So, apparently we're 'immoral'

For a moment this morning I was outraged and nauseated as I read, over my breakfast cereal, Richard Dawkin's latest contrarian tweet.

In response to a woman who wonders about the ethical dilemma of going ahead with a pregnancy after a Down syndrome diagnosis, Dawkins - seeing no dilemma at all - replies:

Abort it and try again. It would be immoral to bring it into the world if you have the choice.

But then I saw this (from Craig Porter):







































...and now I feel better. Best. Response. Ever. 

Suck on that, Richard Dawkins.

If this is what immoral looks like, then paint me scarlet.

It's not me, it's you

I think I mentioned that the holidays, while largely beautiful and relaxing and contemplative, also brought some moments of bitterness. Courtesy of our own family, in fact.

By way of the briefest of summaries, we've struggled with how to maintain family relationships with some of our relatives over the last 3+ years, when their callous, indifferent or demanding reactions to our loss(es) and experiences of infertility have placed extra strain and hurt on us in a time when instead we should have been seeking support and compassion. I knew that a subsequent pregnancy would compound this tension in so many ways. I've alluded to it as one of the reasons why I was reticent about sharing our exciting (but still scary) news for so long.

The visits with H's family over the last three weeks were intended as a kind of olive branch, a renewed effort on our part to let things go and start afresh (albeit with reduced expectations: you don't always get the family you want, but they're still family. Aren't they?).

It kind of worked out that way, but also, not really very much at all. Two vignettes, brought to you from the suffocating depths of our loving extended family homefires:

1) During a reunion in which H and I were making genuine efforts to let bygones be bygones, on the cusp of a new year with all the symbolism that implied, my mother-in-law wanted to revisit the topic of why we had sent 'hurtful' emails to her, oh...two odd years ago? That's right, apparently we hurt her when (you're gonna love this) we sent an email indicating that while we understood their concern for us, some forms of..ahem, grief management advice (and I'm using this term loosely here) were not welcome. To whit: when, on the first anniversary of S's death, H shared his feelings with his mother, her directive was to 'put it in a drawer and forget about it'. Yes, she referred to my son as an it. Still though, who were we, in our naivety, to imagine that we knew what we needed or to have the audacity to ask for it? That was hurtful to her, and she insisted that new year's day was the time to clear the air. New year or not, I guess a bitch of a mother-in-law tiger doesn't change it's stripes.

2) Lest you think that my own side of the family is immune from such gaffs in grieving etiquette (is there a manual for this? Because there should be), I present my sister. Things have not been great between us since, among other things, she blandly stated, 'Why should I grieve for your son? I didn't know him'. Since, on my first meeting with her after my loss - when I also met her son born a mere few days after S should have been - she indicated that she saw no reason to be sensitive in proffering her new babe because 'My first priority is my baby, and if you can't deal with that it's your problem'. Yeah, she is sensitivity personified, that woman. I'm not actually sure what her deal is, given that she had the same happy childhood as I. Anyway, she wanted the holidays to be a time when to reach out to those she so evidently loves and cares for, with the message that 'Family is so important, and as a parent this becomes all the more true when you have kids of your own'. She is extremely family oriented. Obviously. Here's what I would do with her version of 'family values'. Take them and delete, delete, delete not suitable for some audiences!. Just wait 'til she finds out about the little seedling. She's the type who will suddenly have all the love in the world for us.

As I am sure you are all too aware - though I admit to being deeply envious of some of you who seem to have such warm, understanding support around you - dealing with other people, and with community life in general, can be one of the hardest things about being in this already crappy ALI club.

There have been some break ups. The stupidity, insensitivity or just plain careless, this-is-no-big-deal-at-least-it-wasn't-a-real-baby attitudes to my grief on the parts of some people were enough to make me re-evaluate a few 'friend'ships. (This is to say nothing of the people who dumped us, initially on the pretense of 'giving us space', but later because grief is fucking hard, ugly work and they weren't up to the task; or so I can assume. Most just sort of disappeared, never proffering even a lame excuse, and never to return.) I give people lots of chances. If you've hurt me, I always try to talk openly, honestly and calmly about how your behaviour makes me feel (hence the 'hurtful' email to my mother-in-law), leaving a chance to clear the air. However, if your response to those attempts proves even more self-absorbed, sometimes you gotta know when to throw in the towel, if only for self-preservation.

But these people are my relatives. Unfortunately, things aren't so simple here. I can't break up with them. So I come here to vent, to shake a raging fist at the universe for bestowing me with such a frankly useless support system, and to beg your patience with me as I do.

And I know what they say about relationships being hard work, and how it takes two, and yadda, yadda, yadda. That's all totally true. I've worked hard over the past few years.

But still, I'm pretty sure it's not me. It's them.

The ties that bind. Like, literally. Source.

If you've faced similar insensitivities, what do you do to manage? How do you learn to bite your tongue, turn the other cheek, and keep that pasted-on smile upturned?

Disqualified

Allow me a brief interlude in all my shiny, happy talk about blissed out babies and real OB appointments, for a missive of a more bilious nature. Those of you who have been reading for a while may remember I have previously on these pages both praised the NHS for its comprehensive, free-access care and decried it's insensitivity.

(I have to say, that while we are blessed to live in a society that - for now - continues to view high quality healthcare as a fundamental right of citizenship [or even, as in our case, residence], we have also been on the receiving end of that disinterested attitude on more than one occasion. But today I'm here to rant in a more generalized way.)

The universal healthcare of the UK's National Health Service: weighing in on the generosity end of the spectrum, there is the fact that all pregnant women in the UK receive what is called a Maternity Exemption Certificate, entitling the bearer to totally free prescriptions of any kind, as well as dental coverage, for the duration of their pregnancy and until the first birthday of their child. Wonderful.

At the other, less humane end of the spectrum, well...New levels of insensitivity have been reached today people.

After filling out a form with my midwife about a week ago, I received my certificate in the mail this week. Below the instructions for use, under a section entitled 'Important Information', alongside routine details of what to do in the event your address changes, etc, there was the following:

If you have a miscarriage within the first 24 weeks of your pregnancy, please return your certificate to us. (If your baby is stillborn after 24 weeks, you can keep it. Yay!)

Subtext: because really, if your sorry uterus can't even manage the job of carrying a baby to a minimally respectable point at which it is considered a death rather than just release of the 'products of conception', what right do you have to the privileges enjoyed by other, more effortlessly fecund women?

Ah, all the tiny, effortlessly cruel ways in which the world reminds us of our failings, of how we just don't qualify, of how we're not quite enough.

Okay, okay, I get it...Age of Austerity, economic bottom line, risk of welfare fraud, cold, heartless neo Thatcherism, yadda, yadda, yadda...

But seriously? Seriously NHS?! You can't come up with a more appropriate way of keeping tabs on the allocation of the state's resources, or show even the slightest hint of compassion in the context of your bloated bureaucracy?

I know that when I lost my babies, in the midst of all the grieving and gnawing pain and self-loathing, one of my absolute top priorities was to undertake the paperwork necessary to keep me in good standing with my healthcare registration status.

Honestly, I'm not even sure how to appropriately convey the sense of repugnance I feel at this piece of 'information' and the way in which it is delivered, because it would involve a string of expletives so long and ugly I would doubtless alienate the more genteel among my readers and belie my true, less-than-ladylike nature.

If, however, this stokes the fires of your righteous indignation as it did mine, fellow IFers, fellow loss moms, well then, please feel free to let loose with as many colorful expletives as you care to share.

I'll start us off: Fucking, thoughtless, asshole, inhuman, dickhead, douchebag wankers.

<End rant>

Does not qualify as humane treatment

Contents of my uterus: confidential until further notice

Not so long ago, I received an email; to be precise from this friend, he of the oh-so-early, oh-so-unassailable-pregnancy-optimism.

This most recent communique was a quick, punchy two-liner probing enquiring about the...ahem, situation with our efforts for a dream baby. Quote: success with pregnancy...dare I ask?, followed by a signature asking that I pass on his best wishes to H. He is clever and interested and witty and great fun to have at a party, this friend. No one has ever accused him of being overly delicate.

As for me, I have never been someone who confided my deepest feelings and angst around our struggles in that department to my friends or family, at least not since the early days of loss and grief, when I learned a disheartening lesson about how disinterested, selfish, trivializing people can be when faced with the kinds of tragedies they'd rather not think about. Most have a tendency to make it all about them, so that even when they do speak, clumsily, it is to assuage their own fears or feelings of inadequacy. (But that, dear readers, is a post for another day.) However, just as I have not shared the deepest darkest truths of infertility after loss, neither have I been secretive about our reality. Friends who ask after our well being have been told, in there amongst the updates on job searches and big moves and recent vacations, that yes, the patter of little feet is something that fills our daydreams, that no, it has not been easy and no, there is nothing (nothing!) yet to report. The friend in question knows about our struggles, which is one of the reasons I was so screamy about his artless pregnancy announcement back in my most barren - of hope or baby - summer months.

Normally, I would have brushed off this equally artless, if well intentioned, attempt at friendly concern with just the sort of update described above: full of trivialities about our goings-on, inserting somewhere in their midst a concise response on the contents of my uterus in the negative.

But.

But, it just so happens - still much to my amazement, even writing it now - that when this particular enquiry reached my inbox, I was (am) indeed with child. It arrived, in fact, only days after we had first encountered that glorious second line. Not only that, but really, the brevity and focus of this email prevents me from just throwing out a random, cheery response which skirts the issue entirely: We're great! Still in England! H is working on his thesis! and so on and so forth and so blah blah blah.

Initially of course, my lack of response was due to the fact that, well, we were processing some heavy, if exciting, stuff. For many days I simply didn't oh ok, still don't now, have much time or headspace for anyone or anything other than the burgeoning hope growing within me, the terror that has been its twin, or the intimacy of the secret that H and I share (uh, with all the lovely peoples of the interwebs, natch).

But then, actually, how do you answer this email? I don't want to write my little seedling out of existence with a harmless lie. It would feel too much like...tempting fate? Lacking maternal instinct? I don't know exactly, but I wasn't prepared to do it. At the same time, I'm obviously not in a place where I am wanting to share this massive, life changing news, this secret of secrets with all the world. It is still too precious; let me savour it a while longer, as the magical, intimate, unbelievable, sacred thing that it is.

Nonetheless, this stupid kindly email has forced me to think much earlier than I had anticipated about the inevitable question of when and how and who to tell.

I have feared this time, feared it long before I even had that concrete, second-line, reason to. I fear the forced joyfulness (where for us, pregnancy is far from the joyful, naive time that most parents experience). I fear fresh grief, over the knowledge that no one who has not been through something similar can really, truly provide any emotional support for such a pregnancy as ours. I fear the sense of isolation that will grow with that knowledge. I fear the 'helpful' advice on how we should be coping with it all, because I'm already bitchy and hormonal and mostly, besides H, nobody can do anything right even if they try and I want need to protect that as my prerogative for right now, here in my little cocoon. I fear the anger which will almost certainly be my response to the amnesiac joy I anticipate from others, forgetting my sweet baby S (if they ever acknowledged him to begin with), forgetting the heartbreak we experienced just in getting this far, belying the view that another pregnancy will fix it all and maybe, finally, I'll 'go back to the old Sadie'.

I won't go back. I don't want to. I don't want to forget my son, for he is as much a part of this family story, of the branches that shyly, tentatively search outward as the tree grows, as are H and I and this new little seedling, this branch. He is the deep and abiding love that has enriched the soil in which our family tree grows. And our struggles after S, the other losses and the months of disappointment and the prodding and invasive appointments with numerous medical specialists and the fear of remaining forever childless. All those experiences, too, colour this path, not only with abiding sadness, but with the gift of intense joy, the relish of every minuscule progression towards the future we've so long dreamed of with such ardent hope. Our joy is our sorrow unmasked, in the wise and comforting words of Gibran. Those same sorrows that have carved us with scars are also what allow us this joy; they are forever intertwined.

And really, on a more selfish, less poetic point, I fear that amnesiac joy coming from those who could not share my sorrow is a step too far for me. Maybe, in these moments, I don't have the ability to forgive and forget. What right do people have to share in my fresh joy when they could not share in, or even be present for my raw grief?

But all this too, I suppose, is a post for another day. Now I just have to figure out how to reply to that email, before I start to appear really rude.

I am working on it. Source

Fragmin frenzy (all for nothing in the end)

This story has a very happy ending, thank the gods, but for a while there on Thursday and Friday, it was panic-induced, ugly crying central over here again. It all started on Thursday afternoon, when I was finally able to track down some now moot blood work results. (For the record, all looked well; I would have been able to carry on with IVF at our original clinic. Of course, I'm doubly fortunate that as [amazing, magical, can-still-hardly-believe-it-myself] events transpired, we didn't need to go down that road.) I got my results and I hung up.

Five minutes later, my phone rang again: Hi, I've just seen a note in your chart and it looks like Dr. M (the RE we'd been seeing at the subfertility clinic) would like you to go on Fragmin. Can you come in tomorrow so we can show you how to do the injections at home?

There was more about how the doctors had discussed it and it was quite commonplace and it was just a precaution and not to worry and...(I'm not worried about taking the meds, you twit, I am worried that my failure to do so for more than four crucial weeks at the beginning of pregnancy might have killed my baby!!). Truth be told, I didn't really absorb anything further at this point, as my mind was already racing with the tragic inevitablity I was sure we were being led toward. That, and it took all the strength I could muster not to verbally assault the woman on the other end of the line, with her cavalier tone, who seemed to be treating the care of my hard-fought-for unborn child as a kind of afterthought, oblivious as to why such news might make someone in my situation anxious.

Now for those who don't know, Fragmin (or heparin solution) is commonly prescribed for patients with a history of recurrent miscarriage, but we'd reviewed my repeat bloodwork again and again, and since I don't carry the MTHFR mutation, and because of my cancer history and the risk that blood thinners pose to my already vulnerable platelet counts, it was decided there was really no need in my case. I spoke about it with Dr. B (the MFM) during that first, nervous terrified telephone consult.

If you know anything about the MTHFR mutation and its treatment though, you'll know that treatment with heparin is indicated as beneficial to preserve pregnancy at the earliest possible stage, from the moment of a positive pregnancy test, through the first trimester. Cue panic, more raw, mucousy wailing and a feeling of dread and certainty that I and my caregivers, through neglect of the most horrible and obvious kind, had surely killed my baby. <And then I got up, left for work, and had to sit through and pretend to care even a smidgen about a looong meeting on the changes to asylum law which was little more than white noise> I don't know why exactly this particular news threw me so badly - I suppose any such forgotten 'detail', sprung on me so thoughtlessly, probably would have - but for those hours, I was convinced I was once more carrying a dead baby in my useless womb.

So off we went yesterday afternoon, and I won't bore you with the agonizing details, but suffice it to say that several screamy, demanding phone calls back to the clinic, in which I insisted on having our next u/s moved up from next week so that we could see the damage, resulted in a long meeting with Dr B, a reprimand to the nurse who handled the phone call, and best of all <drum roll please> another peek at our little seedling, very much alive and thriving and measuring ahead now at 8 weeks 3 days, having transformed from adorable grey blob to unmistakably human: giant adorable head, arm and leg buds all present and accounted for. And all 1.9 cm beautiful to behold. We found a strong heartbeat immediately with the abdominal u/s (the transvag invader having weilded its last).

I won't be taking the Fragmin, as originally agreed. Dr. B reviewed all my files, and still feels that it's not warranted in this case, especially as (music to my ears) my 'pregnancy seems to be progressing beautifully and you have a beautiful, healthy baby in there'. I trust him. The RE who put that note on my file (truly it seems as an afterthought) apparently makes a habit of that protocol, and I am suspicious of any approach to treatment that deals with patients by rote, irrespective of their individuals needs and histories. Dr. B kindly but firmly encouraged me to relax and enjoy as much of this as I possibly can, and it's medical advice I'll certainly (try to) take to heart. He ordered the scan I had demanded, just as reassurance: he is the first doctor we have dealt with who understands that when he is dealing with patients who have our reproductive history, it's as much about treating the parents and their wounded nerves as it is about caring for their baby. 'We understand that this is not just about the common cold, and you're entrusting your hopes for the future with us'. Melt. I wanted to hug him just as much as I wanted to strangle the RE and his stupid nurse for freaking us out in the first place.

But as promised - and despite unhealthy levels of adrenalin and cortisol having doubtless being released in the interim - a happy ending. Which just leaves me to make introductions.

World, meet little seedling. Little seedling, mee...well, I guess you don't need to worry about any of that right now. Plenty of time for all those introductions soon enough. Today (again) just joy and relief.

No, thanks, I think I'll wait for mine

From the lab tech taking my blood this morning at the clinic --

Her: Do you have any children?

Me: Nope. That's kinda why we're here.

Her (very brightly): It'll happen for you eventually! Or if not, I've always got a good-for-nothing eight year old at home you can take off my hands!

Me (disbelievingly, weakly): Ha...ha?

I mean...Who thinks this is a remotely ok thing to say to someone undergoing fertility treatments?

(In fairness to my clinic, we are normally very impressed with their high level of sensitivity and training when it comes to the medical realities we are dealing with, so I can only assume this woman was a temp or something; I've never seen her before today).

Here's my rule of thumb: Anyone who finds themselves in this shitty Club of IF has the right to make light of their (our) situation with as much irreverence, shock value and cursing as they see fit. Anyone who has no clue what this is like, kindly keep your humour -- and your children -- to yourselves.

Too harsh?

Take foot. Insert in mouth. Source

************************

In other bloodwork news, they have re-tested me for a clotting disorder. When my OB/GYN first tested for this in March the results came back borderline, and he said that he was satisfied this was not likely an issue for us beyond the possible need for baby aspirin should we manage a pregnancy in future. But in all the data collection run-up to our IVF, when they tested again recently in the fertility clinic, they said the results were 'inconclusive'. We'll be able to discuss these latest results (from today's test) at our appointment on the 25th. Is it wrong of me to say I almost wish they'd find something? At least that way we'd have some answers, and a fairly straightforward means of managing any pregnancy so that it doesn't end in such a dire/devastating/baby-less way in future.

We should be so lucky.

I'll never be able to imagine what that feels like

(WARNING: This post is pretty much unadulterated bitterness and bile, prompted by a rather self-absorbed meltdown today [in turn prompted by an innocent-enough email exchange], and hammered out here in the blogoverse on the basis of the better-out-than-in principle. If you've passed by today in search of more beautiful holiday snaps, or a nice, wholesome recipe or something, well...I apologize. If, on the other hand, like me you're having a particularly bitter infertile kind of day, stuck alone with your darkest, ugliest thoughts... well, far be it from me to offer any kind of validation, but feel free to stay and read on. I'm mixing the stiff drinks right now.)

Something I think will never stop stinging, whenever I encounter it: the way everyone else is so damned exuberantly confident as they face down pregnancy and parenthood...

'We are eight weeks pregnant!' 'We are expecting our first child in February!'

(Eight weeks?? I'd be terrified to ever again announce a pregnancy until...well, essentially the child is here and screaming. We don't ever indulge in any sense of expectancy anymore, except perhaps as it pertains to heartache and disappointment).

I wish they wouldn't be quite so cavalier, especially when they are aware of our own history. And yet here's the thing: other peoples' assured sense that everything is simple and easy and a pregnancy unequivocally results in a healthy-baby-nine-months-later is almost always rewarded with the very scenario their casual confidence imagines. I have to keep reminding myself that we fall on the distant margins of the statistics, the dark side of the moon.

('Less than 5 percent of women have two consecutive miscarriages, and only 1 percent have three or more consecutive miscarriages'. Thank you, Mayo Clinic, for using my miserable stats to reassure other parents about their odds, thereby pointing out to me what a freak I actually am. [I am the 1%. So special.] Actually, I guess the world does a pretty good job of reminding me just how not normal we are, with painful frequency. On my better days I probably just do an okay job of blocking that out. Lalalala I can't hear you!)

And then most of all, it stings that anyone else's justified joyful excitement over something so pure and beautiful is a source of pain and rage and just-please-shut-the-fuck-up-about-your-eight-week-pregnancy-and-plans-for-the-nursery mindset for me.

(Though at this point, I'm not sure what's worse: all that confident, babyiscoming! bravado, or the avoidant, furtive, whispered, poor-woman-I-don't-know-how-I'd-cope pity.)

I hate it that all this has turned me into such a shit head.

I hate it that one of the first things I think when I hear these kinds of happy announcements is:
Don't you know how long and hard some people have to struggle to get there?

I hate it that one of the second things I scream internally think is:
Don't you know that unborn babies die?!

In these misanthropic moments of self-pity, I kind of hate everyone, but I think I hate myself most of all.

Just...fuck.

Among the less commonly discussed side effects.  Source

Behind every case of infertility, apparently

...is a woman, according to our insightful GP's office. I want to share this wonderful gem with you so that we can all indulge in a moment of sisterly, unpredictable-threatening-female-hormone-induced! seething rage at conventional social (medical?) attitudes.

But first - because I just know you've all been on pins and needles awaiting the update - I can confirm that the sperm have left the building and are now, as I type, nestled safely in the andrology lab awaiting results. What can I say ladies?  Thanks for all your comments, commiserations and solidarity over my husband's ability to embrace Zen and the Art of Reproductive Uncertainty. Yesterday he made good and did his small part. And I have no doubt that he would be delighted/horrified at the thought of so many strangers over the interwebs cheerleading his masturbatory efforts. I spared him that detail.

The truth is, it wasn't the first time he's had to do it and it likely won't be the last, so it's not like we didn't know the drill. We are lucky enough to be only 20 minutes from the hospital, so it's possible for him to do his thing at home, aided by me, and drop it straight at the lab, (as many of you suggested).

Oh wait, you didn't actually want to know all that? Oops. Sorry...

Anyway. So yes, that's done. Again. Not that I'm sure it really matters. Will it get us any closer to confronting the eventuality of IVF? Will it provide any answers? What are the questions again? Even I'm getting bored with this dinner table talk.

But none of that is really what I want to dwell on right now. Instead, I'd like to share with you a piece of medical wisdom which H gleaned from the doctor, perhaps entirely obliterating the necessity for his sperm sample at all. A kind of old husband's tale, if you will.

Because of a paperwork mixup, he had to first go to the GP's office to get a signature to send along to the lab. A minor inconvenience, but no big deal. Except that when he asked for the signature, the (male) doctor thought it worthwhile to cheerily provide some becalming (and unsolicited) assurance.

I wouldn't worry. Usually it's a problem with the woman anyway.

Yes, really. (Because, ya know, usually is a totally, scientifically valid, quantitative measure of data analysis.)

To which H, like the consummate feminist social scientist that he is, calmly replied that perhaps if the medical establishment weren't so patriarchal in its vision of the ideal body, it might ask a different set of questions entirely. And also pointed out that really, an approach which seeks to assign blame for the problem on the basis of a clear division of the sexes (or anything else, for that matter), might actually, possibly, just be missing the point anyway, being that this is not really the height of good practice in person-centred care.

(Not that I'm sure the doctor realized he was providing anything but wonderful, reassuring, person-centred care to one of the boys.) I only wish I could have been there.

I will say this though. H may not always get it, and he may unwittingly pose frustrating barriers to this whole process in the form of occasional foot dragging...

But.

I  am so in love with my husband at moments like these.

Swoon.

Insert appropriate comment about patriarchal medicine and the male gaze. Source.

Something to hold on to

Of the weeks and months following when S died, there is one really clear recollection I have, a random little event of the kind that you always think shouldn't still stand out in your mind, but inexplicably does.

In the autumn after losing S, on the way to a work assignment abroad, we spent a few weeks in Vienna visiting with H's friends and family (well, not all: my heavily pregnant sister-in-law, due three weeks after me, refused to see us until her own babe was safely in her arms, for fear it would 'jinx' her own pregnancy. She said just that in an email to my husband. She shamelessly incarnates the hurtful but widespread fear and superstition of pregnancy loss as contagion. For people like her, there are no words really, and thus I'll waste no more. For this is a post about another, more hopeful topic).

It was a difficult visit for me; in the depths of my grief, caught in a whirlwind of inescapable social engagements, everyone around me resolutely pretending as if there had never been any baby, like I had not held my tiny, perfect, 200 gram son in my hand and stroked his warm pink skin not months before. I remember many a morning sobbing in the shower as we prepared to enter that world of indifference and quiet fear. It was exhausting.

One afternoon I caught a brief moment of reprieve and spent the day wandering aimlessly through the shops in one of my favourite Vienna neighbourhoods. Aimless, that is, until one item caught my eye and tore at my already ragged heart. A Barbapapa onesie like this. I have already professed my fondness for these cute characters, and this was the sort of colourful, quirky item we would have delighted in for S. The thought, however, of my tiny, fragile son and just how much his body contrasted with the norm of the chubby full term newborn that such a garment demonstrated, the knowledge that he'd never wear or need any chubby baby clothes, sent me running from the shop in a rush of hot tears. I've often thought about that afternoon, over the many months as the early pain has considerably softened. And as profane as it sounds, I've often thought of that little onsie also, with something like melancholy.

You know why I'm rueful about that day? I wish I'd bought it anyway. Not because I wanted the baby outfit; at the time I had thoughts and love only for the baby I could never have, would never hold again, and the thought of a future pregnancy was unthinkable.

No, it's because I wish I had told that version of myself, deep in her pit of black despair and and grief, that even then - yes, perhaps most of all then - it was ok to hope. Recklessly, defiantly so. Because as the months have accumulated behind me, with their potential for pulling me deeper and deeper into that pit, it's this hope that has at times been the only thing that sustained me.

For the longest time though, I never really allowed myself to imagine a a future where we would parent a living child, at least not actively or in too much detail. Items that so blatantly speak of babies used to hold a magical, dangerous allure for me, like mystical talismans the presence of which could somehow deter the very thing for which we longed. Like fire, I was almost afraid to touch. Afraid, I suppose, of the return of those hot tears. Afraid also that such items would never hold any other value for me.
  

**********************************************

This weekend, we did what I would have thought unthinkable only several months ago. We were out shopping for my nephew, the sweet little boy who should have been a playmate to our own sweet little boy, meant to be born just days after. When we'd selected and paid for a lovely set of books for him, our eyes both feel simultaneously on a very cool set of puppets. It was a large Peter Rabbit-like hand puppet who springs up from a series of individually quilted lettuce leaves, each of which nestles a tiny insect finger puppet - caterpillars and ladybugs and bumble bees. It was unique and adorable. And as we looked at each other, H did something very unexpected; he proposed we buy it, right then and there. Not for our adorable nephews, but for our own future child, something to remind and maybe even motivate us when the hope and optimism flags. And so we did. Mind boggling, really.

Again, it's not so much the item itself which holds significance, although I'm proud of us for boldly carrying it to the counter and buying it. Rather, it was the conversation and the realizations that followed, which felt like a profound juncture in our road to parenthood and our committments therein. I'll share the details later, as we process things, but suffice it to say that I was touched and amazed anew by the depth of feeling H expressed in our commitment to a family. 

I don't know yet what we'll do with this toy while we're waiting for a child to play with it. As I type, it sits on the table in the hallway, still in its paper shopping bag, unceremoniously deposited along with the rest of yesterday's purchases. And somehow the normality, the informality of that feels right. It feels brave even, like we're again defying the bad luck we might otherwise worry this cavalier attitude would bring. Stored away or out in the open, this item will be one that we can hold onto especially for our future child, for him or her only. S already has lots of adorable little things that have become just for him.

And so, we have a tangible symbol of our reckless, defiant hope and our determination to hold our one-day baby. What a long way we've come, (and how far we have still to go). But I've learned that no matter how much I try to distance myself from my secret heart, it won't make the disappointments that sometimes come any less painful, and I may be missing out on little moments of magic along the way.

For who we wish for. Source.

Bloggy friends, do you have a talisman of hope that you hold on to as a promise to your future self? That brings you hope for the children you will one day bring home? I'd love to hear about them, silly or symbolic or just plain random.

Well, I'm glad I asked then!

In all the recent excitement about presents and awards and wondrous surprises, both random and rather more expected, I have completely overlooked the report on my last doctor's appointment. (Because the internet provides me nothing if not the folly that other peoples' thoughts besides my own spin around the state of my cervix). But well, really, that's also because there's not much to tell. Nonetheless, read and rage with me a moment, won't you?

So I made it to my GP's office (because in this land of NHS referrals you don't get the opportunity to speak directly to a specialist and just ask the straightforward question pertaining to the procedure you're due to have in a mere five - ok, three now - weeks) to discuss the relationship of the surprise discovery during my recent cervical exam to this current cycle.

We're at a new(ish) practice, and you get seen by whoever's on that day, and our conversation with that day's whoever (because honestly, I had trouble believing that her medical qualifications were earned anyplace but the DeVry Institute of Technology*) can be summarized as follows:

Any number of questions I had...

Could this polyp, and not, as I had been told, my miscarriage last August, account for my wonky cycles the last several months?

Do they often materialize that quickly? (Remembering my HSG and uncountable pelvic exams in the last six months)

Will this jeapordize our ttc attempts for the coming cycle?

If we were to become pregnant, could it put the pregnancy at risk?

...were met with a stock answer:

'Again, I really don't know. That's something you'll have to ask the specialist'. In a mere five three weeks. After this cycle has come and gone. Seriously, I've never heard such a continous string of 'I don't knows'.

So yeah, that happened. Thanks for comin' out folks.

The good news is that the results from the original smear test came back normal, meaning there is almost certainly nothing of concern with regards the polyp itself. That was really scary, so...Phew. I'm still hoping ('cause hope springs eternal) to get some insight into how this may be implicated in (and potentially even resolve) our struggles to conceive over the last months. But - as I've been reminded again and again by my caregivers (let's use the term loosely) - that will have to wait.

So I'm hoping, in the coming days and weeks** for more little surprises, or at least shiny things, to keep me busy.

Feel like I'm hitting one. Source.

* If you actually earned any of your degrees there, and are reading this...Well, sorry.


**Because there's also that other, more familiar kind of waiting just around the corner.

Are you listening NHS? No, I thought not.

I should probably preface this post with the statement that I am, as a proud and grateful Canadian, 200% in favour of totally free, totally accessible universal healthcare. And, with roots as deep in this country as in my country of birth, and having spent many formative and happy years of my adult life here, I can also say that I'm something of an anglophile. Actually, it's for that reason that I feel the need to post an angry missive. (I did warn about my rants on perceived social injustice).

I'm so angry for all of us - in this community in particular - that in a country like the UK, with £1000,000s worth of technology at our disposal and a huge knowledge based economy full of specialists and highly trained individuals, that poor attitudes continue and bad practices can so negatively effect the quality of care. I'm speaking particularly of obstetrical, gynecological and prenatal care here.

When I read reports like that in last weekend's Sunday Times - indicating that many NHS staff don't trust their own facilities - and which, more importantly, told the story of a woman who was informed by hospital staff of the high likelihood that her baby had died in utero, but then that she'd have to come back on the following Monday to confirm it because the ultrasound department only operates weekdays, (I'm not making this up)....Well, what can I say? It makes my heart break, my blood boil and yet it's all too familiar.

When I first realized something was up while carrying S, I called the Early Pregnancy Unit (which is meant to exist precisely for such moments) at my then local hospital, to be told that, at under 18 weeks, 'there would be little we could do, so try and enjoy your evening (!!!) and if the problem persists call us back tomorrow'. Again, not making this up; a prenatal care nurse actually said that to me. It was my first pregnancy, so I didn't quite realize at the time how appalling that truly was (though I've kicked myself so many times since for the fact that I didn't. Oh, the guilt). As true as it might be (though in some cases not), that a pregnancy at just under 18 weeks is far from save-able, do they not understand the notion of person-centred care? Do they not appreciate that we are not merely carriers of life they sometimes hardly seem bothered to acknowledge, but also whole people with concerns and fears and hopes of our own, and that we deserve care and empathy for all of that too?

The hospital in question in the article, in a neighbourhood of south London very near to where I once lived, offered a formal apology after the case was included and published in the wider research report.

And the NHS wonders why the UK has one of the highest stillbirth rates in all of Europe? Pretty scary. Of course the sad truth is that many losses (including, probably, my own), are not preventable, even with the interventions of modern medicine. Some causes (particularly the 'unexplained' variety) of infertility are not easily treatable. But that doesn't mean that when we place ourselves, our hopes and dreams and fears in the hands of those we trust to care for us, that they cannot display a minimum of compassion, even when their hands are tied so far as intervening goes. Sadness and disappointment in such cases are inevitable, but they can be minimized if treated with kindness. Successful medical treatments almost invariably contain an element of psychological and pastoral care as well as biomedical. I'm not just speaking from the experience of a patient; in my profession I know this also to be true.

It makes me so angry on behalf of all those lovely, loving, resilient and brave women and men I know here in the UK, struggling to conceive and then often struggling through scary, difficult pregnancies to bring home healthy babies they desperately want to care for. They deserve so much better. This country deserves so much better.

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In tangentially related news, I received my appointment letter from the GYN clinic with a date of 14 March for my necessary colposcopy. Yeah, they were quite literal about the 'emergency' six week wait, almost to the day. I'll speak to my GP tomorrow about how that might affect our attempts for trying this coming cycle.

The letter itself arrived a mere three days after my initial exam. So I guess they're pretty efficient with correspondence, if not treatment.

Shaking my angry fist. Source.

Visiting the acupuncturist, revisted

I've already mentioned how much I appreciate my acupunture sessions, and how they've been an integral part of both my healing from loss and ttc journey. Having relocated back to the UK, I recently managed to find a practitioner who takes my health issues seriously and doesn't underplay their emotional dimensions. I'm excited about some of the newer treatments he's offering. But in order to get there, I first had to kiss a frog or two, as it were.

The first practitioner I saw when we arrived here, I selected specifically because she advertised a specialism in infertility and loss (something which was really never available in Portugal). At the first appointment, I couldn't help but note that her manner was a little overly clinical for my liking (I want someone who's aware of the mind/body connection), but the needles seemed to do their thing of calming my anxieties and putting me in a meditative state just fine, so I stayed the course.

On the second appointment however, we were discussing how acupuncture can be beneficial in treating infertility and loss, and she used the following phrase: 'women who have a habit of miscarrying'. ...Say what?!?! I am sure she meant nothing by it and it was just a stupid choice of words, but it bothered me. I didn't say anything at the time, but I left her office and it stuck with me all the next week, until my following appointment. I decided to give her the benefit of doubt and gently call her on it - not in order to reprimand her, but out of a genuine desire to improve her practice. After all, given her speciality, and the fact that she has links with the local IVF clinic, she must be seeing many women like me. I want them to have quality of care too. Most of all, I want the awfulness of my own experiences to count for something, whether that be challenging the taboo and silence surrounding our paths to parenthood in the ALI community, or helping people (particularly in professions that are often mandated to care for us) to be compassionate and supportive of our losses - whether the loss of children who were here for too little time, or of those we have dreamed of but never had the chance to bring into being.

So at the end of our next session, I politely explained to her that I had been taken aback by her choice of words and wanted to draw her attention to some of the sensitivities around recurrent pregnancy loss and infertility. I said that many women in my place struggle with feelings of responsibility and guilt, of somehow feeling incapable, like failures, and suggested that perhaps we need to use words that help challenge that implication of responsibility (of choice even, according to her formulation. Like we just made bad decisions that lead us towards bad 'habits'). After all, I pointed out, you wouldn't say of a cancer patient 'he has a habit of developing tumours', would you? She stared at me blankly for a few moments, but here's where it got irreparable: instead of offering anything like 'I hadn't thought of that', or 'thanks for pointing it out', or simply 'I'm sorry', she was clearly annoyed. She said in a kind of snippy voice, 'fair enough'. Just like that. Nothing more. So needless to say, I didn't book another appointment with her.

Just goes to show that even those with so-called 'expertise' can totally let us down in their lack of understanding. Sometimes I think there isn't even the will to understand. That makes me all the more glad to have a space like this, and the support of a warm and wonderful group of women who truly understand, though I wish they didn't have to. And my search for those whose expertise can truly aid me, with compassion and empathy, continues with this journey.