… says my pregnancy countdown as I’m writing this. My due date is tomorrow and we have decided to go with medical advice and accept induction at 40 weeks. Two days ago I went in for a second membrane sweep, but although it had been 12 days since the last attempt, there was no progress at all. It was impossible to do a sweep on me. My cervix is still tightly closed and the baby is not engaging at all. The doctor said they would have expected to see at least some development at this point, but since there is none it’s very unlikely to make any difference to postpone induction a few days or even their usual policy of 10 days past the due date for low risk (and non-IVF) pregnancies.
Basically there are strong indicators that I will need induction no matter what. So if there is only a very slim chance of any benefits to waiting, why take the risk and the worry. Especially since they do not actually investigate how well the placenta is working at this point. With this we feel at peace with the decision and in acceptance of intervention once again. Whatever it takes, whatever happens – it will all be worth it!!
In thinking about this over the last two weeks, I have come to realise that I’m not attached to any particular idea of a natural and idealised birth experience. I only care about the end result of holding a healthy baby in my arms, while of course hoping that the process to get to that point will go as smoothly as possible and involve as little distress as possible for both me and baby. But I would never even consider giving birth anywhere else than in a hospital and I trust the professionals there to deliver my baby safely by whatever means necessary. ‘Mother nature’ is also cruel and cannot necessarily be trusted. The millions of women and babies who have died and still die in childbirth in places and times with no access to medical help, is testament to that.
Personally all those years of infertility has taught me not to celebrate or have blind faith in ‘the natural way’ or be attached to any idea of ‘mother nature’ as a superior force. Of course I wish I could have gotten pregnant easily and naturally by making love to my husband rather than by way of doctors and IVF procedures in a hospital, but the reality turned out to be what it was. I no longer mourn that fact. It is what it is and my gratitude to modern medical science, and the intervention that got me pregnant, is limitless. The miracle of life is as amazing under these circumstances as in any other. Maybe even more so.
Tonight at 9pm I will be admitted to hospital to begin the induction process and I will stay there until the baby is out one way or another. It will be prostaglandin gel to start off with and probably a second dose later if nothing happens. Later again they might break the waters and eventually if labour is still not progressing they might put me on a syntocinon drip. They told me there is a risk that induction will fail and in that case a c-section will be considered. Thus prepared, we hope for the best while accepting to take each step as it comes and deal with whatever happens. In the end of the day no labour and birth is guaranteed to go smoothly. Anything can happen to any of us in that situation. Natural low risk labour can end up involving serious complications and drug-induced high risk labour can work out just fine. As with life in general you just never know what you’re gonna get!
Yesterday I went to the hospital for the first membrane sweep. It failed. The consultant couldn’t reach my cervix, which is still long, closed and posterior. The baby also has not fully engaged. So all in all, the conclusion is that labour looks likely to be far off. The conditions are unfavourable as the consultant put it. At 38 weeks this is not really that surprising, but it does bring the prospect of medical induction to the forefront since the general practice at the hospital is to induce IVF pregnancies early at 40 weeks, i.e. on my due date the 17th August. They will attempt a sweep again on the 14th which is just 3 days before my due date, but with the way things are looking I have my doubts whether there is any chance that it will help trigger labour naturally. Consequently I’m also starting to doubt the planned medical induction at 40 weeks. This I wonder might pose greater risks than allowing the baby to go overdue. Especially if the next sweep attempt reveal that conditions are still unfavourable.
So I have been google searching like crazy to try to find evidence for why IVF pregnancies should be induced early at no later than 40 weeks. It seems to be common practice in a lot of hospitals in the UK going by forum posts and the like. Although there are also many examples of this not being the case. The advice women, who have gone through IVF, are being given is clearly very inconsistent. And the evidence for the risk of going over the due date is sketchy at best, as far as I can find out. The reasons given are usually similar to what we have also been told – namely that the risk of still birth is higher due to the placenta not functioning as well beyond 40 weeks in IVF pregnancies.
Based on the lack of evidence there seems to be good reason to question the plan of induction at 40 weeks if the cervix is still not showing signs of being ready. We have decided to wait and see whether we should postpone the induction date. Maybe things will start happening in the mean time. Move on downwards baby boy 🙂
Last night we celebrated hitting the 37 week mark while watching the opening ceremony of the olympics. For us the countdown to the olympics has had a very special meaning because it’s taken us almost as long to get to this point as it has taken London to make the olympics possible. Now it’s all happening right around the corner from us here in East London while we are waiting in anticipation to meet our little baby boy. Everything is buzzing with a typical London combo of excitement and chaos. The chaos part is the worrying bit, because the hospital where I’m giving birth is right in the epicentre of it all. In fact it’s the officially designated hospital for the olympics. Not that the maternity unit as such will be affected by that, but the journey to the hospital will…
On Thursday 2. August we will get a taste of how difficult it is going to be to get there. I’m having a ‘membrane sweep’, which is the first step in the process of induction they have planned. We have been told that they want to ensure that I do not go over 40 weeks because it’s an IVF pregnancy. Apparently there is a higher risk of stillbirth when overdue because the placenta does not work as well anymore. Whether this has more to do with higher maternal age than IVF as such is difficult to say since the two factors often coincide. In any case, we do not see any reason to take the risk so we will go along with the plan.
A membrane sweep is viewed as the natural approach done prior to medical induction. It involves manually stretching the cervix and sweeping inside to try to encourage the release of prostaglandins, which are hormones that help trigger labour. It sounds rather unpleasant, but if it means a chance of avoiding medical induction it is worth the try. How effective it is is questionable. Presumably there should be about 50% chance that you go into labour within 48 hours. But it depends on how ready the cervix is at the time. If it doesn’t work they will do another one a week later. If nothing has happened by my due date (17. August) it will be time for medical induction. By then the olympics will be over, so it will be easier to get to the hospital. But I’m so hoping to avoid medical induction and I’m also just ready for him to come out now. So fingers crossed for an olympic baby!! 🙂
There is something special about February. It’s the month of love. It’s the month we first met on a dance floor in London 9 years ago in 2003. It’s the month we decided we wanted to start a family 3 years later in 2006. It was so special and romantic for us to make that decision then. Little did we know what kind of journey lay ahead and that wanting to have children is something completely different from actually being able to make it happen. Now, 6 years later, it’s February again and I have entered the realm of the 2nd trimester of my first pregnancy.
February now feels more magical than ever before. But it also makes me think back on all those years of living with unexplained infertility and going through fertility treatment. These 6 years have changed me and us forever. I can’t imagine myself and our life any other way. We have learned that life is unpredictable and beyond our control. We have learned that nothing can or should be taken for granted. We have learned that it is possible to be happy even when life is turning out so differently from what we had imagined. We have learned that resisting what is only creates more suffering. At the same time, we have also learned that there are subtle, but very important, differences between denial and acceptance. We have learned that there is a time to let go and rest, but that there is also a time to start fighting again. We have learned that living outside the social norm is difficult, especially when you have had no choice in the matter, but also liberating. It teaches you to find your own way and to make conscious choices about who you are and how you want to live within the limits of whatever life is handing you. It has make us stronger and closer as a couple.
To put it differently, we have learned that being involuntarily ‘stuck’ in a liminal life state like infertility for years is painful on many levels, but also transformational. Looking back on my posts prior to IVF and pregnancy, I did know this when we were still in the trenches (see for instance this post), but only tentatively. It is much easier to reflect on it now when I’m no longer in the same state. As I do so, I realize to my surprise that I don’t actually wish that these years had been any different or that we had been spared the long journey to get to this point. I also realize that the only reason I can feel and say this is because the liminal state of infertility has effectively ended for us. For now at least. Over the course of the first three month of pregnancy I have transitioned into a new state – that of pregnancy. We have not become parents yet, but for the first time ever we are actually on our way there. We can see the light at the end of tunnel. This last stage of the journey is significantly different from any of the stages that have come before because the creation of a new life is no longer theoretical and impossible. It is happening. A new life is coming into being slowly and steadily with every day that passes.
We resisted IVF for a long time, but in the end it was IVF that made the miracle possible. Yesterday we went for the NT scan* and got to see our little miracle dancing again. He/she was making it very difficult to get the measurements done because of all the moving around. As the technician was waiting patiently for the right position we had lots of time to enjoy the show and revel in the representation of our miracle on the screen. I’m still in awe. I still can’t quite grasp that it’s really happening, because it has seemed like a complete impossibility for so long. But I’m getting there slowly. More so now when the morning sickness has lessened because I’m functioning more normally again. We have not looked at baby stuff or anything like that yet, but a few days ago I started looking at websites of hospitals in London to try to get an idea of where to give birth since we are moving there. As I was watching a little video that took you on a tour of a birth center, tears started streaming down my face. It was hitting me. It’s happening, it’s real. I’m pregnant. We are going to have a baby.
*Update 16/2-2012: We received a letter two days after the scan with the assessment of the risk for Down’s Syndrome etc. based on the combination of blood results, NT measurement (1.1) and my age (37). The risk was assessed to be 1 in 11000, which is reassuringly low for my age.
My husband has a fantastic record collection (good old-fashion vinyl) and the last couple of weeks he has been spinning his jazz, soul and funk tunes like crazy, because as he puts it – you have to start music education as early as possible… 🙂 I’m not complaining. It’s candy for the ears, makes you move and soothes the soul!
We know of course that it’s too early for our little one to actually hear anything, but today at the second ultra sound we could not help but wonder. He/she has sure got the moves! We were treated to the greatest dance show I have ever experienced. It was so funny and amazing. I still can’t stop smiling and tapping my feet to the music coming from the living room.
Nauseous as I am, I just need to take one look at that ultra sound picture to remind myself that it is all real and more than worth it. Everything is going well with the pregnancy and I feel so grateful, thankful, amazed and all kinds of other things I don’t know how to express. This scan in particular has definitely kick-started the bonding.
Thank you all for the supporting comments on my ‘morning sickness’ post. While I’m still puking away, I have asked the guilt to move out and instead I’m just trying to accept that I feel crap at the moment and it’s ok to feel drained physically and mentally and it’s ok to voice it. I had lost a bit of weight which is not exactly what I need, but it was not alarming. On an emotional level the scan today has helped boost morale enormously and there is just two weeks to go for the next scan (NT). By then I will hopefully be feeling better.
It was amazing. Indescribable. By now I have experienced a lot of ultra sounds, but this one was out of this world. In the best possible way! There on the screen we saw the blinks indicating that a tiny heart is beating away at 156 bpm. It is really happening. Our baby is growing and developing inside me. It’s a miracle, nothing less. The miracle of life.
I’m 8 weeks pregnant today, so we still have a while to go before we reach those 12 weeks. But seeing a heart beat gives us so much more confidence to keep believing and trusting that everything will be fine.
It also means that we are slowly starting to transition out of this liminal state we have been stuck in – as I have written about in previous posts (Tagged with Infertility & Embracing the liminal space). It has felt like life was on pause for a long time. Now it’s moving forward again. With every day, every week that passes we are entering a new stage in life. That of expecting parents. I can’t even express how thankful I am!
Tomorrow I will be 6 weeks pregnant. It still feels quite unreal and although we are still in that zone of being absolutely overjoyed, there are also other feelings starting to take up more and more space. Namely worries and fears. Because it’s still so early days and because there is always that risk of a miscarriage. I’m trying to trust life, trust that our little ‘sprout’ is doing great, trust that everything will be ok. But sometimes it’s difficult.
Again I feel the effects of that addiction to seeing and knowing I wrote about in a previous post (Addicted to knowing). I so need a fix! I need to SEE with my own eyes that I’m pregnant – despite the fact that I can clearly feel it. I need to KNOW that everything is ok. I need to SEE a heartbeat. I am in other words craving an ultrasound scan and I’m not going to get one until the 6th of January.
I know all pregnant women are anxious in the early stages of pregnancy. It’s normal. But I think it’s more of a challenge when you have been living with infertility for years and finally get pregnant after fertility treatment. Firstly, there is that feeling that you can hardly believe it has actually happened at all. It feels like a miracle and that in turn makes it enormously precious and special. All of a sudden you have so much to lose and you know it might not be simple or easy to just get pregnant again if something goes wrong. It feels like a ‘once in a life time’-thing. To top it all off, there is the issue of the way fertility treatment has fundamentally changed your perception and sense of your own body. It has become the object of reproductive interventions by professionals and you have become used to relying on this intervention rather than the natural functioning of your body.
Now my body is all on it’s own again. I have even been told to stop taking the progesterone by tomorrow when I’m 6 weeks along. I fear stopping, because it seems so early. Especially compared with how it’s done elsewhere as my google research is telling me. At the same time I’m also deprived of access to any external knowing and seeing what is going on, i.e. I have no way of feeding my treatment induced addiction until the 6th of January.
It’s hard to all of sudden trust your body and trust that nature can take it from here. And to accept that there really is no need for me to know or see what is going on. I have no control anyway, neither do the professionals. They can do as little as I can to ensure that things work out. I have to let it go, trust and hope for the best. I need an antidote in the form of some good old fashion ‘taking things as they come’. As my dad said it when I was talking with my parents on skype about all the blood tests, ultrasounds and screenings which are now common in any pregnancy: “Well in our day we assumed things were ok when the belly starting growing…”. There were no BETA numbers, no scans, no tests. Maybe I will be ok then, waiting a mere two weeks for that first ultrasound :-).