So, I've alluded here and there to a health scare I had last year that kick-started me into a healthier lifestyle. "Heath scare" is putting a pretty nice spin on things, since what happened is: I gave birth to a stillborn baby girl at almost 6 months, and as a result found out that I have a genetic blood disorder that very likely caused it to happen.
The blood disorder is called Factor V Leiden (FVL) and it's one of several blood clotting disorders most of us have never heard of.
Basically, it's a hypercoagulability issue -- I have "sticky blood" that wants to clot.
Which is bad news since when blood doesn't flow freely, those clots can lead to Deep Vein Thrombosis -- and they can travel from your legs to your lungs, causing Pulmonary Embolism. It's serious shit. You can develop clots anywhere, but DVTs in the leg are the most common.
As it turns out, clotting disorders like this crop up a lot among people who have gone through miscarriages and stillbirths.From some medical journal:
Pregnancy: It is thought that Factor V Leiden increases the risk for recurrent fetal loss and has been associated with severe pre-eclampsia, unexplained intrauterine growth retardation, placental abruption, and stillbirth as well as maternal clotting during labor and in the postpartum period.
Contributing factors that increase the risk of thrombosis: obesity, smoking, oral contraceptives, surgery, trauma, and high blood pressure.
Frighteningly enough, clotting disorders like this are not routinely tested for, which is crazy when you consider the barrage of other tests you're subjected to as a pregnant person -- and the fact that 5 percent of the Caucasian population is thought to have Factor V (and again, FVL is just ONE of the clotting disorders out there.)
I was "lucky" in that stillbirths -- although more common than you'd think -- still happen less often than miscarriages (defined as fetal losses earlier than 20 weeks), so after it happened they tested me for EVERYTHING to see what might have caused it. If I'd "only" had a miscarriage, they probably would have just let it go.
Many doctors will let a woman go through 3-4 miscarriages before they seriously start trying to find out what's wrong.
I get that they can't always discern why these things happen, but the way they often don't even try is just one of the many examples of the way women's healthcare is not taken seriously in this country. If I had been tested for this disorder as a youth, I wouldn't have spent years and years taking oral contraceptives in my 20s, which I'm now told COULD HAVE KILLED ME. It's so incredibly fucked up.
So yes...I'm "lucky" in that doctors did an autopsy, and think my baby died as a result of the untreated FVL. She was small for her gestational age, and the placenta was nearly half-clotted, so she couldn't get enough nutrients and oxygen.
Even armed with this knowledge, and realizing that my next pregnancy will be closely monitored by high-risk specialists and such -- there's no guarantee the outcome will be any different (notice the part about "recurrent" fetal loss in the medical excerpt above?). And this is the crux of what scares the living shit out of me.
It's on my mind because around August or September of this year, my husband and I decided to start actively trying to get pregnant again, however scared we both might be (because let's face it -- the fears affect us both).
I'm in a better place, health-wise, than I was last time around -- I'm down 40 pounds, my blood pressure is normal, I exercise regularly and added certain foods to my diet the doctors said would be beneficial for my circulation (flaxseed, walnuts). But again, that word -- "recurrent" -- haunts my brain.
Not enough to stop trying to get knocked up, but enough that it can really give me a case of The Sads.
I try very hard to have a positive attitude about my future chances. After all, there are many women with FVL who have completely normal pregnancies and don't ever develop symptoms.
I've sought out some "Pregnancy and FVL" groups online, and I do like hearing the success stories, but it feels like a lot of the posts consist of women bitching about the price of blood thinners and insurance issues. All of which is valid, of course, but I guess I'm looking for info of a more personal nature.
Info like…when you get pregnant after a loss, how do you let your guard down long enough to allow yourself some excitement about it? Is it even possible, when that first-time expectant parent optimism is just gone? I can no longer take for granted that everything will go normally and end well.
Also, when you're pregnant it's as if your body becomes public property in a weird way -- people (strangers and friends alike) love to share their opinions about pregnancy, childbirth and childrearing.
They want to touch you, and they talk your ear off. I dread the thought of someone asking me, "Is this your first?" and the short-circuit that will likely happen in my brain when I try to formulate an answer.
If I say No, they may assume I have a living child and start prodding me for more information and oh-so-cute details -- and then I'll have to be a complete downer and explain. If I try to keep things light and just say Yes, I'll have to sit through their exuberant blathering about what to expect.
I'm especially wary of sitting through those countless, "Oh boy was my labor tough!" stories again.
It was bad enough being stuck on a maternity wing full of mothers giving birth to healthy children, overhearing those first screams and husbands cheering wives on, while I was in my own room going through a horrible, Bizarro World version of the same thing.
Trying to anticipate how I'll navigate these social situations is mind-boggling, and at times this seems like too much to bear.
Conventional wisdom says that after you've reached 12 weeks in a pregnancy, you're in the "safe zone" and can safely tell friends and family. But having gone twice that length and still gone home from the hospital empty-handed, I don't know that I can be as free and easy with the information the next time around.
How will I decide who to tell, and when?
Try as you might to get the word out, part of the aftermath of losing a baby is that for months and months afterward, you run into folks who haven't heard yet. You get used to happy faces asking you how the baby is, which fall sharply when you awkwardly explain -- trying so hard not to make them uncomfortable -- that your baby died. They feel like shit, you feel like shit.
It might be better to just move into a cave for 9 months and hopefully emerge with a surprise at the end.
And what of baby stuff? Do we prepare for the baby next time? Do we think of names and purchase clothes and assemble furniture? Or do we go the traditional Jewish route (I'm not Jewish) of not having a baby shower or discussing names until the child is born?
Part of me thinks this could help ease some of the pain if something should go wrong, but part of me thinks it might also rob us of some potential happiness. I mean, I would love to "nest." This shouldn't be 9 months of self-torture and depression. I'm really torn.
One thing I am not torn about is that I absolutely want a baby. I'm married to an amazing man who will be a fantastic father, and I know that if given a chance I'm going to be a kick-ass mom.
The mere fact that we've decided to take the step of trying again must show some sort of hopefulness (if not confidence) on our parts, I think.
So the best approach to this whole thing is probably just going to be to take it day by day and do what feels right -- and until I see those two pink lines on a pregnancy test again, I guess I won't know what "right" is. But I look forward to finding out.