After nearly three years, we made the decision to add to our family. I'm due in early September. When we first told Olive about it, she thought for a minute and said very confidently, "no, I just want mommy instead." That sums up her feelings on the matter. She doesn't want a baby brother or sister, and she certainly doesn't want to have to share her belongings let alone her mother. She is already trying to hoard her baby items that she insists the baby cannot use. She regularly begs us to get out her baby toys or bumbo or carseat so that she can put them in her room. It may be a rough transition for her, but having a sibling is character building right? We are confident that in the long run it will be great for her as we certainly can't let her go on believing she is the be all end all in this world.
Why did we decide to pursue a second pregnancy? Well, it wasn't simple. For most parents it probably isn't easy to decide if and when to try to add to your family. It's said that it's never really a good time to have a child, and I very much agree with that. There are so many things to ask yourself. Can we afford another child? Do we have room? Will our first do well with it? Is it possible to love a second child as much as we love the first? Can we deal with the sleep deprivation again? Am I ready to be pregnant again? And I think these are the kind of questions that everyone asks. On top of that, we needed to consider the implications of already having one child with special medical needs and the fact that we were signing up for a high risk pregnancy with the possibility of having it happen again. Needless to say, a lot of thought went into it. It probably falls onto the short list of "hardest decisions we've ever made."
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| She's way more excited about that swedish fish than being a sister. |
After Olive's early birth, I was explicitly told not to get pregnant again for at least two years. Preeclampsia research has shown higher rates of reoccurrence for pregnancies less than two years or more than ten years after an initial pregnancy with preeclampsia. That was an easy directive to follow since having another child was the furthest thing from our minds in the midst of everything we went through with Olive those first two years. And honestly I didn't feel completely well again until near that two year mark. The pregnancy, preeclampsia, c-section and ensuing mental, physical and emotional exhaustion that comes with having a micro preemie really took a toll on my body and my mind. We agreed early on that we would meet with a perinatologist sometime after Olive turned two years old adjusted and take it from there. So last August we found ourselves sitting in a tiny room with the doctor who delivered Olive and nervously asking for his opinion on whether or not to pursue a second pregnancy.
I'm very much a believer in empirical evidence and scientific research so after months of obsessive reading I knew going in to it that we have a very strong chance of having preeclampsia reoccur. As someone with early onset severe preeclampsia in a previous pregnancy, I have a 60% chance of reoccurrence according to the published statistics. However, our perinatologist didn't feel like this should deter us. In fact he said unequivocally that there is no reason not to pursue a second pregnancy. He explained that the likelihood of delivery before 32 weeks is less than a 15% chance, and that while I am at high risk for it happening again, it often occurs later in subsequent pregnancies. We also spoke about the benefits to taking low dose aspirin during pregnancy, which studies have shown reduces preeclampsia reoccurrence by 25%. The doctor ran blood work on me to make sure that I don't have any underlying autoimmune diseases that could put me greater risk, but when that all came back normal, we were basically given the green light from a medical standpoint. We were fairly surprised by this as we hadn't expected that our doctor would be so supportive, but it was nice to get good news for a change. If he had told us anything else, we were prepared to look into alternative ways to add to our family like adoption.
Dain and I obviously discussed the topic at length, and we went back and forth. It's not easy to wade through all of the what-ifs, especially when we both know what it's like to limp out the other side of a worst case scenario. But we both agreed that we want more children and that we are willing to try again. It was very much a gut decision. Once we agreed on our near future plans, I did some other things to prepare as well. I got in fairly good shape over the summer, running most days and eating healthy, just to make sure that I was ready from a physical standpoint. I also took out life insurance on myself because I'm a planner and I'd been meaning to do it. Dain already had it. We already had wills and health care directives along with a named guardian for Olive, which are all things that I think are incredibly important once you have children. I also have a binder that I regularly update with all of the critical information someone would need to take care of Olive because one of the scariest worries for me is what would happen with Olive if I wasn't around. Obviously Dain can take care of her, but if something happened to both of us, it wouldn't be at all intuitive for someone to jump in and take over her tube feeding regimen. So I have written out everything from her schedule to her menu to how we prepare the food to all of her medical information and contacts. It mostly just makes me feel better.
Most importantly, I found and met with an OB/GYN practice this fall that came highly recommended and works closely with the perinatal group I prefer. Their practice also delivers at the hospital we want to deliver at since we could never again plan to have a baby anywhere that doesn't have a level three NICU attached. We just know too much about everything that can go wrong. The perinatologist suggested seeing a regular OB doctor with the knowledge that we would transfer to his group of specialists immediately if anything was out of the ordinary with a second pregnancy. The best thing we can do in another pregnancy is to watch my blood pressure closely and treat it aggressively at any sign that it's rising. Unlike my first pregnancy, I'm certain that I will have competent and diligent medical care.
On New Year's Eve, we found out that I am pregnant. Cue the terror and panic. Just kidding. Or not. It ebbs and flows. We chose not to tell anyone for a few months this time around. Mostly because I knew other people would worry too, and I wanted to prolong that as long as possible. It was a long, cold winter of nausea and fatigue, and Olive was kind enough to stop napping to coincide with my pregnancy. She is so sweet. I've had lots of symptoms that I didn't have while pregnant with Olive so we are hopeful that this will just be a completely different pregnancy in a good way. Long and healthy.
As we entered the second trimester, we slowly told family and friends and started to talk to Olive about it more. And it seemed more real. We've had what seems like many doctor appointments in accordance with the written care plan from the perinatologist that details careful monitoring during this pregnancy, and at 23 weeks now everything is looking good so far. We've had three ultrasounds already and will have growth ultrasounds every four weeks at this point along with weekly monitoring at 30 weeks. We had a detailed level two ultrasound with a perinatologist at 20 weeks, and thankfully the baby was measuring around the fiftieth percentile and looking healthy in every way. Also, my blood pressure has been normal. I monitor it at home a few times a week, and I take one low dose aspirin daily along with my prenatal vitamin and a calcium supplement (the verdict is out on whether this will help but research has shown it to be helpful in reducing preeclampsia in populations with low calcium intake.) In other words, I'm doing everything I can. We will definitely not be missing any warning signs around here this time.
We debated but ultimately decided not to find out the sex of the baby, at least not yet. Our nicely packaged, sugar-coated answer to the ever popular "are you having a boy or a girl" question is that we are going to be surprised. The truth is that we are both scared as hell that we're going to have a baby born early again, and we know that preemie boys fare worse than preemie girls in the NICU. Knowing if it was a boy would unnecessarily add to our worry list. But that's a heavy answer for the checkout line at Target or the mom at the park just making conversation. And the honest truth is that it doesn't matter. We'd be exceedingly happy with a big, healthy baby. Boy or girl.
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| My exhaustion has led to a new household standard of "good enough." |
I'd be lying if I said it wasn't terrifying to be pregnant again. It absolutely is. I don't like anything about it. I'm not glowing. I'm not buying tiny clothes or planning a Pinterest worthy nursery. Instead, it's uncomfortable and exhausting and stressful, and it's hard to turn off the anxiety. One of the hardest parts for me is having everybody comment on it now that it's obvious. I know people are just being nice and friendly and that it's probably something most pregnant women don't mind, but left to my own devices, I'd stay home until September in order to avoid the awkward conversations that I end up in. Last week another mom at one of Olive's activities asked me if I go full term. I was kind of taken aback by it and blurted out that no, I hadn't with Olive and that she was born at 28 weeks. Her response? "Oh that would be soooo much better than going late. I was 42 weeks and in labor forever before they had to do a c-section." After I picked my jaw up off the floor, I said something nice like I'd much rather go late than early. And she said, "really, you think?" It was like being in a bizarre, parallel universe. I know she didn't mean to be offensive and obviously didn't stop to think about it, but it's hurtful to hear somebody trivialize a very traumatic experience. If I'd had a giant inflatable hammer in my bag, I may have bopped her with it.
For now, I'm trying to take it one day at a time. And honestly sometimes it's more like one hour at a time. My mind wanders to my fears on a regular basis, and I try to acknowledge them and quietly move on without dwelling. But I am very much a worrier and a planner, and I like to be prepared for every possibility. I'm already doing things like buying birthday gifts two months out "just in case." 23 weeks is a scary place to be because it is the brink of viability for a baby born early, but I'm thankful for every day that I'm still pregnant. I'm also thankful that I have Olive around to keep me occupied so that I rarely have time to sit down and think too much. Every time a negative scenario crosses my mind, I try to remember to consider the possibility of something amazing happening too. Nothing would make me happier than to have the magical moments. The moment where the doctor hands you your baby in the delivery room. The moment where the big sister comes in to meet the little one, and you think to yourself that your family is complete. The moment where you get to tell grandparents about the new grandchild and have everyone full of happiness and joy and love. Those narratives keep me sane. The best quote I've seen lately is something from J.K. Rowling as written in Harry Potter along the lines of "what's coming will come and we'll meet it when it does." It pretty much sums up being in the midst of a pregnancy with a high risk of preeclampsia. Because if it's coming, it will come. And truly all we can do is meet it if it does. And then fight like hell of course.
