Tag Archives: motherhood

What to Expect When You’re Not Expecting

I lost another embryo. This one was a girl. The only girl. Now there is only one embryo left. We learned about the loss on February 28, so it has been about six weeks. Once again there was crushing grief, but this time it came with a couple of new elements. The first is that the possibility of having a daughter is likely gone. The second is that now, even if our last embryo makes it, he will be alone. An only child is never what we pictured. The grief is compounding, and my faith that I will have any children at all is dwindling.

When we lost our last embryo, the first boy, I don’t think we took enough time to cycle through all the phases of grief. After the first loss we learned that about 30% of women have a different implantation window than the majority of women. We underwent a test cycle to find out if I was one of those women. The test cycle involves taking all the same drugs: daily Lupron injections (small needle) for several weeks followed by daily progesterone injections (giant needles to the upper hip that my husband I have affectionately dubbed “murder needles”) for a week. After the hormonal prep, instead of doing an embryo transfer they do a biopsy of the uterine lining. My results were that I am (of course) one of the 30% if women with a different implantation window. Also, I had a bacterial imbalance and some new polyps. Awesome. I had to take antibiotics for a couple of weeks and then had an in-office procedure to remove the polyps (I was on valium, but awake. I do not recommend).

Once that was all done, it was time to try transfer number two, our girl. The transfer went smoothly. I didn’t think much during the two-week wait. My perspective was that worrying about it or thinking about it wouldn’t change the outcome. When I learned that I wasn’t pregnant, I did go to blaming my stress levels and my weight. My job can be super stressful and was particularly so during January and February this year. Also, I am overweight, and being on hormones for most of two years certainly hasn’t helped. I look pregnant even though I’m not.

When I had my post-failure consult with my doctor, she assured me that stress doesn’t have as big of an impact on pregnancy success as people think it does, and that if it did nobody would every have babies because all modern women are stressed out. That was reassuring. She also said that, contrary to popular belief, caffeine doesn’t make much difference, either (I had given it up anyway, other than the odd square of dark chocolate). She said that she wouldn’t consider my weight to be a big factor, but it is the only medically significant issue that I have some control over. If I want to try losing some weight, it might help, but the bottom line is that I am very healthy by all markers, including the ones that may typically make weight an issue (blood pressure, cholesterol, diabetes). In other words, there are no known health indicators for why my embryos haven’t implanted.

When we lost our first embryo, we went right into a test cycle, and I think that kept us busy enough to defer some of our grief. With the second embryo, we are taking a break from everything. No drugs of any kind, including birth control. I want to give my body a chance to stabilize, and give my heart a break, too. One of the results of taking some time is that I have made it to the anger stage of grief. I think I am beginning to see what’s on the other side of it, which might be hope. But for now, I am still pretty pissed off by how unfair this all is; that I can’t have the most natural thing in the world. That I have been through so much emotional and physical and financial turmoil for nothing. That I have to grin and bear it while people say well-meaning stupid shit to me about what I’ve been through. That others can’t bear to face it and prefer not to acknowledge what’s been happening. That I still have to go to work and pretend I’m fine. That somehow, I still have to actually be fine because there’s no shared language, no social conventions, for infertility or pregnancy loss. There is no other choice but to be O.K.

We’re going to take a break at least until the end of summer. I will try to lose some weight…maybe it will be easier once all the drugs are out of my body. It takes awhile to get them out – I can still feel some bumpiness and tenderness from the progesterone in oil. I will try to remember who I am. I will go to a lot of concerts and spend a lot of time outdoors and with friends. I will take walks. I will read books. I will listen to music and try to patch my heart back together. I will try to take care of myself, and in the fall, I will try one last time to physically be a mother.

Loss and Recovery

My first embryo transfer didn’t take. After a million shots, two egg retrievals, three fibroid surgeries and one transfer, I am not pregnant. It was a boy and he didn’t stay with me. I learned on October 1 that the pregnancy test was negative. Then the ground fell out from under me for a couple of weeks.

That first weekend there was wailing. Sounds came out of me that I didn’t know I could make. There was grief that I haven’t felt before in my life. That embryo had become a child in my mind, and I didn’t even know that had happened until he was gone. I thought that I was internally preparing myself for the possibility that the transfer wouldn’t work, but I was surprised. Shocked. I didn’t realize how certain I had been that everything would work out and that I would be birthing all three embryos that I have. He was a person to me, and his loss was crushing; despite having never met him; despite the distance I thought I was keeping. Now there are just two left.

That first weekend there was also writhing. There was moving the grief through our bodies (my husband was there, too). There was fatigue. And then there was numbing. In the following days and weeks, after each wave of grief receded, we called people to let them know that this part of the story was over. We had decided from the beginning to be open about our IVF process. It involved so much time away from people that we felt it would be hard to hide it. Also, we hoped for support. We got it, too – so much true empathy and so many people rooting for us. We had to let them know what had happened. Some sent us food and cards and texts and other comforts, and several of them cried with us. We are so grateful for that.

We have also absorbed a lot of passive judgment. We have people in our lives who don’t believe in fertility treatment, because they think pregnancy is God’s will (casually implying that I don’t have children because God doesn’t want me to have them). Related to “god’s will” are a healthy portion of people who respond with platitudes along the lines of “everything happens for a reason.” There are some people that respond with advice (as if they had been through this when they haven’t). Then there are a few “manifestors” (people who believe their thoughts can literally impact physical reality, ie. magical thinkers) who can’t accept that this is all happening to us for no reason, and that sometimes, most times, terrible things are just random. I understand that those responses are coping mechanisms. It’s a defense against feeling one’s own feelings, or engaging with someone else’s feelings, or acknowledging that the world, the universe, is not actually under anyone’s control. If things can happen to others for no reason, then they can happen to you, too.

I do understand now that the responses people have to our situation are usually more about them than they are about me. I know that people aren’t conscious of what is in the blank spaces of what they’re saying, and they don’t mean to be hurtful. They don’t realize that to me these statements sound like “you are not enough. You are not doing enough. You are not trying hard enough. You don’t deserve.” I get it, but it can be difficult for me to get past that, especially since I already feel so alone in this experience and am already very challenged not to believe those things myself. I am trying my best not to take it personally.

In the meantime, I am rebuilding my reserves of resilience and self-love for the next round. I have a new working model for what faith might look like to me going forward: things don’t happen for a reason, but we are responsible for giving them meaning. I could assign a self-critical reason for why I lost the first baby and beat the shit out of myself to “fix it.” Instead, I choose to give him meaning as part of my story and reaching, with loving kindness, for motherhood and the life I want.

Fertility Warrior

It has been one year, one month, and fourteen days since I learned that my infertility treatment was going to be longer and more difficult than I expected. One pandemic, two egg retrievals, three surgeries, and a shitload of hormones later, I finally arrived at embryo transfer day. Last Tuesday, hopefully, at age 42, I finally became a mother. After waiting for so long it seems completely surreal, and after so many steps and distractions, it is also getting real.

In the spirit of self-preservation, I have had to take the whole fertility process one step at a time. I have had to focus on each day of drugs, each ultrasound, each surgery, each recovery as singular events to get through them without losing it. Meanwhile, I’ve had people reaching out to me about taking their baby hand-me-downs and a lot of well-meaning certainty from family members that this transfer is going to be successful. I would have loved to get excited, but I have been navigating the steps with a walled-off heart thanks to a long, difficult path (including the 10+ years before going to an infertility clinic) and some early disappointment.  However, even in my current state of spiritual ambiguity, I can still acknowledge that closing your heart to pain also closes it to joy. So, for the last two weeks I have been slowly lowering the drawbridge on the possibility of joy.

One of the things to unfold this week is an examination of how I actually felt about the big day finally being here. I have been so process-oriented since my disappointing first egg retrieval that I actually didn’t know. I know I have vaguely judged myself for not being more obsessed with the outcome of the process. So many women that I see on fertility online groups and message boards, fertility warriors as they sometimes call themselvs, are absolutely humming with baby fervor. Every waking moment appears to be full of nothing but baby and fertility obsession. That has not been my experience. I have rarely thought about the outcome of all of this. I haven’t gotten bent out of shape or all hyped up about every appointment and every step. I haven’t had much impulse to photo-document (there has been some, which maybe I will share some day). It’s basically just been a thing I’ve been doing. I have wondered at times if that meant that I didn’t want it as much as I used to; didn’t want it as much as my fellow fertility warriors. I might not know how bad I still want this if it hadn’t been for the sharp grief after every setback and the fact that I kept going, despite how hard it’s been.

Now that I’m on the other side of the hardest physical parts (I can’t say I’m past the hardest emotional parts yet), I know that some of my passiveness has been about self-protection, some has been about experience, and some might just have to do with my age. I think that the self-protection piece is pretty self-explanatory: if you don’t put a lot of energy into it it’s less likely to disappoint you. In terms of experience, I was a woo-woo girl. I have learned the hard way, and the intellectual way, that obsessing and desperation don’t actually change outcomes. Spending every waking minute thinking about whether or not I’m going to have a baby is not going to manifest a baby. It’s just going to stress me out and give me anxiety. Consciously trying to manifest a baby with my thoughts isn’t going magically bring a baby into being, and actually sets me up to blame myself for things that I can’t control (ie., no baby for any number of physical reasons).

Finally, I am 42. My clock stopped ticking awhile ago. When I was in my late-twenties to mid-thirties I was baby crazy, just like all the ladies that I see online. I won’t pretend to understand the hormonal motivators behind some of that (though I know there are some). But I do understand that you can’t maintain that level of highly emotional obsession forever without crashing. I was baby crazy for about 8 years, and here’s what the crash looks like for me: acceptance. At some point in my late thirties I began to accept that it might never happen for me. I was able to start picturing a life where I didn’t have children, and I had some time to come to terms with the fact that if it didn’t happen, I would be O.K. That doesn’t mean that my heart doesn’t crack open and make me cry every single time I think about actually having and holding a baby of my own. It doesn’t diminish my “fertility warrior” status.  

Now that I potentially have a little passenger, I am in the much-dreaded two week wait, when it is so easy to spin out. My dreams of having a baby feel so close, and I am trying to balance letting my heart open a bit more while still having reasonable expectations. Journaling, time with girlfriends, self-care, (mostly) good food, distraction, and A LOT of sleep are in order. And maybe some prayers and positive visualization…what can it hurt? There are no atheists in foxholes.

Third Time’s a Charm

As I mentioned in Empowered, on May 12 I had a second myomectomy surgery to remove more of the giant fibroid that has been keeping me from becoming a mother. Unfortunately, the surgeons were still unable to get all of it out safely in the second sitting. Not only was it large and connected to my uterine wall in multiple places, but it was also hard and vascularized, and difficult to cut. They had to end the procedure for my safety, to keep me from filling up with water like I did during the first surgery. On June 2 I had my third and final procedure. My surgeon and I agreed that the third surgery had to be the last, so I signed a consent for them to go in laparoscopically through my abdomen if they couldn’t complete the procedure hysteroscopically. The surgeon told me that he has done thousands of these procedures and that I was his most difficult case. What a way to be special, right?

Thankfully, I woke up without any stitches on the outside of my body. The team was able to finally end this period of surgical limbo that has seemed to drag on forever without cutting me. The head surgeon told my husband that they were so excited that there was a celebratory cheer in the operating room when the last chunk of tumor came out. After the second surgery I cried (along with the nurse and the resident) because I had to have a third surgery, and I felt like the trauma would never end. After the third surgery I cried because I was so filled with gratitude and relief.

In the interim between the second and third surgeries, I can say that I still didn’t slip into self-pity or full melancholy. However, I did feel a bit dead inside; so I can’t really say I wasn’t depressed. A malaise set in, and I didn’t know to where or what I could turn for support. My relationship with any version of God is tenuous at best right now. I lost all my new-agey “woo” beliefs between going through IVF and listening to a whole lot of Conspirituality Podcast. I was sensing that the people in my life were hitting a point where they didn’t know how to respond to my continued surgical adventures, and I felt like I was no longer connecting with the therapist I had been seeing for the last year and a half. I also couldn’t go to my old unhealthy coping mechanisms like smoking and drinking, because obviously physical health is paramount when trying to have a baby.  When it felt like there was no direction to go with my emotions, I guess I just checked out and went into autopilot to get through the surgeries. Let’s just say there has been a lot of TV watching and overdoing it at my day job.

Now that the surgeries are done, some of the malaise has lifted, and I recognize that I need to reestablish some habits that will help me stay embodied and grounded through the next part of the process (implantation). A big lesson that I’ve learned this year is that part of being the hero of my own story is being willing to practice. It is understanding that ease will never come without the sometimes un-fun but necessary daily habits: Do the yoga practice. Take the walk.  Write for an hour. Show up for yourself. It’s not something that comes easily to me – I am a master at being “busy” as a form of distraction and overperforming as a means to feel in control. Practice without knowing where it is going is patience embodied (a.k.a., a big challenge).

Here, finally at the end of Phase 2 of my fertility prescription, I still feel strong. I still feel proud of what I have done and what I have made it through already on the road to becoming a mother. This summer I will focus on practice, not only for myself and my own wellbeing, but also because I would love to be able to model showing up for oneself for my children, once they are here.

Empowered

The fact that I happen to be heading towards becoming a mother at the same time that I’m having a mid-life reckoning is super-fun. Now I’m not only trying to birth an actual child, but also all of the other things that I want to birth in my life, like essays and books and articles and a daily and more robust yoga practice. The fact that I am picking up a dropped thread with most of those things can feel an awful lot like failure or hopelessness. For a long time, it was my habit to lean into my feelings of failure and wrap myself in “poor me” mentality. It can feel good to feel bad. It can make you feel justified about making unhealthy indulgences and wasting time. I always had magical thinking to fall back on; I was sure that if I just did enough visualization and ritual everything would work out.

Back in January when I lost my magical thinking security blanket, I began a spiritual crisis. The crisis is largely around redefining my idea of God and my relationship with whatever that is, and my current spirituality is still an ungrounded mess that is just beginning to get sorted. However, one of the unexpected gifts of “losing my religion” around manifestation is that I’m no longer falling into the “poor me” hole so often. Magical thinking not only puts the blame on individuals for things outside of their control, but it also depends on some ambiguous thing outside of oneself to do the heavy lifting of dream-making. It can distract and detract from the personal work and changes in behavior that need to take place to actually make things happen. Though magical thinking gave me an illusion of control, losing it has made me feel more empowered.

Two weeks ago I had surgery to remove the giant fibroid that had made me unable to carry a baby. Once the surgeons were in my uterus, they were able to see that it was even larger and more complex than they were able to see on the MRI. The method of this particular surgery can cause a patient’s organs to take on water if it lasts too long. My fibroid is so large that they had to end the surgery before they removed it all because my lungs were beginning to take on water. Waking up coughing in the recovery room was scary, and I had to unexpectedly spend the night at the hospital so my oxygen levels could be monitored. I will now need to have another round of the same surgery in a couple weeks to remove the rest of it. A year ago this would have all sent me into a self-pity downward spiral. Honestly, I think this one would have been justified. I wouldn’t blame anyone for feeling sorry for themself after all the shots and the four surgeries it’s requiring for me to do a perfectly normal, natural, basic thing like have a baby. Weirdly, I don’t feel sorry for myself.

I have always wanted to be a mother. It is one of my dreams for my life.  Thanks to medical science, pregnancy is a possibility for me when it would have been impossible otherwise. The same benevolent mother nature to whom my woo woo crunchy granola self had capitulated turned out to be the thief of my dream thanks to her giant fibroid. I understand that I am blessed to have the resources and technology at my disposal to choose this process, and that this process is a privilege. However, I am also choosing the hard thing. The painful thing. The very expensive thing. I am not giving up. I am doing everything it takes for me to become a mother. Even when some might argue that maybe God or the “universe” didn’t want me to. And that makes me feel powerful. That makes me feel like a badass. That makes me feel like a true creator of my own life. Now I sincerely know my own power to make my dreams happen.

Mama is a Realist

I think that the events of the last year have definitely accelerated the mid-life crisis I was already beginning to experience in late 2019.  I thought of it as a mid-life crisis at that point, anyway. ‘Crisis’ implies fast movement or the need for immediate reaction. I’m beginning to look at it more as a reckoning. Changes are happening, but much slower than in a crisis.

I have learned that a major element of mid-life reckoning is grieving what didn’t happen. Sometimes that has to do with personal choices or things that you can still do something about (ie. writing that novel…or buying a Ferrari). Sometimes it’s just that life is nothing like how you pictured it or dreamed it and you just need to mourn the loss and move on.  In my case, specific to trying to have a family, a major elimination has happened in both what I perceived as normal and in what my dreams were for the processes of being pregnant and giving birth. When I got married at age 28, I assumed that I would be pregnant within a couple of years. I assumed that we would conceive easily, and that trying would be this lovely time of connection between my husband and me.  I pictured my pregnancy as young and glowing and full of love and life. That’s just the way things go, right? I was also very into all things natural and holistic, and envisioned myself doing a lot of prenatal yoga and working with midwives and giving birth without the aid of drugs in a kiddie pool in my living room. My visions of raising my kids were similar to how I was raised: by younger people who were learning the world along with me. I was picturing myself as a different type of mother than I will likely be.

The reality is that I’m at an age where my body hurts in the morning just from sleeping, without carrying another human. I look like I’m 41. I have some collagen loss in my face. I already have a mom-bod without having actually given birth. I do not look 28, I do not have the energy of a 28-year-old, and I never will again; pregnant or not. The probability of radiant mama vibes during my pregnancy seems pretty low. Obviously, with IVF there is also absolutely nothing even remotely natural about the process of conception thus far. Every single thing has involved scientific intervention. Our one tiny nod to leaving anything to chance is to implant the embryos in the order that they were created. I’ve already had to make my brother (aka future “fun” uncle) promise that he won’t call my children test-tube babies to their faces. Because I am older and will need to have surgery via my uterus to make this pregnancy happen, there is a high likelihood that I will need to give birth via C-section. There is still some hope for delivering naturally, but I am high-risk so it will definitely be in a hospital with an ObGyn (and hopefully a midwife, too!).

My idealistic vision of early motherhood literally can’t happen. There was a time, a pretty long time, when I was angry, resentful, and so unbelievably sad about that. I was self-soothing with negative emotions, which is O.K. for awhile, but eventually it becomes a trap. Once I identified what was happening as grief, I could choose to actively engage with it. Then I could realize that internally fighting things that I can’t change leads to misery and inability to appreciate what is. I won’t be the mother I thought I would be. Instead, I will be a mother who has gone through some shit and now has the wisdom to better discern what’s important. I now know that, even when things are hard and messy, I can let go of what isn’t, be present to whatever reality motherhood presents, and love it anyway.

Fertility

My particular pandemic pain point has been the pursuit of motherhood. Motherhood, or lack thereof, has been the most painful element of my life for 13 years. I am a person who has never questioned whether or not I want to be a mother. I have always wanted it. When I was young it was completely a matter of course that I would have children. No question about it. I went off birth control when I got married in 2007. When I was 28. And then…nothing. For 13 years I have lived in this painful limbo, with the last year being the most excruciating in some ways.

Throughout the entirety of my 30’s I was holding my breath, waiting for the pregnancy that never happened. I watched as friends had babies, and then watched as those babies grew into children and those friends grew into parents. I also watched myself disappear into my grief about it. It felt like all of my dreams and inspiration for what I wanted my life to be died along with the dream of being a mother, like all potential for who I could have been faded away. I gained a bunch of weight and became prematurely middle-aged by age 33. I vanished into the idea of being a total failure. I was too depressed and hopeless to pull myself out of it in terms of focusing my life on something else, and my husband and I couldn’t afford fertility treatment or adoption. I basically lost a full decade of my life to despair and hopelessness.

Sometime around age 38 the fog began to lift a bit. I did yoga teacher training, went to Thailand, finished my Thai Yoga Bodywork certificate. I began to resurface, to find myself again. The other thing that happened was that my husband’s career took off, and mine did, too. We were finally making pretty good money. The year I was 39 we bought a house in the city. The year I was 40 we started pursuing fertility treatments. That was a year ago, one month prior to pandemic lock-downs beginning in the U.S. We had a plan in place to start towards intra-uterine insemination (IUI) in March. Then the fertility clinic was shut down due to COVID-19. It was July before we could get back on track with the plan. I’m not going to lie; I did a lot of drinking during that four-month period.

 In late July 2020 I started taking the hormones for IUI. I went in for a baseline ultrasound and found out that, though my hormone panels were perfect and I have a freakish number of eggs for my age, my uterus looks like a war zone. I have giant fibroids, polyps, and a huge cyst on my right ovary. After confirming all of the above with a sonohysterogram (super pleasant procedure), the clinic pronounced me no longer a candidate for IUI. If I wanted to proceed with trying to have a baby, I would need to do In Vitro Fertilization (IVF). For me that would involve retrieving my eggs, making embryos, having them tested, freezing the viable ones, having surgery to clean up my uterus, letting my uterus heal for at least three months, and then putting the embryos in one by one until one of them takes.

Now, in February 2021, I am healing from my second egg retrieval, which happened last week. In the first egg retrieval, out of 33 eggs (a freakishly high number for a person of any age), 20 were mature and 16 fertilized. Eight embryos developed enough for genetic testing and only one of those did not have a chromosomal issue that would cause miscarriage (the doctor assured me that it was entirely due to age and not anything I had done or not done). We decided that the entire weight of our parenthood dreams was an awful lot of pressure to put on one little embryo, so we went for a second round. In round two we got 30 eggs, 24 were mature and 20 fertilized. Twelve developed enough to be tested. Next week we will find out how many were viable. Regardless of how many that is, we will not be doing any more egg retrievals.

The next steps for me are an MRI and a consult with the surgeon who will be fixing my uterus. That is in early March; a full year after lock-downs began. For me, as for many others, it has been a year of waiting. A deeper pressing of pain points. A development of patience. And maybe, hopefully, dreamfully, optimistically, a time of incubation.