Saturday, December 22, 2007

News roundup

So much to say, so little time. Eggbert had her one-month birthday on Wednesday. I can't believe that I've already been a mama for a month now. It's gone so fast, and yet I can't remember what life was like without her.

She had her one month checkup on Thursday, and all was more or less well. She's still tiny, but is growing well. Her latest stats: 3.4 kg (~7 lb, 7 oz), and 52 cm (~20.5 inches), up from 2.8 kg and 44 cm at birth. That places her around the 10th percentile for weight, and the 25th for length. Her head is above average for her age, so she's a real Egg head. She's also grown a very fetching double chin, which makes me quite proud. The doctor was very pleased with her growth, and congratulated me for exclusively breastfeeding, which was nice. The only less-than-pleasant part of the visit was a hepatitis B vaccination. Eggbert does NOT like having needles shoved into her thigh, as it turns out. She turned purple and screamed for about three hours straight. Not fun.

While we love her with every molecule of our beings, and think that she's just about the most perfect creature on earth, there are no signs yet that she is a rocket scientist. Twice now she's started screaming hysterically because she had a fistful of her own hair and was pulling. It took several seconds (and a lot of resistance on her part) to pry her fingers out of her hair. You'd really think that this lesson would be one that you'd only have to learn once, but apparently not.

Aside from occasional mishaps like the above, though, she's a pretty cheerful girl as long as she gets her way. Unfortunately, her way involves her being on the boob 24 hours/day, which can't always be arranged (I haven't quite managed to master the art of changing her diapers without pulling the nipple out of her mouth, for example). So, she occasionally gets the opportunity to give her lungs (and our ears) a good workout.

Breastfeeding has been a bit of a challenge, but it's going well at this point. I was pretty sore for a while, and it took her a while to figure out how to latch, but now we're both old pros at the feeding thing. We also tested the bottle out a few days ago, just to start easing her into things in anticipation of my return to work, and she took it graciously, although she then slurped it down in one nanosecond, and wailed until I pulled out the boob. Oh well. We'll just have to put more in the bottle next time. The one real fly in the ointment so far is that while feeding her is going well, pumping is not. For some reason, I find pumping really painful. My nipples are sore for hours or even days each time I pump. I've tried setting the pump on the lowest setting, and that helps, but it's still a bit much. I'm thinking I might need to get a different kind of pump (I have the Medela mini-electric). Any thoughts?

One final thought--why is it that while everybody warns you about cluster feeding, nobody says anything about cluster pooping? Just wondering...

A reader asked for an update on my friend H, who is pregnant with twins again shortly after losing her much-wanted twins at 20 weeks in March. She has been on bed rest since 14 weeks, and is now at 23 weeks, and holding steady. There haven't been any signs of trouble, so we're now all cautiously optimistic that she'll make it to her doctor's goal of 30 weeks. Obviously 36 weeks would be even better, but her doctor thinks that they should have an excellent shot at good health if they at least make it to 30. Thanks for asking, dear reader!

Happy holidays!

Monday, December 10, 2007

Three weeks ago

I can't believe that my little girl is already three weeks old! Time really flies. I had thought that the first three weeks would be hard, and in some ways they were, but they were also absolutely wonderful. We're not getting much sleep in La Casa Lower, but we're having more fun than I ever could have imagined.

Even though I'd read book after book about caring for a newborn, I still found myself completely clueless when she came home. We had several false alarms (e.g., Oh no! She has diarrhea! She must be sick! Oh, wait, never mind. The poop of breastfed newborns is supposed to be watery. Oh no! She's on the boob all day long! She must not be getting enough milk. Oh, right, cluster feeding), but she's shown remarkable patience with her idiot parents. She's feeding like a champ, prolifically producing poop, and giving us enough adoring glances to make us completely melt.

Anyway, before too much time passes, I thought I should post the story of the birth. In the interest of honesty, I should admit that I wrote out the story shortly after the birth. I just didn't get around to posting it here until today. It's amazing how hard it can be to find a free minute.

The birth was really difficult, but ended up being wonderful, kind of like this whole journey has been so far. I started having occasional contractions and my mucus plug passed on Saturday, November 17. Then at midnight, a few huge blood clots came out. That freaked me out, so we went to Labor & Delivery (my doctor had told me a zillion times that if something happened, don't try to phone her, just go to L & D). They said it was OK, so we were back home by 2 am. I woke up at 4 with some stronger contractions. Then at 7 am Sunday, my amniotic sac broke in the middle of a contraction, so we were off to L & D again.

When I got there, they checked me out quickly, then put me into a room, and did all kinds of things to me, including putting me on an IV and a fetal monitor. Nobody really spoke much English (and I don't really speak Korean yet at all), but nothing that they did surprised me too much, since my doctor (who does speak fabulous English) had told me to expect the IV, monitor, etc. The one weird thing was that they offered me an epidural right away. Not only did that seem odd given that I wasn't in too much pain at that point, but also because I was only dilated to 1 cm, and my doctor had told me that she doesn't allow epidurals before 4 cm. I told them I wanted to make that decision later, and they pushed a bit, saying that it takes anaesthesiology a while to come, so I should at least get the port put in right away. I refused.

Then they pretty much left us alone in our room. Within an hour or so, the contractions were fast, furious, and really painful. I also felt horribly dehydrated, but they wouldn't let me drink anything, telling me that the IV was hydrating me. They kept coming and turning up the IV, but I kept feeling worse and worse. About four hours later, my cervix still hadn't dilated at all, but I was pretty much in agony. The pain really freaked me out, because I hadn't expected early labor to be so bad. Given that active labor is supposed to be much worse, I realized that I wasn't going to be a happy camper at all without pain relief, and asked for the epidural port to be put in. To my surprise, when the guy came and put it in, they turned it on right away. When I asked why they allowed it even though I was nowhere near 4 cm, they said "for induction patients we allow epidurals right away". I said "oh, you're going to induce me"? And the doctor on call (still not my doctor) said "we put you on pitocin right when you arrived. You've been on it for five hours". To her credit, she was pretty embarrassed that she had neglected to mention that little detail! No wonder the contractions were so much worse than I had ever imagined in early labor.

About half an hour after the anaesthesiologists left, the epidural started to work. For a while, all was wonderful. I could still feel the contractions, but they were completely bearable. Then a few minutes later, they took my temperature and said that I had a fever.

They put ice packs around me, and took my temperature again every few minutes for many hours. After a few hours, the doctor on call said that it was probably because I was dehydrated, and FINALLY turned up the fluids and let me have a few sips of water. The fever stayed high until morning, though, which was so scary, since I was afraid it would hurt the baby. It was also worrisome since my water had been broken for several hours at this point, so even though they had me on antibiotics, there was a real risk of infection. This whole time, I'd been on the fetal monitor, which was pretty miserable, since it only worked when I was flat on my back, which was of course the most painful position. However, I could handle it with the epidural. After about two-three blissful hours on the epidural (I wasn't keeping track of time), the doctor came in again looking worried. She said that the fetal heartbeat and movements weren't looking good, and that she thought that the epidural was to blame. So, she shut the epidural off again. (I was still only at about 2 cm at this point). Within 30 minutes, I was once again writhing (still 2 cm). Later that night, they turned down the pitocin a bit to give me a break, but I still didn't get any sleep at all, and was an absolute wreck by morning. At about 6 am (about 22 hours after they started the induction), they cranked the pitocin back up again (still 2 cm). Soon after, my doctor arrived. I talked her into trying the epidural again, but again, the baby responded badly, so they had to turn it off. At this point, I was just about ready to give up. Honestly, if she had offered me a c-section, I would have said yes. But she didn't offer it (bless her), and instead told me that I was now at 5 cm, and that she expected that I would be able to push within 2 hours. That was a huge relief. After 24 hours, I knew I could handle 2 more. I just knew I couldn't handle 12. Anyway, by about 10 am or so, I was allowed to push. That part was amazing. I know it's weird to say this, but I really loved the experience (although I don't want to do it again for a while). I have never felt such intense focus, and for once, my body seemed to know what to do. Even though there were about a million doctors and nurses running around me, the only people in the universe were me, the baby, and Mystery, who was holding my hand. The doctor told me that this was the part that I had to actually DO rather than just experiencing. She said that the speed of the delivery would depend on how well I pushed, and that I had to be active, and not just wait it out. So, I pushed with everything I had.

She was out within 30 minutes of pushing (with an episiotomy AND a tear), 27.5 hours after my water broke. I didn't feel the episiotomy or the tear at the time, but I did feel her coming out, which was amazing. Mystery was bawling, and I was just stunned. They put this gorgeous little thing on my chest right after she came out (and let dh cut the cord), and she immediately opened her eyes and looked at me. At that moment my life changed forever. They let me hold her for a second, then took her away to clean her off. They then gave her back to me swaddled so I could let her try to latch on while she still had that reflex right after the birth. It was only then that I realized that I didn't know the sex yet! My doctor has known for months, so I guess it just didn't occur to her that she should say "it's a girl!" The first time I held her, when she was still naked, it didn't even occur to me to look. Nothing mattered but that she was healthy and I loved her. I guess I was a pretty loyal team green member!

So, the rough part was that I was afraid throughout much of the labor, because of the fever and the baby's unsteady heartbeat, and that I ended up having an anaesthesia-free labor and delivery (which I had wanted to try, but wasn't particularly a goal for me), but one with an extra side of pain, thanks to the pitocin). But, in the end, it was absolutely wonderful, and worth every bit of the pain. I'd do it again in a heartbeat, but even if I never get to do it again, I'll continue to thank my lucky stars for this amazing experience.

Sunday, December 2, 2007

Time flies

I can't believe it's already been almost two weeks since Eggbert was born. Time really flies. We haven't slept in days, but these have still been the happiest days of my life. Being a mom is absolutely wonderful. Words fail me.

I don't have time to post a real update, but just wanted to check in and say that we're still alive, still doing great, and that Eggbert is an absolute joy. She is a creature of many moods, including hungry, clingy, whiny, chipper, and sleepy. Well, I guess that's not so many moods, but given that you never know which you're going to get in the next minute, it feels like a lot. She keeps us on our toes, never lets us sleep, and enchants us anew with every passing moment. I can't imagine how I lived without her. I remember that living without her pretty much sucked, though.

I'll try to post the birth story in the next couple of days. Really.

Saturday, November 24, 2007

I can see my feet (and so can people on the moon)

Thanks so much for all of the good wishes, and sorry for the abrupt cessation of communication. After all of my whinging about having made no progress at my last checkup, to my great shock, I passed my mucus plug and started having contractions two days later. The morning of the third day, my water abruptly broke, so off to the hospital I went. The following morning, November 19th, Eggbert arrived.

The birth was difficult, but the ending was wonderful. I'll tell the birth story in detail soon. Meanwhile, I just wanted to announce her safe arrival, and give the vital stats.

Eggbert is a little girl. Born at 40 weeks, 6 days, she weighed in at only 2.88 kg (6 pounds 5 ounces). She is healthy and voracious. We love her passionately. I'm tearing up just writing this.

While she is utterly perfect, her mama is still a bit of a mess. My feet are so swollen that I swear they actually make a sloshing sound when I move, I had an episiotomy and a tear, so things down south are a bit fragile at the moment, and my pelvis is improving, but slowly. I can now walk without crutches, but it still hurts, so I'm trying to minimize my movements. None of this matters at all, though, because she's HERE!!!

Friday, November 16, 2007

Thank you

Thank you dear friends in the internet for your words of encouragement, and also for in some cases undoubtedly biting your tongues when you wanted to slap me upside the head. You said exactly what I needed to hear, and I am truly grateful.

It has been a hard week. I think that the thing that made it the hardest was that I genuinely did not expect this to happen. The third trimester has been so generally drama-free (other than the IUGR scare) and comfortable that I had stopped preparing for bad things to happen. And so when something relatively minor happened, I freaked out, and acted like I was the first person in the world ever to be miserable after going past their due date. Oops!

Before we moved to Korea, Mystery and I lived in southern California. His work was only about five minutes away from my work, so we drove in together in the mornings. Every day, we'd listen to the news on the way. One day, there was a human interest bit about a book on happiness. It wasn't about the philosophical underpinnings of happiness, or the meaning of life, or anything like that, but rather a series of practical tips to maximize your chances of making good decisions for yourself. The author's main thesis was that people are absolutely terrible at imagining how they will feel in a given situation that they have never actually experienced. We all THINK that we're pretty good at it, but we are wrong more often than not. Therefore, the author advocated talking to people who are actually IN that situation and finding out how they feel about it, rather than trusting our own imagination. His point was that if you're considering a new job, or a move, or what have you, you should talk to people who actually DO that job, or live in that place, and see how they like it, and give their reactions some real weight when making your decision.

At the time, I was struggling with infertility, and it really struck me how right he was about the fact that it is just about impossible to imagine how infertility feels if you're not actually infertile. I don't think it's possible to go through the day as a "fertile" and really see how many little insults and booby traps are out there. The happy moms. The pregnant bellies. The "innocent", but shockingly painful questions: "do you have children?", "do you ever think about having children?", "why did you decide not to have children?" or my all-time favorite "when do you think you'll start a family?" The commercials, oh god the commercials. Nobody who hasn't had to sit through the "having a baby changes everything" commercial the day of yet another BFN and managing not to cry, vomit, or strangle the nearest person simply out of sheer indecision as to which would be the most profitable course of action, or had to attend a baby shower after two years of trying, or endured the 25th pregnancy announcement that month (14 of which are described as "accidents"), can really understand what it's like.

Up until now, pregnancy hadn't been much like that author said, though. The conception was, rather obviously, quite different from the standard experience. My first trimester, I was so distracted a family medical crisis that I barely had time to feel the morning sickness. The second trimester, which is supposed to be such a breeze, was a bit of a nightmare. And the third trimester, which is supposed to be so hard, was rather a breeze. Add to that living a million miles from my family and old friends, and living in a small, obviously temporary, flat, so no baby shower and no decorating of the nursery (the baby will share our room), no choices about cloth diapers vs. disposables, dealing with unfamiliar baby products right and left, and it's not really surprising, I guess, that I had been feeling like my pregnancy was fairly unique in the history of the world. Well, of course it IS unique to me, but it was hardly realistic to think that mine was really that special or different, odd though my life circumstances may be.

So, I really shouldn't have been surprised to find out that the last few weeks of pregnancy are hard, and that going past your due date is frustrating. EVERYBODY says so. All of the books. All of my friends (in the computer and "real life"). All of the strangers who so generously share their experiences on the internet. My mother. My sister. My cousins and aunts. And yet, it turns out that I had been imagining myself sailing into labor and delivery and just popping Eggbert out without breaking a sweat.

Now that I'm over the disappointment, I actually think that my hubris was kind of funny. So here I am to tell you that, guess what? The last few weeks of pregnancy are hard. Going past your due date is frustrating. Labor must REALLY hurt if people mainly talk about that, rather than the week or so leading up to the delivery.

I saw my doctor yesterday. Still no signs of progress whatsoever. Eggbert is in a position that most babies reach by 28 weeks. I will be induced next Thursday (the 22nd) if nothing changes between now and then. I'll be 41w 2d.

Wednesday, November 14, 2007

Bloggers remorse

Well, it's been only four hours since my last post, and I'm already drowning in guilt for complaining. I know that so many people would do just about anything to be in my situation. Heck, 40 weeks and two days ago, I would have done just about anything to be in my situation. I am thrilled to be here. Really I am. It's a dream come true. I'm just having a bad day, and my butt hurts.

No more Mrs. Nice Preggo

OK, now I'm just pissed off. The pain on the left side of my pelvis has gotten worse, and now it feels like I'm being stabbed every time I try to take a step. So, I'm overdue, in pain, and can barely walk, and yet people are STILL not rushing to do my bidding. What on earth is the matter with them? Why I just hobbled to the bank today (all of about 50 meters from my apartment), and people didn't even get out of the way of my mammoth form as I lurched awkwardly down the street, leaning so hard on Mystery's shoulder that I had serious concerns about breaking it. One young woman, a member of a high-heeled gaggle of college students walking in parallel, actually plowed right into the fist that I was holding threateningly at my side in an attempt to stop people from crashing into me. And I wasn't even sorry. THAT's the state I'm in.

Of course then I got to the bank, and it took me about half an hour on my rapidly-swelling feet to convince the teller that yes, I really did want to pay my bills there, even though it was the WRONG BRANCH, and they would therefore have to charge me an extra dollar, which I could easily save just by walking an extra two blocks and paying at the right branch. Unfortunately, my Korean is simply not up to the task of saying "if it's two blocks away, it might as well be on the moon to me these days", or "I'm willing to pay an extra thousand if you can induce labor while you're at it!".*

If you were ever wondering whether I am a great big whiner, or just play one on TV, please put your doubts to rest. I'm the worst. I realize intellectually that I am incredibly lucky. Against all odds, I have managed to carry a pregnancy to term (and beyond). This is incredible. I should celebrate. And I will, as soon as someone gets this long-awaited baby out of me!

Eggbert, honey, don't be upset. We've had a good run. I've loved having you in me. I cherished those kicks, my growing belly, the sight of you on the ultrasound, even the digestive issues that ensued, because I wanted you so badly, and love you so much. Being pregnant with you has been one of the highlights of my life, and I know that when it's over, I will miss it. However, all good things must come to an end, and I am now ready to take our relationship to the next level. Don't you think it's time?

____________________________________________________________________________________
* (If the whole paying bills at the bank thing doesn't make sense to you, bear with me, it doesn't make sense to me either, but nothing about the financial world in Korea does, and yet things hum along here with astonishing vitality, forcing me to admit that as foreign as the system is to me, it does work. For other people anyway.)

Monday, November 12, 2007

Well, that's interesting

I had been thinking that as long as I didn't actually say how utterly amazed I was that I hadn't had any lower back pain at all during this pregnancy, I wouldn't jinx myself. Well, it turns out that thoughts can jinx too. Yesterday I woke up with a sore sacroiliac joint (the back of the pelvis), and by mid-afternoon, I couldn't even walk. So much for my plans to work right up to my due date (tomorrow). I spent today at home in my pajamas instead. Not so bad, I guess.

Only one week until induction if nothing happens sooner. If my pelvis doesn't get better, it's going to be a very long week.

Thursday, November 8, 2007

Still no progress

Today, as the doctor completed my internal exam, she didn't say anything. She just gave me a sympathetic look and shook her head. Then once I was clothed again, she started talking about the induction that we'll schedule at my exam next week. So, I guess there's no need to pack my hospital bag yet.

Sunday, November 4, 2007

Remind me never to leave the house

So, today I thought I'd run one final baby-preparation errand. I realized a little while ago that we don't have any diaper/nappy rash cream. So, I thought I'd run out and pick some up at the (somewhat fancy) store near our flat. Mystery said "don't you think it might be a little expensive there?" I said "yeah, probably, but how bad can it be? It's diaper rash cream!"

The answer: $34.00

On what planet are people willing to pay $34.00 for a little bottle of something that you spread on your kid's butt?

Friday, November 2, 2007

No progress

Well, I saw the doctor on Thursday, and the official cervical prognosis is "no progress whatsoever". Eggbert is still fine, healthy, and in training for a brilliant soccer career, but doesn't seem to have any interest in coming out soon. Who knew that my uterus was such a comfortable spot?

Saturday, October 27, 2007

Infertili-time

While most people would have us believe that time marches forward at a steady pace, infertiles know otherwise.

The cyclical ebb and flow of time associated with each cycle of trying to conceive "the old-fashioned way" are familiar to us all, as the days speed by in the exciting peri-ovulatory period (if ovulation occurs at all), and then slow to a glacial pace during the dreaded two-week wait.

For those of us who have upped the ante by adding medications or other interventions to our attempts, time crawls by as we wait to start a cycle, rushes by at the speed of light during the early days of the cycle, and then once again slows to something approaching unbearable as we stare down the barrel of the beta gun, which we know is capable of delivering both unbelievable joy and crushing despair.

When one of us is lucky enough to "win" one of those rounds of Russian roulette, time starts acting up again. The first few days feel like years, as we wait for repeat betas to either confirm our joy or dash our hopes, and then for that first ultrasound, and then for a date, in some cases arbitrarily chosen, and in other cases cruelly established by a history of loss, at which we have promised ourselves to believe that the pregnancy will actually stick.

When that date finally arrives for us lucky ones, most of us still don't really believe, yet time nonetheless speeds up a bit. Several weeks pass in the blink of an eye. All of a sudden you're in the 3rd trimester. Almost there...

Then time stops completely.

And that's where I sit right now. It's not a bad place. It's actually pretty wonderful. I can no longer deny that there is a real live baby inside of me, and that there's every appearance that this baby will be arriving in the next few weeks. I'm not on bed rest. I don't have hyperemesis, gestational diabetes, pre-eclampsia, or any other known pregnancy complications. Eggbert has finally admitted that he/she was just being a drama queen, and doesn't have Down Syndrome OR IUGR. On the whole, all is well. Yet for some reason, days pass like years.

I saw the doctor today, and thus far, my cervix is neither dilated nor effaced at all, and Eggbert is "definitely not engaged". So, I'm on standby. I could go into labor tomorrow, but it could also be another three weeks.

I'm not complaining. I always wanted to carry a child to term. Now I have. It's a glorious thing that I celebrate every day. It's just that now that we're at term, I'm kind of ready to move on to the next life goal, which is the birth itself, and then being a mother. However, my body clearly has its own plans once again. And so once again, I wait.

Saturday, October 20, 2007

Grade A Jumbo Eggbert

I had the growth scan this morning (exactly three weeks after the doctor uttered the dreaded words "growth restriction") and I'm happy to report that all of the eating that I've been doing has not been in vain. I had gained two pounds in the last two weeks, and it turns out that's all Eggbert! The weight estimate has been revised upward from 3 pounds 10 ounces to 5 pounds 12 ounces. Yippee! The Egg is still a little behind, but is growing at a steady clip, and is even catching up a bit with gestational age. I didn't actually see the doctor today, but she instructed the nurse to send me on my merry way until next week. It's looking like I may get to go to term after all. I may just be the happiest mama in the world today.

Monday, October 15, 2007

An open letter

Dear Korean people,

I came to your country about a year ago, and have found it to be for the most part a delightful place. My friends and colleagues here have shown me incredible kindness and loyalty, the dynamic city of Seoul has kept me entertained, fascinated, and amazed with its rich mix of high technology and modern and ancient culture, and the natural beauty of the mountains and forests can take my breath away. So, it is with deep respect and admiration that I offer you the following (admittedly unsolicited, but hopefully not unwelcome) advice.

I read today, not for the first time, that the birth rate in Korea is among the lowest in the world, which is leading to rapid aging of the population, and fears of associated social problems in the years to come. While the reasons for this trend are complex, and cannot be addressed using a quick fix, I nonetheless recommend that if you are interested in increasing the number of women interested in having children in this great nation, you adopt the following policy: stop being so mean to pregnant women.

By mean, I don't mean the alternative (older) definition which is to be stingy or ungenerous. While many people have noted in public communication spaces that the prices of baby-related goods in Korea are absurdly high (to the point at which my Korean birthing class instructor and my Korean OB/GYN both recommended buying such basics as car seats and strollers overseas and bringing them here), I am enough of a believer in the power of the market to rest assured that an entrepreneur will soon notice the opportunities available for the first business to market low-cost, high-quality baby goods here, and solve this problem. Rather I am referring to the everyday practices of jostling and pushing pregnant women, pushing the "close doors" button on the elevator in blissful disregard to the pregnant woman shuffling toward the door as fast as she can on her swollen feet, elbowing pregnant women in the belly to encourage them to take up less space in the elevator, and denying even the most heavily pregnant women seats on the subway.

I know that my descriptions of these behaviors may come as a bit of a surprise to you. Do you really jostle and push pregnant women? Well of course you do. You jostle and push everyone. While I understand that this behavior is considered acceptable (although not necessarily polite), what to a normal person is a slight inconvenience can be a real danger to someone who is suddenly burdened with 10-15 extra kg, has had a dramatic shift in their center of gravity, and has the softening ligaments associated with late pregnancy, throwing their balance off, and rendering their movements distinctly wobbly. Just today, I was knocked over by someone, apparently someone in a hurry, as I walked down the street and fell so hard that I have badly bruised my wrist and shoulder, and skinned my knee. Luckily, I twisted during the fall, and managed to avoid landing on my huge pregnant belly. However, the fall was shocking, painful, and frightening. To add insult to injury, as I lay on the ground gasping for breath, not a single bypasser (and there were many) bothered to check and see if I was OK, or to help me up. Now I'm no expert on human behavior, but I would have thought that seeing an 8-months pregnant woman fall flat on her face should cause witnesses to feel some kind of concern. However, it seemed as if I could die or miscarry right there on the pavement in a busy public place without anyone being much disturbed.

Then there's the subway. Now I know that nobody likes to stand, and that seats are distributed on a first-come first-served basis. However, I noted with admiration on my pre-pregnancy trips on the subway that special seats are designated for the use of the elderly, people with disabilities, and pregnant women. This is a wonderful design feature of the Seoul subway, and one of which the public transit system should be proud. However, it is now apparent to me that many of the people of Seoul are apparently unaware of the purpose of these seats, as just yesterday, I, a hugely pregnant woman, was forced to stand on two separate subway rides while young healthy families sat in the handicapped seats. On the second trip, I tried to gently remind one young family of their civic duty by pointing at the sign indicating that these seats are reserved for the elderly, people with disabilities, and pregnant women, then pointing at my belly, and then pointing at the seat. The family thought that this was a very good opportunity to enjoy a detailed conversation with their young son about the fact that I am this funny shape because there's a baby in my belly while resting comfortably in their seats. Now I'm a big fan of education, and do believe that this was undoubtedly an important and special moment in their parent-child relationship. However, I nonetheless was somewhat disconcerted by their obvious comfort in sharing this happy moment while I stood on my hugely swollen ankles right in front of them, fuming.

Now I know from my interactions with people with whom I am actually acquainted that the Korean people are by nature kind, generous, and loyal. You have much to be proud of in this great nation. Therefore, I am confident that a little more attention to the etiquette of pregnancy will address this problem, leading to positive effects on the feelings of women here about pregnancy and childbirth, and hopefully an improved birth rate.

With respect and friendship,
Sara

Sunday, October 14, 2007

Still at large

According to the non-stress test that I had on Saturday, Eggbert is doing just fine. Two different doctors commented on how active the Egg is (no kidding! last night's kick count broke 200). I was proud, of course, but also a little frightened to think about what that level of energy will mean in a toddler. Anyway, I had been expecting an ultrasound as well, but it turns out that will be next week. Based on my recent weight gain (worthy of Miss Piggy), and the non-stress test, I have been released on my own recognizance. So, unless something exciting happens between now and the ultrasound, it looks like Eggbert will get to stay on the inside at least until 37 weeks. Whew!

Thursday, October 11, 2007

There are worse things than a BFN

I spoke with an old friend this morning. H has featured in my blog before, when she lost her IVF twins at 19 weeks and 20 weeks last spring to an incompetent cervix. This was followed by a life-threatening uterine infection. H has been through a lot.

Since I've been in Korea, we had been in touch every few days or at most every week for a while, when she suddenly went completely silent in late July. I have been worrying a bit, but thought that her silence might just indicate her inability to cope with my ongoing pregnancy in light of her own losses, which would have been completely understandable, so I didn't push. Finally, though, a few days ago I phoned her with a whole speech planned in my head about the fact that I didn't want to talk about me, but just really wanted her to know that I am thinking about her and that I am here for her any time she wants to talk about HER. Well, she wasn't there when I phoned, but then this morning she surprised me with the news that she did another round of IVF in July, and is now 12 1/2 weeks pregnant.

With twins.

Her high-risk OB/GYN estimates that her chances of ending up with living babies is only about 50%, in light of her history of preterm labor and her twin pregnancy.

I just don't know how to react. On the one hand I am ecstatic that she has a shot of having the family of her dreams after so much unhappiness, and I am SO proud of her for not giving up. It took a lot of courage to walk into the RE's office again, and I really admire her for finding it somehow. I congratulated her from the bottom of my heart, as I do feel that every pregnancy for an infertile mom is something to be celebrated.

On the other hand, I simply cannot understand how a medical professional could transfer THREE embryos (two good-quality embryos, one poor) to a patient with a history of cervical incompetence associated with a twin pregnancy. Yes, she had a slightly higher chance of pregnancy with a multi-embryo transfer, but she had a much better chance of actually taking home a living baby with a single embryo transfer. Is the BFP really worth the risk of the loss of TWO more babies?

I am hoping and praying for a good outcome. But I'm also terrified. And angry.

Monday, October 8, 2007

I'm too tired for this post

Well, the good news is that Eggbert's training for the baby Olympics continue. We haven't had a kick count of less than 50 since my last post. I know that this is silly, but it seems that the kicks are reaching higher up under my ribs, too, so I've decided that the Egg is still growing.

The only fly in the ointment is that I'm suddenly so tired that I can barely cope with getting out of bed. I see the doctor again on Saturday, and now I'm actually secretly hoping that she puts me on bed rest. It was my worst nightmare until recently, but at this point, I could really use a good excuse not to haul myself to work every day. Of course it would be better yet if Eggbert got a clean bill of health, and I started feeling better too. Still, at this point, I'm getting quite ready to hunker down and just wait for the big day.

Wednesday, October 3, 2007

Lord of the dance

Thanks so much for the advice, encouragement, and good wishes. I'm trying to just take things as they come and to keep a close eye on Eggbert's movements.

Here are the kick counts for the past three days (one hour each day). My doctor ordered me to go straight to labor and delivery if the count is ever below 3.

Sunday--37
Monday--32
Tuesday--122

Obviously Eggbert hasn't looked at the ultrasound, since his or her preparations for the baby Olympics continue.

Over a hundred kicks/hour. No wonder I can't sleep.

Saturday, September 29, 2007

This I did not expect

Being a sensible, rational person, since getting pregnant I have spent a lot of time worrying about things like the RE having mixed up the embryos, Eggbert being born early because of my being elbowed in the belly by an aggressive middle-aged woman who REALLY wants a subway seat, or Mystery losing Eggbert at the mall. You know, the normal stuff. However, since the karyotype came back normal, and everything was going so well, more recently I've been focusing my attention on irrational worries about the birth instead. It's quite normal to be convinced that the baby is breach and that I'll need a c-section, and that the nurses in the hospital will then mislabel Eggbert, feed him/her so full of formula that breastfeeding is out of the question, and let him/her cry all night long, while giving us someone else's baby. Because that's pretty much standard practice at most hospitals, right?

I have been so busy worrying about things like that that I completely forgot to worry about Eggbert's health for the past few weeks. So, this morning when I went in for my "final" ultrasound before the birth, I was completely focused on whether the head was up or down. I was ecstatic when the tech put the probe on the lowest point of my belly and a little head showed up. I was even more delighted when he found two little feet on the top, two little hands down below, and a butt wedged under my ribs. I floated back down to the doctor on a cloud, only to be told that while Eggbert was measuring pretty much right on date at the 28 week scan, at 33w 4d, Eggbert's abdominal circumference is dating to only 30 weeks. So, in five weeks, my poor little Egg has fallen three weeks behind. The head is still measuring on date, but my doctor is now officially worried. The weight estimate is only 3 pounds 11 ounces, or less than two kg. I have to go back in two weeks for another ultrasound and a non-stress test, and if the results aren't improved, I'll be admitted to the hospital, and Eggbert may have to be delivered early and tiny.

Now I miss my irrational fears.

Saturday, September 22, 2007

Desperado

So are you ready for another "life in Korea" post? Well, ready or not, here it comes. I've added a little pregnancy-related blah-blah in too, just to keep things true to theme.

Living in Korea is good and bad, fun and frustrating, inspiring and annoying. Kind of like life anywhere, I guess. I don't actually know what it's like to live in Korea as a Korean, though, so I really shouldn't make sweeping generalizations. I just know that as an expat I am routinely both delighted and horrified, often within minutes of each other.

One of the great things is how unbelievably kind and supportive my Korean friends and colleagues are. It really does amaze me how many different ways they find to express their concern and consideration for me. I can go to work, or to lunch, or what have you in the foulest of moods, and they never fail to make me feel warm and fuzzy within 10 minutes of my arrival.

One of the bad things is how unbelievably rude (from the perspective of a different culture) strangers are on the street. In the last week, I have been elbowed in the belly (yes, my 7-month-pregnant belly) TWICE in elevators by people who were in such a hurry to get in or out that they couldn't be bothered to notice that there are other people in the world. I also got into a shoving match on the subway with a healthy middle-aged woman who really thought that she deserved a handicapped/elderly/pregnant seat more than I did. There is a queue to get on the subway, and I was ahead of her. She reached out and shoved me out of the way as the train started to move into the station. I thought that maybe she didn't see that I was pregnant, so I just calmly returned to the queue in my original place. Then as the train doors opened, she shoved me again, and ran past me (with the agility of a cat--there is no way this woman was disabled in any way) to grab the last seat. While I was actually only going one stop, and therefore didn't much care about the seat, I made a point of going right up to her, looking into her face with an appalled expression (I can't communicate well in Korean, so I have to pantomime sometimes to get my point across), and then standing up and shoving my belly in her face. To her credit, she was absolutely mortified and then leapt up and offered me her seat. Still, I was annoyed for hours.

That wasn't really what I wanted to tell you about though. I promised a while ago to tell a bit more about my childbirth class, and my feelings about the class are very much tied up with my feelings about living in Korea as an expat. Being foreign, looking different, and not speaking the language isolates Mystery and me in many ways from the main flow of life here in Seoul. Nonetheless, I have assiduously avoided the "expat" scene since I've been here, since I don't like the idea of being one of those people who moves to another country only to surround themselves with people just like those in their place of origin. So, when I walked into the childbirth class for foreigners, it was the first time that I'd been around more than one or two non-Koreans at once in months. To my great surprise, I found the situation absolutely delightful. Not only was it thrilling to be surrounded by other big pregnant bellies and to be able to gush about my pregnancy without worrying about annoying everyone around me, but it was also delightful to be able to do so in fast English, without worrying about my manners. I hadn't realized until that moment how on guard I am every day to try to remember not to make comments about anything Korean that could be construed as negative to my Korean friends and colleagues. Many of these things aren't really negative at all, but I'm always so conscious of being a guest and so concerned about being a good one that I do make strenuous efforts to be polite. In this mixed group (a few Americans, several Germans, a few Koreans that are married to foreigners, a Kiwi, some Brits), I found myself exploding with words that have been kept unsaid for months. A lot of it was just the typical "you have leg cramps? me too!" kind of stuff, but I could also finally actually talk about the subway experience, or how kimchi feels in my heartburn-plagued digestive system (not good), and the difficulties that I've experienced in finding "normal" baby things here without feeling guilty. It was wonderful!

It was also embarrassing. I don't think I drew a breath for up to 15 minutes at a time because I was so anxious to release some of this impacted commentary. I also very much liked everyone there (fertile and oblivious though they were), so I was fairly frantic to make enough of a connection that it wouldn't be weird to invite them to lunch or whatever after the class was over. I was aware the whole time that I probably was coming off as desperate for companionship, but just couldn't stop myself.

Luckily, they were all quite kind, and tolerant of my irrational exuberance. I think I may have found some mommy friends in Korea at long last. Now if I can just manage to let them get a word in edgewise, I'll be in business.

Sunday, September 16, 2007

Language again

Thanks so much for all of the helpful hints about strollers and preparations for the big event. Thanks especially to M-B for devoting a whole post to helping me out. You're the best! Mystery and I do LOVE the Xplory, especially the idea of having the baby up high, but they're over $1000 in Seoul, and that's just for the basic one without any of the fun accessories. If we decide to go for it, then we'll probably just buy it on our next trip to the US, which is scheduled for about 6 weeks after Eggbert is due. Is that completely insane?

In other news, yesterday I learned an important life lesson. As it turns out, it is not a good idea to let someone with whom you can't communicate at all cut your hair. My Korean really hasn't progressed much (or to be honest, at all) since I became pregnant, and as a result, I didn't have the vocabulary to truly describe what I wanted to the pleasant-faced woman holding the scissors in the salon yesterday. I thought that gestures should suffice, but as it turns out, either a) I'm not very good at charades, or b) she was annoyed and decided to punish me, because my head now looks very much like a Christmas tree. A big, frizzy Christmas tree. Not quite what I was hoping for.

On a happier note, I saw the doctor yesterday, and everything was fine. Eggbert's heart is still beating, my belly is the right size, my weight gain is right on target (her target, not mine, I didn't really want to gain those extra three pounds since three weeks ago), and my bp is still normal. I go back in two weeks for the FINAL ultrasound.

Tuesday, September 11, 2007

Still infertile after all this time

While I realize that this would be impossible to tell from my posting rate, the last week or so has been a whirlwind of activity here in la Casa de Eggbert. Mystery and I had a childbirth/baby care class three times last week, and while it was great fun, it also kicked my well-padded ass energy-wise. I'll post about the class itself another day (too many stories, too little time). In the mean time, I want to talk about infertility.

For the past few months, I'd been feeling a little post-infertility. I don't mean that I was suffering from amnesia, or anything as sinister as that. I will never forget where we've been, and will never stop caring about my infertile sisters and brothers and their struggles. I just meant that I have been in a phase of excited anticipation, rather than one of sadness and fear. Oh I still have fears, I fear that Eggbert will come too early, that Eggbert will spontaneously die for no good reason, that I'll be such a basket case of a neurotic mother that Eggbert ends up hating me, that Mystery will be so relaxed as a dad that he accidentally sets Eggbert on fire. You know, the normal stuff. However, I have now started to believe more and more firmly that there will actually be a baby in my life in a few months: two months and two days, plus or minus a week, to be precise. I even ordered a crib yesterday. An actual crib. Sleeping spot for an actual baby. Pretty much useless for anything else. So, I wasn't really in an infertility head-space, so to speak.

Then I went to childbirth class. The instructor was a mother of four, who clearly gets pregnant at the drop of a hat, as she regaled us with tales about how her last was an "oops". I was surrounded by big bellies and glowing faces. I heard crack after crack about how sex during pregnancy is fine, because "how do you think the baby got there in the first place"? I thought about raising my hand and saying "with the help of a team of crack embryologists and a big syringe", but thought the best of it. Had there been an opening, I suppose I should have spoken up. Part of me wishes I had spoken up. The other part reminds me that this falls squarely into the "too much information" category as an announcement to a group of complete strangers. So I just sat there and squirmed. It didn't help when the instructor went on at great length about how breastfeeding makes you more fertile (?!?), and the importance of using contraception while breastfeeding. Or when the other students started talking about what month would be best to conceive #2. For the first time in a good long while, I felt thoroughly infertile.

Being a pregnant infertile isn't a bad thing. It beats the hell out of being a non-pregnant infertile, that's for sure. I'm mostly very happy and at peace with my situation. However, it is still jarring to be reminded of how little the "normal" population understands about how infertility, and how off their radar we infertiles really are.

I've also (stop reading here if you don't want to hear something that sounds so ungrateful that it may make you want to club me over the head) found my mind wandering to a very wistful place whenever the topic of shopping for baby crops up (which happens a lot). My decisions about how much to spend and what to buy are constantly affected by the twin realities that a) We're unlikely to be lucky enough to have a #2, and b) We probably won't live in Korea forever. So, every object that I buy is likely to be used for only one child, and then will have to be a) given away or sold in Korea, or b) shipped overseas. So, rather than buying the perfect crib (I found it, for the low low price of only ~900 USD), I bought an adequate crib (~120 USD), and rather than buying a changing table, we're going to make do with whatever surfaces present themselves. As for a cute dresser for baby stuff? Well, how about a set of plastic drawers from the Korean equivalent of Wal-Mart instead? I realize that none of this stuff really matters. All that I really care about is a healthy baby. Still, I feel like I'm missing out on yet another one of those little joys of first-time parenthood. Each time these thoughts pop into my head, I can't help but spend a moment wallowing in the thought that this is likely to be the first and the last time that I ever get to experience pregnancy. That makes me sad. Still, I am so grateful to have had the experience once. It is enough. It may have to be.

We ARE going to buy a good stroller, though, dammit! Recommendations are very welcome.

Sunday, September 2, 2007

Eggbert's new game

Last night, Eggbert discovered a new fun thing to kick. It's firm and round and full of pee (even 30 seconds after the last time I peed). Like a rubber ball. For added enjoyment, it makes me jump and squeal every time he kicks it. Fun for the whole family.

Friday, August 31, 2007

Confessions of a beached whale

You know how once you get a new life experience, you sometimes realize what an asshole you've been all of your life? What, that doesn't happen to you? Well, erm, that's embarrassing then.

When it comes to most things relating to fertility and reproduction, I think I've always been on solid ground. I am positive that I never in my pre-infertility life told anyone infertile to "just adopt", and I know for sure that I have ALWAYS given my subway seat to pregnant women, and insisted that they go ahead of me in the bathroom line. However, I actually only recently realized that saying "you're huge!" to a pregnant woman isn't the heart and soul of courtesy. I am fairly certain that I have enthusiastically gushed about the tremendous size of the bellies of several of my pregnant friends in the past, and now consider myself fortunate that nobody ever actually slapped me upside the head. I meant it in the nicest possible way, I swear. I LOVE big pregnant bellies, and think they're gorgeous, so it never really occurred to me that people might not like having theirs pointed out. It wasn't until a pregnant friend complained to me about people saying that she was huge that I realized that this comment could possibly be interpreted in a different way. Sometimes I'm a little slow.

The other day, Nina's post in which she discussed her feelings about being called "fatty" because of her pregnant belly, made me think about how my feelings about this issue have and have not changed with my own pregnancy. Here's what I came up with:

Being a bit hormonal, I am even more mortified than ever that my comments might have made my gorgeous friends feel anything less than wonderful about themselves and their bodies at a time when they may have been feeling fragile. On the other hand, I don't mind a bit if people point out that I am huge. You know why? Because I AM huge. Enormous. Gargantuan. I can't believe that I'm already this big at not-quite 30 weeks. Having an enormous belly does create many logistical and emotional issues. I can't sleep, it's hard to negotiate small spaces, and hauling this thing around is no picnic either. I'm also worried about stretch marks, sagging muscles, etc. However, when people comment on my size, I nonetheless take it as a compliment. Because I'm not fat, I'm pregnant, dammit, and I refuse to conflate the two in my mind. Mystery has no such compunction, and has taken to calling me a name that translates roughly to "fatty" as a pet name. I suppose that I should be offended, but really I'm not. It actually annoys me more when people say "you're not that big", because given how supersized I actually am, it's obvious that they're lying, which makes it clear that THEY think that being huge is a bad thing. I'd rather that people just said "you're huge, and so cute!" That way I can at least pretend that they're being honest in both parts of the sentence.

Maybe one of the reason that being pregnant doesn't make me feel fat relates to my prepregnancy body shape. I've always been a curvy girl. I have big round boobs, have until recently had a small waist, and then a big old butt. I've described it as a J Lo ass in previous posts, but to be honest, my ass looks like it ate J Lo for lunch. It's not a fat thing, it's just the way I am. Losing weight doesn't help. Surprisingly enough, men seem to love it, but the fashion industry does not. I've always had trouble finding trousers that have enough space for my arse, but have a small enough waist that you can't look straight down the back. For the last few years, with the "low rise" trend, it's been even worse. Pants that look great from the front don't have enough fabric to make it all the way around the curve in the back, leaving several inches of crack flapping in the breeze. So, while I have plenty of body issues, my body issues don't relate to my belly.

Being pregnant has made only three discernible changes to my body shape. First, my boobs got bigger. Then my belly got huge. Now I am sporting a rather impressive set of cankles. Well, I could do without the cankles, but two out of three ain't bad. My butt actually looks small now, in comparison with Mt. Eggbert in the front, and maternity pants fit great! So, while I realize that I'm likely to start puffing up in strange places in the next 10 weeks, I'm actually pretty happy with the way that I look right now, at least above the knee (and below the neck--am I the only one with pregnancy-related frizz issues?)

Still, I'll never call another pregnant woman huge again. Even though I embrace the term, I do feel like an idiot for missing the boat on this issue for so many years.

In other news, I'm still having heartburn, and I never sleep anymore, but otherwise, I'm doing well. I am beginning to realize that the last trimester is going to be a bit of an uphill slog as my weight increases and basic functions become more difficult, but still think that so far I've been pretty lucky. Last week I asked my doctor how long she'd let me go if Eggbert is overdue, and she said only 1 week, so at the MOST I have only 11 weeks and four days to go. Hopefully my luck can hold out for that long.

Sunday, August 26, 2007

10 weeks later

Tuesday will be the 10-week anniversary of my amniocentesis, which was done reluctantly, after a "positive" quad screen for Down Syndrome. One would think that after 10 weeks, I would have formulated some coherent emotional/intellectual response to the events surrounding the amnio, and some conclusions about screening in general, but honestly, I'm just as confused about it as I was during that scary time. I've sat down to try to process and summarize my thoughts and feelings several times, but every time I ended up walking away. Well, with the 10-week mark approaching, it seems like it really is time to clear my head, so hear goes.

I'm normally an information girl. Inquiring minds want to know, and all that. So, upon becoming pregnant at age 38, you would think that I would naturally have signed up for every kind of screening possible. However, after almost three years of infertility, I was not only reluctant to take any chances whatsoever with this precious pregnancy, but also, to be honest, I was reluctant to even think about the possibility that something could be wrong with little Eggbert. So, while my doctor, citing my 1 in 200 risk of chromosomal abnormalities, recommended amniocentesis at 16 weeks, I declined. I did, however, let her do the quad screen, which involved a nuchal fold translucency screening at 12 weeks coupled with a set of three blood tests at 15-16 weeks. Denial being my friend, I never seriously considered the possibility that the result might be "positive". But then it was, predicting an estimated risk of 1 in 35 of Down Syndrome.

That positive screening result turned my world upside down. While before I actually did the test, odds like 1 in 35 didn't sound too alarming to me. I had been very comfortable with my age-based risk of 1 in 200 (a result already scoring as "positive" on most screening tests), and even at 1 in 35, that means 34 times out of 35, all will be well, right? Well, while that is technically true, there is another factor involved in estimating the psychological impact of a risk estimate. When reacting emotionally to risk, I find that there are two factors that matter to me: the probability that something will happen, and then the suck factor--how much it will suck if it does happen. So, a risk of 1 in 35 of rain tomorrow doesn't cause me to bat an eye, whereas a risk of 1 in 35 that I will drop dead tomorrow would cause me become hysterical. It drives Mystery crazy that I freak out if he e.g. goes clambering around on coastal rocks like a mountain goat, displaying his natural athleticism and incredible sense of balance to all within visual range, because even though I realize that the odds that he will fall are low, the suck factor involved in watching my love plunge to his death would be enormous. The thing that I hadn't really thought through about screening was that a chromosomal abnormality diagnosis comes with a huge suck factor. Yes, children with chromosomal abnormalities can go on to have wonderful lives in some cases, but nonetheless, hearing that there might be something wrong with your beloved child is not something that's easy to take in stride.

It was hard. I freaked out. I cried. I despaired. I whined and pouted. I decided to have the amnio after all, not so much because it would affect the outcome of the pregnancy, but because I couldn't go on another 21 weeks in that mental state. I needed to know, and I needed to know RIGHT THEN. So, I had the amnio, and after several stressful days, I found out that Eggbert has the right number of chromosomes. We were in the 34 out of 35 category. That was a tremendous relief. Words can't even really describe the feeling. Honestly, it was kind of like getting the positive beta result--one of those days that changes your life. Still, it didn't change my life back to quite what it was before. One of the things that I realized during my fit of self-pity was that there's nothing special about me or Mystery that should make us exempt from the normal and abnormal stresses of parenthood. Infertility not only doesn't buy you a free pass from miscarriage (as we all know, many from bitter experience) or stress during pregnancy, but it also doesn't exempt your kids from the risk of disease, injury, death, or bad hair days. There is actually no reason to think that I "deserve" a kid with DS any less than anyone else. It was a sobering thought.

But back to my real focus here--having been one of the many "false positives" resulting from a quad screen or triple screen test, and as a result having suffered profound stress and worry unnecessarily, how do I now feel about screening in general?

I really don't know. I don't even know what I'd do if I were lucky to become pregnant again in the future.

From a logical perspective, the argument for doing the quad screen is unassailable. Crunching the numbers makes that clear. The risk of miscarriage from amniocentesis, if it is done between 16 and 20 weeks by an experienced practitioner at a high-quality facility is estimated at around 1 in 1600. The risk of a chromosomal abnormality is about 1 in 200 for a woman my age. The risk of doing no screening is that you will be blindsided on your child's birthday by a diagnosis that not only changes your life forever, but also may require immediate and effective intervention you your part to advocate for the best interests of your child. The risk of a "false positive" is about 5%. So, if you take a group of 1600 women like me, and

They all do amniocentesis right away, then on average:

1591 will receive a clean bill of health
8 will receive an early diagnosis of a chromosomal problem, and
1 healthy fetus will die.

If, on the other hand, they all do the quad screen first, then on average:

1520 will receive a clean bill of health
80 will get a positive screening result

If the women with "negative" results then refuse amnio, and the women with "positive" results all have amnio, then on average:

1592 will receive a clean bill of health
1-2 will receive a clean bill of health, but will then be blindsided with a chromosomally abnormal child on the birth day
6-7 will receive an early diagnosis of a chromosomal problem
0 healthy fetuses will die

So, if the choices are screening and going directly to amnio, from the perspective of the baby's health, the choice is clear to me. Both procedures will diagnose almost all cases of chromosomal abnormalities, but by choosing to do the quad screen first, the overall risk to the group of 1600 women of an amniocentesis-induced miscarriage is reduced to a negligible level. If I was a doctor, I'd recommend that my patients have the quad screen, based on these numbers. However, these calculations overlook two things:

First, once you actually GET that positive quad screen, your risk of miscarriage from amnio is still 1 in 1600, so given the outcome, you are still facing a difficult choice

Second, getting the positive screen is tremendously stressful.

How do you quantify the cost of that stress? I don't have any idea. Is it actually worth it? I don't know. What would I do if the situation came up again? I have no idea.

I did leave out one of the options. It's only fair to consider them all.

If nobody does any testing:

1582 will have chromosomally normal kids
8 will be blindsided with a chromosomally abnormal child on the birth day

Is that better? Is that worse? After 10 weeks, I still have no idea.

I do think that if the amnio result HAD shown a chromosomal abnormality, I'd be glad that I did the tests. But of course there's really no way of knowing.

I do know that I am beyond grateful for the fact that my little Eggbert has the right number of chromosomes. I realize that doesn't guarantee health or happiness, but I'll take it.

Tuesday, August 21, 2007

Mind your manners

Many years ago, I took an intensive language course in preparation for a study abroad program. The course was great, in that it tried to prepare us not only for the linguistic challenges that we would face, but also for the cultural issues that would almost certainly arise. Going into the course, I had fancied myself a sophisticated world traveler, and therefore not in need of a lesson on cultural differences, so I wasn't entirely receptive to this message at first. However, I was struck by a metaphor that the instructor used. She described a situation in which you visit a culture in which the standard polite greeting is to spit in your face upon meeting. Since you KNOW this about the culture before you go there, the first time it happens, you're started, and perhaps a little disgusted, but not annoyed. The second time, you're less startled, still disgusted, and moderately amused. After the 10th time, though, it's just about impossible not to become annoyed. The intellect can only overcome one's own cultural baggage to some extent, and beyond that, it's just about impossible not to have an emotional reaction to behavior that is considered unacceptable in your own culture, even when you KNOW that no offense is intended.

I've found that indeed, in every country where I've spent a sufficient period of time, there is some habit or custom that I find difficult to accept. Well, after 11 months in Korea, I am now fairly certain that I have identified my Korea-specific Achilles heel. You see, I don't like to be pushed.

I don't mean metaphorically pushed. I mean physically pushed, either by a hard jostle with the shoulder, or by actually having someone reach out their hand to push me. Koreans are lovely people when you know them, but apparently it is 100% acceptable to push a stranger who is in your way, even if you can see with your own eyes that that person doesn't actually have a choice about being there. Impatient to get off of a crowded train? No worries, just push the person in front of you until they slam into the person in front of them. It won't get you out any faster, but it'll make you feel better. Are you having trouble negotiating your shopping cart through a crowd? Just slam it up against the legs of the person in front of you. Sure, they're stuck too, so the only result is to make them yelp with pain, but hey, wasn't that more amusing than just standing there waiting? What if the person in your way is elderly, disabled, a small child, or a pregnant woman? No worries. This is a democracy. What if they're not in your way at all? Oh heck, push them anyway.

At first, I interpreted the pushing as subtle expressions of anti-foreign sentiment. I do stick out like a sore thumb here, so I assumed that the pushing was related to my appearance. However, the more I looked around, I realized that everybody pushes everyone else, and nobody seems to get mad, or even to notice.

This is hard for me. Americans are particularly orotective of their personal space (ask any European, Asian, or African), and in that way, I'm typically American. I don't even like being crowded, and having a stranger make avoidable physical contact for no reason feels like an act of aggression. I have been particularly sensitive to this since I've been visibly pregnant. It is just very hard for me to understand how someone could really think it's OK to push a pregnant woman when she's not in the line of gunfire or something. I'm trying to learn to cope with it, but it's hard.

Being hugely pregnant actually raises lots of issues about manners and etiquette, no matter where you are in the world. Should people let you ahead in bathroom lines? Should you be annoyed if they don't? Should people give you a seat on the bus/train? Do they? Does it bother you?

Since I've been showing, I've spent time in three countries: Indonesia, Singapore, and Korea. Here is the score:

Long bathroom lines encountered:

Indonesia: ~100
Singapore: ~10
Korea: ~100

Times someone has offered to let me go ahead:

Indonesia: 0
Singapore: 0
Korea: 0

Rides on trains/subways when empty seats were not available:

Indonesia: ~10
Singapore: ~10
Korea: ~10

Times someone offered me their seat:

Indonesia: 1 (an old man who was then immediately given a seat by a young healthy man, who had been ignoring me)
Singapore: 0
Korea: 4 (but that number includes 2 Americans)

Unimpressive, all around.

In Korea there are specially designated seats on the subway for people who are "elderly, disabled, or pregnant" (that's what the sign says), and generally, people that don't "qualify" don't sit there, even if there are many empty "special" seats, no needy people, and the rest of the train is full. However, people from the "normal" seats pretty much never give up their seats. So, it's all about rules, not about the "honor system". I suppose that's fair enough. However, the "honor system" IS used by people deciding whether they qualify for the "special" seats. When do you become elderly? Well, according to my own observations, some people seem to become elderly at age 50. Then, once sitting, people in the "special" seats don't seem to give them up, even to someone who fairly clearly needs them more. I have actually only seen a sitting passenger get up from a "special" seat once, and that was when I got up from a "special" seat, because there was a very old woman with a cane standing. Apparently this shamed the healthy 50-year-old man next to me to the point at which he then offered me his seat. Does that count? I don't know.

What's it like where you live? Do people give up their seats for pregnant women? Do you?

Friday, August 17, 2007

The third trimester

I really don't know how this happened, but somehow I've found myself in the third trimester. It's become clear to me that pregnancy has its own time frame, which is completely different from every other kind of time that I've ever experienced. TTC time feels like dog years. Each month seems to take almost a year off of your life. Before TTC, a month took about a month, more or less. But in pregna-world, a month seems to take about five minutes.

Don't misunderstand me, they are an action-packed five minutes. I laughed, I cried. In the last month, I've experienced constipation, anemia, hypoglycemia, diarrhea, bizarre navel pains, a level of sweating that MUST put Seoul in danger of flooding, and many other strange symptoms. Still, pregnancy III, The Belly Strikes Back, has somehow snuck up on me. So far it's kind of like pregnancy II, but with hem*orrhhoids.

On the one hand, I'm thrilled. Somewhere along the way, I've started to believe that there might actually be a baby at the end of all of this. On the other hand, the fact that my due date is now less than three months away forces me to start actually preparing for the arrival of this so-far fictitious baby, which freaks me out. We now have baby clothes in the house. And bottles. Ack! We almost bought diapers the other day, but at the last minute we choked. As for the big-ticket items, well, it turns out that Korea had another trick up its sleeve for us. We have now spent three straight weekends shopping, and STILL haven't found a single crib for sale. Or a decent stroller for under $1000. Or for that matter, a Baby Bj*orn or a onesie. If I don't find where these items are kept, I may be forced to draw the conclusions that Korean parents keep their babies at home and naked until they can walk. Surely there must be another explanation, something that involves mandatory cosleeping, a preference for separate pants and little tops, and a belief that strollers are foreign luxury items, rather than basic necessities. Still, it's pretty alarming. We can always buy the Bj*orn on line, and we plan to visit the US while I'm on maternity leave, so we can wait and buy the stroller then. The crib issue is a more vexing problem, though. While I love the idea of cosleeping, the reality is that both Mystery and I are terrible flailers. We regularly whack each other upside the head in our sleep. Somehow I just don't think this is the ideal sleeping environment for a newborn.

A newborn. Holy cow. If everything goes well (please let it go well!) Eggbert will be a newborn in only three months.

Saturday, August 11, 2007

News from the world

M-B was induced yesterday, three weeks early, after a very difficult pregnancy. Please go visit and wish her luck with the delivery and with her new baby SON.

Friday, August 10, 2007

Things that end in -emia

Hi all,

I would have posted more in the last week, but honestly, I've been too damn tired. Ever since I got back to Korea, my energy has been ebbing dramatically from day to day until as of Monday, I could barely crawl out of bed. I was just starting to think "this is not normal" when an email from my doctor arrived, informing me that I got an F- on my last hemoglobin test, and tanked the glucose tolerance test too. No, I don't have gestational diabetes, it seem to be rather the opposite. My blood sugar wasn't too high, but rather too low. After extensive consultation with Dr. Google, I came to the conclusion that this probably just means that I need to eat more often, and avoid sugary foods. My doctor, though, had different ideas, and made me repeat the glucose tolerance test. Have I mentioned that the syrup that they made me drink is unspeakably vile? Well, if not, it is, and it didn't get any better the second time. Luckily, I managed to register as alive the second time through, so I managed to skate with a heavy-duty iron supplement (for the anemia), and advice to eat more often (for the hypoglycemia). After only two days of iron, I'm already feeling better, so hopefully I'll be back to something approximating normal soon (well, whatever version of normal has a belly the size of Texas, anyway).

In other news, my belly button is KILLING me. Seriously. I had never imagined that a belly button could be so painful before, but mine is incredibly sore. Is this a normal part of the process whereby an "innie" becomes an "outie"?

Friday, August 3, 2007

25w3d

I can't believe that I'm almost at the six-month point. I never thought I'd get here. I've had six months to get used to the idea, but I'm still sometimes astonished when I look down and see my belly. Then I think "where are my feet? I thought I had feet?"

The lovely M-B asked if I knew the sex. The answer is no. My doctor(s) know the sex, but I have asked them not to tell me. Why? I can think of a few different answers, but I really don't know which one is the true motivation. It seems to change from day to day. Really the bottom line is that waiting to find out feels right for me and Mystery. If it stops feeling right, then we'll call the doctor and find out.

Reasons, in no particular order:

-To keep from getting flooded with pink or blue gifts (yes, I do realize that this means that we'll get green and yellow instead...)

-To keep from projecting a personality onto Eggbert before we even meet. Let's face it, some girls hate pink, and some boys love dolls, but it can be very difficult not to project one's own expectations about sex/gender-appropriate behavior onto a child. De-emphasizing the sex in our own minds at this point is one way for us to practice being open-minded about the little person that we hope to welcome in November.

-To avoid disappointment, part I. I don't think that either of us has a strong preference, but that may just be denial speaking. I can't imagine feeling anything but joy on the actual birth day, whereas finding out now, before we have an actual baby to hold, opens us up to the possibility of disappointment.

-To avoid disappointment, part II. Right now, I am very much enjoying both boy fantasies and girl fantasies. Since I don't know Eggbert's sex, the world is my oyster. I can dream about whatever I want. I think that finding out now would expose me to a sense of loss, since it would render half of my fantasies infeasible. At least on the birthday, I'll have a baby to console me.

-To do at least one thing the "old-fashioned" way. Given the years of infertility, the multiple interventions, the high-tech conception, and the intensive monitoring associated with this pregnancy, I'm enjoying the fact that there is still a little mystery left in the process.

I totally get why other people want to find out. I always thought I'd want to find out too. I can see a huge number of arguments for finding out. In the end, though, it doesn't make any difference to the baby, so there's not any "right" or "wrong" thing to do. For us, this decision feels good, and in the end, this decision IS all about what we want. So why did you decide to find out or not?

Tuesday, July 31, 2007

Indonesia in a nutshell

I arrived back in Korea on Saturday. It's good to be home.

Having been a very bad poster for two months, I feel like I owe my blog some sort of cathartic summary of the missing time, in which I laugh, cry, and possibly even hurl. Unfortunately, though, I'm far too lazy, and life moves too fast, so you'll have to make due with a random series of impressions of my time spent in Indonesia.


Indonesia would be a VERY bad place to be infertile.


Everybody asks about children all of the time. Children are a big deal in Indonesia, and are considered to be a standard part of marriage. Generally the very first question that people asked upon meeting me was "how many children do you have?" As it was, I could smile and say "I'm working on the first one now", but if that last IVF had been BFN, it would have been difficult to avoid tears when it happened for the 10th time in a single day. I can't imagine what it would like to live or visit there while still in the infertility trenches. I heard from others that if you just say "not yet", the follow-up question is usually "why not?", which would make things about a million times worse.

There are children EVERYWHERE. The current fertility rate is only ~2.4 children/woman of childbearing age, but as recently as 1990, it was 3.3, and in 1980 it was 4.6. Lots of families contain 4-10 kids. Kids are also a very big part of public life. It is widely assumed that people will enjoy interaction with other people's children, so children are not discouraged from approaching strangers, or making a spectacle of themselves in public. I actually did an informal survey in a big grocery store, and found that of the estimated 300 women in the building, only one was neither pregnant, nor accompanied by at least one child.

Indonesian children are beautiful. Now I think that all mothers think that their kids are beautiful, but Indonesian kids are particularly stunning. Looking at some of them practically makes my uterus ache.

Indonesia is full of neglected and unwanted kids. I frequently saw tiny kids (some as young as 3-4) begging on the streets at night, or approaching cars on busy streets, singing while soliciting "donations". The number of these "street kids" in Indonesia is staggering, especially in urban areas. Some live with their poor, often homeless, parents, while abandoned, orphaned, or runaway kids are often exploited by older kids or adults. It's absolutely heartbreaking. There are also orphanages everywhere. I asked people about the culture of adoption, and apparently it's very rare in Indonesia. Only infertile couples usually adopt, and then they often seek to adopt a blood relative, rather than seeking a child needing parents. To make things even sadder, it's VERY difficult for foreigners to adopt Indonesian kids. I looked into it, and the requirements are prohibitive for all but the most dedicated potential parent (perspective adoptive parents must live in Indonesia for at least two years before they can adopt an Indonesian child).


Indonesia is a good place to be pregnant


When they found out that I was pregnant, everyone that I met was obviously, exuberantly happy. I was invariably treated like gold after sharing the big news, even by people who had been rude or disinterested before they knew. On day 3 of my visit, the woman that was waxing my legs (unrelated aside-I have been a hairy mama since I've been pregnant, and my belly is making it increasingly hard to cope with all of the undergrowth), upon realizing that I was pregnant, felt my belly, pronounced that it felt "healthy" and "hard", showed me her stretch marks, enthusiastically held forth on the benefits of a vaginal vs. c-section birth, and then called in all of the other employees of the beauty salon to share my good news. (Another unrelated aside-the fact that on my way out, she slapped my ass and told me that I was sexy may or may not have had anything to do with my pregnancy, but definitely scored her a big tip).

Indonesia is also a bad place to be pregnant

I think that all Y-bearing fetuses in Indonesia are issued with their first pack of cigarettes while still in utero, and they spend their first 9 months longing for a little air so they can start smoking. Not only does the whole country smell of clove cigarettes and durian (see below), but men enthusiastically smoke while sitting at their desks in public offices right underneath prominent "no smoking" signs. They also feel absolutely free to light up in small enclosed spaces, public buses, and restaurants, and while holding small children, or sitting right next to women in the advanced stages of pregnancy. I felt like I should wear a gas mask the whole time I was there.

Indonesia is also very smelly. Some of the smells are good, some are bad, and some are simply horrifying. I have always had a very sharp sense of smell, and pregnancy has made it even sharper. So, I was constantly being assaulted by a wide array of challenging aromas. Thank goodness I was mostly over the morning sickness before I got there.

Indonesian roads are very bad. Not only are they badly paved and windy, but the drivers tend to be very aggressive. So, the net effect is that being in a car involves constant lurching around, trying not to fall out of your seat, scream, or cry, as the driver dodges chickens, children, and oncoming traffic. The fact that taxis tend not to have seat belts makes this even more fun. Good times, good times.

Indonesian food is very spicy and greasy. I suffered from hideous heartburn most of the time I was there. Now that I'm back in Korea, my symptoms have miraculously been reduced by at least 50%. I'm positive that the change is all due to the change in diet. It was hard to find foods that were both nutritious and safe (sanitation is a real issue there). In the last five weeks that I was there, I didn't manage to gain any weight at all.

Squat toilets are very hard to use when your belly gets big. I spoke with several pregnant Indonesian women about this, and am now fairly certain that this problem is not restricted to clumsy foreigners.

The quality of medical care in Indonesia is decidedly questionable. I knew this before I went, but was still shocked with the vehemence with which my (Indonesian) doctor insisted that I travel to Singapore for the amniocentesis.

Indonesia is beautiful

This one has been done to death, but bears repeating. There is just about nothing in the world more beautiful than a tropical rain forest, and forests try to grow anywhere there is a gap in the pavement in the tropics. The sheer exuberance of nature in Indonesia is breathtaking to behold, and really did my heart good. There are also spectacular volcanoes, beaches, mountains, palaces, and temples. Indonesian arts (especially dance and visual arts) are also amazing. There's really something for everyone. What a fantastic place for a vacation (but NOT a fertility-related vacation).

Indonesian people are absolutely lovely

Not only are the kids good looking, but they grow up into incredibly friendly, fun-loving adults. Smiles are everywhere, and there seems to be a song in every heart. It truly is a special place.

Friday, July 20, 2007

Still alive

I can't believe that it's been almost a month since my last post. It's not my fault, I swear! I haven't had internet access for almost three weeks. THREE WEEKS! That's kind of like not having chocolate, or air, for three weeks. It's amazing that I survived. It'll take me weeks to recover from the trauma.

Anyway, I'm now back in the land of the wired, and have so many things that I've been dying to post about. It'll probably take me weeks to catch up. I thought I'd just start with a quick pregnancy/health update, though. Thanks for the sweet comments checking on me, and I'm sorry to have worried you with the long silence.

Long story short, all is well with my pregnancy and everything else. I've just been in a very remote area, and while we were supposed to have a satellite internet connection, it failed, so I've been stuck with no means of communication. Thankfully, though, I'm now back in Jakarta, and will be heading back to Seoul in a week, so that won't be happening again.

Pregnancy-wise, the main news is that I am now officially huge. I think that the technical term for my size is "ginormous". It is now obvious to the most casual observer that I'm pregnant, and several people have commented that they can't believe that I'm only five months along. (Can you believe that I'm five months along? Time really flies). Eggbert is clearly planning to become either a soccer star or the next Lord of the Dance. The kicks are now clearly visible from the outside, which is great fun for both me and Mystery. So far I've been spared a lot of the aches and pains that so many pregnant women suffer (knock on wood!) However, I have made an amazing discovery that will forever change my perception of human digestion. Are you ready?

Heartburn really hurts.

I know, I know. It's fairly trite, but for me, this is big news. Before last month, I had never experienced heartburn, and I am ashamed to admit that I had absolutely no idea what heartburn sufferers go through. I suppose that the endless commercials for heartburn remedies on American TV should really have clued me in to the fact that this is a major problem for many people (and thus a major market), but somehow I missed the boat. I had always thought that it would feel like some minor irritation in the belly. If I had known that it was like having molten lava poured into your chest, I would undoubtedly have been much more sympathetic to sufferers for the past 38 years. I apologize to all of the chronic heartburn sufferers of the world for my shameful ignorance.

A recent scientific study suggested that the old wives' tale about heartburn during pregnancy may actually be correct (I'll try to find the link and post it soon). Apparently, if the mother has severe heartburn, the baby is much more likely to be born with a lot of hair.

I must be pregnant with a baby gorilla.

Monday, June 25, 2007

Good news!

According to the preliminary amnio results, Eggbert is chromosomally normal.

Words can’t describe how relieved we are. This experience has affected me profoundly, and I think I’ll still be processing it for a while. I had been thinking that once I got the results I would write a post about what I now think about prenatal screening, but honestly I’m still not sure. If the results had been positive for Downs, then as devastating as the news would have been, I think that I would have been grateful for the opportunity to find out early. I can imagine that being stunned with news like that on your baby’s birthday must be even harder than hearing it a few months in advance. However, given that I seem to have been yet another “false positive” (a status that I am THRILLED to have, given the alternative), I am forced to ask myself whether it was all worth it. I’m going to have to think about that, and get back to you.

Meanwhile, let me thank all of my friends in the computer for your unfailing support. I really don’t know how I would have survived all of this without you. While you’re here, please pop over and give Mony a little support. She's going through the same thing.

Saturday, June 23, 2007

No news is good news, right?

I was supposed to get the preliminary results yesterday. I checked my email at 1 pm (Singapore time), right before I boarded the plane to Jakarta. No message from my doctor. I figured that he would send it out at the end of the day. Well, as it turns out, I figured wrong. There was still no message this morning, and his office is closed, so I can't contact him until Monday.

Could he have forgotten? About me? Surely I'm a bit more memorable than THAT!

So here I am, still waiting. (Note to self--next time phone doctor on day that results are due.)

Wednesday, June 20, 2007

In Singapore

First order of business- thanks so much for all of the supportive comments. It really means the world to me at a time when I'm feeling quite down.

So, I'm in Singapore now. I arrived late Saturday night, so that I'd have a day to get oriented before my 9 am appointment on Monday. Sunday night I had what I thought was a lovely Indian meal. About three hours later, I was face down over the toilet. I managed to stop vomiting a few hours before my appointment, so I dragged myself there anyway. The doctor was very kind, and tried to schedule a level II ultrasound immediately. Unfortunately, the hospital apparently has a hard and fast rule about not doing level II ultrasound before 20 weeks, and I was only 18w6d on Monday, so there was simply no way to get it done this week. He could get me in for an amnio the next day, though (as a favor, he normally only does amnio on Monday mornings, but since I was in from out of town, and fairly frantic, he managed to schedule me in for the next day before his first appointment). The nice thing about the behavior of the folks at the hospital here was that they were all very calm and reassuring. When they spoke of the risks of amnio, they invariably said "but this won't happen to you", which of course they can't guarantee, but was what I really wanted to hear anyway. They quoted me risks of 3 in 1000 of miscarrying as a result of the procedure. Of course we all know that we can be (and sometimes are) on the wrong end of the odds, but somehow that number sounded much better than the numbers ringing through my head, so I went ahead and scheduled the appointment. Then I went back to the hotel and vomited some more. And had explosive diarrhea. About a thousand times. Charming.

Tuesday morning I showed up bright and early for the amnio. Before the amnio, they did a "quick scan". Now I don't know if quick means something different in Singapore, or if they were just doing me a favor, since they wouldn't let me do the level II, but the scan took about 1/2 hour, and they looked at every little bit of Eggbert's body (have I mentioned that the little one finally has a temporary name?) I saw two little hands, two little feet, lots of details of the brain, four chambers of the heart, two kidneys, a perfect little spine, etc. The tech took about a million measurements, and then said that everything looked great. Whew!

Then I was called for the amnio itself. They popped me up onto a table, did another quick ultrasound just to find the baby, and then swabbed my belly with antiseptic. They didn't bother with anaesthetic, since they said that the anaesthetic hurts as much as the procedure itself. I was skeptical, but honestly, it was true. The needle going in was somewhat worse than a suprefact injection, but infinitely better than a PIO shot. Really not bad, and very quick. The only freaky thing was seeing them pull about a liter of fluid out. Well, they said it was 20 cc's, but those were 20 of the biggest cc's that I've ever seen. It was over in about 20 seconds. They made me sit for about 20 minutes before sending me home, and then instructed me to report to the ER if I had any issues at all (fluid leakage, bleeding, pain, contractions, fever). That was it. I should get preliminary results on Friday.

So, then I went home for more vomiting and diarrhea. Good times, good times. Did I mention that I foolishly told Mystery Man that he needn't come with me? Of course he SHOULD have insisted, but then again, so should I. I always think that I'm tough, but then once I've committed to a course of action discover that actually, a little help would have been very nice. So, it's been kind of a crappy (literally) few days.

The good news is that as of last night, I am no longer extruding foulness from every orifice. I've managed to keep some food down, and Eggbert is wriggling vigorously, which leads me to believe that he's none the worse for wear. Whew!

I'm scheduled to fly back to Jakarta on Friday. The doctor said that should be fine, but to take it easy for a few more days after I arrive. No worries there! The very thought of exerting any effort toward anything strikes me as fairly ludicrous at the moment. I plan to have Mystery carry me around on a litter for the next four months.

Thursday, June 14, 2007

35

My doctor in Korea emailed me back. My risk of Down Syndrome was estimated at 1:35. How sad is it that I was happy with those numbers? It was 1:200 based on just my age. Still, that means that in 34 out of 35 cases, the baby won't have DS.

Is it too much to hope that I'll be on the right end of the odds this time?

The other shoe

Well, I've got to say I didn't see this one coming. Lately I've been ridiculously happy. Like Watson, I've been worried about becoming a painfully boring blogger because really how many times do you want to hear about sunshine and fairy tales and how grand life is? It's nice the first time, but after a while, it does get monotonous. Still, I was having trouble coming up with anything else to say or think, other than "yay"! Yesterday, I sent my best friend an email that included the text "this is the happiest I've ever been in my life". Two minutes later, I opened the next email, which was from my doctor, and found out that the quad screen produced a "positive" result for Down Syndrome.

I know I know. The quad screen is just that. A screening test, with a high rate of false positives. I knew that before I took the test. Still, that didn't stop me from crying all night after getting the results. It didn't help that the doctor didn't include anything specific (or helpful) like actual test results or a risk estimate. I'm a numbers person, dammit! What is she trying to do to me? She just said that I should have amniocentesis, and that there was a high false positive rate, especially for women over 35.

I don't want to have amnio. I really don't. However, I also don't want to worry for five months, or to get bad news on my baby's birthday. I really can't imagine terminating the pregnancy no matter what the result. I'm already far too in love with this baby. However, when I consider my life objectively, I do have to admit that a little advance warning of the birth of a disabled child would be helpful. Let's look at the facts:

1) I live in Korea
2) I don't speak Korean
3) My husband also doesn't speak Korean
4) I have very few choices regarding medical care, given that I am limited to English-speaking doctors
5) I have a job that requires frequent international travel, often to remote areas
6) I live thousands of miles away from my family and closest friends.

When I crunch those numbers, I realize that if we are going to have a child with Downs, then we should probably plan to move back to the USA asap, which means looking for new jobs for both of us (and a career change for me), figuring out where we'll live, etc. These are probably not steps that I should be postponing until I'm recovering from a birth, the shock of discovering that the positive wasn't false, and possibly dealing with the baby blues, all while living far away from most of my loved ones.

So, I guess I'm going to have the amnio. Since I'm in Indonesia right now, and the quality of medical care here is, quite frankly, rather sketchy, this means that I'm going to need to fly to Singapore in the next couple of days to have a big needle stuck in my belly.

I'm terrified. Mainly terrified of miscarriage, but also terrified of the results.

(I appreciate supportive comments, but please don't tell me stories about how delightful Down Syndrome kids can be. My next door neighbor growing up had a little girl with Down Syndrome. She was sweet and precious, and the light of her mother's life. I know how special these children are. However, I really don't think that anybody would actually WANT their child to have a major disability, so while I can imagine much worse things, I'm not quite ready to celebrate hearing that my child may have massive life-long medical problems.)

Saturday, June 9, 2007

I still think it's snide

One of my all-time least favorite habits of smug fertiles has always been comments like "when you're a mother, you'll understand", or "you can't imagine until you have children..." I always felt that this was self-congratulatory and dismissive. While relatively inoffensive when the context is things like breast infections, episiotomies, or cracked nipples, I find these comments outrageous when the topic is something like how much you love your children, or how awful it would be to lose a child. I always thought that being infertile didn't in any way negate my ability to imagine the love of a parent for a child. In fact, I thought that being infertile in a sense made me even more sensitive to this issue, as infertiles have to deal with ongoing grief for children never even conceived, which is surely a pretty strong manifestation of mother love. However, I also wondered, somewhere deep down in myself, if there was something to what they were saying.

A few days ago, I felt fetal movement for the first time. I have been dreaming of this moment for years, and now it's finally here. I can actually feel the presence of my child inside of me. It's absolutely amazing. Incredible. Words fail me.

For some reason, this experience made me think about whether pregnancy so far has proven the smug fertiles right. The answer, so far, is no. Pregnancy is amazing. As I always thought it would be. Feeling those movements gives me a feeling of happiness and fulfillment that I've never felt before. As I always knew it would. Yes, the feelings are intense. But I always knew that they would be. Imagining these things does feel different from experiencing them, in the same way that looking at a photo of the Great Wall of China, or the Pyramids of Giza, or sunrise over an African savannah, is not the same thing as actually being there. However, I still think it's insulting to someone who hasn't had the privelage of seeing these places to say "you can't imagine" to them. I think that many people can imagine the feeling quite clearly. That's why they want to experience it! In fact (stretching the travel metaphor so far that I'm cringing while waiting for it to snap), I think that someone who has never had the good fortune to go down certain roads might actually much better appreciate them than a world-weary seasoned traveller.

I do agree that many things (infertility, the loss of a loved one) are actually unimaginable to those who have never experienced them. In fact, human imagination often proves a particularly poor predictor of our actual reactions to stressful events. Indeed, in my pregnancy, there have been a lot of surprises along the way. I didn't expect, for example, the constipation, the problems produced by spectacularly enhanced cleavage, or the strangeness of having life go on as normal around me while my own attention is so completely focused a few inches below my navel. I also didn't expect the constant fear of loss. Still, the overall feeling is exactly as I'd always hoped and imagined. I guess that years of not only dreaming of this moment, but also watching my friends experience it, has created relatively realistic expectations of the whole thing.

Still, I do admit that nothing could have prepared me for my ultrasound the other day. I saw a perfectly shaped little head (measuring a week ahead!), a spine like a little string of jewels. A little human being.