Wednesday, January 18, 2012

The Next: Part One

We spent New Year's Eve the year with boy J., girl J. and their daughter C., who I mentioned in this post. C was born in June after Aidan died. She is now a very advanced 18 month old who already knows many of her letters and is close to being potty trained.

Impressive as hell, right?

Anyway, since they have done such an awesome job of turning baby #1 into a smart little toddler, J. and J. have announced that they are planning on trying for baby #2 at the end of this month.


Now, while I am genuinely happy for them, and look forward to the day that I can meet J. & J.'s second amazing offspring, I can't help thinking "here we go again". Hearing about others pregnancies and births doesn't carry quite the same sting that it did for most of 2010 and 2011, but I do still feel a little twinge. Not because I necessarily want to that to be ME right now...but because I don't know if I will ever have that opportunity again.

It really hit home this morning when Brian dismantled the bassinet that we had set up in our room. Kaia's time as a newborn is over. She might be my one and only (living) baby and she's already growing up and moving away....right down the hall to her own room of course...but still...

Part of my sadness about her being in the cast is that she's not my squishy baby right now. She's heavy, and awkward, and cuddling with her is kind of like cuddling a brick. I'm just sad that if Kaia is the only baby I ever get to raise, we will have spent 19 weeks of her first year (over 1/3) having to love on her via a hospital visit or through a cast.

Knowing the difficulty we had in having a family is probably why I get asked "are you guys planning on having another child?" in such a hushed and solemn tone of voice. People want to know, and I don't mind them asking...however...

I really don't know how to answer this question.

Actually, no that's not true. I DO know how to answer this question, but it involves launching into a long complicated pro/con discussion that goes a little something like this:

I would love another child. I always wanted at least two (living) children and I currently haven't met my intended quota. However, after two disastrous pregnancies, we are understandably a little hesitant to leap into that unknown.

If we are looking at it in terms of MY health, then I feel confident my body could handle another pregnancy. My heart did well in both pregnancies, and my cardiologists were impressed with my recovery. I could currently use a whole lot of toning and strengthening and some cardio, but that's nothing getting back to work, the gym and chasing Kaia around when she can walk won't cure. I don't know how long I would want to put off another pregnancy in terms of my heart. I'm going to be 30 this year, and I think the younger I am when attempting a pregnancy the better. So if this were the deciding factor, I'd say we'd be trying for baby #2 within the next 2 years.

Oh, how I wish that were the only consideration...but alas...

If we are looking at it in terms of the prospective baby, then that puts a whole new spin on things. We currently have NO idea why I developed a Breus mole placenta in both pregnancies, which probably led to my water breaking WAY too early in both cases. The first time, my team of doctors considered it a fluke...the second time they pretty much shrugged their collective shoulders and said "huh, well maybe it's genetic". Yeah great, awesome deduction guys! We just don't know how 'heritable' this condition is. ie: how likely is it to happen again? 100%, 50%, 10%? Also I don't know if we can do anything to modify this risk. Certain supplements I could take? Certain medications? Certain medications I should STOP taking? I think I'd like to talk to Dr. K., the placenta specialist again, before any decisions are made, but my feeling is that any pregnancy we embark upon will be done with the caution that 'it might happen again'.

And, I don't know if we could handle that.

How could I embark on another pregnancy with the knowledge that there is a certain (small, medium, large, extra large?) chance that pPROM could happen again, causing the possible death/disability of theoretical baby #3? Is that fair to the baby? Is that fair to us? Brian and I and our families still have such sadness in our hearts for Aidan. We feel such loss for him and for ourselves. How could I chance that again?

Of course, if they had told us after Aidan was born that we had a good chance of having another pPROM caused by a Breus mole, then we may have decided against any future pregnancies. In which case we would not have Kaia. She has brought such light and love into our lives, and despite a few set backs (prematurity, her hip), she is a very healthy, happy girl. So, how could I NOT chance that again?

Then there is the physical toll that pregnancy took on my body other than my heart. I think my current back problems still stem from all the bed rest and the strength that I lost during that time. I remember on the night before Kaia was born, when they told me I was going for my C-section within the next 12 to 24 hours. In amongst the 8000 thoughts that were flying through my head was this one: THANK GOD, TOMORROW BED REST ENDS!!! I'm NEVER doing this shit again!!!!

But if I was pregnant again and things went the same way my last two pregnancies did, how could I NOT agree to do bed rest? How could I deny the best possible care for theoretical baby #3 that I did for Aidan and Kaia? I don't know if bed rest was what got Aidan to 23 weeks and Kaia to 32 weeks, but it probably didn't hurt. Both Brian and I know, that faced with that situation again, we'd probably do the same thing. Emily in bed doing next to nothing (and relying on EI for money). Brian at work and doing all the chores and having to shoulder a large part of the financial burden. Only this time we would have Kaia to consider. Not sure how mommy on complete bed rest for weeks on end with a small child would go, but I'm sure it would only complicate matters.

The main issue I have is that we don't know why it happened, twice. Once could be a fluke, twice and I begin to question if something is wrong with us. But if something IS wrong with us...what IS that something?

Is there something wrong with my baby-making parts? Does my heart affect blood flow in a way that causes pPROM? Does my short luteal phase point to a deeper problem that is, as yet, undiscovered? If we put our genetic material into another person via surrogacy, would that make a difference? It seems like a hell of an expensive shot to take, and I don't know if I could, in good conscience ask another woman to risk that for us.

If it is strictly genetic and the 'vessel' doesn't matter could those embryos with self-destructive placentas be 'weeded' out with pre-implantation diagnosis? If that was possible, then we could start saving our pennies for IVF. Or, if it's one of us that carries a 'defective' placenta making gene, then maybe we should consider either sperm or egg donation. Not sure about those logistics in Canada, and not sure how I feel about our child being genetically linked to only one of us, but it would be another avenue to consider.

Or, if the problem is genetic, and we can't figure out a high tech way around it and we don't want to risk another placenta going 'kaplooie', then maybe adoption would be right for us.

As you can see, there is a lot to consider. I would LOVE another baby some day, and a chance at a 'normal' pregnancy. But, unlike J. & J. who seem to be focusing solely on the financial and organizational logistics of having a second child, I feel like we have a lot more to consider.

And a hell of a bigger risk to take.

People rarely solicit advice on their personal blogs, but I'm going to do just that. Pretend you're me. Would you risk it again?


  1. I know there is a huge difference between having your own child and adopting, but if I was in your situation and worried that there was some genetic predisposition that would impact all my pregnancies, I would look into adoption. There are a lot of babies in the world that could use loving parents :)

  2. I've had complications with most of my pregnancies or births but the only "advice" I can give you is what someone told me once when I was fearful of repeats:Don't let fear rule your life.

  3. I honestly don't know. And right now, I know that really isn't much help to you. You have some huge and difficult decisions ahead.
    My love to you.

  4. As someone who has had two fairly uncomplicated pregnancies (so far, we've still got a couple of months of cooking with this one), just knowing that I would never carry another baby would break my heart. The answer is easy for me, but I've never had my childrens' lives on the line (as well as my own) so my perspective is a little skewed. In time I think you and Brian will know what is best for you family, you're still pretty close to the actual event and surrounded by the reminders of your pregnancy, birth, and the effects on Kaia.

  5. I'd want to, definitely, but only you know whether you can do it. I think, having Kaia around as a toddler would definitely complicate things if pregnancy meant you being on bed rest again.

    I realize this is going to be an ignorant question, but would being on bedrest before 16 or so week be of any benefit to avoid your fluids leaking? Like if there wasn't a lot of pressure (bc you're laying down), would it be more likely you could get further before your water broke? I guess it could break even if you were up for only a few minutes to use the washroom though, right?

  6. I honestly don't know Emily. I really don't. I would completely understand your decision either way. I feel very nervous TTC again, and I don't have your history.

    Wish I could look into the future and tell you if you should risk it or not...

  7. I found your story on faces of loss, faces of hope. I am so sorry to have found your blog because it means you've had a loss, but its good to know we aren't alone in our grief. i'd love to have you follow along on my blog as well:

  8. Yes I would risk it again. I have one living child now 4. I had issues with his pregnancy (iugr and was induced when he stopoed growing and moving) My second pregnancy ended at 31 weeks during labour after pprom at 21 weeks. We are not sure why my waters broke. My third pregnancy ended in miscarriage at 11 weeks and my forth also in miscarriage at 11 weeks. That was 8 months ago, we have been trying for another baby ever since. I know I am very lucky to have my living son but now he is older I desperately want him to have a sibling. I have come to the conclusion that my son may well be an only child. I know we will eventually be ok with that if we have to be but right now I cannot accept that. If I get pregnant again and miscarry I will try again, the only exception is if I lose another baby in the second or third trimester, I think then I might not be brave enough to try again.

  9. Personally, no. I don't think I would risk it again. If I were in your situation, I think I would seriously consider adoption for my next child =)

  10. I did 20 weeks of bedrest for IC and preterm labor fears. I would do it again. Even the harrowing weeks of 20-30, I would do it again. Even having a toddler around, I would do it again. Right after my living daughter was born, I thought that I would never do it again or want to do it again but now as she is growing and thriving, I know I want to.

    Yes, I would suggest accepting the fact that you and Brian will follow the same routine and pattern that helped Kaia make it to 32 weeks. As my OBGYN said, it worked last time so don't change it. While I know p-prom wasn't the definition of "working" Kaia is healthy.

    Also, my back is killing me. I'm 31 now and those 5 months of bed rest clearly physically affected me. So, even though I want another baby soon soon soon, I HAVE to strengthen my muscles and prepare my body physically for that kind of muscle deterioration. The thought of getting pregnant again is still years away.

    I also like to think that no one but you and Brian can make this kind of decision, clearly. If your doctors believe that you have the same likelihood of a healthy pregnancy as a problematic one, then you two should do what your heart and head tell you, not what others might do. When my doctor told me that she believes I can get pregnant and do it all over again (but be prepared for the months of total and complete bed rest), then I feel confident about my decision.

  11. Without going through what you have it is hard to comment, but I think that I would not risk it again. Your pregnancies were incredibly stressful and hard on you both physically and emotionally. I fear that it would be too hard on you if things did not end well with a third pregnancy.

    Kaia is so beautiful and was so worth the effort you put forth that I can see why you might want to try again. I can also understand wanting her to have a sibling. I can say as an only child myself, I did not really miss having a sibling and instead formed very close friendships that are/were almost as close as siblings.

    All that being said, I'm sure it will be a hard choice, and not one that you will rush in to. Right now I bet you are counting down the days till you get your squishy baby back!

  12. I wouldn't do it again. I am also not a good baby maker.While my first was fine, my second, a boy, was stillborn at 31 weeks. Like you, I work in the NICU. It was really, really hard. My husband wanted to try again soon, so after 6 months I got pregnant. Then miscarried. Then I was pregnant again within 6 months. With close monitoring, I had 36 weeks with her and she was healthy. Mentally, I made it about 9 months before falling into a depression. Eventually, we separated and I've been a single parent since she was 18 months. It just took its toll on me and I was a different person when it was all over.
    I know we are not the same person, but make sure you leave time to be stress free for part of your life. It is equally important.
    This is just my opinion.

  13. wow....good question. I like to jump into things with both feet and eyes closed, so I would take my opinion with a grain of salt...just sayin'.

    I would do it. And probably more than just one more time.

    You are a brave mama. Aidan and Kaia are and any future babies you may concieve and bear are lucky to have you.

  14. It's SUCH a tough decision. Particularly when you know it is something that has a chance of recurrence. In my case, I now know that I have a short cervix and that would put any baby at risk of premature birth and all its attendant risks. How could I risk that? But, as you say, I look at the two children, I do have and think how I could not risk that? I can't bring myself to regret having either of them.

    I don't know how I would have coped with bedrest with a toddler, thankfully it didn't come to that this time round. I know that is a major consideration in my own plans for another, the impact on the two children I do have and whether another pregnancy would have too much of an impact on them.

    It's just such a big risk, as you say. I think all of just wish we knew what was normal, what had happened last time and will it happen again? If only we could know for certain. I hope that you and Brian can find the right way forward for you both and for Kaia xo