…at least not ours.
The phrase that make up the title and subtitle of this post is one of my mother’s favorites, and I have been reminded of it many times recently. As such, I’m going to leave those of you waiting in anticipation for part 2 of my parenting post hanging a bit longer. Fair warning, for those of you who have experienced pregnancy loss or infertility, the content may be emotionally triggering.
This latest post has been a bit delayed for several reasons, not the least of which was preparation for my Child & Adolescent Psychiatry Board Exam that I took last week. For those of you who are not in medicine, board exams are the standardized tests physicians take to demonstrate they have acquired sufficient knowledge to be deemed specialists in a given area of medicine. Think of them like final exams on steroids, lasting anywhere from 6 hrs to 2 days. In some specialties, they include oral exams. To even be eligible to take a board exam, you have to have completed residency (or fellowship which comes after residency) training in that specialty area, which is 3 to 7 years of training AFTER your four years of medical school. This was my third and (hopefully) final board exam. Yes, this means I spent WAY too long in school/training.
Anyway, I digress. Back to the topic of life not going according to plan…
For starters, in my master plan, this board exam “should” have been last year. In fact, all of my board exams “should” have been a year earlier.
I have a wonderful husband whom I married at the end of my intern year. I have always wanted children, and knowing family members who struggled with infertility, I worried about waiting too long. Even though medical training is challenging, I did not want to risk waiting until it was over to have a family. Halfway through residency, my husband and I decided we were ready and easily got pregnant. I couldn’t believe it as it seemed too good to be true. The timing was perfect: a spring baby to avoid respiratory viral season (these are the things you think about as a pediatrician); 6 months postpartum when the first board exam would be scheduled. A few weeks later, we found out his brother and sister-in-law were also expecting their first, due within a week of us! For the next six, glorious weeks, things couldn’t have been more perfect; then, the perfect plan began to crumble.
It began with a nagging feeling I couldn’t shake that something wasn’t right. Then, my morning sickness suddenly disappeared. Everyone tried to reassure me I should be grateful. We had an ultrasound confirming a heartbeat just before 7 weeks. I was at 10 or 11 weeks, which was when many women begin to feel better. Statistically speaking, they were absolutely right, but I just couldn’t shake my intuitive sense that there was a problem. Then, just shy of 12 weeks, my fears were confirmed and we found out I had lost the baby just days after that initial ultrasound. For some reason, though, my body had not shown even a hint of spotting despite being 5 weeks out from losing the pregnancy. This was the first in a seemingly endless stream of betrayals by my body over the next 4 years.
Devastated doesn’t even begin to describe how I felt during that time as I watched my sister-in-law’s pregnancy progress, marking each milestone of my failed one. I experienced postpartum depression, which affects 1 in 10 women who experience a miscarriage, and ended up taking a few months off from my residency to heal.
Again, though, I was fortunate- I had a supportive program director who had recently been through pregnancy herself, FMLA to protect my job and policies in place that allowed trainees to continue receiving pay during medical leave, a neighbor who had experienced loss of a pregnancy while her sister was pregnant to help support me and access to great medical and mental health care. This is critical as data suggest that almost half of women who experience pregnancy loss will suffer from symptoms of depression, anxiety, PTSD or OCD afterward. For those of us in the medical field, this carries extra weight as we are at higher risk of depression than the general public to begin with and data suggest may be up to twice as likely to experience pregnancy loss.
Fortunately, my husband and I were able to conceive again very quickly, had just passed the 12-week mark with multiple ultrasounds confirming heartbeats when our beautiful niece was born and had a healthy baby boy six months after our original due date- though he had the audacity to be born the one week out of the year that the American Board of Pediatrics offers their board exam. Needless to say, all of this set me back a year in my pursuit of board certification.
If you read my first post, you know that my son’s delivery also did not go according to plan and was really complicated. I required surgical intervention to stop a massive postpartum hemorrhage (i.e. excessive bleeding) and got converted to general anesthesia during my c-section so my son’s first meal was formula and I didn’t get to hold him until 6 hours after he was born, even though he was perfectly healthy. I was told if I ever decided to have more children, I should only have scheduled c-sections as the likelihood of a successful natural delivery was very low (my son was only 7 pounds and he was definitely NOT going to fit). For the minimal intervention, “I will be exclusively breastfeeding, thank you” pediatrician, this was the exact opposite of everything I wanted. As someone so used to success and achieving the goals I set for myself, being so utterly unable to control what seem like basic, evolutionarily based functions of my female body was incapacitating.
I’ve only recently begun to realize just how traumatic it was for me, having used my “skill” of emotional detachment (which one often hones through medical training) for the first two years anytime I re-told my story. It was as though I was presenting a patient case as opposed to one of the worst experiences of my life; in psychological terms, one might call this dissociation. However, part of healing means learning to re-integrate one’s trauma so that the trauma(s) and emotions are no longer in the driver’s seat. The crummy part of this is, for a period of time at least, it can feel like the mute button no longer works but the volume knob is stuck on max.
In the midst of working through our trauma in the hopes of expanding our family, life took yet another unexpected turn. This time, a pregnancy did not happen quickly. Over the last year, we have been dealing with what is known as secondary infertility. Secondary infertility occurs when a couple or individual has been able to have a child/children previously, but then is unable to conceive. In our case, we eventually determined the culprit was scarring from the life saving interventions required during my son’s delivery. And while they were able to release the scar tissue and modern medicine could boast a relatively likelihood of subsequent pregnancy, it came at a cost- up to 25% chance of a condition that would result in a c-section hysterectomy at 34-35 weeks if it occurred and couldn’t be diagnosed for certain until after 20 weeks. In other words, a delivery worse than the original one whose trauma we were still working through. Add to that talking to a colleague who personally knew two people who had died from this pregnancy complication and I knew I just could not justify the risk. I came to this conclusion during my yoga practice one evening and I spent the entirety of savasana overcome with sobbing.
Logically, the change in plans made sense. I have a beautiful boy, wonderful husband, thriving career. There are other ways to expand a family, and only children are also wonderful and becoming more common (I also happen to be one along with several of my best friends and I’d like to think we turned out alright). Emotionally, though, it was another devastating blow. I had difficulty reviewing cases at work because it was too painful to be confronted with how unfair life can be (I provide consultation for the foster system). At times I was ( and occasionally still am) paralyzed with grief. Being around pregnant women is not exactly my favorite thing these days. But I also know that without the storm, there is no rainbow.
So for now, it’s back to the drawing board and, in the meantime, I’ll be sure to enjoy plenty of snuggles from my awesome little boy who just climbed up next to me on the couch. š
Unarmed Mama, MD 