Our Preterm Labor Story - Baby Born at 21 Weeks

*Warning, this post deals with pregnancy loss*

I’'ve hesitated to write about this because pregnancy loss is a hard subject, but I haven't found many stories similar to mine, so if writing it out helps one person searching for information, then this will be worth it.

Last I wrote on this blog, I had an early miscarriage after trying for two years to have a second child. My husband and I had decided that we were content with being a family of three with our son, and that our TTC journey was over.

Fast forward to March 7, 2019 and I find myself unexpectedly pregnant. My RE had told us that we had a 1% chance of conceiving naturally, so finding out that I was pregnant was the surprise of a lifetime. Because my tubes are so damaged, I was immediately concerned about an ectopic pregnancy. My OB wouldn't see me until I was 10 weeks along, but they were willing to do a beta, which came back at 115, but they wouldn't do a repeat beta. Thankfully my RE is amazing and was willing to have me come in around 5 weeks for an ultrasound. At 5 weeks we saw the start of a gestational sac in my uterus, and nothing wrong with my ovaries or tubes. At 6 weeks we saw one baby with a heartbeat. 7 week ultrasound looked good as well, and I got released from my RE. Thursday, April 25 I had my first OB appointment at 11 weeks. Baby was measuring right on track and both of us were doing great.

I had another OB appointment at 15 weeks where the ultrasound tech guessed that baby was a girl. At that appointment I was referred to a maternal fetal medicine doctor because of a concern my OB had, but everything looked great at the MFM appointment, and baby was confirmed to be a girl.

June 26 I had my 20 week ultrasound and an early gestational diabetes test (I had gestational diabetes with my son, so we wanted to catch it early this time around if I was going to have it again.) Baby girl looked wonderful, cervix looked long, my GD test came back negative.

Monday July 1, I had a bit of pink tinged discharge when I wiped. I called my OB's office and spoke to a nurse who said it sounded normal, to take it easy the rest of the day, and to call if it turned to bright red blood. Tuesday, the discharge had increased, so I called my OB and asked to be seen. The only available appointment was at an office 40 minutes away, but I decided it was important enough to go. I was taken to the ultrasound room right away where the ultrasound tech began with an over the belly ultrasound. Baby girl looked great, had a strong heartbeat and enough fluid. The ultrasound tech then switched to a trans vaginal ultrasound and became concerned. She asked me to stay lying down while she got the doctor. When Dr. T. came in, he looked at the ultrasound and told me that it looked like my bag of water was bulging, I had a small hole in my bag of water, and that I was 4 cm dilated. I was in preterm labor.

Dr. T. wanted to keep me at the hospital next to this clinic, but I knew that wouldn't work with my husband working almost an hour away, so I chose to drive back to our home town hospital. My husband met me there and I was taken directly to labor and delivery.

I was hooked up to the contraction monitor, given an IV, and baby's heart rate taken with a doppler since she was too small to be monitored with the over the belly monitor. A different OB, Dr. L came in and told me that the plan was to keep me lying down with my head lower than my feet in hopes that my bag of water would fall back behind my cervix, and my cervix could be stitched closed. I was also given medication to stop the contractions I was having.

I was 21 weeks and 2 days, and the ultimate goal was to keep me pregnant until at least 23 weeks so that I could be given steroid shots for baby girl's lungs. At first we were told I was going to stay in the hospital until 23 weeks, and then I would be moved to a different hospital that had a NICU where I would stay until I delivered. A few hours later, Dr. L told us that our insurance wouldn't pay for me to stay in the hospital until I reached 23 weeks, so I would be sent home.

Later that night, Dr. T came in and told us again that I would be staying in the hospital. We were very confused about all of the back and forth about the plan, but decided to take things day by day. I sent my husband home to be with our son and to sleep, and I settled in to try to rest.

The next morning, Dr. L came in and again told us that I was going to be sent home. She said that insurance wouldn't pay for me to stay, and the hospital wouldn't do anything special for me that we couldn't do at home. At this point, it was a waiting game to see if strict bedrest would keep me pregnant for the next week and a half. I was given the instructions to come into the ER if my contractions picked up, or if I had bright red blood.

I was sent home that afternoon and settled in for what we hoped would be a couple of weeks of lying around. I was allowed to get up to use the bathroom, but besides that, I was stayed horizontal. I fell asleep around 9 pm and woke up again at midnight with horrific back pains. My back had been sore all day due to the uncomfortable hospital beds, but this was worse. I tossed and turned for about an hour to try and make the back pain go away, but no matter the position, it just got worse. I woke my husband up around 1 am because I was getting scared. I knew I needed to stay on my back, but I couldn't handle the pain. I wasn't having contractions, and I wasn't bleeding, so we weren't sure if I needed to go back to the hospital, but we decided to anyways. In my head I thought, "if they could just give me something for the back pain, I can stay on my back again and we can keep baby girl safe."

While my husband was waking up our son, the back pain increased. I couldn't sit down in the car on my way to the hospital, it hurt too much. I started feeling like I needed to push, and right as we pulled up to the hospital, my water broke. As I got out of the car to get into a wheelchair, I felt our baby girl be born. I told the ER nurse what had happened, and he ran me up to L&D while my husband parked the car with our son.

I was taken into a room and put on a labor bed. As soon as my pants were taken off, our baby girl came fully out and the umbilical cord was cut by Dr. L. Our baby girl was taken over to the warming table to be looked after, but she was too small to survive. During all of this, my husband and son had come up to L&D and some amazing nurses offered to take care of our son so that he didn't have to be in the room with us. My husband was by my side as the nurses tried 5 times to start an IV, and while we waited for the placenta to come out. Finally they were able to start an IV and Pitocin was started to try and get my body to push the placenta out.

Dr. L ended up having to leave around this time and Dr. T was called in, I think around 3 am. Dr. T tried so hard to manually take out the placenta, which is the most painful thing I've ever had done to me. He got most of it out, but was worried that there were pieces still inside, so he opted to do a D&C to make sure everything was taken out. While I was in surgery, my husband called friends to come take our son so that we could have the day to mourn and figure out what our next steps were.

We held our baby girl before I went back to surgery and again after it was done. She was so tiny; 12.9 ounces and 11 inches long. She was absolutely perfect and healthy, for some reason my body just didn't want to hold onto her.

I stayed in the hospital for 24 hours so that I could get multiple doses of an antibiotic to make sure I didn't get an infection. I spoke to Dr. T before being discharged, and he apologized for what happened. He said that I should have never left the hospital, and while staying may not have changed the outcome, at least it wouldn't have happened at home/in the car. He also said that he didn't know I had been discharged until he got the call saying I had come back in labor. I have a 2 week postpartum appointment with him in a couple of days where I hope to discuss what could have caused this to happen.       

It's been almost two weeks since our baby girl was born on July 4. Two weeks of mourning and going over the "what ifs". We will never truly know why this happened, or if we could have done anything different, which has been the hardest part. Physically I'm healing, but mentally and emotionally it's been really hard. We've had good days and bad days, and our family motto has become "take things one day at a time."

It's been a roller coaster ride of emotions these past few months. From being happy as a family of three, to learning I was pregnant, to wrapping our heads around becoming a family of four, to mourning the loss of our daughter. I have no idea if another pregnancy is in the future for us, but right now, I just want to focus on healing myself and loving on my little family.

The End

I think I'm finally in a good enough place to talk about what's happened over the last month and a half.

I had a positive pregnancy test at about 11 days past IUI. It was too light for how many days past IUI I was, but I scheduled a beta test anyways. Unfortunately because I got my blood taken on Friday, I didn't get the results back until Monday. I kept taking pregnancy tests, but the line got lighter and lighter, so I knew logically that things weren't going well, but my heart was hoping that the tests were faulty.

Monday afternoon I got a phone call from my RE's office, and as soon as I heard my RE's voice, I knew it wasn't good news. My HCG levels weren't high enough to sustain a viable pregnancy. I held it together to ask a few questions, but as soon as I hung up the phone, I broke down. Ended up leaving work early and going to sob in my car.

I met my husband at home and had to tell him the news. I hadn't told him about the positive test because I wanted the reassurance of the beta before getting his hopes up, so I had to tell him that I was losing the baby, which is the hardest thing I've ever had to do.

I started bleeding the next day and had a fairly light period, which was not what I was expecting. The next few weeks were really hard. I felt this constant weight on my chest, and was close to tears at all times. I don't know if it was hormones or the reality that our TTC journey was actually done, but I think I was in somewhat of a depressive state.

I started sorting through my son's baby clothes, getting them ready to sell at a consignment event in September. Going through those tiny sleepers and onesies was very difficult. Logically, I know it's just "stuff," but there was so much hope attached to those tiny clothes. Getting rid of them feels like I'm officially giving up hope.

My period started about a week and a half ago. I was absolutely dreading it; I was afraid it would trigger a wave of emotions and sadness, but I handled it better than I expected to. I'm not sure what we're going to do moving forward. I don't want to go on hormonal birth control because I'd like to see what my body is like without a bunch of hormones flowing through it for the first time in 5 years. Permanent birth control (getting my tubes tied or a vasectomy,) almost seems like betraying the dream. But, I don't know if I can live with that small hope every month, even if there's just the tiniest chance of conceiving spontaneously.

As time has gone on since the miscarriage, my emotions have leveled out. I'm not as sad all the time, and seeing newborn babies doesn't make me want to run to the bathroom to cry. But, there are some things that have been a stab to the heart. Filling out the family tree for my son's daycare was hard. Not filling out the "brothers and sisters" part stung, but when my son asked what a brother was, and why he didn't have one, I got emotional. It's going to be hard moving forward having to explain to my son that no matter how hard Mama and Daddy tried, we couldn't get him a baby brother or sister.

So, that's where we are now. I'm not sure if I'll update this space again since our TTC journey has officially come to a close. I want to thank everyone who has been with me for the past 5 years, I honestly don't know if I could have survived without your love and support.

The Last Shot

Guess who didn't blog again after my laparoscopic surgery? Really killin' it at this whole blogging thing.

Anyhoo, had my surgery on April 13 which resulted in finding out that both tubes are almost entirely blocked (boo,) but no endometriosis (yay!)

Not much could be done for my poor tubes, so my RE suggested doing 3 IUIs with increased stimulation in hopes that having two or three eggs release would increase our chances of one getting through the blockage. IUI #1 was done at the beginning of May with 10 mg of Femara (instead of my normal 5 mg,) which resulted in one mature egg. End result was not pregnant, but I went to Disney Land for the first time ever and rode all of the roller coasters, so I wasn't too upset.

I took off the next cycle because we were traveling again, which brings us to this cycle. The plan was 10 mg Femara days 3 - 7, 75 unites Gonol - F days 7 - 9, ultrasound to check follicles on day 10. At the ultrasound, I had one lead follicle that was at 14.5, another at 12, and a couple at 11 and 10. The RE decided to trigger me that morning with an IUI the next day. Unfortunately my husband's count was only 3 million which is lower than my RE is typically willing to do an IUI with, but since we were there, she went ahead and did it. I started progesterone suppositories the next morning and will be on them until I get a positive pregnancy test, or my period comes.

It's been a week since the IUI and I have no idea which way this cycle will go. I have periods of hope where I think about estimated due dates and how we're going to announce to our families, but those are quickly overshadowed by thoughts of doubt. If it hasn't worked for the past two years, why would it work now?

Even though my RE is willing to do one more IUI, this will be our last cycle of treatment. I know in my heart of hearts that IVF would be the way to get us pregnant (or at least closer to,) but we can't financially afford it, and since we only want one more child, I don't want to have to deal with deciding what we'd do with leftover embryos.

I have a lot of emotions around deciding to stop trying for another baby. I'm simultaneously relieved and heartbroken. Since getting pregnant with our son was relatively "easy," (he was a Clomid and TI baby,) I full expected baby #2 would happen quickly. Learning that my body is even more broken than I originally thought has made it hard for me to trust and believe in its abilities. The ups and downs of cycling have impacted my ability to parent the child that I do have, and I'm ready for my emotions to be more steady. I also have a lot of guilt about the money we've spent. We could have used the money to start a college fund, or take a really awesome vacation. But, what's done is done, and I'm ready to move on, in whatever way that looks like.

Laparoscopic Surgery

I had a sit down conversation with my RE two weeks ago to talk about our next steps. She suggested having laparoscopic surgery to check things out because she suspects something other than my PCOS is causing us not to succeed. She said she expects to find one of three things to be the culprit:

1. Endometriosis 

2. Blocked tubes 

3. Things didn't heal correctly after my c-section in 2014 

I'm not really sure what the best outcome of the three is. Endo can be removed which will hopefully improve our chances over the next year. My RE said that surgery to un-block tubes isn't very successful, so if that's the problem, I'm assuming our journey is over. If my body didn't heal correctly after my c-section, I'm not sure what the course of action is to remedy that, besides maybe stitching things back to their normal places. 

If the problem is something that can be treated with something other than IVF, my RE suggested hyper stimulation to increase the number of eggs I get with each cycle. I've only been getting one good egg each cycle, so she's wanting to see 2 or 3 to increase our chances. Obviously this increases our chances of multiples, but I'm not very worried about it (famous last words, eh?)

I just learned that I have to check in at 6:30 tomorrow (Thursday) morning, so if you happen to be awake at the time and want to send some good juju my way, I'd appreciate it. 

0 for 9 (Yet Another Update)

I just got a comment on my last post, which made me realize that I never wrote an update about what has been going on with us.

Spoiler alert, I'm not pregnant.

Last I posted, I was on medications to get rid of a cyst that was found after my first IUI. Since then we did two more IUIs, neither of which were successful. I swear I saw a very faint positive test after our last IUI in January, but tests never got darker and I ended up getting my period a few days afterwards.

We decided to take February off because ovulation would have fallen right in the middle of my work's biggest fundraiser, and I couldn't take time off. My RE and I spoke over email a few times and her suggestions going forward were either a laparoscopy followed by IUIs with injectibles, or IVF. We're not doing IVF for numerous reasons, so I have an appointment at the end of March to speak with my RE about the laparoscopy.

I've been fighting with a lot of emotions about continuing treatment. We originally said we'd do 9 rounds (3 Clomid, 3 Femara and 3 IUIs,) and be done after that, but my heart isn't ready to be done yet. I'm also wanting to try and get to the bottom of why things aren't working out as easy as last time (my son is a Clomid with timed intercourse baby.) My RE wants to use the lap to check to see if my tubes are blocked, and to see if I have endometriosis, and I'm really curious if one of those reasons is why I'm not pregnant yet.

On the other hand, I have a lot of guilt about trying for a second baby. All of the time and money we've spent so far could have gone to something else that would benefit the child we already have. We're also in a really good place with our son. He's sleeping well, he's to the age where we can go out and do things with him, and he's really fun right now. I'm afraid that bringing in another baby is going to completely throw off the awesome groove we have. But then I feel guilty about not giving him a sibling, all that talk about having a life long friend and someone to support him when we pass gets to me.

Some days I am dead set on never having another kid, other days I cry over pregnancy announcements and ache for that newborn smell. It's a constant back and forth in my head, so I'm taking things one day at a time.

Does anyone have any helpful suggestions for the laparoscopy? My RE is 3 hours away, so I'm most nervous about driving back home after the surgery. Would it be best to get a hotel room that night? Any suggestions are much appreciated!

0 for 7

3 cycles of TI with Clomid, 3 cycles of TI with Femara, and 1 cycle of IUI with Femara, and not even a hint of a positive pregnancy test.

I went on Monday for my baseline ultrasound to start another IUI cycle, and a 2 cm cyst was found on my right ovary. The RE that I spoke to that morning suggested cancelling this cycle because the cyst could interfere with ovulation, and when my RE called me later that afternoon, she agreed.

I am now on Norethindrone for the next three weeks to suppress my body in hopes the cyst will go away. I go back in 21 days for a second baseline ultrasound to see if everything is good to move forward.

Since we're only wanting to do 2 more IUIs, I asked the RE that was present on Monday if there is anything that we can do during these next two cycles to increase our chances of success. He suggested a laparoscopy to check for endo, including injectible medications, or doing a combination of Femara and Clomid.

As of this moment, I'm leaning against the laparoscopy. If endo is found, and our only chances of success is IVF, then we're done with TTC. We're just not willing to have left over embryos when we're only wanting one more child. But, on the flip side, is it worth throwing money at multiple IUIs when they're never going to work?

I've asked a few friends if they've ever heard of doing Clomid and Femara together, and no one has, so I'm going to ask for more clarification from my RE at my next appointment. Currently, I'm leaning towards injections, but that all depends on cost, especially with this IUI falling right before the holidays.

I'm simultaneously wanting to be pregnant, and wanting the TTC to stop. I was so happy when we weren't actively trying to conceive, but now my days are filled with pills, appointments, and disappointment, and it's really weighing on me. It broke my heart when I had to tell my husband that the IUI didn't work, and he said, "I really had hope this time." I'm ready to move on and focus on myself and my family, whatever size that may be.

9 Chances

I've been meaning to write this post for a long time, but I can't seem to get my thoughts in order so that things make any sense.

We're currently on our third and final round of Femara. If this cycle doesn't work, we have 3 rounds of IUI, and then we're done.

It's scary to think that we could go through all of these treatments and still not come home with a baby at the end. When we were trying for baby #1, we would have gone to the ends of the earth to get pregnant, but now that we have K, it's hard to justify all of the money and time spent on TTC.

If I'm honest, I've struggled more with this round of TTC than I did our first. I think it has a lot to do with the fact that we've put a limit on what we're willing to do, and with each month that is unsuccessful, it's one less chance we have.

3 rounds of Clomid
3 rounds of Femara
3 IUIs

9 chances to become pregnant, carry a healthy baby to term, and deliver it safely. I feel like the odds are not in our favor, and it's scary. I struggle with mourning every month that is unsuccessful, while wanting the months to go by faster so that we know what our future holds.

I'm also struggling with the idea of having another child. There are days that I feel like I'm failing K in every way possible and can't imagine having another to take care of. Then there are days that I see K interact with another child and think he would make the best big brother. There are also days that I look at my small family of 3 and feel complete. We're at a really good place with K right now, and I'm starting to get a sense of "me" again. Do I want to add a newborn to the mix and fall back into that haze of sleepless nights and diaper changes?

I think emotionally, I'm ready to be done with the logistics of making a baby. But, I know that if we don't go through all of our options, I will always ask the "what-ifs." No matter what happens, I'm ready for TTC and infertility to be behind us.