Pregnancy After Loss

Milestones

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motivational simple inscription against doubts

Last week in therapy, I told my therapist I was 28 weeks pregnant and she said, “wow that’s amazing, so you made it to your goal!” I started laughing and I said, honestly, I’ve made it to a lot of my goals, but I keep moving the goal post.

Later in the week, I had a similar conversation with a friend who was a college athlete and she told me that my mindset was an athlete mentality of taking things one step at a time to mentally push through hard things. That’s exactly how I feel. First hurdle: AFP test. Second hurdle: Maliyah’s gestational age. Next: 7 months. Next: 30 weeks or “still be pregnant on my birthday.” My absolute ultimate goal is to make it to July, which gets closer every day, but I’ve also come to a sense of peace that it may not happen and that’s also ok, because my REAL ultimate goal is a living, healthy baby.

But this post isn’t about simply gestational age milestones. First of all, that’s boring, and second of all, every single day is a milestone for PAL moms. Shit, every single minute feels like a milestone on some days!

Today I wanted to talk about other milestones. There have been a lot, and there are many more to go.

Let me start by saying, much of this post is an ode to myself. Just like my “Proud of Myself 2023” post, I am proud of myself for each and every one of these things. To a non-loss parent, some of these things may seem inconsequential. But for a loss parent, each one of these was like Everest and sometimes the mere thought of scaling the task took my breath away. I’m not seeking congratulations, affirmations, compliments or well wishes. I’m writing this to open the eyes of those who may not realize how small things seem HUGE, and how important it is to recognize small wins.

Interestingly, I had a conversation about this (recognizing wins) in therapy this week, too. I go to a lot of therapy. I was lamenting all of the things I haven’t been able to do (create a registry, have anything related to a baby in the house, call our baby by name) and all of the things I have had to scale back on (going to the gym, hanging out with friends). My therapist spent a full three minutes reminding me of all of the things I have done, how far I’ve come, and suggesting that maybe, just maybe, I was setting the bar too high for myself to ensure I’d never reach it and set myself up for failure. It’s possible. I have high expectations!

Me: I quit law.

Therapist: …After you graduated law school and passed two bar exams and got a job at a law firm that was a terrible work environment.

I guess she has some good points.

So anyway, I decided to dedicate this week’s post to my personal achievements relating to this new baby. The first milestone happened before I was even pregnant.

My first milestone for myself was following Pregnancy After Loss Instagram accounts. The thought of entering another pregnancy was daunting. The idea that I would willfully engage in the content was a huge step in and of itself for me. Long before I took a pregnancy test, I was favorite-ing inspirational quotes about “one day at a time” or “different pregnancy, different outcome.” I was hoping that by swiping by these mantras on social media, they would somehow mind-meld into my thoughts. Osmosis works, right? It’s how Chandler thought he was a strong, confident woman (there is ALWAYS a Friends reference). I’m not sure if any of it worked, but the mere following of accounts that mentioned alive babies, or ongoing pregnancies, as opposed to following solely loss-parent accounts and muting anyone with a child, was a big step for me.

The next milestone came in the form of feeling movement from baby boy. With Maliyah, I had an anterior placenta, so I didn’t feel movement until much later in pregnancy, and I was never able to feel her from the outside. This also meant that Chris was never able to feel her moving. The first few weeks of movement for this pregnancy, I was in a bit of denial. First, it started a lot earlier! I wasn’t sure if I was making it up. For a while, I ignored it. Then eventually, I would put my hand on my stomach at night (another mini-milestone) and see if I could feel him kicking around. Eventually, I knew I could. Again, I waited a few days-weeks until I said anything. Then, I told Chris. When I finally told him and let him put his hand on my stomach, that was a massive milestone for me. The idea that we were both in on this, and we could both fall so so so far, was something that took me a long time to reckon with.

Some people are excited to be a cute pregnant person in cute pregnant-people-clothes. They take photos holding their bump, they make little hearts with their husband’s hands. They purposefully wear form-fitting clothes. Not me. Not me one bit. If I showcased my pregnancy, that would mean acknowledging it. Worse, that might mean someone would TALK to me about it. That was/is the very last thing I wanted. I imagined the day that strangers would approach me on the street and ask when I was due. When you are just trying to make it one day at a time, that is a LOADED question. But eventually, I didn’t fit in my jeans. And it was getting too hot to wear leggings every day. Also, leggings are tight, and the bruises on my stomach were more and more pronounced as my blood volume was increasing. I needed clothes. I held out as long as I could, but eventually, I dove in and purchased some maternity clothes. I talked about this in support group, and someone suggested that perhaps it was easier to think about buying something for me as opposed to buying something for the baby. That reframe actually helped me a lot. Whether or not this baby survived, it was hot, and I needed to wear clothes. I wasn’t jinxing the baby by having clothes, I was just… living in a world that requires clothed people. I decided I would become an “overalls girlie” because having no waistband means having no pressure on my stomach bruises. Thank god for Amazon returns because my tall self needed to try on a LOT of shorts overalls before finding a couple that worked. #LongLegsBruisedCity. If you thought I’d be including photos here, you’d be wrong.

The next huge milestone I looked forward to was having our baby boy surpass the weight of his older sister. She only weighed 634 grams when she was born, or 1 pound and 6.4 ounces. I didn’t have a scan for this baby at the exact gestational age of Maliyah’s birth (25 weeks 4 days), but I did have one a week prior, at 24 weeks, 4 days, and he was already 728 grams, or 1 pound, 10 ounces. This was huge news for us. Trust me, I know most moms aren’t jumping for joy at a baby under 2 pounds, but the fact that he was growing bigger was a sign that things were already going better. That measurement put him in the 58th percentile, which was MASSIVE as far as we were concerned. No wonder I needed maternity clothes!

Our next milestone was one I put off for a long time: picking a name. Chris was all in on choosing names. Last time, we used an app called Baby Names, which is like Tinder for expecting parents. You tie your account to your partner’s and then you swipe left or right on names and it alerts you when you have a match. The idea is fun, it’s gamified, and it’s easy. But… it’s only really fun if you think your baby will be alive. It’s not a “fun” task to pick a name for a baby you still believe will likely be dead. Chris had more confidence than me. He also probably remembered how hard it was for us to pick a name last time, so he thought we should start the process early. He redownloaded the app and told me to, too. He purchased the upgraded account so we could filter different names by national origin, celebrities, all sorts of things. I put off downloading the app, and put it off some more. I wasn’t ready to call this baby anything other than “baby.” Or “maybe baby.” Finally, after much cajoling I downloaded the app and forced myself to swipe a little bit every day. As you read in the post about our “maybe babymoon,” we picked some front-runners. We have a name we have been test-driving in the house. By we, I mostly only mean Chris. We picked a name, but I can’t bring myself to say it. I cannot acknowledge him by name because what if…

I’m working on it. Let’s call it a milestone-in-progress.

The final milestone I’ll mention for now, was when I decided to tell my coworkers I was expecting a baby. I put this off for a WHILE. When I was pregnant with Maliyah, we had some worries about her before things went south for REAL for real. So I put it off. I didn’t tell my work until I was 22 weeks pregnant. I waited for our anatomy scan, and once that was clear, I thought we would be smooth sailing. I told the whole staff on a zoom meeting, with all cameras on. 3 weeks later, to the day, I checked myself into the hospital and my supervisor had to un-tell the staff.

I swore I would never make that mistake again. I thought I had waited a long time last time, but this time, the idea of telling anyone at 22 weeks felt like tempting the universe in a huge way. I needed to wait longer. And I could not imagine looking at anyone’s face while I said it. I assumed I would see either sympathy or excitement, and I didn’t want to see any of it. I didn’t want to be forced to react to any of it, either. Also, I am now so keenly aware of many others’ silent struggles, and I wanted to minimize the pain that I might cause them as much as possible. I decided I would wait until absolutely necessary, and then I would send an email. I wrote and rewrote that email 5 times. Then, I asked Chris to proofread and approve it. He told me it felt “cold.” It was. I didn’t want warmth in return, I didn’t want ANY response in return (in fact, I even said that). I wanted to simply make an informational announcement. I made Chris stand next to me while I sent the email. My heart was racing, I got zone minutes on my Fitbit. But I did it. Then, I immediately went to the gym and locked my phone in a locker, which has become my standard way to avoid the world and human interaction.

I am on to the 4th page of this blog. Those are a lot of milestones to celebrate! Again, I will reiterate that to some, these things may seems small. So what, I followed an account on Instagram? Obviously, I would let my husband feel our baby move. Of COURSE I told my coworkers I have leave coming up in 3 months (hopefully). But none of those things were easy, small, obvious or straightforward. To me, those things were huge. I hope to have more milestones soon… as my therapist would say, even a tiny step forward is a step forward.

(Written at: 28 weeks 4 days)

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Pregnancy After Loss, Travel

Babymoon?

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Chris and I just came back from a week-long trip to the Catskills. When he was asked at the time of reservation if we were celebrating anything, he said it was our Babymoon. Was that true? I guess so. We probably wouldn’t have gone away for a week in the middle of earnings season if it wasn’t for the thing growing inside me. We also probably would have gone somewhere much further than a 2-hour drive away, if I wasn’t too nervous to step on a plane or be anywhere far from a hospital. I also am terrified to leave the state, since it seems that every other day, there’s a news story of pregnant people dying in other places. Anyway, we went on a babymoon. Maybe.

I really don’t know why I hate the term. I guess it’s just the confidence factor. Like “we are on vacation because soon we will have another person to bring with us!” Will we? I don’t know. No one knows.

We didn’t take a babymoon with Maliyah, although we talked about it with a lot more confidence. But we never got past 25 weeks with Maliyah. Most people take babymoons much later! Maybe that’s why they have (false) confidence. This time, I just knew that once I hit the third trimester, my anxiety wouldn’t allow a trip. Ironically, before we booked the trip, I wasn’t sure if my doctors would be ok with it, so we decided to clear it in advance at 23 weeks. My main doctor seemed a lot more confident than me, in fact, she said she thought it was a GREAT idea. i.e. she knew I needed something to lower my stress and distract me.

So that’s how we ended up in the Catskills in a crazy luxurious lodge with only 5-7 other guests on any given night.

The entire property only had 14 rooms, including three stand-alone treehouses, and they were all suites. We were there during the week, and during a low season, so we were upgraded for the entire week to the second largest room in the place (thank you husband and your credit-card-churning-hobby). It was insane the size of this place. We had an indoor AND personal outdoor fireplace. We had an indoor and outdoor shower. We had a hand-painted claw foot tub and double vanity. We had a separate sitting room and minibar. We also had random animal sculptures around the room including a bear perched on the corner of the 4-poster bed. The bougie log-cabin aesthetic was so cozy and fun. It really felt like we were thousands of miles from home, even though it was a relatively short drive from the hustle and bustle of the largest city in the country. The “room” itself was actually the least impressive part of the place, if you can imagine.

The grounds were breathtaking. Our room was directly on the waterfront of a reservoir, and we had a dock, hammocks, chaise lounges and a jumbo Jenga right on the water. Unfortunately, it was a bit too cold to spend long periods of time out there, but I did spend some time journaling midday when the sun was highest. I also spent lots of my time walking around the grounds and trails, either listening to an audiobook, or listening to nothing at all (besides my more-laborious-every-day breathing up hills). Every evening, dozens of deer took over the grounds. It was a common sight for us to pass 10 or more on our way up to the main lodge for dinner.

On our way!
Purple Bear… King of the Castle (King og the Catskills?)
Our private firepit on the lake.
SOOO beautiful
View from the main lodge
Relaxing and reading by the indoor fire.
Deer!
“treehouses”

The best part about this being a lodge, but also being a 5-star resort, was that there was impeccable wifi everywhere. That meant that I was still able to have therapy and attend a support group, and Chris was still able to work. Thankfully, he didn’t have to work at all the first two days we were there, but after that, he had a comfortable work set up, and I had lots of down time to read three books, go on walks, and of course explore the many activities I could do solo. More on that later.

When we first booked the vacation, they listed all the activities that were included on the property, but they also offered individual activities if we chose to partake and wanted privacy. One of those activities was horseback riding which was a hard no from me, but some of the others like archery and stargazing sounded fun and pregnancy-safe. However, when we arrived at the property and noticed that there were basically no other guests, we realized we didn’t need to book private activities, because basically all activities were private.

Our first full day there, we saw that archery was on the lodge schedule. We both had been intrigued by archery, since we had done it as kids, but not in 20+ years. We decided to take our chances with a lodge-wide lesson, and said we could always ask to have an individual lesson later if it was packed. Well… we were alone. 100% alone with our instructor Anthony who was an amazing instructor AND photographer. (See photos below of our Katniss and Peeta moments.) Once I realized I could only wink my right eye and switched to shooting leftie, my aim improved exponentially. Anthony said he would call on us for the next zombie apocalypse. High praise. As we were getting tired (it’s a massive shoulder workout!), another couple arrived (also pregnant!). Perfect timing.

Our home-away-from-home was 10 minutes from the site of Woodstock, which was very exciting for me as a child of boomers. I told Chris we needed to go visit Bethel Woods, which has an entire museum dedicated to 1960’s and 1970’s music, the soundtrack of my childhood. We had so much fun exploring the hippie bus, learning about the last-minute location change, and hearing about the artists who turned down the opportunity to perform (talk about having regrets!). Unfortunately, the main grounds weren’t open yet for the season, so we couldn’t explore, but it mostly looked like beautifully landscaped fields, probably much cleaner and more manicured than they were when 890128930 un-washed music fans overtook the grounds for a week. I also texted my mom while I was there and learned that she unknowingly drove through the area while Woodstock was happening! I love learning new old stories about my parents.

While it was fun to leave the resort grounds for a few hours, we primarily stayed on the campus. Our main goals were to relax, spend time together, and try to keep my stress low while getting through the 25 week, 4 day mark with baby 2, also known as the day I had Maliyah. That meant that we mainly hung around, went on walks, and played games at the Rec Center. They had pool (Chris was far superior), jumbo Connect 4 (I out-strategized him), shuffleboard, curling, and cornhole. They also had a LOT of fire pits. It felt like everywhere we turned there was another one, and on our very first night, the groundskeeper set us up with a private fire and a s’mores kit with branded chocolate disks. It was delicious, but I always forget that being fire-adjacent means I need to wash my hair. Thankfully our massive room shower had multiple shower heads for very clean hair.

Chris had to work on a couple of the days, but I kept myself busy. I went to the gym, I went on hikes on a few trails, and I did a solo crafting activity where I painted my own bird house for the staff to hang up on one of the trails. See the little hearts on each side of the door for my babies?

On our final night, they brought in a resident astrologer who came with his massive telescope, and walked us into the low reservoir for star-gazing. He pointed out constellations, specific stars, and he had a special app on his phone to line up the telescope exactly with many of the celestial beings. He personally felt he was cheating by using the app, but I had no idea something like that existed! We saw neighboring galaxies, we saw the red-orange hue of Betelgeuse, a red super giant star, and toward the end of the night, the moon rose high in the sky and we saw every tiny crater. It was unbelievable.

S’mores
My Personal Peeta
Don’t mess with us!
KATNISS EVERDEEN
Anthony, the man, the myth, the legend.
Acitvities (cornhole) before dinner
Trip to Woodstock
Chris would not peace sign with me.
Pool shark.
Quiet Crafternoon
See the hearts?
Moon Gazing

Besides the major relaxing vibes, I’d say the star of the show for the week was the food. It was absolutely incredible. Not only did it feel like we had an on-call private chef because there were basically no other guests, but everything we had was amazing. Ok, I hated the quail but that’s my fault, I was trying to be too adventurous. Of course they also had many mocktail options, all included!

Room service was available 14 hours/day, and since there were no other guests, it appeared at our cabin on a golf cart nearly instantaneously. After our Bethel Woods adventure, we ordered late lunch to the room, and I was even able to ask for the turkey club sandwich, which I have been sorely missing while being pregnant, and they heated up the meat for me so I could eat it! Every single change to a menu item we wanted, they did and they didn’t bat an eye. One night, we were stuffed after dinner, but decided we wanted to have dessert later, and they said no problem, they’d deliver it right before the kitchen closed. So, while Chris and I discussed possible baby names with the in-room fireplace blazing, room service delivered a massive banana split sundae that we ate in bed. Talk about decadent!

I will admit, I see a lot of people go on babymoons to far-flung places and beaches, they get tans, they feel completely comfortable getting on a plane, they don’t worry about blood clots or proximity to level 4 NICUs, and they don’t panic about fresh fruit or contaminated water in other countries. It makes me jealous. I wish I had that confidence and naivety, and those uncomplicated circumstances. But that isn’t my story and that’s ok. What we wanted to achieve, time together, and a low-stress environment at a distance I felt comfortable going, we did. And we had a great time. We maybe even decided on a name…

(Started writing at: 25 weeks, 6 days, finished writing at 29 weeks 3 days)

We did not buy this… because Chris thought it was ugly and I was too scared to jinx anything.
Banana Split in Bed
More amazing views
🙂
Final night
He says he loves me
Alcohol-free bubbles
Congratulations… hopefully
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Pregnancy After Loss

Crossover Day

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white clouds with sun piercing through it

It’s Crossover Day: the day I have been both dreading and looking forward to since I saw two lines on a pregnancy test.

At this exact gestational age last year, I checked myself into the hospital, only to be discharged 6 days later with no baby.

I’ve wondered for many months how it would feel to be here again, and the only word I can put my finger on is: weird. It feels weird. Not good, not bad, not really nerve-wracking (ok… a little nerve-wracking), but it feels strange. It’s kind of like déjà vu, but actually not. This pregnancy has been so different than my last one.

I was having dinner with Chris last night and I brought this up. He asked what I meant by “different,” and the best way I could describe it was that last time, I felt like my pregnancy was going on in the background of my life. Yes, I was growing a human, but I was still going about my life business-as-usual. I had the same friends, the same activities, I was following the same people on social media, I was still focused on work, I was still going to the gym, and I was still hanging out with friends. On the side, I was watching YouTube videos about what to add to your baby registry, and I had doctor’s appointments about every 4-5 weeks, but that was just going on in the periphery.

This time around, my pregnancy IS my life. It’s the first thing I think of when I wake up, and the last thing I think of when I go to sleep. My friends group has changed. I rarely leave my house. My morning and evening centers around my meds routine and taking my blood pressure. My main focus in my life is reducing stress. My Instagram is flooded with loss-mom-content. My social calendar is mostly non-existent, but when I do have things to do, they are scheduled around my frequent doctors’ appointments and scans. Almost every conversation with Chris eventually veers into “do you think the baby is ok” territory.

My entire life is this pregnancy. And finally, tomorrow, I will be the most pregnant I’ve ever been. Well, that’s not entirely true, Maliyah lived for 48 hours after I checked into the hospital, but tomorrow will be my most-pregnant-not-hospitalized day. Hopefully. I don’t foresee any emergency hospital visits, but you never know. 25 weeks and 2-4 days has been in my mind for months.

For crossover day, we are currently in the Catskills. The main reason we picked this week was because my office was closed. Also, of course, I knew crossover day was coming and I needed a distraction. After we booked the trip, I told Chris we’d be away for crossover day, and I fully expected him to be surprised. I feel like he is able to compartmentalize much better than I can, so I figured he hadn’t thought about the timing, but I was wrong. He said of course he knew that. I asked him if it made him nervous to be away from a hospital (because it definitely made me nervous!) and he said no. He said no, because we had a scan 2 days before we left, everything looked perfect, my blood pressure has been great, and we have no indications of things going south. But still, I’m nervous.

We also picked this week because it’s nearing the time I will not feel comfortable leaving the city anymore. I know for my mental health, I will need to be within 15 minutes of a Level IV NICU at all times. Also, I will need to be within New York State, because every other state continues to make headlines for killing pregnant women.

A few weeks ago, someone asked me how far along I was, and I said 20 weeks. They were surprised, and they said, “wow! 20 weeks already? Time flies, doesn’t it?” I looked at them dead in the eyes and said, “no. time does not fly. Time is crawling.” I thought 25 weeks 2 days would never come.

I have been jealous of my loss mom friends who had earlier losses and therefore had their crossover days many weeks ago. I know this makes no sense; I didn’t actually want Maliyah to die before she did. But when you have an early loss, you get past that date in a subsequent pregnancy sooner and sometimes getting past that date brings along with it some peace and confidence. For me, 25 weeks and 2-4 days was soooo far away from that initial positive test. There were many months, weeks, days, hours, minutes, seconds to get through before this moment. And they did NOT fly by.

Two weeks ago, I spoke to my mom on a Friday afternoon, and she asked me what my plans were for the weekend. That question stopped me in my tracks. The weekend? I had completely forgotten it was Friday, and I had literally 0 plans. By the way, I am completely fine with 0 weekend plans, it was just remarkable that I hadn’t even considered the two days ahead of me. I was so extremely laser-focused on the current moment in time and getting through it, that it had not occurred to me to make ADVANCE plans.

I mentioned in my post about the danger zone that everyone has different points at which they feel confident in their pregnancy. For a lot of people, 24 weeks is that point. Many doctors call this “viability,” or when a baby has a chance of survival outside the womb. But that chance is not great, and I was already past 24 weeks when Maliyah died. Also, “survival” could still mean immense complications. The numbers are: 40% of babies born at 24 weeks’ gestation survive, 50% of those born at 25 weeks, 60% of those born at 26 weeks, 70% for 27 weeks, and 80% for 28 weeks. The countdown is on.

As I approached crossover day, my anxiety was ramping up. I could tell by my heartrate when I took/take my blood pressure. It’s a vicious cycle, I’m nervous it will be high, I get stressed about taking it, the stress and anxiety makes it high, and then I’m more stressed and nervous because it’s elevated. Being out of town and far from the hospital doesn’t help. I see that my pulse is nearly 100 before I’m going to take my blood pressure and the moment I’m done, it goes back down to 75. I can’t seem to get a handle on my stress, and I know it’s crucial to do so, which only makes me more frustrated. The loop continues.

I am hoping I will feel less stressed once we cross this threshold of 25 weeks 4 days, and once I am back in the city in proximity of emergency care.

I keep hoping and hoping to front-load the growth of this baby, in case we need to take him out early, so he has the best chances. So far so good. We’ve already hit a few crossover milestones (more on milestones coming soon). He is officially bigger than Maliyah ever was. And he’s probably 2 pounds by now, which is a weight Maliyah never hit. At our last scan when we found out he was 1 pound 10 ounces, I turned to Chris and I said, “2-pound babies live.” Would I like him to be 3 pounds? 4? 5? Even 6? Yes! But being across the 2 threshold is already giving me some hope. I would not say I’m “confident” in any way, shape, or form, but my hope is slowly growing.

I remember vividly being in the hospital last year and begging for additional days or weeks, and now, I’m getting them (hopefully). I am thankful for each day more, and I hope there are many of them.

I’ve used the word, “hope” 7 times in the last three paragraphs. Maybe if I type it here some more, I’ll internalize it!

Hope… hope… hope… hope… hope… hope… hope… hope… hope… hope… hope… hope…

(Written at: 25 weeks, 2 days)

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Pregnancy After Loss

A Day in the Life: Pregnancy After Loss Edition

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postit scrabble to do todo

This blog is a weird one, it’s stream of consciousness, and it’s a true window into my mind. There was nothing special about this particular day, this was just one of many, many days. As I wrote this, I realized the amount of times I have anxious thoughts. Spoiler alert: it’s a lot.

I think this may be an interesting read for those who have never experienced pregnancy after loss (“PAL”), and for those of you who have, it may sound extremely familiar. I wish I could say that this was a more anxious day than normal, but it wasn’t. It was just a day like every other, of which there are many. All in a row.

I have been finding myself so incredibly exhausted lately, but it’s not always physical exhaustion, as much as mental exhaustion. After reading through my own thoughts, I know why. Being pregnant after loss is all-consuming. Literally every normal thought is followed by a catastrophic one. Every reassuring thing seems to disappear into thin air mere moments after. It’s a never-ending thought spiral, and it is tiring. If you have been wondering why I’ve been absent (from get-togethers, social media, group chats), it’s because I am BUSY. In my own head.

8 am:

Lucky me, another day alive. Ready for 16 hours of anxiety.

First things first:

“Chris, do you think our baby is dead?”

“Um no? Why would you say that?”

“I dunno, because it’s my first thought every day when I wake up.”

Let me check my Fitbit app, did I sleep alright? Yes! Only 3 times awake to pee, and 4 nightmares that I was in the hospital. Not bad. Resting heartrate looks normal, maybe my blood pressure will also be normal. Let me not get my hopes up.

8:20 am:

Time to take my blood pressure. How long will it take me to get calm this morning? Maybe I can trick myself into thinking I’m still asleep. I probably shouldn’t have brushed my teeth and put in my contacts. Ok, deep breaths. Nope, that makes it worse. Shallow breaths. Why do I feel like I’m on a run? Let me check my Fitbit. My HR is already up 20 bpm from resting. I will just sit here quietly some more and hope it goes down.

Phew, worst part of the morning down. Now time for vitamins, meds, and injection. How long is too long to hold the ice pack on my stomach? The bruising hasn’t been too bad lately. Does that mean the blood thinners aren’t working? How do I know if they’re working? Yesterday I had a nose bleed and I thought that was a good sign but “the bruises aren’t bruising” as Gen Z would say. Why can’t I be happy about not having too many bruises?

9 am:

Work time. This should be a good distraction. I have two meetings in a row, great distraction. Easy: Don’t think about being pregnant. Thank goodness for Zoom, I can wear stretchy pants that don’t push into my minimal stomach bruises and no one can tell. I don’t look pregnant on Zoom! Great!

Wait, is my face puffy? Face puffiness is a sign of pre-eclampsia. I don’t have pre-eclampsia, I literally took my blood pressure 10 minutes ago. I am fine.

What is this person on the meeting even saying? Right, right, they want to switch jobs because they can’t afford to live there with their two kids. Two LIVING kids. Sigh. I won’t bring up my dead one, but it sure does cost less! I mean, the therapy is expensive but…

Alright, meeting 2. I will stay focused. I will not think about how maybe my baby is dead inside me right now. Oh, they want to launch a project in the new fiscal year in July! That’s fine. Well, maybe I’ll be on maternity leave. They don’t know that, but I do. But then again maybe I won’t be on leave if the baby is dead. Should I tell them about this baby? No, I haven’t seen him alive on a scan in 3 weeks, that would be presumptuous. Good chance he died since then. And last time I said something to my coworkers about Maliyah, she was dead 3 weeks later. I can’t jinx it. I will just pretend I will definitely be working in July.

12 pm:

Gym break. I need to get out of my head. I need someone to tell me what to do for an hour. I need to move my body and get out of my mind. This is good! I can still run relatively well. I need to keep my eye on my HR though. My nephrologist says no more than 140bpm. But my MFM says I can do anything so long as I can keep up conversation and breathe regularly. Maybe I’ll compromise at 165 but only in short bursts. Ok, 3 minute push pace. If I start at my base, I probably can increase as I go, but if I start in a push, it’ll be harder to bring my HR down if I need to. Will running too hard for 30 seconds suffocate my baby? I don’t think so, but I also can’t be sure.

I don’t think anyone can tell I’m pregnant, they probably just think I’m lazy. As soon as I hit orange zone I start taking my speed down. This is fine, I feel good. The gym was a good idea. I wonder how many exercises I’ll have to modify when we start lifting weights. Will anyone know why I’m switching exercises? I hope no one says anything. I am still non-pregnant passing I think… no one would dare say anything would they? I need to stop thinking, it’s bringing up my heart rate and everyone can see on the screen.

2 pm:

One more meeting and it’s by phone. This is good. No dissecting whether my face looks pregnant or pre-eclamptic.

3 pm:

How many emails can I get through before the end of the day? Wait, is that the baby kicking? Yes! It is. He’s alive. I think. I’m pretty sure. Only alive babies do that right? Let me do a quick Google. I thought I had some pain under my rib but I don’t think that’s “upper right quadrant” pain, even though it’s technically in my URQ. I am probably just dehydrated. And my blood pressure was perfectly normal this morning! It’s not that. It’s not that. It’s not that. Back to emails.

6 pm:

Work over, no more distractions. I could watch tv. I still haven’t finished the Mindy Project. But they’re all OBGYNs. Hard pass. Maybe I’ll go to sleep early. Not that I can ever manage to do that, but maybe tonight is my night. First, dinner. What do I want to eat? Nothing really. What does the baby want to eat? Who even knows if he’s still alive. No, he IS alive. I felt him 3 hours ago. My baby is alive. My baby is alive. Everything is fine.

“Chris, do you think our baby is ok?”

“Um yes, why wouldn’t he be?”

“I dunno, just checking.”

“One day at a time.”

“I know, I know, it’s just… there are so many days.”

8 pm:

Support group! Yes! Other crazy people! All my feelings are normal. This is normal. PAL is hard. Everyone worries. REMEMBER THIS EMILY. The facilitator says I can always go into the hospital if I am worried. Even if I have “no reason” to be worried. I don’t know if I can bring myself to do that. But maybe I will. I have a nephrology appointment Thursday, it’s 2 blocks from the hospital… I haven’t seen our baby in 3 weeks, I could just hop over and get a quick look-see. No… that’s crazy. I felt him move today! BP was good this morning! I don’t want to waste anyone’s time…

9 pm:

Blood pressure and then evening meds. I can calm down. I will calm down. Everything is fine. BP was good this morning. Progressive muscle relaxation. Slowly melt into the couch. But don’t actually slouch. I need an accurate reading. Feet firmly planted on the ground. Back supported. Arm at heart level. Ugh my pulse is going up again I can feel it. Let me check my Fitbit. Yep, it’s up. Way up. Ok, I will sit here calmly for another 5 minutes and see if I can chill. Breathe regularly, but don’t think about breathing. Easy.

Phew normal! I don’t have to do this for another 12 hours. Maybe it’ll also be normal tomorrow. Better not get my hopes up though.

11:30 pm:

I will read in bed until I get tired. OMG he is moving again. HE’S ALIVE. Now maybe I can sleep. But I shouldn’t sleep on my back. Wait, no, maybe that’s an old wives’ tale. My last OB said any sleep is good sleep and my body will wake me or move me if necessary.

My body doesn’t know shit. It didn’t warn me of anything last time. I should probably try to sleep on my side. One day down. One day closer.

“Chris, want to say goodnight to our baby? I hope you’re in there!”

“I hope you stay in there!”

“I hope you’re healthy!”

“I hope you’re growing!”

“And I hope you don’t try to kill your mama.”

“We love you.”

(Written at: 22 weeks, 6 days)

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Pregnancy After Loss

The Blame Game

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Recently, I have been extremely bothered by the seemingly-innocuous question, “how’s the baby?” So many people have said this to me recently in person, by phone, or by text. It always leaves me completely frozen.

How’s the baby? I HAVE NO IDEA. And trust me, I wish I did.

I want to scream at the question-asker, “I FUCKING WISH I KNEW.” It’s something I think about basically every waking moment of every day of every week of every month.

Depending on my mood, I usually say something with a similar meaning to, “I fucking wish I knew,” but in a slightly nicer tone. I’ll say something like, “I wish I knew! Lol”. That “lol” gets them every time. I want people to think, “She’s so breezy! So casual! Look at her, what a chill loss mom!” FALSE.

Sometimes I say, “your guess is as good as mine!” Sometimes I say, “how do you think?,” which always leaves them confused, because how would they know? But the thing is, they honestly do know just as much as I know.

In this weird in-between time where people know I’m pregnant and I’m definitely showing (if you know what my body usually looks like), but I’m not feeling consistent movement and I don’t have closely-spaced appointments, I really do not know how the baby is.

I was chatting about this with my therapist this week, and she said, “why can’t you say, ‘last time we saw him, he was good’?” Sometimes, I do say this. But that usually leads to follow-up questions about why I stated it that way, and what happened since that last time. Nothing bad happened! But also, nothing happened at all. I am just operating on a wing and a prayer. I haven’t had visual confirmation that my baby is alive in weeks.

In my mind, I compared this to another frequently-asked question I receive, “how are your parents?” Of course, I don’t have airtags on my parents and I don’t watch them on monitors at all times, I have no idea how my parents are doing at the exact moment when someone asks me about them. And yet, I answer that question all the time. I say they’re great and give some sort of recent update about them. It doesn’t send me into a panic, and I don’t say, “well, I haven’t had proof of life from my parents in 9 days, but last time I spoke to them, they were very much ok.”

So, why is it so different when someone asks about my baby? First of all, just like I mentioned about trauma informing anxiety around pre-e, trauma is also informing my thoughts here. Thankfully, I have never had someone ask me how my parents were, and then something horrific happened and I didn’t know about it. If that had happened to me, I might have a similar trauma response now when people ask about them. That’s exactly what happened with my last baby: things were very bad, and I had no idea.

But it’s more than that. People don’t expect children to be their parents’ keepers. People do not expect a human to know IMMEDIATELY, with some sort of psychic capability, when something happens to their parents. With pregnancy, people do. If it turns out that a mom had no clue their child was in danger, the blaming and shaming comes out with a vengeance.

When speaking with my therapist, I told her that for some reason, with this specific question, I find that I can’t “lie” and say the baby is good. When pressed, I said, “what if I say the baby is good, then the next day I find out he isn’t, and then not only did I lie, I will be blamed for not knowing something had happened?” We dug into that blame a little bit more, and as with everything else, there’s a touch of PTSD there.

Last year, I will never forget when I checked into triage at labor and delivery, and the nurse there called me a mom for the very first time. She said, “you’re doing great mom; you did exactly the right thing for your baby coming in and getting everything checked out.” At the time, I said, “don’t call me mom, it’s way too early.” In hindsight, that statement bothered me even more, but for a completely different reason. I know she meant it to bolster my confidence, and to make me feel like I did a great thing by coming in when I thought something was amiss, but the reality is, I didn’t know anything was wrong. I had no clue. I felt great and I was at home cooking dinner! The only reason I went to the hospital was because my doctor called my cell phone and told me to. That statement from the nurse actually made me feel terrible because, if great moms knew when something was wrong with their babies, then what did that make me?

Good moms are expected to always know what is going on with their kids, and this extends throughout their lives. I hear the guilt from moms who had reduced fetal movement and didn’t know, or moms who put their kids to bed and then they never woke up, and from parents of much older kids who maybe let them go out late at night, even when they had a “bad feeling.” The guilt never ends.

My therapist shared a personal story about someone she knew who was taking care of her 20-something-year old grandson, and he had a seizure and died, but she hadn’t known because he was in his room with the door closed. This poor woman was blamed for not checking on him sooner, and somehow not preventing this completely unpredictable event. He was a fully-grown adult who had the right to privacy and a closed door! It’s not just guilt, but also blame that never ends.

In pregnancy, it feels like, as Gen Z says, “you have one job.” The job is to keep your baby alive, but it’s also to know when they’re not alive, or not doing well. This is easier said than done.

As I’ve said many times on here, with Maliyah, I had no symptoms and no signs. But I also didn’t know what the symptoms or signs were that I was supposed to be looking out for. Parts of me blame myself for this, and wonder that if MAYBE I had known what to look for, I would have spotted something. I know this is probably not true, since I was in the hospital for days, and doctors were asking all the right questions and looking for all signs, and I had none.

But this time, I do know. The main difference between last pregnancy and this one is my knowledge. With that knowledge, comes more blame. I say to myself, “this time I will KNOW if something is wrong.” But what if, yet again, there are no external signs? What if I don’t know? I will never be entirely sure. What if I say things are good, and they aren’t? I wish I had an ultrasound machine at home, but I don’t.

I am symptom-spotting all day every day. I know that a headache is a tell-tale sign of high blood pressure and pre-eclampsia due to brain swelling. But headaches are also just a common occurrence in pregnancy. Also, I am prone to headaches outside of pregnancy! This does not help my anxiety. I also know that dizziness and light-headedness is a sign of low blood pressure. Since my blood pressure has recently been on the low side, I am now looking for this possibility as well.

Monday, I was at the gym, and I started to get a headache. I was panicking. My blood pressure had been fine in the morning, but what if it was spiking? How quickly could I get to the hospital? Should I go home and check my BP or just go directly there? I felt paralyzed, stared blankly at the wall, and I hadn’t done any exercises for 2 minutes when my friend asked me if I was ok. I remembered that I had not had a headache before class, and one thing that had changed is that I put my hair up. Sure enough, when I took my ponytail down and quickly braided my hair, my head felt a lot better.

Then, 3 minutes later, we went into a circuit of chest presses to high bridge pulls on the TRX. I got up from the bench, and felt light-headed. Panic set in again. Was my blood pressure actually too low? How do I make it go up? I’d never had this problem before, so I wasn’t sure what to do. Should I also go to the hospital for that? Again, I stood paralyzed by fear. Then I remembered that it is semi-common to get light-headed from standing up quickly, and it’s even more common in pregnancy, especially when feeling overheated. After standing there staring at the wall for a second, I felt completely normal again. At least, I felt normal physically. Mentally, I felt like a crazy person.

Meanwhile, the blame game was continuing in my head. What if I went to the hospital and they asked where I had been when it happened, and said I shouldn’t have been at the gym? I have followed all of my doctor’s advice, but surely this would somehow end up my fault. Don’t I care about my baby? I should know better! As a reminder, readers, I entered this thought spiral simply because my ponytail was too tight. The self-blame is never-ending.

In my rational mind, I know there’s no explanation for what happened with Maliyah. It is not my fault. Many doctors have told me this. But to me, it still feels like I somehow made some mistake. Maybe I didn’t make a mistake causing her demise, but I certainly feel like I made a mistake by not realizing it faster. Everyone is allowed one mistake of innocence. Two mistakes though? Not ok. I feel even more pressure now to do everything in my power to protect this baby because I already used up my naiveté, and I do not want to be blamed if something goes wrong again.

There’s no good way to answer the question, “how’s the baby.” This is part of why I avoid discussing my pregnancy in general. I have decided that for now, I will simply sidestep the question like a good politician and instead say, “physically I’m feeling good.” That is true, but a non-answer to the actual question. Another one of my favorites at the moment is: “no news is hopefully good news.” Also true. Note I didn’t say, “no news is good news,” because that may be a lie. Every one of these interactions is a stark reminder of how lovely it would be to be pregnant and naïve, and how nice it must feel to just answer simple questions with simple answers. But that’s not my story, and none of this is simple.

(Written at: 21 weeks 4 days)

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Grief and Pregnancy Loss, Pregnancy After Loss

The Anger Zone

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pexels-photo-987585.jpeg

Anger is not an emotional state I typically find myself in. Not before my first pregnancy, not ever. This is not to say I never get mad, but I don’t usually sit in a space of anger. Recently, that has changed.

I noticed a drastic shift in my mindset toward anger in February 2024. The days were slowly moving forward toward Maliyah’s 1st birthday, and I could not stop myself from reliving my February 2023. Every day in February 2024, I found myself logging into the hospital app on my phone and obsessively rereading my old medical records. I read doctor’s notes, ultrasound tech annotations, and blood test results. I was back and forth, furiously switching apps between Epic and Google, searching every single medical definition. I went into my blood pressure app and looked at my readings day after day from the year prior. Truly masochistic behavior, day after day after day.

I got madder and madder.

We all know the saying, “knowledge is power.” Well, in my case? Knowledge was anger. Knowing what I know now, when I looked back at my charts from last year… I became increasingly angry every day.

I found my anger directed more inward than outward. I did not blame my doctors. I truly think they were doing the best they could with the knowledge they had. I have learned over the past year that doctors have specialties, and often, despite our common belief that doctors know everything, it’s truly a misconception. Doctors know their field. Doctors know how most cases resolve in their field, and how most bodies react to certain things, they know means and averages and medians. Unfortunately, as I said two weeks ago, I was an EXTREME outlier. I do not blame my doctors for not expecting I would be the .00001 case.

However, I found myself in February in an anger spiral, extremely angry at myself. The reason I was so mad, was because I know now that I had a lot of red flags. I had yellow flags, and they were flags I raised to my doctors. However, because the yellows don’t usually transform into reds, my concerns were dismissed. Now, knowing what I know, knowing the ending of my story, I am extremely livid with myself for not pushing harder. In my rational mind, I know this is not fair to me. I know that I did my best, and all I knew last year was to raise any concerns I had, and to trust my medical team’s expertise. But now that I know what I know, I find my blood boiling.

I mentioned a test last week called an AFP test. I am not going to get into the details here, but the short version of my story is, my test result was high. Not just high-ish, but HIGH. Now in 2024, I am an AFP expert. At the time, I was not. At the time, I raised my concerns, my doctor did a scan, said it was “unexplained,” and I threw up my hands. Now that I know what I know, I see my records and I say, “why didn’t I insist on seeing an MFM immediately?” I’ll tell you why… because I literally didn’t know what an MFM was last year.

I chastise myself now for not reading my charts during my first pregnancy. At the time, I was told specifically not to check the ultrasound reports or notes, because they said the baby’s sex, and we were keeping that a secret. My doctor told us that she would tell us verbally if anything was wrong. I really did not question this. I naively thought that medical notes were meant for a doctor’s own records. Yes, I knew I could access the notes on my app, but why would I? Wouldn’t my doctors say everything aloud to me that they put in there?

It turns out, that answer is no. There were many notes in my chart that were either inaccurate to the information they said aloud, or were just excluded from our 1:1 conversations. I know now, that notes are often not added to a patient’s chart until 3-4 days after the appointment. I know that, because nowadays, I refresh the app constantly after appointments, and I read the notes religiously and thoroughly.

What happens between the appointment time and the notes-entering time? I really can’t say. But I imagine that sometimes, a doctor looks over what they saw, observed, felt, heard, etc., and then later, they put those pieces of information together and write down some theories in the chart. Also, days later, when a doctor is seeing patient after patient, it’s very possible they told one patient something that they didn’t tell me, but 3 days later, how could they remember what they said to whom? Also, just like in any profession, doctors have specialized knowledge that they may inaccurately assume patients also know.

One glaring personal example is that no doctor ever mentioned pre-eclampsia to me after 12 weeks. At 12 weeks, my doctor told me to start taking one baby aspirin a day because it was proven to reduce the risk of pre-eclampsia, and I had two risk factors of pre-eclampsia: being 35 years old, and the fact that it was my first pregnancy. I started taking that one aspirin daily, as suggested, and nothing else was ever said. I didn’t ask what pre-e was, what to look for, how early it could begin… I didn’t ask anything. I just took the pill daily, and lived my life. And that word was never said again to me until I checked myself into the hospital.

Imagine my surprise when, in February of this year, I opened up an ultrasound report from 5 weeks before Maliyah was born, and found the note “close monitoring for preeclampsia.” I don’t know what “close monitoring” was meant to entail, but first of all, it was never said out loud, and second of all, I never saw a doctor in 3D between when that note was written, and until I was in triage with stroke-level blood pressure readings. But I didn’t know. So when I saw that note, I was mad. Very, very mad. Also included in that same notes section of the ultrasound was this: “We reviewed the association of an elevated AFP with adverse maternal and/or fetal outcomes including but not limited to stillbirth, fetal growth restriction and preeclampsia.” None of this was true. I mean, the actual risks are true, but they certainly did not “review” that with me. Nobody ever said the word “stillbirth” to us.

I felt so blindsided when I saw that note, that I asked my husband. I don’t remember being in a heightened state of anxiety such that I would have forgotten such a dire possibility being mentioned, but I was glad I had an additional witness. Sure enough, my husband confirmed, this was never stated to us.

Of course, hindsight is 20-20. I’d like to think that if I had seen that note, if they had said those words aloud to me, I would have asked more questions and I would have done more googling. I’d like to think that I would have advocated for myself more when, 3 days later, I had a video appointment with my doctor, I told her my blood pressure was rising, and she said, “that’s normal in pregnancy because your blood volume is increasing, it’s not high enough to medicate.” I didn’t know what that could mean back then, and I didn’t even know that I had already been flagged for pre-e. But now when I read those notes, and relive all of the events that followed, the what-if voices in my head are loud, and they are incessant.

Five weeks after that video call, as we were pleading with the doctors in the hospital for 1 more week, 5 more days, 3 more days, it’s impossible for me not to think, “WHAT IF I had just started on blood pressure meds a few weeks prior? What if I had actually been monitored closely and had even one routine blood draw?”

I’ll never have those answers, and it’s infuriating.

I had months of anger about my previous pregnancy, and what I should have done, if I somehow could have known. Then, I thought I was through my anger phase. Things continued to progress smoothly through pregnancy #2. I had a week where I had two very big appointments: first, an appointment with my MFM, then, an appointment for an anatomy scan, which is often the most detailed scan a pregnant person has throughout their entire pregnancy. I was extremely anxious (as usual), because I could have learned about many possible anomalies, or likelihood of preterm labor. I also could learn if my baby was growing on pace.

Everything went extremely well, and I was so incredibly happy that I screamed it from the rooftops! I announced baby #2 immediately on social media and excitedly told all my coworkers!

PSYCH!! I did none of those things.

I took the bus home from the hospital and cried. Then took a hot shower and cried. Then I laid in bed and cried. A lot. And I wasn’t even sad, I was MAD. Truly furious.

I couldn’t understand why everything was going so well. Of course I wanted it to go well, but why did one of my babies die, and this one was just… hunky-dory? I wanted to be so happy but I couldn’t get over my comparison and frustration.

I dug into my brain and went through everything that I was doing differently this second pregnancy. There were a lot of things. I had pre-conception consultations and tests. I’m taking some different meds. I’m taking two aspirin daily instead of one. I’m overseen by a team of doctors who are extremely knowledgeable.

On a good day, those things give me peace and solace. On a bad day, like I was having around 19 weeks, 5 days, it made me furious. Here’s why: the things I’m doing differently are so easy. SO EASY. They’re so easy, that I cannot possibly grasp why I didn’t do them last time. The most invasive thing I’m doing this pregnancy is giving myself one injection a day. Needles don’t bother me, and if I’m honest, I don’t mind the injections at all. It’s not like I had a massive surgery or reconstructed my uterus. I’m taking 1 additional aspirin a day! Those pills are so small I routinely drop them on the ground. The things I am doing are SIMPLE.

And yet, I wasn’t told to do them last time.

If I had done those things, would I have a living child at home? If I had, would our baby boy be able to meet his sister instead of just seeing her handprints? I just cannot make sense of the fact that I had to lose a baby when it seems so SIMPLE to have an uneventful pregnancy. Like I said before, the what-ifs are loud, and they are incessant. I absolutely hate when people in the loss community say “if you didn’t have baby 1, you wouldn’t have baby 2” because it’s just simply not true. We always wanted more than one baby. And I very easily could have had both alive. But I don’t, and I will never know why. It’s unfair, and it makes me angry.

I know anger is one of the classic stages of grief, and somehow, I hadn’t found myself there until recently, but here I am, and who knows when I’ll see myself on to a different stage. Everyone says, “grief is not linear,” and I’m here as a shining example, finding myself back in stage 2, after I made it through the other 4. If you need me, I’ll be at the nearest rage room.

(Written at: 20 week 4 days)

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Miscellaneous

It’s My Birthday (!)

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birthday letterboard with confetti

It’s my birthday. One year older, one year wiser, that’s what they say.

I think it may have been Jane Fonda who said, “it’s a privilege to get older, because what’s the alternative?” I guess that’s true, if you’re truly grateful to be alive. Sometimes I feel that way.

I used to LOVE my birthdays. I had so many parties growing up; here are a few I remember: Plaster Palace, like a Color-Me-Mine around age 8, my roller rink birthday around age 6, and of course I’ll never forget my 10th birthday at the hair and nail salon. There’s a photo that will live in infamy of all the girls with feather boas and grossly too much stage makeup for 10-year-olds.

Not much has changed
STYLIN!!!
FASHUN, look it up.

Then I got older, and birthdays in college revolved around to-do lists, or oversized poster-board scavenger hunts of things to find and do out at the club. This included, “kiss a police officer,” and other things I’d literally never do as a grown adult with a brain. All of this was of course captured on our digital cameras, which never left our hands, and those photos appeared on Facebook in an album of 60 pictures within 12 hours of getting home and waking in a hangover stupor.

Then came the next phase of birthdays, the themed extravaganzas. There was 24 Ready to Score, where my friends dressed as sports players and I was the ref. There was 29 Neon Sign, which was a boat party, on a not-private boat, but it became that because we kind of took over. Then things became a bit less outrageous but still themed, and instead of a bar crawl we moved the party to the rooftop of my building with Nerdy Thirty.

21st!!
“Find the oldest man at the bar”
Last time I willingly got close to a cop.
23rd Revenge of the Nerds
“Ask someone for a cigarette and break it in half”
REF on the bar!!
First bday with the hubs! Boat Takeover
Neon Sign
Nerds back for Nerdy Thirty

That was 2017. I’m not sure what happened in 2018 and 2019, but once Covid hit, my birthday celebrations really took a hit.

It could have been because I was older, or it could have been because my friends’ group was smaller, or because my hangovers got worse, or because my energy continued to dwindle (probably all of the above), but I also think it’s just because aging became less fun.

I used to adamantly say my favorite holiday was my birthday because it was special, and it was just for me (disregarding the other 20 million people worldwide who have the same birthday). Now, it feels like a cruel demarcation of time that shouldn’t be celebrated. I am pretty sure this feeling is worse when you’re a woman, since our societal value decreases with age, not to mention our waning fertility, but maybe I’m wrong and men feel this way, too.

This year I’m 37 and I mostly spent the week leading up to my birthday thinking about what I thought my life would look like versus what it actually looks like. I thought my family would be complete by now. I thought I’d be in my forever-job. Instead I have a dead kid, multiple degrees I don’t really use, 100K in student loans from my dumb decision to go to law school, new health issues from a pregnancy that resulted in a dead baby, and an uncertain future as far as location, family size, and work are concerned. Basically, everything is “TBD” which is a strange place to be in and celebrate.

I have one piece of the puzzle, my sweet husband, but I’m still figuring out the rest and time is ticking. I’m hopeful I’ll have a living baby this year, and that would be another huge piece of the puzzle. But because of Maliyah, I feel like no matter what puzzle I end up with, there will always be a missing piece and it’s disconcerting.

Every time I don’t think about my age, my doctors bring me back to earth. I was considered “geriatric” even before my first pregnancy, so what does that make me now? Super-geriatric? The more p.c. term now is “advanced maternal age,” but to be honest, that does not make me feel great either. Every ultrasound photo says my age in years and months on the top of the photo, and sometimes I actually forget how old I am until I see that. It seems like the last two years passed in a cloud of grief and anxiety, and the 3 years before that were Covid-years, which we’ve collectively agreed to pretend didn’t happen.

Turning 37 this year, I really feel 32, but I also feel like I’ve lived 100 lives since then.

Two weeks ago, I was at an ultrasound and the tech wished me a happy early birthday and asked if I had any plans. I didn’t. Yesterday, my MFM wished me a happy birthday and semi-scolded me for not having any plans, saying (with a bit too much optimism, IMO) that we should take advantage before our lives change even more.

Honestly, I hadn’t made plans because I just assumed I’d be either in the hospital, or grieving the loss of a second baby by now. Last year I was supposed to be 38 weeks pregnant on my birthday, instead I was 0 weeks pregnant and crying. My big hope and birthday wish for this year was that I’d still be pregnant on my birthday. I really didn’t think it would happen but here I am. Since my ultimate wish came true, I’m happy with that and I don’t need a party.

I’m in a weird spot where every day, I’m one day older, which is kind of depressing, but I’m also one day more pregnant which is great news for the little one who’s still marinating.

This year, that was the only gift I wanted, and so far I have it. Sometimes I miss the big celebrations, the pomp & circumstance, the themes and the dedicated day-of-me, but most times, I’m just chilling on the couch thankful to be pregnant. So, happy birthday to me! From me, in my living room.

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Pregnancy After Loss

The Danger Zone

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white caution cone on keyboard

Here’s a warning up-top: This may be my most boring blog to date. There are a lot of numbers and statistics. That said, it is also possibly my most important blog I’ve ever written. While I’ve never been fully transparent about what happened to me last year during my pregnancy, today seemed like the right time to share since May is Preeclampsia Awareness Month, and May 22 is World Preeclampsia Day.

You will read that my story was incredibly rare. That said, preeclampsia is still one of the leading causes of maternal death in the United States.

American women are more than three times as likely as Canadian women to die in the maternal period, and six times as likely to die as Scandinavians. In every other wealthy country, and many less affluent ones, maternal mortality rates have been falling; But in the U.S., maternal deaths increased from 2000 to 2014. The rate of preeclampsia in the U.S. has increased by 25% in the last two decades and is a leading cause of maternal and infant illness and death. Preeclampsia is responsible for over 70,000 maternal deaths and 500,000 fetal deaths worldwide. Up to 24% of pregnant women with HELLP syndrome and up to 34% of babies die from the condition.

There are a lot of statistics, and in my case, I came down on the wrong side of basically every one, with one important exception: I’m still alive and I could very easily not be.

This blog was a tricky one to write, because my idea of “the danger zone” is very different from other moms. Therefore, even though I know this is my personal blog where I am sharing my personal opinions, I want to start with the disclaimer that, as always, people may feel very differently than I do.

The danger zone in pregnancy is historically prior to 12 or thirteen weeks, or prior to the second trimester. Most people think of the weeks after that as the safe zone for one very specific reason: 80% of miscarriages occur before the 12th week of pregnancy. As someone who has been on the shit end of a statistic before (more on that later), when I see that 80% number, all I see is “1 out of 5 miscarriages happen after that time.” But most (non-traumatized) people don’t think that way. This is why most people announce their pregnancy after 12 weeks. The actual miscarriage danger zone is far more nuanced than that, of course. The rate does not DROP after 12 weeks, it slowly decreases over time, and once you have a confirmed strong heartbeat, a confirmed uterine pregnancy, and a confirmed growth rate, all of these numbers decrease. This can happen far before 12 weeks, even as early as 6 weeks. But in general, people feel “safe” after 12 weeks.

Now that I’m in the loss community, however, I know innumerable ways for babies to die at all different stages. For me, I think about genetic abnormalities such as trisomies, things you might be able to detect in a non-invasive prenatal testing (NIPT) blood draw at 9 weeks. I think about neural tube or abdominal wall holes or placental leaks, which may be detected by an alpha fetoprotein (AFP) blood test at 15-20 weeks. I think about anencephalies, which may be detected in a 12- or 20-week anatomy scan. And of course, I think about everything that could go wrong after, up until full-term stillbirth, SIDS, school shootings, you name it, I’ve thought about it.

Some of those dangers will literally never go away. There is no “safe zone.”

That said, I have learned from my experience, and from my peers in the loss space, that a person’s individual trauma tends to inform their anxiety and their own fears.

For example, I know a lot of women who experienced early miscarriages by discovering bleeding, so then in a next pregnancy, they fear going to the bathroom because they think they’ll find blood. For me, in this second pregnancy I am always elated to go to the bathroom, because of my whole organ-shifting snafu in my previous pregnancy.

For some women who found out their babies had no heartbeat from a scan in their first pregnancy, they are terrified of ultrasounds in a next pregnancy.

For me, my personal “danger zone” is 20 weeks and up, which is exactly what I am right now, to the day. The rate of miscarriage once you get to 20 weeks is less than .5%, but for me, I feel as if I’m entering the danger zone. The reason for that is, except in EXTREMELY rare cases, the risk of pre-eclampsia begins at 20 weeks.

I’ve never gone into the particulars of my story on my blog before, but the reason my pregnancy ended last year was due to an extremely severe form of pre-eclampsia (“pre-e”), known as HELLP Syndrome. HELLP is an acronym that stands for hemolysis (H) elevated liver enzymes (EL) and low platelets (LP). The severity of HELLP is divided into three classes, and I had the worst kind. Serious illness and death can occur in about 25% of HELLP cases, and most of those deaths occur in the top class, the one I had. That percentage is only the first of many in this post, so strap in.

As I mentioned before, I’ve gotten the shit end of the stick in a LOT of statistics. Let’s do some math, and start at the top. Among pregnant women, 5 to 8% develop pre-e but in the United States, it’s more like 3 to 4% of pregnancies. That means 96-97% of women in the US do not develop pre-e. Unfortunately, I was in the 3-4%.

Of the 3-4% of pre-e cases, 15% of those cases develop HELLP syndrome, 85% do not.  Therefore, I was 15% of the 3-4%. Also, of the 3-4%, 90% of pre-e cases occur after 34 weeks of gestation. Therefore, I was in the 10% of the 3-4%, and then 15% of that.

Let’s do the math another way: HELLP syndrome happens in about 1 to 2 of 1,000 pregnancies, or .1 to 0.2% of all pregnancies depending on the study. HELLP syndrome is typically a third-trimester condition, with most (68%-70%) cases occurring between 27 and 37 weeks of gestation.

For me, I was at 24 weeks when I started showing signs. I haven’t done the exact math, but basically, I was in the 30% of .5% of pregnancies. And the percentage is actually even smaller than that, if you consider the fact that my case was so severe.

Most doctors agree that test results are not alarming until they are “twice the upper limit of normal.” When I checked into the hospital, my liver enzymes were five times the upper limit. By the time they said it was “not safe for me to be pregnant anymore,” which was two days later, my enzymes were 11 times the upper limit. This all happened within 48 hours.

If you’re an optimist, and you’re a believer in “lightning doesn’t strike twice,” then you may be thinking that I am worried about nothing. The statistics are SO small, it couldn’t possibly happen to me again, right? WRONG. Here’s the problem: once you have it once, you’re far more likely to have it again.

More stats… here we go:

Research suggests that for women who had HELLP, the rate of recurrence ranges between 5-19% with higher rates if HELLP developed in the second trimester aka me. Now again, if I hadn’t already been 1 in 100,000,000 or something like that, I’d be calmed by that fact that at WORST, 81% of people do not get it again. But in my traumatized brain, all I see is, “1 in 5 chance this happens again.” When I mentioned in a previous blog about the bravery of pregnancy after loss, this is exactly the statistic I was thinking about.

If you’ve gotten through the numbers, thanks for sticking around. For most people this is boring, and completely irrelevant. For me, I do these calculations literally every day in my mind. I think of the risk factors I have, the gestational age of my baby, his chances of survival, how quickly things may escalate, and the time it will take me to get from my apartment to the hospital. I do math in my head all day every day. No wonder I have trouble thinking or caring about anything else. I’m in a constant loop of risk assessment calculations.

Many experts would say that there is a lot of hope, and that in most cases, even if I get HELLP again, it’s likely to happen later, and less severely. But again, when I see “most cases,” I think, “I’m not most.” I wasn’t “most” last time, and I probably won’t be “most” this time.

As I consider how scared I am, even at 20 weeks, my feelings of jealousy continue to creep in. Just last week, I saw 3 pregnancy announcements on my social media feeds. You’d think I’d be happy, because I have a little bean growing too! But instead, I have begun a terrible habit of zooming alllll the way into the ultrasound photos. I know exactly what I’m looking for, after all, I’ve had many of my own photos on my fridge, 6 with Maliyah, and 7 so far with baby 2.

I look for two very specific things in the social media posts on the scan photos: the gestational age in the ultrasound, and the date. Then I calculate how long they waited to post. The only reason I do this is jealousy. I wish I had the confidence to tell people at 13 weeks. I wish I saw my 12-week scan and thought, “I’m going to bring home a living baby and I’m going to tell everyone!” But I am 7 ultrasounds in, and I still don’t believe that.

If anything, as I enter “the danger zone” today, I think less and less that it will happen. All of a sudden, I am watching my own body like a hawk.

Yesterday, I walked 15,000 steps. I came home and I put up my feet to watch tv and I inspected my legs like a scientist. Were there signs of swelling?

If I feel a possible headache coming on (which I’m prone to outside of pregnancy), I wonder if my brain is swelling.

Every night when it’s almost midnight, I play the constant game of, “am I seeing spots, or do I just need to take out my contacts?”

I leaned down to pick up a pen from the floor today, felt a slight twinge in my side, and wondered if that would be considered “upper right quadrant pain.”

All those bolded words are signs of HELLP. They are signs I knew nothing about last year, and to be honest, I didn’t have any of those symptoms, anyway. But now I know, and now I am VIGILANT. I have never known my body more than I know it now.

You may think that makes me feel safer, and that I will now know when there are signs of things going south, but my previous pregnancy took that from me as well. Last year, when I checked into the hospital, even the specialists were floored by the incongruity of my lab work (BAD), and my physical symptoms (NONE). If the doctors couldn’t believe it, how am I supposed to trust my own body? The doubts and fears I have are creeping in with a vengeance, and I am only on day 1 in the danger zone.

Every morning when I wake up, and every night when I go to sleep, I remind myself of what I can control (taking my meds and trying my hardest to keep my stress down) and what I can’t (everything else). I have no words of wisdom. I have no sage advice. All I have is the fact that I will wake up again tomorrow, and try to get through that day, just like I got through this one. One day at a time, day after day. I have a feeling this herculean task will become more and more difficult as the weeks wear on, as we approach the date I carried Maliyah until, and then after, as well. The danger zone is forever, so I am arming myself for battle.

(Written at: 20 weeks 0 days)

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Miscellaneous, Wedding

Happy Anniversary to Us!

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If you’ve been here since the beginning, you have known my husband since the aughts (nearly), back when he was emoji-bf. We’ve come a long way; today, we are now married two whole years. And it’s a happy occasion!

I feel the need to say that because a lot of times in the past year when people wish me Happy Something, it’s not happy at all. Birthday? Not happy, a cruel demarcation of time and my waning fertility. Hanukkah and Christmas? Not happy, as my matching PJ sets (mom, dad and baby) sit in my parent’s basement because I can’t have them in my house.

But anniversary? Definitely happy. I’m so, so happy that I found a partner, and that he has been everything and more to me.

Last year on our first anniversary of marriage, I was on a hiatus from the blog, and kind of on a hiatus from life in general. But this year, I need to celebrate it. In fact, I had a completely different blog scheduled to go out today and I delayed it because this is more important.

There’s a trend on TikTok at the moment that says “please explain to me what you mean by marriage is hard,” and then people stitch together moments of their husbands leaving food on the counter, or leaving their dirty socks beside, not inside, the hamper.

All of those things are hard. But you know what’s REALLY hard? Having your first child die in the first year of your marriage. That is brutally hard. And you know the tough part? In the second year of marriage, your child is still dead. Hard.

But we’re still here.

I’ve seen a meme on Instagram before that says you can predict how badly a relationship is going by how much the couple writes mushy stuff about each other on social media. I consider myself exempt from that. My sweet husband had literally no idea I was going to write this. Hell, I didn’t know either until I couldn’t stop reflecting and decided to put my thoughts in a document at midnight last night. To be honest, he probably won’t love this post (way too many private feelings on the internet!), but it’s all true.

Marriage is hard. But it’s also the best thing ever.

We chose to get married at a resort in Mexico, and we knew we probably wouldn’t be the only couple with the same idea. The resort was like a well-oiled machine, they clearly hosted weddings there often. But when we arrived, we realized there was actually only one other couple getting married the same day/weekend as us, and coincidentally, the groom had the same name as my husband! We ran into them after each of our ceremonies, when we were both walking around the hotel with our respective photography teams taking pictures. We even made our photographers take a photo of the four of us together!

Three months after our wedding, we were on our belated honeymoon in Curacao when I got a text from the bride. Her husband was in a horrific accident, and he had died. She told me to “cherish every day.”

I won’t say I have been cherishing every day, some of them have been really, really shitty, but I have definitely been trying my best to cherish my relationship.

In classic wedding vows, you say, “in sickness and in health.” I never realized how much that would be necessary in our first few years of marriage, both in physical and mental health. I used to cringe when I heard brides say to their grooms in their vows that their husbands-to-be were their best friends. How strange, while surrounded by their real best friends up at the altar!

Now, I get it. Not only do I get it, I say it literally every day to my husband, “you’re my best friend in the whole wide world.” Like, probably 5 times a day. He is the only person who has been there every day, and there are many days when he is the only person I talk to.

He was not just there with me in the hospital, but he’s there with me at home. He has seen the many times I’ve been crying in the corner of the couch. He has talked to me on the phone during a panic attack. He has left the room because his presence was making me nervous while I was taking my blood pressure. Sometimes he leaves me alone, especially at my request. But sometimes, he knows I could use a distraction and he plans a staycation, or a vacation, or he just calls an Uber and takes me to Brookfield Place so I can walk around and get some physical activity without getting sweaty. He gets me, he accepts me, and he’s there for me.

Every relationship has trials and tribulations. I didn’t realize our first bout of them would arrive so quickly, but they did.

I don’t think anyone in the world would come to me for relationship advice. Mostly because I’m a hot mess and I don’t think anyone would come to me for any kind of advice. But if anyone ever asked me, I would say communication is key. This seems obvious, but especially in our relationship where we are so completely different in our personalities and communication styles, it’s important that we keep open lines of both talking and listening. We’ve done a lot of both over the past two years, and I hope it continues.

I know our next year will be even better. Not because I know we will have a living baby, that is very much out of our hands. But I know, because we love each other more every day. Happy anniversary my love (if you ever read this). I love you to the next galaxy and back.

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Pregnancy After Loss

No, It’s Not My First

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monochrome photography of children on swing

Three weeks after Maliyah died, I reached out to the Pregnancy Loss Support Program, and they matched me with a Peer Counselor, who I spoke with a few times. The thing I remember most from our conversations was when I asked her when I would feel normal again, and she said “never.” She said, “even if you decide to have another pregnancy, a random stranger will stop you in the grocery store aisle and ask you when you are due, and if it’s your first. And for the rest of your life, you’re going to face that, and other questions that have no good answers.”

At the time, I thought she was insane. Another pregnancy? Over my dead body. Literally.

But she was right, of course. I am still non-pregnant-passing in most random-stranger scenarios, but at the gym, in spandex and tank tops, it’s become obvious.

The issue is: it’s not my first. But unless I want to follow up with “my first one is dead,” then I never quite know what to say. If I say I have another kid, then they ask how old she is (dead) or how I feel about being a mom of 2 (probably not the way they think I’d feel, since one is dead). If I do say it’s my first, then people assume I don’t know what’s coming, and offer their unwelcome advice, and I do know.

When I first started to tell my coaches at the gym that I was pregnant, only one of them knew about my pregnancy last year. For the ones who didn’t know about it, I figured they would ask me if I wanted modifications for certain exercises, and I wanted to nip that in the bud. To get ahead of that question, I came in for the kill with the overshare. After their squeals of excitement, I said, “I don’t think you know this, but I was also pregnant last year. The baby died, and I almost died. So, this time around I have a very large team of doctors giving me a lot of advice, and I’ll be following that advice and making some of my own modifications.” This was usually followed by shock, nods, a few “I’m so sorries” and “of courses,” and from then on, I was free to take things at my own pace, unbothered.

I wish I didn’t have to be so blunt, but I just couldn’t stand the thought of playing dumb. I didn’t want to pretend I needed help with a modification for a cross-body woodchop when I was already 25.5 weeks pregnant less than a year ago. I knew what to do and what not to do, and I didn’t want to draw any more attention to myself.

It’s not my first. I know what exercises to modify. I know what foods not to eat. I know to try not to sleep on my back. I know to take the trash out daily because the smell makes me want to vomit. I know every test and scan that exists. I know how my body will look and change and feel. I know, because I’ve done it before. RECENTLY.

This time, I also have a huge team of doctors giving me (sometimes conflicting) medical advice, so I don’t need any more people’s advice, especially less qualified people. I now have the BEST OF THE BEST on my team, experts in their field, sometimes the foremost in their field in the country, thanks to living in New York. They know their shit. As I said to someone recently, “you know the saying, ‘there are too many cooks in the kitchen?’ Well, I have too many doctors in my uterus.”

Also, my pregnancy is not a normal one. Most people under the age of 85 don’t have a nephrologist on speed dial. Therefore, while some coaches at my gym may have training in coaching normal pregnant people, they probably don’t have training coaching “special needs Emily.” I don’t blame them, even most doctors wouldn’t know! Heck, I had different advice from 2 doctors on my own team! But the point is, this ain’t my first rodeo. I know more about the specifics of pregnancy than probably 99.9999% of childless non-doctors; I’ve dedicated the past year of my life to research and information-gathering.

I also know more about pregnancy than a large percentage of people with living children. That’s because I’ve now gone through 2/3 of a pregnancy twice, first with a very complicated pregnancy, and now, a super high risk one. I know every possible scan, every possible blood test, every possible complication. I know the different trisomies by heart, and which tests can screen for them. I know multiple different types of cerclages. I know when bed rest is recommended (almost never) and which recommendations are old wives’ tales. Most people go through a pregnancy with naïvity. I have none of that, but I have a boatload of knowledge. So no, it’s not my first.

The complicated part, of course, is that I have nothing to show for it. How do I explain that I have been 25 weeks pregnant, AND 14 weeks pregnant, but I’ve never parented a child? I don’t. I just stay away from people, mostly, especially parents. I steer clear of conversations I don’t want to be a part of or can’t contribute to. When I see people talk about how they don’t want their kids to grow up, and they want them to stay just this age forever, I shut my mouth. Because I know that’s not true. I know they’d be devastated if their kid, in fact, never grew up. I know because mine never did.

I find that the more often I share about Maliyah as part of my story this time around, the more comfortable I am. Instead of just saying, “I’m pregnant!” I’ll say, “I’m pregnant again!” Depending on the situation, and if I’m in a charitable mood and want to lighten the emotional load on the listener, I sometimes add some humor or jest.

I used this humor tactic recently when I went to the dentist. One year ago at the dentist, I was pregnant. At the time, my gums were bleeding every night when I flossed, so I mentioned it. The female dentist said that it happens often in pregnancy, and not to be too worried about it. Then, 6 months later at the dentist, I wasn’t pregnant. Unfortunately, they assigned me to a dental hygienist who was 9 months pregnant. She asked me if anything had changed “in my general health” since my previous appointment. I said, “I was pregnant, and now I’m not.”

Last month, pregnant YET AGAIN at the dentist, I was asked this same question about my general health. This time I laughed, and I said, “it seems I’m on a schedule to get pregnant annually, so I tend to have the same issues every other time I come here! Still no living babies, but hopefully this time’s the charm!” I laughed, she laughed (uncomfortably) and then the moment passed. I didn’t want to go through the fake chit chat about me being pregnant before, so I led with the facts and a joke.

It turns out my Peer Counselor was right, people always ask about the rest of your family unit when you mention a pregnancy or appear pregnant. I’ve decided that in most scenarios, I am not going to say it’s my first. Usually when I think about the reasons I’d say that, it’s to save the listener from an awkward encounter; but it’s not awkward to me, it’s just my family. My feelings have definitely evolved over time, sharing here on the blog has helped me feel more comfortable sharing IRL. Hopefully I’ll have a living addition to the gang this summer, and he’ll be my second.

(Written at: 13 weeks, 6 days)

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