Pop!

Today when my husband came home from work, I greeted him with, “I think my uterus popped out today!”

A horrified look crossed his face — I don’t even want to know what he was imagining — and I laughed apologetically and said, “No, it’s a good thing. Come feel!”

Backtracking a bit: This morning I felt somehow heavier around the belly, and I pooed like a dream. I just chalked it up to pregnancy weirdness until…

I’ve been palpating my belly most nights lately hoping to feel something that felt like a ballooning uterus. Not much luck so far. But then today I thought to check it and… whoah mama. No doubt about it. That’s a grapefruit-sized uterus right there in my lower belly!

It’s funny how fast it happened — how quickly it went from wedged in my pelvic cavity to perched on my bladder. (And no longer compressing my bowels.) From no apparent evidence of pregnancy to (literally) palpable evidence.

You still can’t really see it from the outside, but Ahmed felt it immediately and smiled in wonder. There it is — we can feel it. It gets more and more real every day.

It was nice that it happened today, because as great a mood as I’ve been in all week, now it’s been a whole week since my last ultrasound, and it seems psychologically impossible to think about waiting another SIX weeks to get another one. Doubts creep in so quickly. I need to get over it and trust that my body knows exactly what it’s doing. (And these damned ultrasounds aren’t cheap on my insurance that was chosen based solely on its premium and out-of-pocket max since I expected to be giving birth this year, not next year. I couldn’t afford to keep getting more ultrasounds even if I thought it was a good idea. And Ahmed still doesn’t want me to get a Doppler fetal heart rate monitor.)

So today, feeling my uterus pop out to say hello… It was another good Monday. 🙂

OB appointment tomorrow (separate from last week’s MFM appointment). There won’t be an ultrasound, just a check-in and maybe some blood work. I’m hoping after the 19 week scan six weeks from today, I can put off any other prenatal stuff until next year so it’ll go toward that deductible / out of pocket max. (Good Lord I hate dealing with the American medical insurance industrial complex.) I’ll be 28 weeks on January 1. There’s no big thing between 19 and 28 weeks, is there?

Anyway, it is what it is. Trying to enjoy the good things more than worry about the nonsense that is the American medical system (which is especially bad in red states that try to undermine what little we have).

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Doulemma

No Colorado vacation for us. It’s just a little too stressy to spend that money right now when we have so many other things to think about. Perhaps when our child is several months old, we’ll have a better idea of our financial situation and can find a nice time to leave the kid at Grandma’s house and have a “couple’s retreat” then. We may even need it more at that point…

I am signing up for a local four-day meditation retreat, which I did a couple of years ago and really got a lot out of. I heard recently that mindfulness practices can help significantly reduce preterm birth, and I’ve gotten way out of whack as far as mindfulness because I’ve spent so much time just gritting my teeth waiting for disaster. It’s no way to live, and hopefully this retreat will help jump-start me back toward being the person I really want to be.

We met with the two doulas I picked out, and they are both fantastic in their own ways. Doula 1 is a bit younger and has a daughter who’s about five years old. The set-up in her office was a little awkward with her on a couch on one end of the (small) room and us on a couch on the other end. And I was nervous for some reason, maybe just my general social awkwardness combined with the oddness of the set-up (she had recently moved to the new office, so maybe things hadn’t really settled in yet), plus my husband still not 100% really understanding what it was all about. It’s certainly easy, on first blush, to see it as an extravagance.

(Oh yeah, and this was before Monday’s ultrasound, so I was also in a really bad place as far as fearing this was all moot anyway.)

But the more I learn, the more I see the impersonal, medicalized version of birth we generally have in the US as problematic. As my mom said, “We all got through it somehow.” But I don’t want to just “get through” the birth of my child. I’ve heard so many stories of women feeling like the whole process was something that happened to them, where they felt like they had little control and everyone else was managing the whole process.

And of course, if you’re feeling humiliated or stressed, that is not good for labor, which is a process that fundamentally involves surrender. Not surrender to others, but surrender to yourself. Random nurses coming in and poking you every now and then as you sweat and breathe and grit your teeth under hideous fluorescent lighting… It just doesn’t sound right to me. In general, being in labor is not a sickness that needs to be managed. It’s a natural process that may need to be tweaked, but only if things go wrong. And in general, they shouldn’t go wrong. You shouldn’t go in expecting them to go wrong unless you have a good reason to expect that.

Now, I’ve already committed to birthing in a hospital because legitimately bad things can happen, and a hospital is the best place to be in those circumstances. But I’m still hoping for as natural a birth as possible, and doulas are one element that is shown to reduce interventions significantly. Which makes sense. One of the key indicators for being more likely to have a c-section is the number of nurses you have while in labor. The more different people are taking measurements, as opposed to one person staying with you through it all, the more chance there is for error or just impatience (not to mention stress).

I happen to have a long cervix, for example, which might make my labor go longer than usual. A nurse might take a look at the stats and decide I should be induced or sectioned or have my membranes artificially ruptured. Not necessarily even for health reasons but just because it better fits the hospital’s timetable. Hospitals like to be able to time things, to be predictable and efficient.

The human body in labor doesn’t necessarily work that way.

A doula is more likely to say, “Women’s bodies have many natural variations, and this one might cause slightly prolonged labor.” If I have someone like that in my corner, who has experience and isn’t a first-timer like me, I’ll be less likely to cave in when someone suggests an unnecessary intervention. Even a seemingly minor intervention can throw your body’s whole rhythm off and put the baby in distress and cascade all the way up to the Big Slice in no time, and I’d rather avoid major abdominal surgery if I can.

(Obviously, if an intervention is genuinely medically necessary, I’ll do it.)

Labor is all about oxytocin, a hormone that is aided by comfort and relaxation and inhibited by fear or stress. Makes sense — if I was giving birth in the wild, and I smelled a leopard, labor should stop so I could get the hell out of there. If I’m basically tied to machines while a bunch of people are coming in and out of a harshly-lit room telling me to lay on my back so they can stick their hands up my business and saying jargony things I don’t understand, it’s not really conducive to opening like a flower. Yet that’s pretty much the current model. No wonder interventions have skyrocketed.

Luckily there is such thing as bodily autonomy, and I can turn down pretty much anything I want to turn down. I won’t go nuts or anything, but I’m not interested in frequent cervical checks (they can inhibit labor not just because they’re uncomfortable but also because they can be really discouraging if the nurse clucks her tongue and shakes her head like you’re failing, not to mention they can introduce bacteria into a place where it shouldn’t be) or constant monitoring where I’m literally tied to a machine unless there’s a good indication for it.

Having one person who knows what I want and knows exactly how things have gone so far and really knows what she’s doing in that room for the whole time I’m in labor and can help me get my preferences across when I’m, ya know, kind of in the middle of something… Yeah, it sounds like a luxury, but like a common sense luxury. Like something that should come standard, but just doesn’t in our society. (Kinda like universal health care…) My husband and I can focus on “right brain” stuff — being in the moment, going inward, feeling this incredible thing we’re going through — while the doula keeps track of all the “left brain” stuff we learned in birthing class and the exponentially more that she learned to get her doula certification.

And if you look back not that long ago in our society, you have truly insane methods of childbirth. Like the so-called “twilight birth,” in which morphine and scopolomine were given to women to essentially cause them to forget the entire experience of childbirth. Sure, this high-class birth method was “pain-free” (or at least free of the memory of pain), but it turned laboring mothers into raving lunatics who had drowsy, depressed babies who sometimes could barely breathe.

Now we just see that as madness. Not having a doula isn’t as bad as all that, but it does seem a bit crazy to me. In most traditional societies, somebody’s there through the whole of labor, and it’s usually not just a (relatively) clueless husband, much less a procession of strangers.

Doula 1 said, “You have an entire generation of people whose mothers weren’t even present for their births. And now…”

“Now they’re voting for Donald Trump,” I said grimly.

She laughed. “Right?” She sighed. “In Oklahoma, you have to be careful before you say those things.”

I was aware of that. But if she hadn’t laughed, believe me, it would have been a deal-breaker anyway 🙂

She had a strong personality and a lot of thoughts and opinions that we appreciated. She also assured me she’d dim the lights and decorate the labor & delivery room with Christmas lights and LED candles if I wanted, and that sounded awesome to me.

I left feeling like we’d be in good hands even if Doula 2 was a complete bust.

But I also knew Doula 2 would be anything but. She comes highly recommended by several friends-of-friends in town, and she used to live in New York (I’ve been listening to the Birthful podcast, and she was mentioned on one of the episodes about a vaginal breech birth in NY!), and she’s also a massage therapist and teaches what looks like a wonderful birthing class geared toward natural birth. Doula-ing with her would involve massages during labor and a discount on her class. Score.

We met at a coffee house, and sitting around a table on a sidewalk sipping drinks was much less awkward than the couch set-up. She was bubbly and sweet, and we were talking 90 miles an hour. A truly lovely woman. She has not given birth yet, but she’s attended about the same number of births as Doula 1, which is about 50. The c-section rate of the births she’s attended is about 19%, which is much lower than the 30-odd% national average and not far from the WHO recommendation of about 15%.

I had forgotten to ask Doula 1 about her c-section rate. I’ve since emailed her and she didn’t get back to me yet. (In fact, neither has been particularly responsive over email.)

It’s a really tough decision. They are both great in their own ways. Doula 1 has a gravity about her that I appreciate, and Doula 2 has a lightness. A part of me thinks Doula 1 will be more fiercely protective (and maybe more simpatico, since we’re both a little guarded at first — I’m generally not a bubbly person, but I can fake it, especially after a happy ultrasound), but… Doula 2 is a professional masseuse! And everyone loves her. And she has that awesome class. Will it be awkward if I take her class but go with a different doula?

And it’s just so hard to gauge a person in 40 minutes for something this momentous and personal, especially since I was so high-strung and miserable before the ultrasound (with Doula 1) and so, well, bubbly afterwards (with Doula 2).

(I am really letting myself enjoy this pregnancy now, by the way. I turned a huge corner with the ultrasound. I’m even telling myself that if, God forbid, the worst happens, there’s still no reason not to enjoy this as much as I can. I could not get to this place before the ultrasound, and I’m very glad to be here now.)

I guess this dilemma is a good problem to have, especially in a place like Tulsa. (My prenatal yoga teacher also mentioned something about being a doula, but I’m having a hard enough time deciding between these other two.) Even in our humble burg, we have more options than I could have hoped for. Another indication, maybe, that having a doula isn’t so nutty after all.

Thoughts, as always, are welcome.

Perfect

Ah, sweet relief. Big, big, big sigh.

Ahmed and I are both so used to gritting our teeth and waiting for the bad news (a hard habit to break after four years), we were sweating bullets before my 12 week ultrasound today. When they took my blood pressure, I was shocked it wasn’t through the roof.

We went into the ultrasound room and I tried to blank my mind as much as I could. The gel was warm (and my newly estrogen-patch-free belly was smooth), and then… there it was. Looking just like a big-headed baby. Or, well, more like a potbellied alien with skinny arms and legs, but whatever. There was some confusion because I thought I saw one baby facing one way and another facing the other way, and I asked, “Are there two in there?”

She said no, she’d just switched the probe around. Ha. So I guess I got maybe five more seconds of wondering if I was a twin mom…

The other sac is still there and still the same size it was before. She said it may absorb or it may stay there the whole pregnancy. Doesn’t really matter either way. She kept jiggling my belly to get it to move this way or that, and every now and then the fetus would flop around a little, clearly moving on its own. Ahmed let out a small laugh of delight.

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There’s a part in the movie Baby Mama where the surrogate’s embryo transfer failed, but she pretended it had succeeded to keep getting paid. Finally it’s time for an ultrasound, and the surrogate knows she’s going to be outed as a fraud. But sure enough, there’s a fetus on the screen.

She jumps up in shock and exclaims, “There’s a BABY in there???”

(Turned out she had accidentally gotten pregnant on her own.)

That’s kinda how I felt.

Or I wanted to ask, “Are you sure that’s mine? It’s not just a movie of the last person’s ultrasound or something?”

It measured 6.4 cm from crown to rump (head to butt), which is 12w4d (today I’m 12w1d, so it’s measuring 3 days ahead), nuchal translucency was normal, heart rate 154. Two arms, two legs, heart and stomach in the right places. The tech, as usual, had to act pretty noncommittal, so I didn’t fully relax until the doc confirmed that everything looked great. Given all the parameters he’d seen, he said I had a 95% chance of a healthy birth.

I like those odds.

Next ultrasound will be at 19w1d (October 30), and we’ll find out the sex then.

Once all the formalities were out of the way, he asked my husband where he was from, and it turned out the doctor had been to Turkey three times. He sat there for 20 minutes regaling us with stories of his travels. (I hope he doesn’t charge us for those 20 extra minutes, lol.)

We were both just so happy and relieved we practically floated out of there. We’re still processing it.

I really, honestly never knew if I’d see this day. With my two pregnancies that failed, I had so much faith. I visualized, I talked to them, I wrote letters to them, I gave them nicknames. And then it all came crashing down. The joke was on me.

This time it just felt safer to be cynical. No nicknames, no letters, just kinda soldiering on. I don’t even think I’ve meditated since the positive pregnancy test because I was too scared to sink into any kind of relaxation and too scared to sink into the full measure of my terror. I didn’t want to face myself or what could happen (again). I practically assumed failure.

Now, finally, hopefully I can unclench a little and maybe even enjoy this a little bit. Start thinking ahead even. The due date is in late March (if my previous pregnancy had made it, I’d be giving birth about now!), and a bunch of my nephews plus my best friend’s daughter and niece (who are practically family) all have birthdays in March. Looking forward to our little one joining the party.

It’s actually been a charmed pregnancy so far, other than our anxiety. Everything has been on track, no scares, and I only threw up once. Not bad at all, especially for an ART pregnancy.

Today also happens to be the day I no longer have to put patches on my belly and needles in my ass. Really enjoying washing my belly in the shower and having it be smooth instead of covered in stickers and sticky gunk. And my bruised ass can finally be left alone to heal.

OK. Just gonna process this for a while. But so happy and grateful. Really never knew if we’d see this day.

This might actually work, y’all. We might actually have a baby.

P.S. As it happens, this week also marks seven years since the day we met (playing soccer in New York), and Ahmed came home only to find that his citizenship interview notification was in the mail. So he’ll likely be a US citizen by the end of the year. Today is a good day!

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Pedicure

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I’m about to have a what? Who said I wanted a sibling?

Week 12

Another week on the books. Five more mandated shots of progesterone in my butt, then on Monday I’ll be 12w1d and (FINALLY) have my next ultrasound appointment, this time with a perinatologist (aka MFM).

I have to admit to being scared. It just seems like there’s no evidence of pregnancy. My belly looks the same, and I don’t feel “pregnant” (however I imagined that was supposed to feel), I just feel vaguely shitty all the time and look vaguely exhausted. It’s really been tough trying to have any faith at all, and my husband still won’t let me get a Doppler. (I could, of course, just get one anyway, but I do see his point. And usually when one of us feels more strongly than the other, we give ground. It’s usually me feeling more strongly, or so it seems, so it seemed right to defer this time.)

The biggest symptom right now, honestly, is the fact that I can’t sign up for my fall soccer league. And a part of me is rebelling, thinking, “You don’t even know if you’re really pregnant or not! Come on, your team needs you! The field is calling!”

Missing out on soccer was hard enough in the summer. But in the fall? The weather is so crisp, my team is gearing up to play all the other teams we’ve been playing for years, 11 on 11, full field, real soccer. The kind of thing that makes life worth living. The green of the field, your sweat cooling on the breeze, big trees and sunsets as a backdrop, sprints where you lose track of everything but stymying your opponent’s objective, flying kicks that seem to happen on a kind of primal autopilot (you know you could never make that kick on purpose), and licking wounds or celebrating victories with your teammates when the game is lost or won.

None of that for me. Just feeling vaguely shitty and hoping I’m not fooling myself yet again, hoping this pregnancy won’t end in searing defeat yet again. It’s lonely. I don’t know anyone else who’s gone through what we’ve gone through, so there’s no one who can relate, really. Instead of playing soccer with my teammates — that thing that gives me so much joy it seems like it should be illegal — I’m in an anxiety-ridden, queasy purgatory all alone.

And I feel completely shitty for feeling that way. I should be nothing but grateful. And perhaps as the weeks go on, if things go well, I’ll get to that place. But I’m not there yet. I still feel like a fraud. My mom and I went to get pedicures the other day and I asked for a face mask. My mom explained, “She’s pregnant.”

I felt embarrassed, like she was lying on my behalf. A part of me wanted to protest, “I might not actually be. But anyway, the smell is giving me a headache, isn’t that a good enough reason?”

It doesn’t help that my husband, for the first time ever, decided to sign up for THREE soccer leagues this fall. So he’s constantly out playing soccer, then coming back and telling me how it was. It’s so unfair. Why can’t I hand the pregnancy off to Ahmed every other week, or just one day a month?

Anyway, I’m not allowed to feel like this, it’s obscene to feel like this when this is what I’ve wanted for so long, but there it is. I would never trade this pregnancy for another season of soccer. (Two seasons, actually, at minimum.) But just right at this particular moment, it’s all downside, no upside. It’s all unpleasant and lonely, no fun at all. No thrill, no sweat, no green field. No feeling strong and lithe and like myself. I puked for the first time a few days ago. Yay.

(EDIT: It should go without saying that underneath all of this is a huge current of pure gratitude. I’m just terrified to dip into it because… well… I’m still so anxious this is yet another sad illusion. My resentment has a lot more to do with that terror than with soccer. It’s just that what I would usually to do get through anxiety, to unwind and detach from whatever was worrying me, would be to play soccer. And that outlet is taken away from me.)

Well, there is some fun. I started taking a prenatal yoga class.

I actually signed up for a different prenatal yoga class during my first pregnancy and paid $99 for unlimited classes. But my pregnancy ended after the first class. I persuaded her to let me try again during my second pregnancy without paying again, but that pregnancy also ended after the first class I took.

She can have my $99. I’m not going back there again.

So I found another prenatal yoga class at the Yoga Room, Saturdays for an hour and a half, and I can get three classes a month for about $35. Not too bad. Of course, I kind of felt like a fraud in there, too, because I looked exactly like I would look in a regular yoga class. Nearly all of the others were in their 22nd week or further. A couple of women brought their tiny babies in (it’s also postnatal). All in all a great atmosphere, and the workout, while not jarring or making any attempt to be badass in any way, was no joke. I was quite sore the next day.

It was funny, though. We all went around at the beginning to “check in” and talk about what was on our minds. The others were talking about feeling bloated or really really not wanting a c-section. Just ordinary pregnant lady concerns. I was honest and talked matter-of-factly (and briefly — much more briefly than anyone else) about the terror of loss after experiencing two losses after trying for four years, and being pregnant with a donor embryo. I felt like I was speaking a foreign language in that room. Like people kind of blinked and then were relieved when the next woman was normal again. But afterwards the instructor came up to me and gave me a hug.

We have two meetings with two different doulas this week, and I’m excited to meet both of them. One of them came recommended from friends of friends, and she also happens to be a certified masseuse. Never a bad thing in a doula. She doesn’t have any children of her own, and I guess that makes it easier to deal with the sometimes chaotic schedule of a doula. The other is a bit younger and has a child, and her profile really spoke to me.

They cost about the same, and I’m sure either will be great. I’m sticking with my general trend of picking two (hospitals, OBs, etc), checking them out, and choosing between them.

Speaking of luxuries we probably can’t afford… Ahmed has ten days of vacation to burn before the end of the year, and we’re thinking of turning at least one of those weeks into a relaxing trip somewhere. A “babymoon” I guess (if there’s still a baby by then). We were thinking of heading south, but hurricanes keep pounding the hell out of the South, and there’s nothing in Kansas, and we already went to Missouri for the eclipse, so that leaves New Mexico or Colorado (within reasonable driving distance).

We can spend a day in Santa Fe and then head on up to Pagosa Springs, where there’s a surprisingly affordable and really nice bed and breakfast kind of back in the woods but close enough to town that it won’t be much of a drive to get back there to visit the springs or grab dinner. Five days of that sounds cozy as hell, actually.

Then we can drive up into the Rockies over the Million Dollar Highway to Ouray, then on into Pueblo, then drive home the next day.

All in all, the trip should cost us a bit over a thousand dollars. Not bad for a week’s vacation. But should we spend it, considering that in our best case scenario, we’ll have shitloads of medical bills next year (birth ain’t cheap) and then a freaking baby to provide for?

I tend to have a “live for today” attitude. During my twenties, whenever I had a little money scraped together, I lit out for a trip. It’s a nice way to live. (Whatever I spent to visit the Galapagos, I don’t even remember. I’ll always remember the Galapagos.) But should I… like… grow up or something?

It seems to me that on the scale of the next few years, a couple grand this way or that (the cost of a doula + mountain vacation) just won’t matter that much. Whereas the memories of those things will matter a lot. They’re the kinds of things that make life that little bit sweeter. It could really be rejuvenating and refreshing after so much stress and strain.

But yeah… we have responsibilities now. And we got down to zero savings last year, and that’s not really an awesome place to be.

Just some thoughts in week 12. Hopefully there will be a week 13.

Embryo Pics

I finally found them! I hid them away for a while because I’d gotten attached to so many other embryo pics in the past, imagining them as children, just waiting for the day to show them their first “baby” pics… only to lose the pregnancy and have all those thoughts and plans turn to dust.

But then I couldn’t find them. Finally I started flipping through books looking for them, in case I stuck them in there for safekeeping. Sure enough, it was in my copy of Walden.

And now I have the problem of not knowing which is which — whether the embryo that looks like a negative of an eclipse diamond ring effect made it or the one that looks like the molten sun itself. (The embryologist said the black blob is just some “nursing cells” that hung around, and they didn’t want to bother it by trying to wash it off.)

Both

And it may be kind of sad for a kid to see this knowing he or she could have had a twin.

So I’m not sure what, if anything, to do with these pics now.

Lovely embryos, though.

Just Random Updates

We’ve decided to go with a hospital birth after all. Turbo OB said with infinite confidence that St. Francis is the best place in Oklahoma to give birth, and after the tour I believe it. Simple fact is, as fit and healthy as I may be, and as young as I may feel, it turns out there are increased risks when using an egg donor and when delivering at age 38. The main risks are high blood pressure (18%) and pre-eclamsia (11%, but that can be reduced to about 8% with 150mg/day of aspirin). But anyone can have stalled or stuck labor, or have their baby suddenly go into distress, or just start hemorrhaging randomly.

There’s still probably a 90% chance all will be fine (my blood pressure has always been exemplary), but I’ve come to realize that if I do try the midwife, I’m going to be stressing out the whole time thinking, “Please go smoothly, please just work, please don’t transfer me to a hospital…” Especially since the midwife’s place isn’t all that handy to a hospital. 15 minutes or so, which isn’t bad, but it can definitely make a difference if something crazy goes down.

Whereas if I’m at a hospital already, I can relax knowing this is definitely where I’ll give birth, and everything I or the baby could possibly need is right around the corner. And from what I understand, Turbo OB is one of the best in the state. It still seems crazy to me that I was able to just call up his office and get in within a few weeks!

Kinda sucks how expensive it’s going to be, though. My usual out of pocket max has been around $7,000, not including the premium (which will probably go up next year), and childbirth will probably hit that max, and this is assuming ObamaCare is even functioning well next year as Republicans try their best to sabotage it.

And to top it off, I’m thinking very seriously about hiring a doula, which costs another $800. Doulas are pretty much the only factor that’s been proven to reduce labor time and reduce surgeries and other interventions. The doc just shows up at the end, and the nurses come and go, and it seems like it would be really nice to have someone in my corner the whole time. My husband will be there, of course, but he’ll probably need breaks sometimes, and he hasn’t been trained as a childbirth attendant. (We’ll take classes, of course, but a few hours of classes can’t compare with years of experience.) Putting all that on him seems like a lot of pressure, when he should just be enjoying the moment as much as he can.

I just know so many people who’ve had traumatic, dangerous, or just miserable childbirth experiences, it seems eminently reasonable to me to tack a few hundred bucks more onto this astronomically expensive endeavor to have a much better chance of a healthy and happy birth experience. And I found a doula who seems crazy compatible. Just very cool. If all goes well, we’ll meet her next week.

But yeah… bracing ourselves for another massive drawdown on our savings, which were just starting to recover a little.

What else? I got my blood work back from my first OB appointment with Dr. Hillcrest. That’s not his real name, but he delivers at Hillcrest South and St. Francis South, and I call him Dr. Hillcrest to distinguish him from Turbo OB. Yeah, I made appointments with two different OBs who deliver at two different hospitals in case one doc or hospital ended up being insufferable somehow.

Dr. Hillcrest was recommended by a friend, and he was great (and so empathetic), but he doesn’t deliver at St. Francis, and ever since the tour I’ve kind of had my heart set on St. Francis. (It’s also where I was born.) Plus I understand Turbo OB’s caesarian rate is only 4% or so, which is phenomenal. I’m not sure what Dr. Hillcrest’s rate is, but it’s hard to beat 4%.

(EDIT: I tried to find that 4% figure again and couldn’t find it. Maybe my progesto-brain made it up? I’ll ask him at the next appointment. 4% would actually be worryingly low, from what I understand. But he is one of the rare docs around here who will do VBACs, which is not relevant to me at this time, but just shows he doesn’t mind pushing the envelope a bit to help women have the birth experience they want. He’s also happy to work with doulas.)

I keep putting off “breaking up” with Dr. Hillcrest because I like him so much (and I didn’t want to cancel the Thursday ultrasound because I still don’t know when I’m going to get set up with the perinatologist that Turbo OB referred me to), but I should really go ahead and cancel on Monday. Insurance is going to start looking at me funny if I keep bouncing between OBs, and I still have no idea what these appointments are going to cost. I have a feeling it ain’t small change. And they always take forever to send the bills, so it’s that much harder to make informed decisions.

Anyway, I had already done most of the recommended prenatal blood work just to qualify for the donor embryos, so I asked if I could just do iron, vitamin D, and TSH for now. He agreed, and my H&H was fine, vitamin D was 36 (low end of normal — I’m stepping up my supplements, and I’m going to try to spend 15 minutes in the sun around noon every day; the research I’ve done shows vitamin D is very important in pregnancy), and my TSH, all of a sudden, was 0.03! That puts me at hyperthyroid. Which isn’t that bad in early pregnancy — certainly better than hypo — but I’m cutting back my dose again, to 100 for a while to let it settle and then back to 112.

Strangely, neither doc talked at all about nutrition, exercise, what to avoid, and all that kind of stuff. I guess they assumed I already knew it? Maybe I fit the profile of obsessive researcher? I also had to bring up to both of them that I was using a donor embryo (they didn’t ask, which I guess makes sense), and both seemed relieved. A 31-year-old egg is much easier to deal with than a 37-year-old egg.

They didn’t recommend genetic testing and warned insurance wouldn’t pay for it for a 31-year-old egg. (Plus with a vanishing twin possibly contributing some of the cfDNA, results may be that much less conclusive and needlessly worrying.) So I guess we’ll have to have some faith that the small odds of genetic problems won’t clobber us and wait until 20 weeks like everyone else to know the gender.

(UPDATE: Just got the insurance notification for my first OB visit with Dr. Hillcrest. Ultrasound will cost me $150, minor blood work will cost $50. Still haven’t gotten a notification of the cost for the visit itself. Ouch. At least with Turbo OB, I’ll only be billed for a visit this time. Next time we’ll see what his ultrasound and blood work cost.)

Speaking of gender, I haven’t liked referring to this embryo — now graduated to fetus — as “it” or “he or she.” It makes me feel more removed from… it. I’ve always pictured myself with a daughter, and Ahmed feels the same way, so for now I’m just calling her “baby girl.” If I end up having to adjust, I will do so happily. Little boys are amazing, too.

Either way, we plan on raising our kid in a gender-neutral kind of way. We won’t force trucks on a boy or dolls on a girl, though of course we won’t forbid them, either — we’ll let them take the lead on what they like. But I worry that as soon as we do announce the gender, certain people will immediately begin purchasing a mountain of gender stereotypes. Ah well — there are worse problems. But it’ll be an interesting challenge.

One thing we both agree on: Our child will play soccer. Or at least we’ll do our damnedest to instill the love.

I’m also settling into the reality of not having twins. It’s fine, really. It just gives our next kid the chance to be that much more unique, and this pregnancy won’t be nearly so hard on my body or on the remaining child. (Most clinics recommend against transferring 2 or more embryos these days for that reason.) I still get a little pang every time I see twins in real life or on Facebook, but it’s OK. That’s just not our story. Our story will still be good.

One of the things that has helped me move on is a comment by a friend who’s a new father after a tough three years of trying. He said he is totally loving the infant phase, and it’s going by so quickly. He’s already looking forward to doing it a second time. And I realized — if we’d had twins, that probably would have been it. We’d have done a whirlwind double-duty infant phase, and then it would have been over for us for good.

Now we have time to really learn and focus on this one and then apply everything we learned to the second one and savor it all over again. It’s such a fleeting time, like an eclipse. Two eclipses at once — and then never seeing one again — would have been intense and wonderful, of course, but I’m OK with waiting a couple years for the next one. Hopefully not seven years, like for the next actual eclipse…

(Of course, having a toddler and an infant at the same time is surely going to be its own special kind of… intense. 😛 )

Finally, my husband and I rarely have serious disagreements. We’re pretty good at working things out and compromising and taking turns giving ground. But he put his foot down when I wanted to get a doppler fetal monitor. They’re only $40, and it seems like it can help put my mind at ease during the endless waits between ultrasounds. (Hearing a strong heartbeat at the midwife’s place let me breathe again a few days after my symptoms started tapering off.)

But he’s afraid I’ll just over-analyze every time it’s easier or harder to find the pulse, or what the heart rate is, and it’ll just make me that much crazier. Plus it’s not perfectly non-invasive. It uses ultrasound waves similar to those in a visual ultrasound, which can heat up tissue. It’s never been proven not to be safe, but the possibility remains that it’s better to limit exposure as much as possible.

So I’m trying to learn to breathe even without fancy hardware, and even when I’m feeling pretty good and not as tired or queasy as usual. (Symptoms coming and going is VERY NORMAL.) My next ultrasound is three and a half weeks away at most, and if the fetus dies between now and then, I’ll either know it right away or know it soon enough. A matter of weeks won’t make that much difference at this point. And so far all indications are that it’s perfectly fine.

And if it is perfectly fine in three and a half weeks (I’ll be almost 14 weeks by then), maybe I can start to relax for real, just a little bit.

I’ve already told a handful of close friends and family about all this, but it’s still hard to fathom a general announcement. I think I’ll need visual and tactile evidence before I can even contemplate that (i.e., a bump and feeling the baby move). And then I’ll have to figure out whether to do it at all, and if so, how to do it as sensitively as possible.

I really hope that’s a “problem” I’ll have before too long.

I really look forward to the moment when I stop holding my breath and stop instinctively clamping it off when I find myself feeling too much joy. But the joy is there, waiting to be unleashed.

Turbo OB or Laid Back Midwife?

I heard the heartbeat today after all! Still pregnant!

OK, let me back up. As I mentioned, I had an appointment with an OB today who offered me basically as many ultrasounds as I want, and he delivers in the best hospital in the state with the best NICU. If I’m paranoid about this pregnancy (which I am), it doesn’t get much better than that.

But… I also happened to have a consultation with a midwife today who runs a boutique birthing center. I set it up back when I thought it was twins just to learn more about it, and in case I lost a twin (which I did). She answered all my questions and laid it all out. She does very little monitoring other than manual measurements and using doppler to measure heart rate. She only recommends one ultrasound (and occasional minor blood work) unless indicated by her measurements.

And then the birth will be in water (if desired) with no intervention other than support and checking the heart rate every now and then.

She said only 10% of her clients end up going to the hospital due to complications. Pretty decent odds, and there’s no particular reason to think I’ll have a complicated birth, except maybe my reproductive luck in general.

I liked the two male OBs, but I felt like it was easier to be myself around her, and I felt more calm than with the male doctors. They were great, don’t get me wrong, but this just felt more relaxed. I felt more like things might really be OK. I felt more like I could breathe instead of holding my breath all the time waiting for the next ultrasound.

She also offered to let me hear the baby’s heartbeat via doppler, just for free, for giggles, and reminded me that I can get a doppler of my own to ease my mind whenever I want, which also makes me less anxious to get ultrasounds.

The heartbeat is still strong. She was actually surprised how strong it was. I was just lying there melting from relief.

I think I’ll be more chilled out with this kind of care, and I think it’ll be a healthier birth than in a hospital — after all, pregnancy is not an illness, it’s a natural process. I’ve always been drawn to this kind of “well woman” child birth instead of treating it like a disaster waiting to happen. That, after all, can be a self-fulfilling prophecy. When the mom is stressed, it can stall labor and stress the baby.

It’s only $3000, including everything but occasional blood work and ultrasounds. That’s crazy cheap compared to loads of prenatal appointments plus a hospital birth! (If I’m lucky, my out of pocket max will be about $7000 next year, and that’s probably about what I’ll end up paying just to deliver. It’ll be more like $14,000 if the baby ends up needing extensive care. The baby will have its own out of pocket max.)

Of course, if there are complications, I’m paying for the midwife plus the hospital. Or losing the baby if it’s something really crazy. And that’s a huge gamble that might, in the end, actually stress me out more.

I’m feeling torn, but honestly more excited about the midwife. But I know a lot of people would say that’s just reckless, especially after all we’ve gone through to get here.

Should I relax for once and do what feels right, or stay hyped up in hyper-vigilant mode to make double damn sure this baby comes out safely?

Thoughts are definitely welcome.