Top 5 Pregnancy Needs

If I were to go through my pregnancy again I would have probably given into maternity clothes sooner or maybe opted for a true pregnancy pillow. But when it comes to my pregnancy there were a handful of things that I couldn't have survived without and that definitely helped me relax and enjoy my pregnancy. I had a very high risk pregnancy, ugly history of loss and was on some sort of bed rest the entire time, although it was absolutely worth it and I would gladly do it all over again just to have her in my arms - sometimes it was really hard. These are my top five life savers, or at least sanity savers.

1. My amazing husband, from listening to my every worry to bonding with our baby girl long before she was born. Many worried trips to the hospital and lots of prayers - I could not have survived without the understanding, support and love from my husband.

Check out my weekly photo project here

2. A pregnancy project, I did a pretty big one consisting of three different photos every week and a big update but I love being able to look back and remember how I felt at 9 weeks or what we were doing at 32 weeks. I can't count the number of days I spent scared out of my mind but this project helped me focus on the positive and the right here and now. For a little moment each week I focused on being pregnant today and stopped focusing on those terrible "what ifs".

3. My doppler, this is very much the kind of item that you need to decide what is best for your family. For me it was a life saver, I got mine here for $50 and they've since released newer versions but even my basic one was great. I spoke with my ob several times and he was very supportive of my use of our doppler but I still tried to limit it to a need basis. Sometimes that was often and other times I could get through a few days, but because of the loss of our son - I was on edge from beginning to end, this was my little bit of sanity. Without having to run to my ob or the hospital every day, if I was scared all it took was 30 seconds to find her heartbeat and time it, pretty quick form of relief.

Check out their channels: Missy Lanning and Heidi Kim

4. Netflix/YouTube, both were great ways to spend my days on bed rest. I could load up a show or movie on Netflix and keep my mind away from the worries but I especially loved having the YouTube community as a mom pregnant after loss. I can't even count the number of times I watched Missy and Heidi, telling myself that they did it - they went through losses like mine and have their rainbows, it was possible. I found so much hope through their stories :)

Keep your eyes out for a review on my favorite pregnancy/baby apps in the near future!

5. Some sort of pregnancy app, specifically one with a forum. Not only was it great to be able to read and track what was going on while pregnant, being in community of women (and some men) expecting baby's in the same month as you was a great experience for me. From finding support from the other women to seeing just how 'normal' I really am despite the high worries. By the time I delivered Lilly I was involved in a handful of other communities with likeminded women; like crafting and c-section mommas for example.

I also want to throw in having an incredible obstetrician, he has followed us from the very beginning of our journey to baby number two, having our ob so supportive and so understanding of my history and how I am - was amazing, I'm very lucky.

Anywho, these things are definitely individually based, very much a this is what worked for me but when you're going into the stress of high risk pregnancy or pregnancy after loss - it is kind of nice to hear about what worked for others.

xo, Anne

Anatomy Scan - little concerns

The anatomy scan is typically scheduled between 18-21 weeks and this is usually a very exciting ultrasound for parents because

But the anatomy scan isn't done just so Mom and Dad can find out if their baby is a boy or a girl, there is a lot of big things that the doctors want to see have developed properly and at this age

My ultrasound was split into two, the first was over an hour where a not-so-great technician pushed too hard and made me immensely worried for (realistically) nothing and because our beautiful baby girl is as stubborn as her Momma we were scheduled to come back in hopes our little one would cooperate and let the technician get a couple other pictures/measurements. Our second ultrasound was much better, in part because by then we had already spoken with our obstetrician and were feeling a bit more relaxed, our technician was wonderful and although our sweet little girl was still being stubborn they managed to get all the photos/measurements they needed and it was a much better experience to finish the anatomy scan.

During the anatomy scan they found a few things;

First that I have a low lying placenta, this is a pretty common finding at this stage of pregnancy. The concern is with a placenta that is low lying or full placental previa (where the placenta covers the cervix) if I were to go into labor naturally or try to labor naturally the placenta will detach trying to be delivered first (since it is too close or covering the cervix) if the placenta is to detach if has the same results as a placental abruption (which was what caused our stillbirth, although our placental abruption was without reason or cause and just happened). Due to the risk this poses to mother and baby a c-section is typically performed to ensure a safe delivery (I have read of some women who have delivered naturally despite a slightly low lying placenta, however that isn't usually the case) . With orders for pelvic rest and some restrictions depending on the obstetrician, this isn't usually a problem and will typically move away from the cervix before delivery.
UPDATE: after an ultrasound at 23 weeks our placenta has officially moved away from the cervix

The other finding was that our baby girl has a two vessel cord or single artery umbilical cord (I typically refer to it as the single artery), normally the umbilical cord consists of three vessels but sometimes the third one will not develop/will disappear. This can be a soft marker for problems with the heart or kidneys as these organs develop around the same time as the umbilical cord - usually an echo ultrasound is done in the following weeks to rule out any problems with the heart. The other concern with SAU is growth restrictions for baby, doctors usually suggest additional ultrasounds to monitor growth and will deliver baby if growth slows as it is easier to help baby's gain weight outside of the womb than inside. However, in most cases a two vessel cord/single artery umbilical cord has no affect on the baby and is considered a "variant of normal".
UPDATE: as of our echo at 22 weeks, baby girl's heart is perfectly developed and although follow up ultrasounds will be done to monitor her growth as of that ultrasound she is growing right on track and weighing 1 lb 4 ounces at 22 weeks.
At 32wks4days our baby girl is growing well and weighs an estimated 4lbs4oz.

At 23 weeks we were sent to Maternal Fetal Medicine to have another ultrasound and be seen by a perinatologist regarding echogenic bowels (or bright bowels, as the fluid she is swallowing is taking longer to pass through). They did see echogenic bowels at this ultrasound (this was also seen at our anatomy scan and although during our echo ultrasound the week before our very skilled technician looked for this and in her opinion this was ruled out) this is a very common occurence with echogenic bowels because each technician/ultrasound machine sees things differently and often this is a false positive. However most doctors will err on the safe side and if seen will assume it is there.

The perinatologist at the Maternal Fetal Medicine clinic told us that although it is strange to see two things that are different and he stressed that "different doesn't mean abnormal" the single artery umbilical cord and echogenic bowels were not connected and more than likely would just be a variant of normal. He did go over what the echogenic bowels could indicate; cystic fibrosis or down syndrome, a rare infection that could have  passed through me to the baby (all of which typically have other markers, which our beautiful baby girl doesn't have), there is also lesser concerns like a possible blockage that they'd fix after birth or that she may have swallowed a bit of blood which would work through eventually and not be a problem. According to the perinatalogist there is a huge likelihood that it will either disappear before she is born and/or cause no problems. He didn't suggest further testing (which includes blood work to check if we are CF carriers, we would both need to be carriers to give her a 1 in 4 chance of having it. Blood work to check if I've been exposed to any of the infections, but the test isn't good enough to tell when I was expose if I have been at all - which the only time that matters is during my pregnancy and the amnio to test our baby for these things which have no treatment until delivery anyway and increases the risk of loss to 1 in 200 a risk we are not willing to take since it wouldn't change anything). We have an ultrasound scheduled in a month, at the beginning of the third trimester to see how she is doing and hopefully that the echogenic bowels have either gone away or at least gotten better, as well as rule out any possible markers that are assosiated with CF or downs. Although we pray and hope that she will be healthy and that she will not have to experience the difficulty that growing up with cystic fibrosis or down syndrome, I am grateful that (for the most part) these are not "incompatible with life".
UPDATE: As of 30weeks our ultrasound with MFM no longer showed echogenic bowels and although they will continue to watch her it is believed to have cleared up on it's own.

While I wish that we didn't have to worry about added concerns for our pregnancy (as I am already considered very high risk) I am grateful that in both findings there is a great likelihood that aside from extra ultrasounds/monitoring, our baby girl will be just fine.

I will continue to update this throughout our pregnancy as there will be many future ultrasounds and follow up.

xo, Anne.

The NT Screening (Part 1: the test and results)

I have had two early ultrasounds leading up to this one; one in the emergency room at 5weeks and a perfect dating/confirmation ultrasound at 8weeks but seeing our baby at 12weeks took the cake thus far.

In my first pregnancy, my only one without the high risk label, my first ultrasound was at 12 weeks but it wasn't for the big screening they do now, instead it was for confirmation and dating purposes and what a beautiful ultrasound that was.

Genetic screening was previously reserved for "at risk" mothers, although I don't believe that it was as easy and risk free as it is now. Now, all expecting mother's are offered something called the First Trimester Combined Screening (FTS) which is a voluntary screening that simply assesses the risk of genetic abnormality. This screening takes the mother's age and details on her present pregnancy, conception, any previous pregnancies and family history then combines that information with the results from blood work and a teeny-tiny measurement of the fluid behind the baby's neck during an ultrasound that little measurement is called the Nuchal Translucency measurement (NT) and is typically done between 11weeks and 13weeks6days of pregnancy. From what our technician told us, these measurements and numbers are found in all pregnant women and each woman's normal is different than another but typically a high measurement can indicate a chromosome condition or birth defect. When combined together they can provide a risk assessment, with which you and your doctor can then decide if pursuing additional testing is necessary which can be more invasive and risky. This is a personal choice and a positive result still has the likelihood of a healthy baby just as a negative result cannot guarantee a healthy baby, this is just to give parents and their medical team the ability to decide if further screening is necessary. There is a background risk given, based on maternal age and an adjusted risk given after reviewing and putting together all the information gathered.

When my ob offered this screening (both in my last pregnancy and with this rainbow baby) I talked to him as well as my husband about this screening, and spent a lot of time weighing the risk and results. Since it is non-invasive there is no risk to the baby but I knew that a positive result would cause me to worry even if I knew that the likelihood was still in our favor. I also knew right away that even with a diagnosis of any chromosome abnormality that I would never abort our baby (I hold no judgement to parents left facing a diagnosis which is "incompatible with life") but with all we have been through, providing no risk to me or suffering to our baby - I see no reason to end my baby's life especially if only to possibly save me from pain. I've had to say goodbye to my full term, perfectly healthy son and although I pray to never have to go through that pain again I know that I would rather that than choosing to end their life. Not to mention you do hear of beautiful happy endings despite poor prenatal diagnosis and I just couldn't live with the what if's.

I knew that even if there was a positive result, after crying my guts out and worrying ridiculously, that we would be able to mentally and emotionally prepare. We would be able to learn about it and prepare ourselves, our parenting and our life styles to better suit our child's possible needs. I like feeling prepared, I also liked that we would be able to find out if our baby was developing properly and it didn't hurt to get another chance to see our precious baby.

So we agreed to get the screening done and are so blessed with our results.

We were able to confirm that our precious baby is developing just as he or she should; both hands and feet, arms and legs are seen. Heart activity is present and at a rate of 163bpm. Baby's skull, brain, and abdomen are visible and appear to be normal as well as his or her stomach, kidneys and bladder are visualised. The ultrasound confirmed that amniotic fluid is normal and that everything is where it should be.

While our background risk, based on my age, was already negative my adjusted risk was into the 1:20,00-150,000 over the three; trisomy 21 (down syndrome) 18, and 13 (which are typically "incompatible with life"). At this point there are no fetal abnormalities or real risk of a chromosome condition and I was given a negative result with which we will not be pursuing additional screening other than the 18 week standard ultrasound.

One healthy, growing strong, little baby. We are so blessed.

xo, Anne.

First Appointment

Written June 5, 2013

Last month I wrote about our plans to go back onto Clomid and my upcoming appointment with my obstetrician, I didn't expect us to get pregnant that same month and after getting two beautiful positive tests before my appointment I was ecstatic (and anxious, as always) to tell my obstetrician the good news. 

"So I take it things aren't going well?" my ob asked as he sat down, I could barely contain the smile that was beaming across my face "Actually...". He was very happy, I knew he would because he has always been very hopeful in our ttc journey - he has been there for 3/4 of my pregnancies and we have been seeing him for the last 3 years. "I really think this one will be it" he told me and I wholeheartedly hope that he is right because we cannot stop loving this little baby already. I left his new office with a boatload of congratulations, a battery of blood work, an ultrasound booked in a few weeks and my next appointment already scheduled.

Can't wait to see our little baby in three weeks and praying that he or she will be our rainbow baby.

xo, Anne.

TTC Update - What's Next for Us?

This month has been a mess, even in the blog you can probably tell that my head has been all over the place. Do we try something new? Do we keep trying naturally? Do we go back to Clomid? Stop charting? Keep charting? I certainly feel all over the place. So I wanted to be honest with you and explain what has been going on in my head, aside from confusion.

I'm getting desperate, May was supposed to mean a new beginning, although we miscarried our little May baby, which was every sort of devastating, I was so sure that we would be pregnant again by now (I don't know, after over 2 years ttc, why I would think it would happen quickly this time?). Everything was (and still is) regular but as we are heading to 6 months without success I'm starting to feel defeated again. I know I am young and that there is still time but I feel like I am stuck in this middle ground. Not pursuing things because “if I get pregnant I can't do this”, not doing things because “I might be pregnant” and yet I keep holding onto the knowledge that Clomid worked last time so I can always try that again. But every month that passes I feel like a failure and it feels like I am wasting my time waiting since I'm not getting pregnant anyway. I know ultimately it will all be worth it, I know that everything we have come through will be worth it when we are holding our baby but this is still so hard to go month to month without any success.

So after spending the last month debating between trying Clomid, continuing naturally, and attempting things that bounce around the TTC community. We have decided to meet with my OB next month and go back on Clomid. We will be going back to the same dose that we got pregnant on last year and although I am nervous to go through the side effects that the double dose of Clomid did to me last year I am excited that it will work again and we might be pregnant. I also have to acknowledge that we may not get pregnant on Clomid again and that means waiting for the reproductive specialist to decide that I'm a priority which my OB warns may not happen for a while considering my age. It sucks thinking that this could mean putting actively trying to conceive behind me for a while, moving my focus away from becoming a Mom but at the same time it means I can move forward which I don't feel like I can right now.

We will still be trying this cycle, I see my OB on June 4^th and of course there is a chance we could be pregnant but I am preparing to go back to Clomid this summer. Interesting note, every time I have started Clomid it has been in the summer 2011, 2012 and now 2013. Hoping that we will have our 2014 baby one way or another!

xo, Anne.

Fingers Crossed

Saw my obstetrician yesterday, he told me that miscarriages are common and that this one has no relation to our previous losses nor does it hold any consequences for a subsequent pregnancy. We discussed testing briefly but ultimately decided that if a second miscarriage occurs then we will follow up with a battery of blood work on both Dyl and I - just so I have a plan, which I am grateful that my OB understands how I my head works. He gave us the go ahead to start trying to conceive, which I was happy to hear, he is very positive for my next pregnancy and said that he believes we shouldn't have trouble conceiving again.

I was beaming, a little terrified, but so thrilled.

He suggested that we try for a few months without jumping back on Clomid, while we know the 100mg worked last August it also wreaked havoc on my body and it is best for my body if we can avoid Clomid when we can. If after 4-6 cycles I haven't conceived and want to go on the Clomid I can, and if my cycles get weird on me again to see him immediately for a plan - but he seems to really think that this year will be ours and his positivity only added more hope to the bucket, while there is still a voice in my head telling me how impossible all of this is, I know I still have a lot of hope to hold on to and no reason to doubt my body.

So here we are jumping back onto the trying to conceive train, since I was expecting to get the go ahead for next cycle (but secretly hoping for this cycle) I had already gotten back to my proper sleeping and eating habits, I am back on the prenatal vitamins and have begun charting again. I still have a pile of ovulation strips for my Clearblue Ovulation Kit but haven't committed to them entirely yet. 

Fingers crossed.

The D&C

A thin, pale blue gown loosely covers my nearly bare body, I feel exposed and hollow waiting in a small, cold room made of curtains. I have no make up on, haven't bothered for days now, and the nurses have told me to take off my rings along with the pins that normally pull the loose brown curls away from my face. I feel like an empty shell of my former self, far from the girl I used to be or at least the girl I am used to being.

I can't even remember the innocent me anymore; the one that never knew babies died, that never knew of all the many terrible things that happen to people that could never deserve it, every single day. I don't remember what it is like to feel free, free of the heaviness in my heart, free of the powerful anxiety that holds tightly onto my chest. I look at pictures, recognize that the girl there is me but I can't recall ever being her anymore & there is a deep sadness in loosing that part of me.

I didn't want to do this, I didn't want this to be how my third pregnancy ended. My obstetrician is so positive for me, so gentle with me and I force to put on a brave face for him and the nurses that visit. I wonder if my act is good enough or if everyone can see right through me. Only Dyl really knows how terrified I am, he tries to keep me calm and distracted, it helps some but my anxiety is eating away at my insides and with every passing minute I am terrified of the surgery that I am scheduled for. I'm holding back tears that are fighting to fall, the tightness in my chest feels like it is squeezing away my every breath so I try to remember what each of the girls on my forum told me about their D&C experiences, trying to remember the comfort I found in their words - it's nearly impossible but it helps a little bit too.

Finally I am being moved to the operating room, there are too many people - okay, I think it is actually less than 10 (maybe 6, including my OB who is doing the procedure), they are all so kind but I am still horrified. My anxiety is at an all time high, I don't want all these people here, I know they all have a reason to be there but all of a sudden I am very aware that each of them is going to see and be part of something very private and personal, I feel very embarrassed and I'm not entirely sure how to process this but soon the medication takes over my body, suddenly I feel warm and sleepy...

and funny, I very much remember giggling (& wanting to laugh even more) when my obstetrician told me that they were going to tie my arms down "to keep them from falling off" and while I understood this was to keep my arms up on the little tables the had at my sides the idea of my arms literally falling off was hilarious (although I kept that to myself).

When I wake up I am still very drowsy, Dyl is at my side and somehow I am back in my room made of curtains. I am warm and safe, a calmness has blanketed me and at that moment I can almost feel a vauge sense of closure.

- - -

Recovery had its ups and downs; physically I had bouts of terrible cramping and my bleeding was incredibly heavy (with some, TMI bad clots -  which I am no stranger to heavy & crampy periods or clots so this was quite bad for me to take special note) but eventually it slowed down & by the two week mark had disappeared. I've been a mess emotionally but I assume that is also normal as we grieve and navigate through the loss of our third pregnancy and the little baby I fell so deeply in love with. At 5 weeks post D&C I had my first period, a little heavier than usual but for the most part (see above) I'm kind of used to it. I have my follow up appointment with my obstetrician booked in the New Year and we will see where things go from there. While I wish that I never got to know what a D&C was, I am grateful that such a procedure does exist, that I had a wonderful team and a bunch of support. I do feel that it was instrumental for my body to move forward as it seemed even my body didn't want to give up on the pregnancy.

Better then Good

At the end of January, I finally met with my wonderful obstetrician where we talked about my last few cycles (perfectly on time & regular, no questions asked), he gave me two options and his opinion. He suggested, because my cycles had seemingly returned to normal; we could either carry on trying naturally or go back onto three months of Clomid. He suggested the first; our age and the return of my regular cycles were on our side and I (while briefly disappointed) understood and couldn't agree more. Since everything seemed to be going well why not give it a go, the first 3 rounds on Clomid were incredibly stressful & difficult on my body if we had even the slightest chance at conceiving on our own it was worth a shot. He told me to continue charting & follow up with him in six months if we hadn't conceived, we left the office almost bewildered. Almost a year after the possible PCOS diagnosis, we were leaving his office with the chance at a natural conception, as if the last year never happened.

Although we're coming home with some pretty awesome news we're actually going to take the month off because I'm scheduled for dental surgery and the pain medication could be dangerous for pregnancy. So we're waiting, but my obstetrician says that we'll be safe to start trying after my next cycle which is great.

I couldn't have come up with a better scenario for this appointment, I'm hoping by the next time I see him I'll be happily pregnant.

My HSG Results

Yesterday was my HSG procedure; as I mentioned in the previous post since I have irregular cycles (paired with the onset of dizzy spells/nausea in the past few days) my ob/gyn ran a pregnancy test just in case, I could tell both he and I knew I wasn't – which of course I wasn’t but like I said before, you're better safe then sorry. The procedure in itself was quick, quicker then I expected. I did experience cramping, which continued afterwards so I tried to spend the day resting when I could. But the minor discomfort was nothing in comparison to the results we received. To my absolute surprise both of my fallopian tubes are clear, I was beyond ecstatic of course since I assumed there would be some sort of blockage from the ectopic pregnancy over a year ago (imagine me not quite skipping away in a very attractive blue hospital gown). The X-ray images did show the shape of my uterus, previously an ultrasound suggested I had a bicornuate uterus but the shape may also indicate a septic uterus (although in either case it appears minor since I have carried a baby, our first, to term). My ob/gyn intends to look into it (we talked briefly about having an MRI done later) but ultimately decided that regardless he wants me pregnant and told me to start taking my pills.

So I'll see him in a couple weeks after this cycle and we'll see where things go from there.

We've Got a Plan

My appointment today went better then I expected, better because I always assume the absolute worst case scenario. I adore my obstetrician, he answered each of my questions and he, as always, was incredibly positive for me. He told me I'm at a healthy weight to get pregnant and just to continue with a healthy lifestyle, which is great news for me and my pre-heating “oven”.

He scheduled a HSG test (hysterosalpingography) next Thursday to ensure there are no blockages in my uterus or fallopian tubes (the tubes are the concern since I had an ectopic pregnancy last year treated with methotrexate) provided he sees nothing wrong we carry on.

He prescribed me two medications to use during my cycle, one is a progesterone hormone supplement which will force my cycle to restart while the other is clomid which will cause me to ovulate & prepare my body for pregnancy. I've also been told to start taking prenatal vitamins again, which of course I'll do. On the twenty-first day of my cycle I have to go in for blood work, I'll either be pregnant (great!) or I'm not, if not and as long as my progesterone level is right we'll restart the cycle until I am pregnant.

It's scary and so exciting all at the same time, if we're lucky mid July we could be pregnant! I can barely fathom the possibility right now. Could we really be so lucky? Heck, even if its not this cycle the fact that we may eventually be pregnant is beyond a blessing for us.

I hope everyone else hoping for some sort of good news gets it :)

Five Days

This Wednesday, five days from now, I'll walk into a familiar office and meet with my high-risk OB/GYN. He found me last year, in the emergency room when I was first diagnosed with the ectopic pregnancy. I was supposed to only see him again when I was pregnant, I'm not pregnant. This spring my family doctor requested an ultrasound that suggested I had PCOS, when asked who I would want to work with from there I immediately requested him.

I have a million questions written down, along with every cycle I've had since the ectopic pregnancy. Do I sound over prepared? I suppose that is just how I am – I think way too much.

Generally I am frustrated by the whole scenario; I am perfectly healthy and overall the “textbook definition of prenatal/maternal health” why have I continued to come across these terrible situations (the placental abruption causing us to loose our son, the ectopic pregnancy ending what would have been our second chance and now this, PCOS) Why Me? Why all three? Why our son? maybe I could have accepted all this if at least he was here. Once upon a time I wanted a big family, I'm at the point where I will be over the moon with one child.. it's funny how things change.

Sometimes, I find the whole thing comical – maybe that is a sign that I am finally cracking under it all, I'm kidding. But it's just the thought of what could possibly be next? It can't be just a simple pregnancy resulting in a healthy baby. I don't even care for the simple pregnancy, bring it on, just result in a healthy baby with both of us happy and alive.

Other times my mind is beyond angry; What did I do so wrong to deserve this? No, forget this attitude, it is because somewhere within me I am strong enough and the same goes for anyone else reading – You're right, you don't deserve this, but this is what it is and you will find strength within yourself that you never even imagined was there. You're a champion and someday you'll look back on your life and think “wow, I overcame all of that” just like I know one day I will too.

Anyway, (if you can't tell) I have such a mixture of emotions leading into this doctors appointment. Part of me can't wait; to have answers, to have a plan, to have someone tell me what is reallu going on. But another part of me is so afraid of what I may be told; What if it takes years to conceive? What if we keep loosing? My heart breaks even more at the thought of not being able to be a mother here in this world, not being capable to give my dear husband the chance to be the wonderful father I know he'll be. It's scary, but I can only hope for the best at this point.