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I finally did it. I made an appointment with a midwife. It made me so happy to do this, and it’s making the pregnancy feel more real. I still have a hard time owning words like “pregnant,” but hopefully I’ll get over that. I’m lucky to live in a city that has a lot of childbirth options, but that made the research process a little more overwhelming. I first joined a local mother’s online board (crazy that I can do that) to research others’ experiences at the local hospitals. I also found the names of some doulas that were recommended highly. I talked to one on the phone, and she was so eager to help and answer my questions, even though I haven’t committed to her or anything. She strongly recommended the hospital and midwife practice I was already leaning towards, but gave me really specific information about the policies at all the hospitals. I felt like I was pretty well informed about what a birth experience would be like at the different places. At my final RE appointment, I asked the doctor what he thought of my choice, too. He said it’d be a great place to go, assuming I was in good overall health. I almost said (but didn’t) that I was in fine health other than having dud eggs. It felt good having the recommendation of a doctor at a big, conservative hospital, too – someone who’s not exactly a card-carrying member of a natural childbirth advocacy group. I want to do what feels right for me, but it helps to have outside validation that what I’m doing is smart and sound.
This decision about where to deliver involved quite a bit of tumult. Not as much internally, but with my (mentioned in earlier posts) so-called therapist, Dr. HamandCheese. She’s the doctor who prescribed the Zoloft for me when I was having a tough time after IVF #3 failed. I would see her occasionally to check in, but never felt that the sessions with her were particularly helpful. Now, I knew early on that Dr. HamandCheese and I weren’t on the same page about everything (she was very much for my staying on Zoloft during pregnancy while I was against it). And I was aware that she strongly voiced her opinions in sessions in a way that I thought was incredibly inappropriate for a therapist. But she’s not really a therapist. She’s a psychiatrist who’s interested in helping women cope with IF. The problem is that she’s clueless about pretty essential boundaries and forms of etiquette that should be part of a therapy session. I’ve been aware of this for awhile, and I don’t really know why I didn’t break up with her earlier. I guess breaking up with a therapist (or even an almost therapist) isn’t an easy thing to do.
So, last week was a pretty hectic week. I was getting used to this whole being pregnant thing, and trying hard to believe that the embie wouldn’t get dislodged every time I coughed or sneezed. I had been told by my RE to investigate where I wanted to continue care and deliver. I was a little overwhelmed by all the research, and then on top of all that, my grandmother died. It wasn’t a surprise, and the woman I knew as my grandmother had really been gone for many years already. But this kind of event brings out all the neurosis in a family, you know?
So, I was coping with all that. That’s where I was when I went to Dr. Hamandcheese last week. I sit down in her office and mention that I’m a little overwhelmed with all the prenatal care/delivery research (not even getting to mention my grandmother yet), and she totally starts in on me! Immediately she starts to question my leanings towards a hospital that is known for supporting natural childbirth, and that’s supposed to have an amazing team of midwives. She even says, “I don’t understand how, after what you’ve gone through, you wouldn’t want to have all the medical support possible to keep the baby safe.” Dude! You’d think I had said I wanted to give birth in a PASTURE! IT’S A FUCKING HOSPITAL, A HARVARD TEACHING HOSPITAL, WITH OBs, NOT GOATS, ON THE FLOOR, IF NEEDED. I was shocked and completely blind-sided. Clearly, (and in keeping with her feelings about Zoloft), Dr. Ham is in the more-medicalization-is-better camp, and I’m just not. I understand that these are heated, devisive issues. I believe that a woman should be able to choose the options that make her feel safest. But it’s a personal decision, and any educated person must understand that thinking people can be on either side of the camp.
Dr. Ham just wouldn’t let it go. She would tell me my research and information was anecdotal, and that I had to be aware of the source and then she’d tell me two anecdotal incidents that happened with her patients and midwives (like there aren’t anecdotal negative stories out there involving OBs). She got specific and argued in favor of episiotomies after I told her that even her big, fancy, high-risk hospital did a study showing that the rate of c-section and episiotomies goes down in midwife-attended births. She even shared how she argued her daughter-in-law out of her original non-intervention tendencies (poor woman, to have such a bullying mother-in-law). At one point, I literally had to say (exhausted), “I really don’t want to be arguing about this with you right now!”
What’s crazy is that my desire to try for a natural childbirth (as long as it’s safe for me and the baby) is part of my effort to have faith that this can and will be a normal, healthy pregnancy, even though I struggled to get here. I believed in natural childbirth before IF, so why shouldn’t I now? The important question is, why should this pregnancy be driven by fear??? And there I was, with this woman (who’s role should have been to laud my attempt to stave off needless anxiety) saying I should try to pile as much medicine on as possible, because I must, as a IF-surviver, be fearful for my baby. It just seems insane and wrong-headed, don’t you think?
I left that session feeling WAY more stressed than I did going in. Stopping at the restroom on the way out, I noticed that my cheeks were bright red from arguing with her. I was WORN OUT. Needless to say, I’ve broken up with Dr. Hamandcheese.
Frankly, I think I’m in a better, more balanced place regarding medicalization than I was before coping with IF. As I’ve mentioned previously, I originally had a really antagonistic, fearful, non-trusting attitude towards anything medical. Now, I think I’ll be able to go with the flow more. I’d like to have as much support as possible, to try to make a natural childbirth easier to have, but if it’s necessary, I don’t think I’ll view a medical intervention as my enemy. I’m happy about that, because I know you can’t control how your childbirth (or much else) will go.
I’ve been thinking about this post for awhile. I don’t know for sure that I’m out of the woods yet, which is why I feel a little more comfortable using the past perfect in the title rather than the simple past tense. At any rate, I’ve been thinking I’d like to share the things that helped me get through 4 IVF cycles and 1 DEIVF cycle, in the hope that they might help others just starting out.
1. I let go of my fear of the clinical nature of IVF and all of its medical trappings.
This no easy feat for me and I wasn’t able to do this at all until my second IVF cycle. Other people may not have such a hard time with this one. Normally, I hate even taking medicine, and because of having a couple of run-ins with incompetent doctors in the past, I don’t have unquestioning trust in medical professionals. During my first cycle, I could actually feel my stress levels surge as we’d walk towards the hospital building. I felt broken and unwell because I had to take medications and do injections. I simply hated the sight of all the medical paraphernalia. I was angry and upset to be doing IVF at all.
With my second cycle, I was able to let go of that fear and anger, partly because the routine was familiar to me. This change in mind-set made that cycle exponentially easier to get through. I also then had a nurse who was warm, funny, and seemed to really care. I learned that the injections were really no big deal. It became routine – a known quantity. I learned I really could pack my Gonal-F pen in my purse and do an injection in the bathroom of a movie theater. I didn’t have to angst about it all the time.
It also helped to find a new way to phrase what we were doing. I would say to myself, “we’re just getting a little help getting pregnant”. Saying that in my head made the whole process feel less catastrophic and earth-shattering. I’m telling you, my mental state was SO different in my second cycle. If I could have gotten there sooner, it would have saved me a lot of stress and pain.
2. I organized my meds and made my injection station as attractive as possible.
This tactic is partially related to my medical-fear issues above. Because it upset me to see a sharps container in my house, I put it in a little paper shopping bag. For most of my cycles I even clipped a pretty art postcard to the outside of the bag (I didn’t do it for the DE cycle, because, superstitiously, I just wanted some things to be different so I’d have a different end result). I finally ended up with a set-up where the sharps container and a mini trash bag are neatly kept together in one larger bag. They live next to my bed, and my injection supplies live in my bedside table. I used a pretty tray to lay out the supplies I was using at the time – the syringe, alcohol swab, etc. for that one injection. It just made me feel better to have things orderly and pretty looking. It also helped to have everything organized when the injections were new to me and I was nervous about screwing up.
3. I listened to audiobooks – a lot.
Normally, I like to read a lot. But when you’re anxious, depressed, negative thoughts are spinning in your head, and you really need to sleep but can’t, it helps a lot to have a distraction that works for you when you’re lying down with your eyes closed and the lights are off. Audiobooks did that for me. Now for me, ’cause I’m a dork, 19th century English novels did the trick. Give me 30 hours of listening time to an Anthony Trollope novel and I’m set. Even during really tough times, I’d eventually get caught up in the story, get distracted from my worries, relax, and eventually fall asleep. It was also helpful on walks, while doing boring housework, when commuting, etc. I have a membership to Audible, so I would download a long, juicy novel about once a month and make sure it was loaded onto my phone. I swear, the audiobooks could relax me despite myself, when nothing else could.
I’ve amassed a pretty impressive collection of meditation CDs by now. I have the usual suspects – Zita West and Circle and Bloom. Sometimes, though, I’ve found it more relaxing to use a meditation that is not IVF related – to take a break from my IF reality. There are a lot of mind-body programs near where I live. I found a CD at the Domar Center and another I really like at the Massachusetts General Hospital store (both available online). My very favorite relaxation meditation is on one of the MGH CDs, and is narrated by Dr. Ellen Slawsby. In it, you visualize a room with a fireplace and a warm bath. There are even the sound effects of a crackling fire. I also downloaded a free meditation app for my phone. There are a lot of options out there.
5. I made a playlist
Initially, I made the playlist for the times I did pre and post transfer acupuncture. I began it with the appropriate pre or post Zita West meditation and then filled out the time with music I found particularly soothing and familiar. I ended up using the music part of the playlist a lot more, though. It was helpful having a collection of music on hand that would instantly calm me – for whenever I was waiting in the RE’s office, when waiting for transfer, and during some of the sleepless times.
6. I spelled out to J – in slow motion and with hand signals – how he could give me the emotional support I needed.
Our first IVF cycle was an absolute disaster for me and J, as far as our interactions went. I’ve never felt so alone and hated my husband SO much as during that cycle. My stress levels were off the charts, and my being so upset basically freaked him out. It was a really ugly combo. It escalated into some seriously ugly screaming fights.
I ended up having to tell him EXACTLY what to say or do when I was upset about the IVF, because what I needed was not what he would need or want in my position, necessarily. None of it was intuitive to him, and he was also panicking at seeing me so unhappy.
This is what I had to say: “When I’m really upset/anxious/worried I need you to give me a hug, because that calms me down and makes me feel safe. I need you to say that you understand how [ ] could be upsetting/anxious/worrying, and that I’m doing a great job.” I literally had to be this specific.
I also had to say: “When you get angry at me when I’m upset or if you try to tell me I shouldn’t worry or be anxious, it only makes me feel alone and judged, and will only escalate things. THAT’S when I really lose it.”
Things got way better, and I have to say he was the most loving, supportive husband possible during this last 2ww. The credit has to go to him. He really listened, and worked hard to give me what I needed.
7. I took an anti-depressant/anti-anxiety medication for awhile.
Now, this is one is very tricky and personal. I’d never advocate taking medication, because each person has to make that decision for themselves. But I do think it’s helpful for me to be open about the fact that I did – and that it helped me through the most painful time in my life. As I mentioned above, I’m actually really reluctant to use any medical intervention. I’m the kind of person who normally will only take a Tylenol if I really, badly need one. I’ve sought therapy in the past when going through tough times, but I’ve always been adamant about not wanting to be medicated. I didn’t want to change myself, and I wanted to feel what was real, even if those feelings were difficult and painful. In my opinion, that’s what living life is all about. And the thought of feeling groggy or fuzzy-headed freaked me out.
But then my 3rd IVF cycle failed, and we had repeated low fertilization rates, despite using ICSI. I crossed that boundary from “the RE just needs to find the right protocol for you” to “clearly there’s something seriously wrong, and you might be one of the women who just can’t get pregnant “. I would have super long crying jags, I wasn’t sleeping, and what was most worrying, I was aching all over. My hands, arms, scalp, shoulders, and legs just hurt so much. Nothing I did could get me to relax my body, because I was in so much emotional pain. I knew that, besides the fact that I was miserable – and consequently J was miserable – there was NO way I was going to get pregnant when my body was so wracked by stress and depression. So, I saw a psychiatrist who specializes in helping women coping with IF and I went on Zoloft.
It helped hugely. What was surprising is that I didn’t feel groggy or “drugged” at all. I felt like my normal self, but with a more protective emotional skin. When things were really bad and before the Zoloft, I’d think something negative or something upsetting would happen and I’d feel this instant physical “pang” in my chest or belly. With the Zoloft, I could have that same thought but the “pang” wouldn’t happen. I’d have a moment to deal with that thought or emotion – to choose to act on it or to reason it away. It was like I had a new buffer. It helped me heal and to put other coping mechanisms in place.
The only downer was that it did affect my sex drive, which I really didn’t like. I didn’t like having any part of me altered like that. I guess a buffer can work both ways. But things were so rough that J and I felt it was worth it. We needed to get through the IF whole, even if it meant getting through it on a little less sex.
Now there’s conflicting research about the safety of using Zoloft during pregnancy. We didn’t want to take any risks, so I was going to taper off if I got a BFP on my 4th IVF cycle – which didn’t end up happening anyway. I was then able to taper off completely before beginning the DEIVF cycle. By that time, I think I had done a lot of my grieving, and could fall back on the coping strategies I’d picked up by then.
Again, it’s something each person needs to weigh carefully for themselves, but I just wanted to put my experience out there.
We’re lucky to live near a lot of green space, so it was easy for me to go out for a long walk regularly. It helped enormously to just open up my world and to remind myself that there are countless of other living creatures busy doing their thing. It also helped me to be around beauty and to breathe in fresh air.
9. I was selective about my social interactions.
The friend who’s been the most supportive of me through all this once said that I needed to, “insulate, ignore, protect, and proceed.” I’m sure she didn’t realize it at the time, but in that moment she made up my driving motto for coping with IF. My biggest priority was getting through this with my sanity intact, and if that meant putting blinders on, so to speak, then I would do that without any guilt or regret.
I stayed in contact with friends who were supportive and who made me feel good, and I distanced myself from people who were threatening or who deep-down I knew I couldn’t really trust. I completely avoided Facebook for years. It was important for me to not compare myself to what others had, but to focus in on my goal.
I found immense solace in the blog and twitter community, but I tried to pay attention to when I needed to step back and focus in. It’s a mixed bag. It’s amazing to have support with an illness that’s so incredibly isolating, but it’s also frightening to learn more than you normally would about what could happen and it’s painful to be left behind. I guess we’re always figuring out how to negotiate that. Ultimately, I’m incredibly grateful to have met so many courageous, generous, and amazingly strong women.
10. I defined my faith.
I’m not a religious person, and I don’t really believe in fate. So, it was really helpful for me to figure out what I do have faith in – what I know I can rely on. Through all the grief and disappointment, I had faith that J and I could get through it together, and I had faith in my strength to endure and heal. The most valuable thing I’ve learned through dealing with IF, and something that I’m sure will serve me throughout my life – because life is fucking hard – is that there’s a huge, unfathomable store of strength in each of us.
So, it hasn’t sunk in yet – that I’m pregnant, I mean. I’m not sure when it will. I asked a pregnant IF friend of mine when it would seem real, and she joked, “Oh, at about 20 weeks.” When I first got the call about the BFP, I was overjoyed and incredibly relieved, of course. J and I were hugging, I was crying and smiling at the same time. It was what you’d expect after four years of struggles. I was surprised by the feelings I was having right after that, though. I realized that I was a little anxious, and that I was focusing more on the odd way my body was feeling than anything else (crazy bloated, burping more than I thought possible for one person, nervous-making deep inside cramping, and boobs that seem to glow with pain). What hit me is that I haven’t been nearly released from the clutches of IF yet. I’m still thinking the way I did during my IVF cycles: How is THIS hormone going to make me feel? What weird side effects are going to crop up? What time of day should I take which medication? What should I do/avoid? I want it all to go well, and I want to do everything right.
It hit me that what WASN’T in my head was that A BABY (OR BABIES) WILL RESULT FROM ALL THIS. A baby who gazes around at everything wonderingly, who giggles when I tickle her belly, who grabs at my face with his clumsy fingers, who falls asleep on J’s chest. I think it just takes time to get there after struggling with IF for so long. I’m not concerned. In time (God, Universe, Whatever-willing and knock on wood), this pregnancy will be mine. Eventually, it will be about me and the baby/babies, and not about the RE, injections, and estrogen patches. Eventually, we’ll have baby things around instead of a sharps container and syringes. It’s just funny to realize that a transition does have to take place.
I think this transition has to happen for my family, too. We’ve already told my parents and my sister. They knew we were doing a donor egg cycle, and knew about all the other failed attempts. Since they were so acquainted with this cycle’s schedule, there wasn’t any way to wait until the second trimester to include them (though I warn them repeatedly that things are far from certain yet). I think right now they’re mostly relieved that we might not have to suffer anymore – that we might have finally reached the other side. My mother said she is only just letting herself imagine being a grandmother. She had just wanted me not to be in pain anymore. The end of suffering was the goal. Again, the end result of an actual baby was kind of lost in the struggle.
J’s family is different. We haven’t included them in any of the details of our IF struggles, partly to save his mother (ill with MS in a nursing home) the worry, and partly to give me some privacy. They were impatient for us to have kids, were worried about us, knew we were “doing our best” in some vague way, and knew not to bring it up. That’s all. My initial instinct was to wait until the second trimester to announce to them, but somehow it’s feeling wrong now to keep them at such a distance when friends – our supporters through all this – already know. It seems wrong to hold them at arms-length, even if it means that they have to mourn with us if things don’t go well.
I’m excited to experience their relief and joy, almost more than with my own family, oddly. It’s complicated and scary, though, because we’ll be telling them a lot at once – that we went through 4 rounds of IVF, that we ended up having to use donor eggs. I’m a little intimidated by it all. For some reason, I get all old-school when it comes to my in-laws, worrying that they think I’m a bad daughter-in-law when I gain weight or because I couldn’t produce a baby. I worry that they’ll think less of me because we had to use donor eggs. I don’t know where that fear comes from, because they’ve only been loving and supportive of me, and after all, we DID use their son’s sperm.
J was thinking he’d tell his father first, and can explain the whole situation to him then. Then I can have the honor of telling his mother (his father will be there, too, because he’ll be holding the phone for her). For some reason, it’s very important to me that J tell them how very hard I tried. At the moment, we’re thinking we’ll tell them after the first ultrasound, when we know exactly how many critters are growing in there. We’ll make it clear that it’s still very early, that they need to keep it to themselves, and that things are far from certain yet. It makes sense to include them in that “inner circle” of supporters, the people who will be there for us if – well, just if. They deserve that. It’s just kind of huge. Telling them will definitely make it seem more real.
Meanwhile, I’m going to focus on being positive and excited. To continue to choose hope over fear…and to relish a blessed puke-free window of time.
Whatever happens, however the second beta on Saturday goes, or how the subsequent ultrasounds look, I really, actually am allowed to say that about myself right now. I can’t believe it. There was a part of me that thought I would never get here – that for some unknown reason I was just doomed to be caught in that limbo forever. I mean, really, I’m turning 39 on Saturday, and I’m pregnant for the very first time in my life.
I know we’re not nearly out of the woods yet, but I’m choosing to be excited and hopeful. One of the reasons I decided to go with donor eggs sooner rather than later is because the idea of having a pregnancy with a little less fear was very appealing to me, especially after all we’ve been through. I’m not naive, but I also know that my worrying about things ahead of time – my being afraid – won’t protect me or make a loss any easier to bear. Now, let’s see if I can hold myself to that. I’m really going to try.
J was incredibly sweet and comforting the whole 2ww. He’s the most rational person I know, but still pointed out “good omens” to help bolster my hope. He would patiently list the reasons we had to be hopeful as many times as I asked him to. He actually had three amazing dreams during those two weeks. In the first, we were caring for two brand-new puppies on our bed. In the two more recent dreams, I told him I got a BFP. It’s so funny that he – the scientist and empiricist- ended up having those dreams.
I wouldn’t have gotten here with most of my sanity intact without the help and support from some seriously generous souls – twitter-friends who listened to my obsessive symptom-listing during that awful two weeks, IRL friends who knew of our struggles and who let me know they were hoping hard for me, E who sent me a photo of her LONG-struggled-for baby girl for inspiration. Without such a supportive community of people I definitely would have emerged from that torturous time with a LOT more gray hairs and a MUCH larger butt.
And I couldn’t have gotten here without my egg donor. When I felt completely hopeless, I’d think of her and how “right” she seems for us. Somehow that “rightness” made me believe this cycle could work, though I know that reasoning makes no rational sense. I kept the card she left me next to my bed alongside the pictures of our embies. Over and over I’d read her words, “My thoughts will be with you in the days and weeks ahead. May your home be full of love and laughter!”. It felt like a blessing.