate is still within range, there is very little change from beat to beat. Instead of seeing peaks and valleys, you don’t have to be standing very far back to see a flat line.

A flat heart rate tracing could mean one of two things: either the baby was resting/sleeping, or he just was not doing well anymore and needed to come out sooner rather than later. So, the first step was to try to “wake” him up.

June 22nd (41w, 5d) – waking up baby

I remember seeing the flat pattern once earlier in the day. That time, the nurse had said the baby was probably resting, and sure enough once I ate something, the baby almost immediately “woke up” and started moving around. So, now we would once again try to wake the baby up.

First I have some sweet apple juice. Nothing.

Then the Dr. (who, along with a resident are in and out of the room this whole time) tries to irritate the baby to perk up by moving my stomach around. Still nothing.

Next, the resident finally manages to pull out the foley in case it is bothering the baby. And still nothing.

While the baby has generally been very active, I realize that this whole time I had not felt him move at all.

At this point, the Dr. starts talking C section if continued monitoring shows no change. From the conversation between the Dr., resident and nurse I find out that of everyone on the very busy labour and delivery ward, they are most concerned about us, and one other patient. In a matter of hours we’d gone from super low priority to highest priority.

The nurse continues to watch the monitor, which continues to show no change. I’d been lying on my left side this entire time, so she suggests maybe if I move to my right side, we might see some improved activity. I move over to my right, but as soon as I do, the baby’s heart rate plummets. Upon seeing this, the nurse yells for me to turn back to my left, and thankfully once I do, the heart rate goes back to its familiar flat pattern.

The Dr. and resident come running into the room. “What just happened there?” The nurse explains the change in position, and the Dr. tells me to stay on my left side.

June 22nd (41w, 5d) – getting ready for decision time

I am not totally sure of the exact sequence of events, or how long any of this takes, but several things happen now:

  1. The Dr. explains that she does not like what she is seeing. She is going to do a C section on another patient, and if there has been no change in the baby’s heart rate by the time she comes out, we will be going straight to a C section too.
  2. The nurse suggests that since I had indicated that I’d prefer an epidural early in the labour process, we may as well get one going now. Even though I am not yet in labour, I would need one if we end up doing the C section, and as this is looking more and more likely, getting an epidural now would shorten the prep time later.
  3. The Dr. says to stop the pitocin as she does not want anything to happen while she is in the operating room doing the earlier C section. I am not clear on when exactly the pitocin was started, but it is now stopped.

June 23rd (41w, 6d) –  sometime after midnight

The resident anesthesiologist comes in to administer the epidural. He asks me if I am a runner, which I find very flattering. I explain that I did not run during pregnancy, but did run on and off before that (though I do find it hard to identify as a “runner” given that I usually did not have a regular routine, and do not run very far or very fast). He explains that he could tell from my muscular back (!).

I feel an icy river trickle down my back as the epidural goes in. It is some time before I feel any effect, but eventually I do start to feel some tingling in my feet. I then start to feel colder. I know from my reading that feeling cold is a very common side effect from epidural (seen in about 50% of cases). I mention to the nurse that I am feeling colder, and she confirms that this is nothing to worry about. She asks if I want a blanket, but I am fine without. We’re in the middle of  a heatwave, and even with the air conditioning going, it has been over a week since I’ve felt anything but slightly warm to unbearably hot. So, the cooler temperature is welcome.

However, after about a minute I feel like I’m freezing and start shivering uncontrollably. My muscles tense up really tight with every shiver. I tell the nurse that I’ve changed my mind about the blanket, and she immediately brings me 2 blankets that have been warmed up, which feel wonderful when she places them on me. I am soon cold again, and have my husband rub my muscles to warm them up and cut down on the shivering.

The nurse continues to watch the monitor, which shows no real change from before. Finally, she says “I’m not a Dr., so keep in mind that this is just my opinion, but I think you should prepare yourself for a C section. We haven’t seen any improvement, so when the Dr. comes out of the operating room, I expect she’ll want to do a C section on you.”

June 23rd (41w, 6d) – sometime after 1AM

The other C section is over, and the Dr. and resident come into my room. The Dr. tells me that she was watching a read out of my monitor while she was in the earlier C section, and that based on what she saw she’d already made up her mind that we weren’t going to wait any longer. They wheel me to the operating room, and my husband goes to change into scrubs.

There are about a million people in the OR. This is a teaching hospital, and every person in the OR has a resident or student with them. By now, I recognize many of the faces, and most of the others come up to me to introduce themselves.

The prep seems to take forever. I listen to the conversations, and watch my monitor screen. Overall, the mood does not feel frantic or panicked, which gives me comfort. At one point, I hear someone ask the Dr. if this is an emergency procedure. “It’s urgent” the Dr. says.

This spooks me a bit, and I keep watching the monitor. At some point, the Dr. comes to talk to me. She explains that she has no idea why the baby’s heart rate is doing what it’s doing, but that it is not a good sign, which is why she wants to get him out sooner rather than later. She then tells me that if everything is fine, I will hear the baby cry when he is born. If I don’t hear anything, things are not good.

After what seems like forever, my husband shows up and stands by my head. I am happy that he is finally with me again. I am still shivering, but also start to feel very hot on my face. Someone takes my temperature and notes that I have a fever. I can’t believe that part of me still feels freezing cold, and yet I have a fever.

The prep continues. The resident anesthesiologist tests my level of sensation by pricking me, first in places where I am not numbed, then in places where I should feel no pain. Eventually, it gets to the point where I can’t even tell he’s touching me. I hear voices counting in unison, as various staff check that they have all their instruments ready.

I keep watching the monitor. The heart rate continues to be flat, but it is now also a bit above the desired range.

Finally, they start cutting into me. There is a curtain hanging down just below my chest so I can’t actually see what is going on, but I know what is happening. Again, this stage seems to take forever.

And then, the baby is out. I don’t remember at what point I realize this, because he does not cry. The Dr. says “Oh, goodness” when he comes out – and not in a good way. (I don’t actually remember hearing the Dr. say that – my husband tells me about it afterwards. He claims we talked about it right afterwards, but either I totally blocked it out, or I was so focused on listening for the cry that I did not hear it). I see a group of 4 or 5 people move from my lower body to the corner of the room. My baby is somewhere in the middle of them, but I can’t see him. More importantly though, I still don’t hear him.

The resident anesthesiologist is up by my head, opposite my husband. “Everything’s fine. Your baby’s okay” he says. “But he’s not crying. He’s supposed to cry.” I answer. “It’s okay, that’s what all those people are there for” he replies, pointing to the corner of the room.

And then, I hear it! My baby cries out an angry cry. Shortly afterwards, someone asks if my husband wants to cut the cord. Based on how squeamish he is, and our earlier conversations, I am sure he doesn’t, so am surprised when he says he does and bounds right over to the corner of the room. When he comes back, I say “I can’t believe you cut the cord!”. He replies “I just wanted to see him”. And then he pulls out our camera, and I get my first look at our baby boy. His mouth is open wide in a wail, and he has several wires coming out of him, but he’s perfect and he’s all ours! We are finally parents.

To be continued (tying up some loose ends).

Birth Story Part 1 – The Induction (That Wasn’t)

I finally managed to cobble enough time to get this post written. Since it’s long enough as it is, it’s not the complete birth story (the baby does not actually arrive until the next post).

Before I go further, I should clarify something about dates. All along in this blog, I have been using a due date of June 7th, which is consistent with the date that my fertility clinic gave me. However, my OB has been using a date of June 10th. Since the decision as to when to induce was made by my OB, his due date is the most relevant date for the birth story, so that is why in this post my pregnancy seems to go in reverse.

June 19th  (41w, 2d) – 11AM

Final OB appointment – Dr. says it’s time to induce. I go home and wait for the hospital to call me in once they have resources available, which could happen at any time over the next few days.

Feels like the longest day ever.

June 20th (41w, 3d)

Still no call from the hospital. I start wondering whether they actually know they are supposed to call me, or if I’ve fallen through the cracks and am waiting for nothing. Time slows down even more (did not think it was even possible!).

June 21st (41w, 4d) – 1AM

I am in the bathroom getting ready for bed when my phone rings. Yes, it is really 1AM, and yes, it is really time to go kick things off.

By 2AM, I am in labour and delivery triage getting a cervical check by the resident Dr. As expected, nothing is happening, so I get cervadil gel inserted which is supposed to help ripen my cervix and get it ready for labour. The plan is that once I am dilated enough, they can break my water and we can go from there (assuming I haven’t gone into labour on my own in the meantime).

I am monitored for an hour to make sure baby’s heartbeat looks good, then sent home and told to return in 12 hours to check progress (or sooner if my water breaks, the cervadil falls out, or I go into labour).

June 21st (41w, 4d) – 2PM

I feel mild to moderate cramping in the morning, which gives me hope that the cervadil is working. I can’t believe that this is actually happening! We go back to the hospital for our progress check, however when I describe the sensations I’ve been having to the Dr. in triage, she does not look impressed and says she does not expect that we’ve made much progress. The cervical check confirms her suspicions, so after another hour of fetal monitoring, I am once again sent home and told to return in 12 hours.

June 22nd (41w, 5d) – 1AM

The cervadil falls out an hour early when I go to the bathroom, so I wake my husband up and we walk over to the hospital (after the last visit, we stayed at my mom’s house which is conveniently located right across the street).

On the way into the hospital, we run into the husband of the woman who came in at the same time we did the night before with contractions. She had her baby not too long after we saw them. We also run into a couple from our birthing classes, and the female is having some serious contractions. I’m tired, but otherwise feel perfectly normal. “I’m not in labour, I’m being induced” I offer as explanation as to why I don’t appear to be in pain at all.

We have the cervical check, and once again the verdict is the same – no progress. We’ve done what we can with the cervadil, so the resident Dr. explains that I will now be admitted to the hospital for the next stage in the induction process. After consultation with another Dr., I learn that the next step will involve inserting a foley catheter (a little balloon filled with water that should mechanically expand my cervix), and hooking me up to pitocin, which should bring contractions on.

However, before we can get going, we’re back to waiting for a room to become available, so spend the rest of the night resting in triage.

June 22nd (41w, 5d) – 8AM

Finally at 8AM, we get moved to a room in labour and delivery. The nurse explains what’s going to happen next, and checks some vitals. Shortly after we settle in, my OB pops in to visit, and in his usual blunt way explains where we stand:

“I know you feel like you’ve been at this a while now, but since the cervadil did not work, it’s like you’re starting from scratch – the last few days don’t count.” He then warned that I now had “2 strikes against me”, since I had not gone into labour on my own, and the cervadil did not work, so with continued intervention attempts being required, my chances of ending up with a C section are now about 50/50.

June 22nd (41w, 5d) – 10AM

Just before 10AM, the nurse and Dr. working that day come in to tell that there has been a change of plans:

“We’re not going to start the pitocin right away. Instead, we’re moving you to the high risk unit and only doing the foley catheter for now. We’ll check you in 6 to 8 hours and if nothing has happened yet, we’ll start the pitocin at that point.”

I ask why I’m being moved to high risk, and the answer from the Dr. is: “Frankly, because we need this room.” While this is getting a little too familiar (and not in a good way), I am happy to delay the pitocin, which scares the hell out of me. As it is, I’m already dreading the pain and exhaustion that comes with labour, and all the reading I’ve done has prepared me to expect faster and harder contractions with pitocin than what would happen naturally. So I’m all about taking things slow with the interventions and hoping that the catheter will be enough to get things going.

The foley is put in, and I felt quite crampy right away. We move all of our bags to the room in high risk, and I am given instructions to walk as much as possible to put pressure on my cervix and hopefully speed things along. My husband and I spend quite a bit of time walking around the ward.

June 22nd (41w, 5d) – most of the rest of the day

We are pretty much back to waiting. Periodically, the nurse checks on me to check my vitals and hook me up to the monitor to track the baby’s heart rate and my uterine activity (ideally contractions). Since she sees we’re interested, she shows us how the read the monitor. The top tracing shows the baby’s heart rate, which should fall within a highlighted range, while also jumping around within that range. The bottom tracing shows my uterine activity, and the nurse explains that a contraction would show up as a low, gradual hill pattern. However, all I get is periodic spikes which correspond to the baby kicking me, or otherwise moving around.

At every check the nurse asks me if I am feeling any contractions or cramps, and how much pain I am in. Initially, all I feel is the constant, dull cramping from the catheter. I estimate the pain at 1.5 to 2 out of 10. The nurse is not impressed. As the day goes on, even that pain goes away. Once in a while, I do feel a little crampy, so report this to the nurse, but again, I can tell that 3 (not very painful) crampy moments an hour is not what she is hoping to hear.

Ideally, if everything went according to plan, the catheter would fall out once my cervix was sufficiently dilated, however this is not happening. At some point, my husband goes to get some food, and comes back to report that the couple from our birthing classes who we’d run into in triage the night before had their baby about an hour and half after we saw them.

Not that I’m counting, but both couples who we saw in triage over the last two nights now have their babies, while we continue to wait. I know it’s irrational because we are so close to meeting our baby too, but I have a flashback to that familiar feeling while struggling through infertility: “Why can everyone else have a baby so easily and I can’t?”

June 22nd (41w, 5d) – 8PM

Finally, after about 10 hours, the resident Dr. comes to check on me and confirm that the foley is still in tight. Therefore, once a room becomes available, I will be moved back to labour and delivery to start the pitocin. In the meantime while we wait, she suggests that I tug on the catheter periodically to see if it’s loosened up at all. I do as suggested, but each time, it feels as tight as ever.

June 22nd (41w, 5d) – 11PM

We finally get the word that they are ready for us in labour and delivery, so it’s time to once again change rooms, hopefully for the last time before our baby comes. I’m nervous, but resigned to the fact that I do really need the pitocin to make this happen, and ready for something to finally happen.

To be continued…

Checking In

Things are good! For those who are wondering, Baby Boy finally arrived on June 23rd. He is healthy, and everyone is doing well. I am in the process of drafting the “birth story” posts, but I am not done yet, and they still need some major editing. So, it will be a while before they will be up.

Silly me…after having such a straightforward, non-descript pregnancy, I assumed the labour and delivery would be the same, however it turned out to be anything but. Hence the need for multiple posts on the topic.

In related news, I am planning to wrap up this blog soon, and continue blogging on another address, as I don’t want to mix the infertility journey posts with mommyhood posts. I still have a few more posts to write here, and will provide a link to the new site once I’m ready to switch over.

Stay tuned!