Elizabeth Petrucelli

Author, Blogger, Educator

Category: Infertility (page 1 of 2)

Don’t Talk About the Baby – Review

It’s a crowdfunded movie that I financially supported. I anxiously awaited the release of the movie after several years of spreading the word about this much needed movie. My hope was that it would break the stigma and silence on pregnancy loss. I was thoroughly disappointed and completed shocked with what I saw in this movie.

It started out well (for the most part). The woman who shares about her daughter was moving. She brought me to tears with her story and I could relate on many levels with her and I was in awe over her mothers intuition. She opens the movie but her full story begins mid-way.  You will see her throughout the movie. I seriously just wanted to hug her.

The first portion of the movie addresses miscarriage. Families share stories of miscarriage and I was so glad they shared about blighted ovum and chemical pregnancy, two forms of loss so often overlooked. The female doctor who speaks is very well versed and I felt she was an excellent resource and empathetic as well as compassionate to her patients.

But that beginning portion began to become concerning for me. They discuss IVF; which to the secular world is fine but as a Catholic, this really bothered me. At no time was faith brought into this and while that wasn’t the point of the movie, religion was not a topic discussed yet is a primary force in the majority of families. In fact, MANY of them wore crucifixes or crosses. These were obviously chosen individually for the interviews.

While IVF was discussed as an option, the way it was presented was almost like an advertisement. The IVF message: The best way to achieve a genetically perfect child, especially for older couples is to utilize IVF. This is my paraphrasing, not the movie but what they didn’t talk about were the losses in each of those IVF trials. The babies who are genetically imperfect that are killed (discarded) in the process. I felt the male doctor really pushed for IVF and gave very little information about the real statistics on IVF.

It lines his pocket financially but the parents lose financially, emotionally, and physically and can leave them in utter despair if they aren’t lucky enough to conceive and carry to full term. The movie did nothing to touch on the fact that IVF increases the risk of stillbirth. This movie is about stillbirth so shouldn’t that have been addressed if you are putting this out there? I suppose IVF can help with creating a genetically perfect child to reduce the risk of miscarriage due to chromosomal abnormalities but then the family is left with a higher risk of stillbirth. I felt like this part of the movie could have been left out. Why discuss IVF at all unless we are talking stillbirth??

IVF is not the only option for older couples or couples struggling with infertility. And before anyone begins to crucify me as ‘not understanding infertility,’ I implore you to read my blogs. I suffered with infertility for over 20 years. It took 3.5 years to conceive my son and 10 years to conceive another living child (Ruby came after 6 years of infertility treatments). I could completely relate to those who had experienced pregnancy loss and those struggling with infertility although I have living children so not all aspects were the same.

I know a movie can’t possibly cover all the pieces of loss, types of loss, and be completely inclusive especially when we bring religion into it but the inclusivity this movie attempted to achieve, deviated onto a path I cannot support. It feels sinful and had I known where this movie was about to go, I would have never supported it.

Abortion. The movie segue’s into abortion. First and foremost, abortion IS a loss. While there are women who utilize abortion as birth control and have no problem with this nor feel any loss from it, there are many women who choose abortion because they believe it’s their best option to reduce either the suffering of their child, their own suffering, or to save their own life.

The woman in the movie described her abortion as medically necessary. The doctors presented her with “your child is suffering inside of you” and your child will gasp for breath, be in pain, and suffer if he is born alive. This mother, like any mother, would never want suffering for her child. Not once though, did the doctors explain the suffering her son would experience from the medication they injected into his heart to stop it.

If this child was born alive, the doctors could have reduced his suffering by giving him medication. But honestly, gasping for air doesn’t always necessitate suffering. I watched my grandfather-in-law die and I have watched multiple babies die. While gasping is uncomfortable for us to watch, it doesn’t necessarily mean there is suffering. But I digress.

I felt this mother was presented with little choice but to follow the doctors recommendation to abort. No where did they offer her comfort care for her very loved child. No where did they offer her support to carry him to term. No where did they offer her any choice but to end her son’s life because he “had no brain function outside her body.” THIS, is where the movie could have helped the medical community and parents enduring fatal diagnosis. Instead of helping a family through that fatal diagnosis, they want to end the life early. Why did they have to normalize abortion instead of carrying to term? Maybe the movie addressed it? I stopped the movie at this point (I did watch the rest the next day).

I feel sick that I supported this movie financially and I was blindsided by it. Had I known they would include such a story, I wouldn’t have opened my check book.

Here are my thoughts after finishing the movie.

I realized this morning that by writing what I have, I am alienating the grief of those who chose to abort their baby. I needed to sit with that statement for a while because alienation is not ever something I would want for those families. I think they feel it enough from the community despite the acceptance of abortion. I am upset that the woman in the video was manipulated by medical staff into thinking that her only option was abortion. I listed other options above. Difficult options. It’s not easy to carry a baby inside you that you know will die inside or at birth but I believe that’s what we should promote. Why?

Because I have had so many mothers who chose abortion for their terminally ill babies who carry immense guilt that they chose the date of death instead of allowing the inevitable process. Many regret the time they lost by choosing abortion. They struggled on choosing the date of the abortion because they didn’t want to become more attached but they didn’t realize how attached they already were. Does every woman or family fall into this? No, but hearing the stories of those who do is gut-wrenching.

I did not want to support a film that would normalize abortion. I am ashamed and this is my public confession. I didn’t know that Ann Zamudio would bring the normalization of abortion into the film “Don’t Talk About the Baby,” and I can tell you that there are more people upset by this than are coming out to say so. But as a Catholic, I can’t keep quiet about it because I don’t want to bring scandal. I didn’t know and I wouldn’t have supported it if I did.

I know many will not agree with me and that’s okay. You are also entitled to your opinion. I won’t berate you, don’t berate me. This is not my judgment against you. I have not stated anything about judgment. This is my opinion. If you are struggling with the words I wrote here, I ask you to explore why. I won’t open comments on this post either because this is very controversial but if you want to engage in open, non-hateful dialogue, you can contact me through the page.

I finished the movie this morning hoping that it would get better, but it didn’t. One of the professionals, kept saying “fetus.” STOP it already. The movie wasn’t called “Don’t Talk About the Fetus.” It made me sick every time she tried to dehumanize the baby by calling it a fetus. I lost all respect for her.

I think the movie is important. It helps shed the light on the stigma of pregnancy loss. It shares the shame associated with it and the silence as well as why there is silence. There are some good resources shared as well and the bereavement doula featured has excellent ideas. Boy, do I wish those ideas would come to fruition all over! She was spot on but I am sure I felt that way because those are the same things I have been screaming for the past 8 years.

Boy, 8 years. That hit me writing that. Ruby would be 8 next month. I can’t believe it.

While I disagree with some of what was presented in this movie, it’s not enough for me to say I wouldn’t recommend it. What I DO want people to know is that the directors placed abortion in here and not all loss mothers can or will relate to that specific topic. In addition, I know many have and will find it offensive. Proceed with caution when watching “Don’t Talk About the Baby.”

As a side note, I thought “Return to Zero” was much better.

The Monthly Miscarriage

What is The Monthly Miscarriage? Is this really such a thing? For many women, especially women struggling with infertility, it absolutely is a thing and it can be devastating. I have experienced it myself although not monthly as my cycles were not that close together but it is a horrible experience to say the least. So let’s talk about it.

The miscarriage begins. It begins with that “inkling” that there may be a baby brewing within your womb. The place where you aren’t quite sure but think you might be. We question every twinge, cramp, emotion, or feeling and try to place it as an early pregnancy symptom. Desperate to know, yet scared to confirm. All the signs could merely be the beginning of the next cycle but they also might be the beginning of the rest of your life.

For here, there is where your life changes. You may pee on a stick. You may hold your breath as the stick holds your fate. Will there be celebration or the feeling of defeat? Will there be excitement or fear? What will this little stick share with you?

So you put it off. You wait and hope for a particular outcome. Maybe delaying the test will give me another day of hope? But what if you don’t really want to be pregnant again? What if you don’t really want another baby? Yet you know you will feel utter disappointment when you pee on the stick and it reveals you are not pregnant.

Those feelings and emotions can also be very confusing. You thought you were done or could no longer have children. Maybe you were planning your family and it’s not the right time but it seems a life may be desperate to get here and you have been chosen. You have been chosen to carry this new child.

But you still haven’t confirmed it. This is where it starts. Those hopes and dreams; that possibility of your life changing. You begin to imagine. You begin to plan. “If I am pregnant, I will…” “If the test is positive, I want to…” “I will tell my husband by…” “I will share with my children when…” “I need to purchase…”

You visualize the pregnancy, your life within you, and can see this child after they are born. You wish, you hope, you pray. Then, you pee on the stick. It was time. You needed to confirm it. You could no longer hold out for what you know is coming. If you are not pregnant, it’s better to find out this way then to see the redness on the toilet paper.

The blood is a sad reminder of what isn’t going to happen. You would rather a stick tell you. So you pee on it.

You hold your breath. You wait. But you can’t not look. You watch and hope to see a line. But nothing comes. You put it in the trash and say you won’t look at it again. That all those signs and the thoughts in your head weren’t real. That the disappointment you feel is silly and shouldn’t be felt. “I don’t have the right to grieve what I never had”, you think to yourself.

But later, you return to the stick in the trash. You look. You stare. You hold it up to the light. You take pictures of it. You reverse the pictures digitally, hoping it will reveal a line. But you can’t see it. You share the picture, desperately hoping someone else will see a line, but they don’t.

You are sad. You mourn. You are angry. You grieve.

Because what you really see is “Not Pregnant.”

Negative Pregnancy Test

Then it comes. The red on the paper. The monthly miscarriage. Your devastation confirmed.

– Breaking the silence of First Trimester Miscarriage

Dear Doctor: What I Wish You Knew About Progesterone Supplementation

Dear Doctor (Part 1),

I heard you say, “You haven’t had enough miscarriages yet,” to warrant the progesterone supplementation my body and baby needs. How much heartache must I endure to receive what we already know is lacking? Why must you make this issue so difficult and painful? All it takes is a push of a button to create the prescription but for some reason, you believe I need to lose more babies before I am worthy of supplementation. Why isn’t my baby worth it? We saw that baby. YOU saw that baby.

Together, we explored the ultrasound monitor, listening to the baby’s heartbeat and measuring the baby’s length. You provided me with a due date yet if you don’t provide me with the supplementation, my baby might not make it to their due date. Why are you foolishly letting me believe everything will be okay? You even said you couldn’t  make any guarantees.

Thanks for sharing that too by the way…”no guarantees.” I am already aware that I am not guaranteed to take home this baby. I have already experienced that painful loss. What I don’t want is to experience another one because my body isn’t producing enough progesterone to sustain the pregnancy.

This isn’t the first time you have denied my need for progesterone supplementation. Five years ago, you said, “there isn’t enough evidence to support the use of progesterone to prevent miscarriage.” Where are you getting that nonsense? It didn’t matter though, I jumped through hoops to get the supplementation anyway but it was too late. WAY TOO LATE and my baby died. Could your lack of support have contributed to her death. ABSOLUTELY. What does that make you? We’ll let God decide.

Progesterone Injection

So let’s talk. Have you seen this research? Progesterone supplementation has been in use for at least 75 years! SEVENTY-FIVE!! There is plenty of research on this. If you take away the corpus luteum, which produces the progesterone, the baby will die. A baby with a heartbeat! A living human person! I am guessing you haven’t seen the research because you don’t act like you care about me or the survival of this baby.

I realize you probably don’t feel the way I do about this baby. Maybe you feel it’s natural selection or maybe you are judging me for my age or how many children I already have? Maybe you have some underlying reason as to why you don’t want to help this little person inside me? Whatever your reasoning, I want you to know that this is a person to me. This is my child. I feel the same way about this little person as I do about my children who are living outside my womb.

Would you treat my children (who are outside of my womb) in this same manner? If one of my sons needed a hormone, would you deny him that treatment? You absolutely would not, so why is this child any different? This child is relying solely on my body to receive what he/she needs and unfortunately, my body has failed time and time again to provide it reliably, without the help of medical technology and intervention. I have two beautiful boys to show for it.

So, while you refuse to return my calls and refuse to provide a supplement, I am desperately seeking care from someone who will provide it. Why I have to go outside my health insurance and network to provide something so basic is beyond me? Understand there is little risk involved and know that I am accepting that risk because I know the benefits outweigh those risks.

I don’t want to suffer through another loss because you won’t prescribe. It could happen anyway but I will know I did the best I could. I was the best mother to this baby that I could be. Are you going to be responsible for killing another one of my babies? I pray not.

– Breaking the silence on First Trimester Miscarriage

I imagined.

I was starting to get excited about you. I had been thinking about you for over eight months now but I have been scared to even think about bringing you to life. There are so many risks, after all, at our age. When I think back about how I envisioned parenthood, this is not what I had hoped for. My reality is so much different.

When we got married, three kids was our number. Did that mean three living children or just three children? I have three children but only two are living. But then I think about it more and I know that I envisioned little ones playing with each other, fighting in the back seat of the car, squatting down in the yard playing in the dirt together, and growing up close in age.

My reality is that I was stricken with infertility for over 22 years. We struggled to get pregnant with our first, trying to remain within the boundaries of our Catholic faith and teachings. After three and a half years, we welcomed our first son. We knew we wanted more. He was perfect in every way.

The fear was there that we would have a nightmare of a child but two years apart is what we had hoped for. So we began that journey. We wanted to try a more natural route this time. I knew my body well and I began trying Eastern medicinal techniques. Two years came and went.

By year four, I began combining Eastern and Western Medicine but our efforts weren’t fruitful. As year six approached, we gave up that dream and began focusing on our careers; at least, I did. My husband had his career and it was going well. I just wanted to start mine.

It seemed that as soon as that decision was made, we discovered we were pregnant. Losing her to miscarriage in the first trimester was devastating and changed me in so many ways. I have done so much research and now dedicate my life to serving families during loss in any trimester. Knowing what I know, makes the thought of you even scarier.

Then, just two years after that loss, we discovered we were pregnant again. Yes, we had been trying and we sought some help but the help didn’t work and we were blessed with a “natural” conception. He was born and I told myself I would never have another. The baby blues were horrendous and the loss of personal time was taking its toll. The feeding struggles and my inability to read his cues were even more troubling for me that I vowed that you would never happen.

And then, as Timmy approached his first birthday, you began to sneak into my life. I began to be consumed with thoughts of you, mostly as I approached the newfound ovulation that my body had begun. It became overwhelming for three to four days out of the month but there was so much fear in letting you in. So much fear in imagining you here. So much fear in me as a mother and in all that could go wrong getting you here. And then it happened. I couldn’t shake you. You wouldn’t leave.

Two weeks ago I made an appointment to see a genetic counselor. I wanted to explore the options for you and make a decision.

Then last week a butterfly appeared in our home. It was the dead of winter, where did this little butterfly come from? I questioned if I had an infestation somewhere but so many of my friends believed this butterfly was a sign. “What bigger sign do you need Elizabeth?” is what some people shared. I was hesitant to believe the butterfly was a sign.

I learned that it was a female butterfly. Her species was White Cabbage Butterfly. She was yellow with 2 perfect, black spots on her wings. As I was doing the dishes, I noticed the light flickering above me and I looked up to my left to see her swoop over my shoulder and land on the cupboard. She walked up the door and opened her wings a few times. As I watched her, I finished the dishes.

I thought to myself, if she is still there when I am done, I will snap a picture of her.

White Cabbage Butterfly

She was still there.

I posted the picture to a group on Facebook. This is where I heard she was a sign. I shared the picture with my husband who was at work. He too, believed she was a sign. The sign was, “Have another baby.” Was this our angel in Heaven sharing the best way she could?

Later that night, the butterfly had moved to above the sink near the ceiling. I wondered how long she would stay. I retreated to my bedroom that night and began to pray. I pulled out my Rosary. Something I hadn’t prayed since I lost Ruby. It was surreal, sitting in the same room, saying the same prayers. The Rosary called for “the sorrowful mysteries.” Three of which had specific meaning to what I was going through. I completed my meditations and prayers within 45 minutes and drifted off to sleep.

The next morning, I felt refreshed. I had prayed for direction and peace in my heart. I didn’t want to struggle with the decision to have you. I just wanted to leave it in His hands and go with that. But things changed today and here I am, trying to grasp the decision I placed on Him. But I digress.

I DID experience peace and I felt the struggle leave my heart. I felt renewed and began to get excited about your impending presence. When I came home from work that Saturday, my husband and I spent some time in the bedroom and were excited that you might be coming as well.

I felt so blessed to have a husband who wanted you and who was supportive of you. I know many women who don’t have that kind of support. I imagined my growing belly and feeling you move inside me. I imagined my husband rubbing my belly and Timmy kissing my belly. I could see him slapping my belly too and I could see Joey trying to wrap his arms around me again for as long as he can while both hands still touched.

I imagined us in church together, with my swollen belly. I imagined driving with my belly and wondered if my new car would accommodate such changes to my body. I imagined the car seats and where Timmy would sit and where your car seat would be placed. I imagined where you would sleep once you were born. We talked about it that Saturday afternoon. We decided your crib would be placed in our room and Joey would move to the basement in a few years. Or if you were a boy, Timmy and you could share a room.

I imagined me feeling as amazing about my body as I did with Timmy’s pregnancy. I imagined finding time for exercise and how I would manage to keep my weight healthy during your pregnancy. I planned who I would call to have my blood tests taken to ensure I was making enough progesterone and I planned who I would talk with to get supplementation if I needed it.

I imagined you and Timmy growing up together. Secretly hoping you were a girl for many reasons, mainly because your father has such a strong desire to raise a girl. I would love another boy but I imagined you a girl. I imagined breastfeeding you. We discussed what we would do if you were tongue-tied like the rest of the family and if we would choose not to circumcise you if you were a boy.

I imagined rocking you to sleep and wearing you everywhere. I researched baby carriers for newborns. I began preparing for you and packed up some of Timmy’s old things so that they can be used for you. I wondered if I needed to keep all his boy clothes or hold off until we found out if you were a girl. I imagined how long your hair would be when you were Timmy’s age. Should I let it grow or keep it short? I wondered if you would wear dresses all the time or pants?

I imagined how I differently I would do things this time. I imagined myself a supermom, carrying two babies and making it look easy. I saw a woman struggling in the grocery story with her two young children and imagined myself doing the same. I knew it wouldn’t be easy and there would be rough days. I wondered how I would handle it.

I imagined you in school. I imagined you would love it as much as I did. My brother came to visit the next day. It was a surprise trip and he brought his children with him. As I admired them and his daughter, I couldn’t help but imagine you, again, as a girl. I imagined you would play with my hair the same way my niece did. I imagined you would have some of the same desires as she did.

I know my husband imagined you a girl, hoping you had green eyes like mine. I imagined him twirling and dancing with you. I imagined him loving you in a way I have never seen him love someone before. I imagined him giving in to your heart’s desire.

I imagined you becoming a teenager and even imagined the yelling and disagreements that might take place between us. I imagined me sharing my life with you. I imagined me teaching you about being a woman, about your fertility, and even thought about your wedding.

I wondered if having you so late in my life meant I wouldn’t get to see those things. I wondered if we would do a disservice to you being so aged as you were in high school. I wondered if I could be all you needed and wanted in a mother. I imagined you with your brothers, and of course, being there for us when we got too old to take care of ourselves.

There is so much I imagined but most of all, I imagined our dreams from 18 years ago coming true. Even though I have two children with years that separate them, I imagined the possibility of also having two children close in age. A dream I gave up on many years ago.

Today we visited with a genetics counselor to determine risks. Some of them are high and include an early induction. It’s not the induction that scares me the most, but the thought that you could die before you make it outside that kills me inside. These are the scary parts about me preventing you from coming. This fear has had me in grips for the last eight months. I have been trying to convince myself that I didn’t want you. I find myself doing this even now, even though I bawled while I was singing and rocking Timmy to sleep during his nap today over the thought of you not coming.

I contemplated what that might look like because over the last five days, I have only thought of you. I fell in love with the idea of you. And I imagined, even if we had you, that none of what I had imagined might come true. I imagined saying goodbye to you at some point.

I don’t want to say goodbye. I want to say hello and I want to say that I love you. I didn’t know just how much I wanted you until now. I fought it for so long. But alas, I can only imagine.

– Breaking the silence of First Trimester Miscarriage 

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Infertility to Fertility – The Loss of a Possibility

I hate the term “Loss of a Possibility” but what has been happening to my body lately has certainly brought this about. In a previous post, The Silent Battle of Infertility and Miscarriage, I wrote, “I know what it’s like to suffer with infertility. To try so hard to have a baby yet every time I peed on that stick, it was negative. I know! I feel! I understand! I am sorry!”

One issue that wasn’t discussed was that egg. The treasured egg that we are desperately attempting to fertilize. With infertility, women can either not ovulate and have to force ovulation through drugs, find a donor egg, or they ovulate but for some reason there is an issue with fertilization. I am certainly not trying to make infertility sound as simple as this because it’s not. It is extremely complicated in many cases.

For me, I was diagnosed with Polycystic Ovarian Syndrome (PCOS). My symptoms have never matched a majority of the symptoms of PCOS but because I had a “ring of pearls” around my ovary, which in essence were eggs (follicles) that attempted to make their way out but were not successful, I was diagnosed with PCOS. I knew I was struggling with infertility but didn’t know the impact until I began trying to conceive my now 10 year old.

When we lost Ruby, her egg was a fluke ovulation. Something I had rarely experienced but I knew the signs and we attempted a pregnancy. It was successful in that her egg was fertilized and life was created but she was not meant for this earth. I was never meant to hold her in my arms. She was never meant to wear the clothes we purchased for her nor sit in the stroller that friends bought for her. Like most people, I was naïve in thinking miscarriage wouldn’t happen to me…that a pregnancy led to taking a baby home. I never imagined my baby being thrown out with the hospital waste.

After a year, we decided to seek medical treatments again in order to conceive. Nothing worked. A last ditch effort was the exploratory surgery that I blogged about in 2012. Miraculously, we conceived just one month following the procedure with no medical intervention. Another “fluke” egg ovulated and we managed to fertilize it.

In the back of my mind, I felt like this pregnancy would throw me into fertility. While I assumed this would happen, it wasn’t logical. I had been infertile since I was 15. That meant by the time this baby would be born, I would have been “infertile” for 23 years. How possible would it be for me to become fertile after being infertile for so long?

Well, in February of this year, I ovulated. I thought it might have been another fluke ovulation and didn’t think much of it but when I ovulated again in April; I began to wonder if I had become fertile. Another ovulation in May and I am convinced, I am fertile. And now…after saying for over a year that I would never have more children, I am contemplating another pregnancy…another child to love. Something we never considered.

This month, the feeling was overwhelming. I imagine the pull during ovulation to fertilize the egg was only natural as it seems to be dissipating slightly after ovulation but every day, for several moments throughout the day, I imagine myself pregnant or Timmy playing with a sibling. The thoughts warm my heart.

Now back to the initial title of this post…”Loss of a Possibility.” I ponder each egg. Every egg that goes unfertilized feels like a “loss of a possibility.” It feels as if I am flushing children down the toilet. That thought doesn’t even make sense to me as I write it but I feel like I am wasting the opportunity to bring forth new life with each ovulation. Sure, the first ovulation felt like it was a fluke. I never expected to ovulate again, certainly not a month later and definitely not again two months later.

With each egg that goes unfertilized I worry…is this the last egg? Was that my last opportunity? So while I struggle with making the decision to have another child (Can I physically and mentally do this? What if the baby has a disorder or illness or worse, dies? What if I die?).

I am also struggling with the wonder of if I just missed my last chance. I know I would never return to fertility treatments. Ultimately, this isn’t in my control. Only God will bless us with another when He deems us ready. That brings IMMENSE comfort despite the push and pull inside me.

The loss of a possibility has put us in a place my husband and I have never walked before. Is this the cliché’ “road less traveled?” Is this a road that most women travel? I doubt that women who ovulate regularly feel that they are killing possible babies by not fertilizing each egg, every cycle but that’s how I feel. Why? Because there wasn’t a time in my life where I had a choice. If I ovulated, I HAD to try to fertilize it. That might have been our ONLY chance at a child. I have never had the opportunity to say, “Hey, let’s wait until next month, six months, next year.” It was always a race against the clock. “The egg is only fertile for 24 hours, hurry, let’s have sex, make your deposit, we need to do this several times or we will miss the opportunity!”

Yes, that’s what infertility sex sounds like. Intimate huh? So here we are, with the opportunity to choose. Another baby or ??

Loss of a Possibility - All That is Seen and Unseen; A Journey Through a First Trimester Miscarriage

Loss of a Possibility - All That is Seen and Unseen; A Journey Through a First Trimester Miscarriage

I can’t even believe I have to update this post with a follow-up that we have become infertile again. Read my newest blog post, Infertility Poem – My Body is Silent.

 

– Breaking the silence of First Trimester Miscarriage

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The D&C for Miscarriage

I am often asked whether or not a woman experiencing a miscarriage should have a D&C (dilation and curettage). I almost always tell them…it depends. It depends on many factors but women must also understand the risks, which are high, when choosing a D&C for miscarriage. This post will discuss just one of the three most common miscarriage options.

It is important to note that if you are beyond 12 weeks gestation, the doctor will likely perform a D&E; which is discussed here. This is a different procedure although carries similar risks. Your doctor may still use the term D&C to describe the D&E procedure; however, these are not the same procedures.

First, why do you want the D&C? Is it to get the miscarriage over with? Maybe you don’t have time to wait for the miscarriage to start? Maybe you can’t spend another moment knowing you have a dead baby inside you? Maybe you want testing done and this is the only way to ensure it? And then maybe, you want to be sure you get the baby so you can bury or cremate the baby?

D&C’s do not come without risk. One of the biggest risks is infertility (primary or secondary) due to scarring which is also referred to as Asherman’s Syndrome. If Asherman’s Syndrome occurs, you will need to have another surgical procedure to remove the scar tissue in order for you to conceive otherwise you will be at risk for further miscarriages.

A D&C procedure is the same procedure used in abortions although the baby has already died. The first part of making your decision to have a D&C is to be certain of your diagnoses. Has the baby really died? Believe it or not, this can be misdiagnosed and you could actually be performing a D&C on your living baby. It is imperative that a vaginal ultrasound (not abdominal) is used and coupled with blood tests to ensure that your baby has, in fact, passed away before moving on to a D&C. Your care provider would note no visible heartbeat and falling HCG levels.

It is recommended that a minimum of two ultrasounds are performed on different days. Keep in mind that if you are very early in pregnancy (less than six weeks) your baby might not be detectable on an ultrasound (living or dead). HCG blood levels typically need to be above 1500mIU in order to see a gestational sac and/or fetal pole and even then, the heartbeat might not be detectable until six weeks three days or longer.

Waiting to find out is very difficult during this already stressful time but this is the time where mistakes are most frequently made. Bleeding can be considered normal during very early pregnancy so bleeding alone is not a good indicator of an impending miscarriage. Bleeding coupled with cramping isn’t even a good indicator, especially very early in pregnancy. It is recommended that you wait until at least seven weeks of pregnancy and have two ultrasounds (at least 1 week apart) to confirm pregnancy loss before proceeding to the D&C. Even so, a miscarriage can take place and you might not even be sure if you passed the baby and placenta due to how early it was.

Besides the D&C, there are other options for delivering a miscarried baby; such as expectant management  and medical management (miscarriage at home either naturally or using a medication to help speed things along).

Having a D&C is a surgical procedure. You will generally undergo a light form of general anesthesia. This procedure is done on an outpatient basis unless there are complications needing you to be admitted such as excessive bleeding. It is becoming more common for doctors to conduct a D&C in their own offices.

Risks to the D&C procedure are:

  • Risks associated with anesthesia such as adverse reaction to medication and breathing problems
  • Infection in the uterus or other pelvic organs
  • Perforation or puncture to the uterus
  • Laceration or weakening of the cervix
  • Scarring of the uterus or cervix, which may require further treatment
  • Incomplete procedure which requires another procedure to be performed
The above risks are located at American Pregnancy.

If you choose to have the D&C, it is highly recommended that the surgeon conduct an “ultrasound guided D&C” instead of the normal “blind D&C.” Using the ultrasound while performing this procedure helps the surgeon to see where they need to use the suction instead of just blindly scraping inside of the uterus and possibly damaging more areas. This also helps reduce the chances of needing a repeat procedure for failing to remove all of the “products of conception.”

Following the procedure, the surgeon may place a “balloon” inside the uterus for approximately two weeks. Some surgeons will refer to this as a splint. This is placed inside and has a catheter that runs out of the vagina allowing bleeding and fluids to come out. Placing this balloon inside the uterus may help prevent the layers of the uterus from binding to each other. The balloon helps to keep all the layers away from each other while they heal. If they are allowed to lay on top of each other, they will heal (scar) together causing Asherman’s Syndrome (which may cause recurrent miscarriage and usually requires surgical correction in order to conceive and carry a future baby to term).

In addition to the balloon, your surgeon may prescribe you estrogen therapy for 2-4 weeks. This helps encourage healing by slowing progesterone production, which builds the lining of the uterus. Normally, it is important to have progesterone to grow our uterine lining as it is an essential hormone needed to sustain a pregnancy but while the uterus is healing, it’s important to reduce the production of the uterine lining so that walls of the uterus do not scar together. Estrogen therapy is recommended in combination with the balloon/splint.

In summary, using the ultrasound while performing a D&C can help the surgeon “see” where they need to work inside the uterus; while adding estrogen therapy and placing a balloon/splint inside the uterus for 2-4 weeks following the procedure will help women have a better outcome and will reduce the chances of developing Asherman’s Syndrome.

Are you or someone you know battling with a miscarriage? Visit Dragonflies For Ruby for support!

– Breaking the silence of First Trimester Miscarriage

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The information presented here is intended to assist you with discussing your options with your doctor. Please seek medical attention if you believe you are having a miscarriage. Dr. Charles March reviewed the section in my book “All That is Seen and Unseen; A Journey Through a First Trimester Miscarriage” before print. The information presented here is from that Chapter.

The Silent Battle of Infertility and Miscarriage

 

Infertility and MiscarriageI was reading a different blog recently, entitled Infertility, Miscarriage, and Hope. The author made me really think long and hard. Her blog was so honest and open. It resonated with me in so many ways. I too suffered from infertility and miscarriage. And I too, had hope and was blessed with my rainbow baby as this woman was. But the beginning of her blog and how she described infertility as lonely and isolated really struck me.

She is right. With infertility comes loneliness and isolation. With miscarriage comes loneliness and isolation. Why are both of these fraught with loneliness and isolation. These are issues where we need others to lean on, yet we are left to suffer in silence. All of us. Not only would I be suffering, but possibly the girl next to me in line at the grocery store, or the girl sitting next to me in church. We are both suffering but neither of us would know about it, because we are suffering in silence.

How horrible is that? If I knew the woman next to me was suffering, I would want to reach out to her and give her a big hug. I would want to tell her everything was okay and that I felt the same way she did. I would want to tell her that I was here for her and she could lean on me at any time. Instead, we trade glances but never realize that the emptiness in her eyes is because she lost a baby or because she hasn’t conceived a baby yet.

I have been in your shoes. I know what it’s like to suffer with infertility. To try so hard to have a baby yet every time I peed on that stick, it was negative. I know! I feel! I understand! I am sorry!

I also know what it’s like to lose a baby. To suffer. To do nothing but cry and writhe in a pain that we should never have to feel. A pain that is so immense and deep that nothing can take away. I know and I am sorry!

We need to break this silence, not just on miscarriage, but on infertility. We need to band together and support each other. Will you join me?

Karli will be guest blogging here tomorrow. Subscribe to this blog to see what she has to say!

 

– Breaking the silence of First Trimester Miscarriage

Crazy Life!

I have been quite busy over the last few weeks. I am sure you have been wondering what I have been up to. Well, besides going back to work and being SUPER busy there, I have been going to school part-time (College Algebra), preparing for my amazing son’s 9th birthday, preparing for the “Walk to Remember,” camping with the family, and baking!!

On the baking front, I HAVE to share one of the recipe’s I tried. These were the most AMAZING cupcakes I have ever had and I was so glad that I attempted this recipe despite all the work involved. You can find those cupcakes here: I made Vanilla Bean Buttermilk Cupcakes with Nutella Buttercream Frosting from Krissy’s Creations. TOTALLY worth it but extremely fattenting so be careful. You will just want to eat the mix!

Joey’s birthday was fabulous! I can’t believe this is the last of the single digit years for my son. He is such a joy and is growing into a great little man. We had a family party for him on Friday and a friend party for him on Saturday. The friend party was a Nerf Gun party and we set up an obstacle course with shooting stations and a prize for the best shooter. For the family party, we took Joey out for Sashimi (the rest of us had Hibachi) and then had dessert at our house. It was really nice and Joey made out with the cash!!

I got a surprise phone call from Greenwood Village Police Department. They want me to come in and interview for a police officer position that I tested for at the beginning of the year. What an opportunity! This is the department I dreamed of working at and was also the department that crushed me out of the academy. Of course, if I had gotten the position there that December, I wouldn’t have this blog or book and Ruby Josephing wouldn’t have existed. That’s strange to think about.

There are many reasons why I would JUMP at the chance to work for this department but as you have read, I have moved on from police work. There are so many reasons why. I didn’t turn down the interview but I think I missed the opportunity. Work has been CRAZY busy this week and even though I could have called back by 7pm each night this week, I worked late each night this week. I didn’t make it home until after 7:30 on Thursday! Ugh! I very much enjoyed the investigations I have been involved in at work. There are a few and they are quite complex!

Now I am focusing on my preparations for the Walk. I am trying to decide if I should purchase a booth for the event. This would be a tremendous opportunity to sell my book but I want to participate in the walk as well. I may try to find some friends or family that might be willing to man my booth while I walk. If anyone out there is interested, it’s September 29th from 8-12. If you can help, please let me know!

I will close with some thoughts from church today. Each Sunday I see beautiful families with their young children. Some sit in the pews, others are up moving around because their little ones are restless. I too would have a restless one. She would be a toddling around and reading board books in mass. She would probably babble and talk through the entire mass. If she would have been anything like Joey, she would probably talk in 3-4 word sentences despite being almost two. I miss her and wish she was here. While I feel so blessed by the gift of my amazing son, I feel like I am missing a child. I feel an emptiness…

Fertility Journey

I have come to a cross roads again on my journey to fertility. It’s now time to have my belly explored due to a pain near my ovary that I have had for years. So, Wednesday, I go under the knife. The laparoscopic knife that is.

Laparoscopy, is a type of surgical procedure in which a small incision is made, usually in the navel, through which a viewing tube (laparoscope) is inserted. Basically, the doctor is going to insert a tube through my belly button, stick a camera in there, puff up my belly using CO2, and look around for what is causing my pain. It could be nothing or it could be something.

I really hope they find something so I know what the pain is from but I don’t want anything serious to be in there. It could be a number of things and not all could be related to fertility.

  • Hernia
  • Endometriosis
  • Cancer
  • Adhesions/Scar Tissue

My worst fear is that NOTHING will be in there causing the pain. My hope is that the doctor finds something minor, corrects it, and we can move on to trying to conceive again. Jason and I have decided we will only try again for a few more months. Probably just until the end of the year. My eggs are getting old.

I have made this decision before and changed my mind so nothing is set in stone and we are always open to another child should God bless us with one but actively seeking fertility treatments and getting on that roller coaster ride is much different than hope and prayer.

We’ll see what happens but for now…I am heading to the operating room to see what my insides look like.

Big Fat Negative!

From http://joysofinfertility.com/2011/the-news.phpThose on the “TTC” Journey which means “Trying to Conceive” understand the Big Fat Negative or rather, BFN. Yes. That’s where we are at in our journey…AGAIN!

It doesn’t matter how you feel as you pee on the stick and anxiously await two lines. But when only one line appears…the control line, disappointment flows.

Expected = disappointment

Unexpected = shock + disappointment

Indifferent = disappointment

Ugh! Then the questions?

Why? Is it me? Is it my husband? Is it not our time? Is it not in our plan? Did I pray hard enough? Was it because I ran in the two week wait (2ww)? Should I try again? Will it work next time? Do I need to try different meds? Should I have exploratory surgery? Do we need to try herbs? Should we try insemination (IUI) again? Etc, etc, etc.

Doubt and pain fills your body. “It’s never going to work,” gets repeated in your head over and over again. Then, you have small wrays of hopefullness. “My period is coming and we can start over again. I’ll eat better, work out more, and focus on my body more. This time…it will happen!”

WHAT?!?!

So, you start the cycle all over again, desperate for those two lines to appear on the HCG stick after the two week wait. Yes. It’s not a pregnancy test, it’s an HCG stick. Pregnancy tests are too expensive so to save money, I get these internet sticks that come with no frills.

Either way, I am not even sure I want to attempt this again. My mind is full of other questions and concerns. I am getting too old. My eggs are getting bad. Jason’s sperm is getting older. Joey is getting older (what’s the benefit to a sibling at this point anyway). I don’t want to be 38 and having my second living child. Will I have a special needs child because I am so old? Ugh! The list goes on and on but then there is a whisper…it’s God but I don’t know what he is saying because I am either not hearing it, blocking it, or not understanding it and now I hit the crossroads of bargaining with God to give me some sign on which way to go.

The one constant is adoption but Jason won’t do it so the only other option is no child or continue with fertility treatments.

Oh, the nice fertility treatments. The one’s I said long ago had no side effects. Well, this last cycle…SIDE EFFECTS. None during the follicular phase (before ovulation) but once ovulation hits..BAAM!! Pain in the ovaries, pain in the uterus, fullness in the uterus, cramps in the uterus. Those last a few days, then BAAM!! Sore @ss breasts! Not just kind of sore, but REALLY sore.

Then there is the joint pain. The common side effect of inflammation from the fertility drugs. Then, the absolute WORST part…IRRITABILITY. Four – fourteen days of pure anger, craziness, and yelling at anything and everything and you don’t know why. You just do it, because that’s what your body does. You have NO control over it. It seeps through every fiber of your being. Your kid doesn’t understand, your husband has no clue and any other person you are around just thinks your being a b*tch!

So…are we going to try again? Maybe. Maybe until Christmas? Depends on how much I am willing to spend. It depends on alot. Good thing I have a phone conversation with my reproductive endocrinologist again. Laparoscopy is my next option due to the pain near my ovary. Hey…maybe that’s a good thing? Maybe I will get rid of something that’s been bothering me for years. I might not get a baby but maybe I will be pain free?

Oh well, we’ll see. Cycle Day 1 will begin soon.

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