Today was my post-delivery follow-up appointment with my OB. It was also Ian’s first outing, as my husband couldn’t come home to take care of Ian during my appointment. It was also Ian’s due date today. But…most importantly, it was the day that I started to truly come to terms with the fact that the beautiful miracle I’ve been given is almost certainly going to stay my only child.
I anticipated that my OB would talk with me about my preterm labor and delivery. I feared she was going to talk to me about the issue of a subsequent pregnancy, even though I knew the issue had to be broached eventually. My fear was warranted. The OB started the conversation by telling me that there is no way to know for sure what caused my preterm labor. I clearly had an incompetent cervix. I may have had an undetected infection in my uterus which triggered labor, though that option is less likely given my lack of fever, symptoms or elevated white blood cell count. A likely cause would have been increased stress. It could even have been the minimal increased physical activity related to my baby shower. My prior uterine surgeries for endometriosis and uterine suspensions may also have played a role. Ultimately, there is just no way to be certain and because of that fact, we can’t “fix it” for the next pregnancy. The OB said that she does not feel I should rule a subsequent pregnancy out, but I need to be realistic about what it would entail. I would likely have preterm labor again, regardless of the precautions we might take, because I actually delivered so early. I guess preterm labor in one pregnancy doesn’t necessarily mean you will have preterm labor in the next pregnancy, but preterm delivery (especially at 33 weeks) creates a really high risk of problems with the next pregnancy. The OB also said that I could never carry multiples to viability so, if we chose to do an embryo transfer in the future, she would strongly recommend not transferring more than one at a time.
If we chose to try to get pregnant again at a later time, I would have to stay on progesterone and hydroxy (?) injections daily, throughout the pregnancy. I would have a stitch placed in my cervix between weeks 14 and 20 to try to keep the cervix from dilating too quickly. I would be on some form of bed rest the entire pregnancy. And, I would have to have my cervix checked every week throughout the entire pregnancy to look for any signs of shortening or thinning. If the cervix changed, I would have to stay in the hospital for the remainder of the pregnancy.
If we were facing all of this trying to bring our first child into the world, I might be inclined to say “Okay. Whatever it takes.” But, we have been blessed with one little miracle. How would I take care of him properly facing all of those restrictions? What if I was hospitalized for weeks (or months) on end? How would that affect him? And, even more of a concern for me…is it fair for me to try to bring another baby into the world when the odds are already stacked against that baby making it to term? We dodged a bullet with Ian. Even though he was moderately premature, he was almost born at 30 weeks and if he had been born that early, though he likely would have survived, he would have been facing surgeries and other difficulties that I would feel terrible putting a baby through.
The OB said we would reevaluate in a year, when we had a better idea of what was going to happen with my endometriosis and my uterus (which hasn’t been able to shrink back to size yet because of the three weeks of contractions before delivery). But I know where I stand on this issue and I don’t see myself changing my mind. I think we should be happy with the blessing we’ve already received and accept that our family is complete. The Prince doesn’t agree with me…or at least he isn’t ready to face the issue. He feels strongly that children should have siblings, and his concerns about having another child involve financial considerations…not medical considerations. I understand where he’s coming from, and ultimately we agreed that it would be better to not try to make any decisions for at least a year. But I also know that I need to start preparing myself emotionally for the reality that I’m not going to be pregnant or give birth again. I know I’m going to have to grieve that loss. And yes, it is a loss. I may have been given the amazing gift of motherhood and it may seem greedy for me to want another child (or at least consider wanting another child) when so many women can’t even have one. But the fact is, being told you “can’t” have another baby is a loss…a loss of the idea of the baby/babies that might have been. A loss that is tempered by the amazing joy I have every time I look at Ian, but still a loss. I will put this issue out of my mind for a while now and will just let the reality of the situation slowly sink in until The Prince, OB and I decide it is time to fully face the issue later on.
Directly intertwined with the issue of whether we would pursue another pregnancy is what we would do with our frozen embryos if we choose not to try again. At least with regards to this issue, The Prince and I have our minds made up and are on the same page. The Prince has always said that he thinks we should donate our embryos to other IF couples if we don’t use them (assuming you are allowed to do that with embryos from an egg donor…which I can’t imagine why you wouldn’t be able to). I was not thrilled with that idea initially. As hypocritical as it sounds (considering that I conceived with eggs donated to me), I felt like it would be too weird to have children out in the world with my husband’s DNA in them. I also felt like the embryos were “my children,” and I had this very possessive feeling about them…like I didn’t want anyone else raising “my children.” Then I gave birth to Ian and I realized that motherhood is even more than I dreamed it would be when I was going through IF. I actually said to The Prince the day after Ian was born that I wanted to donate any embryos we didn’t use to other IF couples, as I would do just about anything to help other women experience the feelings I had when I became a mother. Giving birth to Ian made me realize that the eggs, embryos, sperm, DNA, etc. don’t make a child yours. It is the love you feel for the child that makes the child yours. And that love is indescribable. It is inconceivable to me to have the ability to help other women in their journey to motherhood and to choose to withhold that help. I know everyone is different and I am not saying everyone should make that choice…but for me, there simply is no other choice to make.
So, even though I was faced with hard facts today and started to make hard choices, I am at peace with what the future holds. No matter what happens, I believe that things are going to work out exactly the way they are meant to. And if that means I don’t have another child and another woman becomes a mother by using the embryos we had planned on using, I can live with that.