Wednesday, April 29, 2009

Our first meeting with the new perinatologist

Kevin and I met with the perinatologist today. (If you don't know, a perinatologist is just a fancy term for "high-risk pregnancy doctor".) I still feel optimistic after meeting with her, and I think she will do a very good job of monitoring me closely and being emotionally supportive as well. We did hear some news that was a little bit of a let down but certainly not a deal breaker.

The doctor's opinion based on the evidence she's seen is that the past two pregnancy losses could be related and maybe due to a clotting disorder. She ordered a slew of blood tests in which I had to give half a pint of blood practically. I only lost about a liter of blood during the c-section so I guess a little bit more won't hurt. If any of these tests come back positive, then I can simply prevent this again by taking blood thinners during the pregnancy to prevent clot formations.

The other possibility is that I went into pre-term labor and did not in fact have a placental abruption. The bleeding that I experienced initially could have been related to my cervix opening rapidly rather than the placenta detaching itself prematurely. I see this as being quite possible since all my labors have been very short (and very painful I might add). We can try to prevent the pre-term labor next time with progesterone shots on a regular basis along with monitoring my cervix closely via ultrasound.

I have been instructed to request my post-operative notes from my last c-section so that the doctor can read the surgeon's report on my uterus and placenta during and immediately following the surgery. This will give her clues as to whether the placenta was already detached and/or had clots or other issues and thus indicating an abruption or not.

So right now we are waiting on the lab results from the blood tests and the post-operative notes from Labor & Deliver at the hospital, and we will go from there.

We of course had many other questions we asked the doctor, but the one we were most anxious to hear the answer to is, "when can we start trying again?" And we will need to wait at least 6 months because I had a classical c-section and need more time to heal. We were pretty let down when we heard this, but at least we have the option of trying again. It could be worse.

To end on a positive note, I do have a funny story to share. On my way to taking Kevin back to work (since we only have one car), we were rehashing what we had talked about with the doctor, and Kevin was reflecting back on my birth experience with my last pregnancy. He mentioned that when they did the internal exam after I came into triage, the resident called out, "her cervix is gone!" Kevin admitted to me that his initial thoughts at the time were, "well, where did it go? did it just fall out?" Upon hearing his perspective and because I have a skewed sense of humor, I start laughing uncontrollably. (If you don't know why that's funny then you need to become familiar with the female anatomy and what happens in labor). Bless his heart, his willful ignorance on the matter is one reason I've always had doulas for my births in the past.

Monday, April 27, 2009

After-life?

The experiences of loosing my babies has broken my faith. I do believe there is something out there that created our existence. It would be too happenstance for it to all be an accident. However, if I believed in a God as the majority of people think of one, I would be very angry with Him (or Her, or It, or Them). I was willing to forgive this God the first time it happened, but I don't believe He is involved in our daily lives to have prevented it a second time. The only good and comfort I've seen come out of these situations is because of what people did, not what God did.

These experiences and especially the loss of our second baby has also made me question the idea of an after-life. Specifically, I have questioned if there is one at all. Does our consciousness continue on? Will all the answers be revealed to us? Is there a Heaven and a Hell?

At first the thought of our existence being snuffed out like a candle evoked emotions of panic. How will I get the answers I want? How will I see my family and friends? How will I be eternally happy? But the more I thought about it, I realized it wouldn't be so bad really. If it was like falling asleep with no awareness, we wouldn't care if there was nothing else left.

It also made me realize that we need to make the most of our time here with the people we love while we are living. We should go places and do things and take risks with these people. Strangely, thinking of death in this new light has provided me with some comfort. I have resolved to make the most of the time that I have here and to live my life so that I don't have any regrets. Regardless if there is an after-life, it cannot be experienced as we are experiencing life on Earth, and we need to make the most of our time here.

These thoughts crossed my mind again as I learned today that my grandmother passed away this morning. It was not completely unexpected, but we were hoping for her to make a recovery and have more time with us. I don't know if our spirit, or soul, or consciousness lives on somewhere, but if it does I do know that my grandmother and my other family she has joined will look after my 2 babies until and if we can be with them again.

Sunday, April 26, 2009

Wikipedia

I've always believed that knowledge is power. The more you know about something, the better able you are to make an educated decision and thus more likely to have the outcome you'd like.

I've also always prided myself on researching a topic thoroughly before deciding a course of action, and pregnancy and childbirth have been no different. When I became pregnant for the first time in 2003, I bought all the classic pregnancy books and then some. I read each one word for word and followed along each month as my pregnancy progressed. I took Bradley classes and started eating correctly and exercising. I asked my doctor how he handled labor and delivery, didn't like his answers, and switched to a midwife instead. Thankfully and maybe luckily, my pregnancy was uneventful and we were blessed with a beautiful, healthy baby girl.

Looking back on my last 2 pregnancies, I don't feel I had enough knowledge to prevent what happened. Whenever anything goes wrong in my life no matter how big or small, I always look back on the experience and ask myself, "what could I have done differently to have prevented that?" And then I file it away and pull it out again if needed for similar situations. So naturally, my inclination is to ask myself after this recent tragedy, "could I have done anything differently?"

Today I found myself on wikipedia looking up the terms "stillbirth" and "placental abruption". Why did these things happen to me? I combed the articles for clues. I found factors that increase your risk - none of which I had. Then I came to symptoms of placental abruption, and I had all of these. If I had only known that things were more serious, I would have insisted that I be seen right away.

But aside from all that, I shouldn't have had to have done anything differently. My doctor's office should have seen the signs and had me come in immediately when I called the first time. They should have emphasized the warning signs to look for at every single prenatal visit. How are you supposed to know something's wrong if you aren't educated about it? Isn't this why all the literature emphasizes getting proper prenatal care? Isn't it supposed to prevent stuff like this? I feel like the system (or maybe only this doctor's office) failed me and my baby.

I consider myself an educated woman, so if I don't know the answers I know how to get them. These experiences have left me with only questions that I will probably never be able to get the answers to. All I'm left with is the feeling that our current system of prenatal care is certainly not the answer.

Saturday, April 25, 2009

Abstract art

Do you ever have episodes of deja vu where a thought, event, or action tickles the edges of your memory seeming to have happened before in a dream, past life, or alternate universe? I've noticed these episodes in my life seem to be coupled with crossroad decisions or subjects of great importance (well important to me anyway).

I had one such episode this morning when I was thinking of something while trying to procrastinate getting out of bed, but then my daughter walked in the room and wanted to show me something that she had "created". Her creations in the the past have included burnt microwave popcorn, artwork involving scissors and a scattering of microscopic clippings, sculptures involving every toy in the house, abstract drawings involving a banana and the wall as the canvas, and incinerated hot chocolate (which resulted in a small fire in the microwave).

So naturally, her use of the word "created" always sends a wave of panic through me and made my mind expunged the thought as an act of self-preservation to my worldly property. The creation this morning was only a minor affair involving random clutter used to bar the top of the stairs.

Oh well, such is the life of a mother (that I wouldn't trade for anything). As my mother used to say, "if it is important, the thought will come back to you."

-- Post From My iPhone

Thursday, April 23, 2009

Today I received my records from my OB's office and setup a consult appointment with my potentially new perinatologist.

With the last 2 pregnancy experiences ending in loss at this same office (in addition to other reasons resulting in dissatisfaction), I decided I need a new doctor.

I understand that the cause of 50% of all stillbirths are unexplained. I understand that we do not yet fully understand the causes for placental abruption. But there has to be something wrong with me for this to happen twice, and I want answers so I don't have to go through this again. I'm not getting any younger, and we want more living and healthy children!

In reality I don't expect to ever get those answers, but I do want someone who will watch me very closely and be as concerned about my developing baby as I am while also being emotionally accommodating. I didn't get that sense of concern for my baby from my old doctor's office, and they certainly weren't emotionally accommodating. Unfortunately, I didn't realize this until it was too late.

Should they have handled things differently? Maybe. Would it have allowed my child to stay inside me longer to develop more fully first before being born? We hope this potentially new perinatologist will be able to answer these questions.