Browsing Tag

Maternal Health

Zika and Pregnancy: What You Need to Know

By January 19, 2016 2 Comments
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The Zika virus has been in the news a lot lately because it’s been linked to a cluster of cases of microcephaly in Brazil and Columbia. Microcephaly is a rare birth defect where the fetus’ brain does not develop fully in utero, and as a result, the baby is born with an abnormally small head and multiple neurological disorders.

Public health officials have been aware of Zika for decades, however, it was only believed to only cause mild flu-like symptoms with few, if any, lasting negative outcomes. The virus is spread by mosquitoes and recently cases as far north as Mexico, Hawaii and Puerto Rico have concerned public health officials in North America.

On January 15, the Centers for Disease Control and Prevention (CDC) issued a level-two travel alert for Latin America and the Caribbean, with a special note for pregnant women to avoid those areas. Since then we’ve been asked about Zika by a number of readers. We reached out to Dr. Waleed Al-Salem, a tropical medicine specialist and father based in Liverpool, England, to have him answer your questions.

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Categories: Ages + Stages, Chronic Illnesses + Conditions, Disability + Disability Advocacy, Infectious Disease + Vaccines, Newborns + Infants

Passive Immunity 101: Will Breast Milk Protect My Baby From Getting Sick?

By January 10, 2016 15 Comments
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As a neonatal nurse specialist, mothers often ask me about the antibodies found in breast milk and how they can work to protect their babies. To explain it to them, and to you, I have to delve into immunology, and those conversations are usually too technical for most readers and mothers I meet in the NICU. Unfortunately, the information that is readily available to mothers that isn’t highly technical is a large body of conflicting information. So I’m here to talk more about this very important topic in a way that makes it straightforward! My goal is to answer very common reader questions like these:

“Why does my infant need any vaccines at all since she’s getting all the antibodies she needs from my breast milk?” and,

“Why does my seven-month old son need to get a flu shot if I received it during my pregnancy?”

Both, excellent questions! Parents, take note – there are 2 ways babies acquire immunity: through passive transfer, and active transfer (also known as acquired immunity).

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Categories: Ages + Stages, Food, Nutrition, + Infant Feeding, Infectious Disease + Vaccines, Newborns + Infants

The Best Science-Based Pregnancy + Parenting Books

By November 30, 2015 4 Comments
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I’m enjoying my first few weeks of maternity leave after the birth of my daughter, and I have to say, it’s been a different experience than the last time I was pregnant. Between being more aware and educated on what to do with a newborn, and the wonderful lack of colic this time around, I have actually had time to rest and reflect on things.

One of those things (and veteran parents know this) is that when you or the mother of your child becomes pregnant, one of the first things people will do – besides terrify you with horrifying birth stories – is recommend pregnancy and baby books for you to read.  When this happened to me, I started to read some of these books, but each one seemed to have a specific parenting angle they were working.  Not to mention that there were usually a plethora of products endorsed by the authors that were hawked for sale. It started to be a red flag to me if someone passed along a book and at the front or end were instructions to go to a website in order to buy products to use to carry out the advice in the book (slings, oils, creams, CDs, cosleepers, you name it!).

Midway through my first pregnancy I’d finally found a set of books that worked for me.  They were no-nonsense, based on science, and backed by recognized health and medical organizations.  So for you, dear readers, I’m passing along my recommendations for the best baby books that will give you the facts, only the facts, and won’t lead you down the rabbit hole to huckster products and new parent guilt:

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Categories: Pregnancy, Birth + Family Planning, Science 101 + Mythbusting

The Promise of the Human Placenta Project

By November 4, 2015 No Comments
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We caught wind of an interesting new project out of the National Institutes of Health called the Human Placenta Project, and reached out to learn more. Today’s post is written by the project’s coordinator, who has a personal connection to his research.

 

In her second pregnancy, my wife, Cynthia, started bleeding at five months. She hadn’t experienced any complications the first go-round, and we were terrified.

Were she and the baby going to be okay?

Her doctor was concerned but unable to provide answers. Bleeding in the second trimester could mean any number of things: placental problems, impending preterm delivery, even cancer. The ultrasound provided limited information, and he had no other tools to diagnose the problem.

Ultimately, the bleeding stopped, as mysteriously as it had begun. The pregnancy progressed without further incident, and my son Evan was born healthy and on schedule. We soon became preoccupied with his naps, feedings, diaper changes, and all the other things that consume parents of infants.

But that feeling we had during the scare is one I’ll never forget. It shook me to my core. And I know how fortunate we were to have a healthy outcome when so many other families do not.

That was 24 years ago. Today, I work at the National Institutes of Health on a research initiative to help doctors improve pregnancy outcomes. Specifically, we’re interested in learning more about the placenta and its role in maternal and child health and disease.

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Categories: Pregnancy, Birth + Family Planning, Science 101 + Mythbusting

My Journey to Surrogacy (Part 3) – Trusting Another With Your Growing Baby

By September 16, 2015 1 Comment
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Marisa faced a traumatic pregnancy wrought with complications and kidney damage for the birth of her first child, and doctors warned her that a second pregnancy had the potential to kill her. You can read the details here in part one and part two of Marisa’s story. Below is part three:

When we tell people that we’re expecting our next baby via surrogate, the most common question we get is, “how does that work exactly?” The short and unscientific answer is that they took my egg and my husband’s sperm, mixed them in a Petri dish and 5 days later popped the embryo into our surrogate’s uterus. Of course, it’s not really quite that simple, as I explained in my last post.

But here we are, with a surrogate 22 weeks pregnant with our second child.

Once we knew for certain that our ‘bun was in the oven’, we shouted it from the rooftops, and the response of love and support was so tremendously positive and heartfelt. Our family and friends have been nothing short of incredible, both before and after the pregnancy was official. There aren’t enough good words to say about those people in our lives who supported us during that time, just more blessings to count!

However, our biggest supporter in all of this has been our surrogate, Stephanie.

Trusting Our Surrogate

It’s a pretty foreign idea to have someone else walking around living their day-to-day life carrying your baby, while you live yours with very little control over what your surrogate is doing. For me, there needed to be a certain level of trust involved for us to feel comfortable with someone carrying our baby, and fortunately we have that with Stephanie.

She and I text each other most days, and we talk about so much more than the surrogacy journey. We discuss how she is feeling, if she has any new or disappearing symptoms, if the baby is moving, what gender we think it will be, and all of the fun pregnancy chatter. But we also share our day-to-day lives. We discuss weekend plans, funny stuff our kids and husbands say or do, their accomplishments, or what we are making for dinner.

Marisa and her family's surrogate, Stephanie

Marisa and her family’s surrogate, Stephanie

Prior to pregnancy and while we were still in the care of the fertility clinic, I used to meet Stephanie in Toronto for our appointments and we would meet up to share a meal together and chat like old friends. The night before the embryo transfer, she and I stayed in a hotel and went out for dinner and a movie. All of this was important to me, as I didn’t want to feel disconnected from the person we chose to carry our baby.

I have heard of surrogacy being compared to having a good babysitter.  You don’t ever think that your babysitter is going to keep your child, but you want to make sure that while they are in their care, you don’t spend your time worrying that they are OK. That’s how we feel about Stephanie. The life and development of our child is completely in her hands, and we don’t lose a wink of sleep over it.  I think trust is the most important part of any relationship, and maybe even more so in this situation.

My husband Trent and I always say that if we had gone on a vacation somewhere and met Stephanie and her husband, we would have become lifelong friends with them. I just never expected I would love them as much as we love Stephanie and her family. I am so appreciative that it has turned out this way, and it’s comforting knowing that our growing baby is being taken care of by such awesome people.

Surrogacy Isn’t The Easy Way Out

As much as surrogacy is an amazing gift, no intended parent that I know really wants to have to take the surrogacy route.  We are lucky it’s an option, but given the chance, any of us would gladly go about bringing a child into the world the good old-fashioned way. I say this in response to many people who have mentioned that they thought surrogacy was just for women or celebrities who don’t want to “ruin their bodies” or sacrifice their careers. Let me be the one to stomp on that misconception.

I’m sure that there are some people out there who have done that, but they would be the exception, not the rule.  I have met a ton of fantastic and determined intended parents who have spent years trying to conceive, having multiple tests, ultrasounds and miscarriages, draining themselves financially and emotionally just trying to have a baby. I assure you that any of these women would have given anything to carry their own child. Like me, some of them couldn’t because of medical contraindications. Others have unexplained infertility. Others have some sort of immune response where their body doesn’t recognize their baby as part of their own body and won’t allow the pregnancy to carry to term. We have all experienced some form of emotional destruction or another.

The soon-to-be newest member of the Fletcher family

The soon-to-be newest member of the Fletcher family

I am very grateful that I got to experience pregnancy and feel my first child growing inside my womb. For most of the people I have met and talked to, that is not the case, and that in itself is a loss. No one grows up imagining building their family and having someone else carry their baby for them.  Pregnancy, while uncomfortable at times, is a gift, and gestational surrogacy is usually the last resort for people in these particular situations to have a biological child.

Looking Forward to the Future

That being said, we are so very happy that we were able to take this journey and add to our family. Although I would have gladly attempted another pregnancy if my doctors had have been supportive of it and if my life wasn’t endangered, once Stephanie was pregnant with our baby and things were well on their way, I felt relieved that I wouldn’t have to go through it again and recover from it again.  I’m happy to say that in the 3 years since I gave birth to my son, I’ve gained back 20% of my kidney function giving me a grand total of 60% function, and I haven’t needed any assistance with treating my diabetes for a year and a half.

My son Elliott will turn 4 in November and is very excited to start junior kindergarten, or as he likes to call it “Big School,” in September.  He is not-so-patiently waiting for his little brother or sister to arrive! I can’t wait to see him in action as a big brother, or to be the mom of two kids.  I look forward to meeting our baby and seeing his or her sweet little face, and analyzing which characteristics came from whom. Trent and I will feel more complete as a family and we won’t spend any more time mourning the loss of a child who never existed, but was wanted so badly that it hurt.

Circumstances and outcomes often cannot be changed, so I started telling myself to trust the universe.  Just do the next right thing, and it will work itself out.  This has become my personal philosophy.  We are looking forward to January when our second miracle baby is due, and although it wasn’t how we thought we would get there, life just had a different path for us to take.  We are so excited and truly ecstatic for the opportunity!

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Categories: Pregnancy, Birth + Family Planning

My Journey to Surrogacy (Part 2) – It Takes A Village to Conceive A Baby

By September 9, 2015 2 Comments
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Marisa faced a traumatic pregnancy wrought with complications and kidney damage for the birth of her first child, and doctors warned her that a second pregnancy had the potential to kill her. You can read the details in part one of Marisa’s story here. Below is part two:

After my doctor warned me that I should never, ever, get pregnant again, my husband and I turned to surrogacy as the answer to our prayers for a second child. Once we made the decision to pursue surrogacy, I spent much of my spare time researching procedures, timelines, costs (ohhhh the costs, there are many!), legal contracts, and the emotional aspect of it for everyone involved. I spoke with women who had been gestational surrogates (those impregnated via IVF), and with other intended parents about their journeys, how they got there, and how they found the experience. I also spoke to fertility clinics, lawyers, potential surrogates, and surrogacy agencies.

Perhaps most important of all I had appointments with my own doctors to discuss the how egg retrieval would affect my kidneys and diabetes if we were to have my eggs retrieved instead of relying on a donated egg. Thankfully, I got the green light from my medical team.

Finding a Surrogate

When I spoke with our lawyer, I was surprised to discover that in Canada it is illegal to advertise that you are looking for a surrogate, and it is also illegal for an agency to charge a fee to match you with one. This makes for a tricky scenario for everyone involved. How are you supposed to find a surrogate if you can’t tell the world you want one and there are hurdles for surrogates to being matched to families who want one?

There are websites for surrogacy agencies, but again, they can’t charge you to match you with a surrogate, which poses problems that I won’t address here. What I will say is the agency that we chose ended up being a good choice for us. A lot of intended parents struggle to find a surrogate, but with our agency we were able to get matched quickly. It doesn’t always happen this way, but we happened to find the perfect match on the first try.

Our surrogate’s name is Stephanie. Her and her husband have 3 children of their own. I’m going to talk about them more in my next post but they are truly amazing people. There just aren’t words for how kind and selfless they are.

How the Surrogacy Agency Works – Including Costs

Once we were matched with Stephanie, our surrogacy agency helped to get us in quickly to a fertility clinic that was selected based on my medical history, and in the meantime, the rest of their process began.

Marisa and her family's surrogate, Stephanie

Marisa and her family’s surrogate, Stephanie

The surrogacy agency deals with all financial transactions between our surrogate and us. In Canada, it is illegal to pay someone a set amount to carry your child, but you can reimburse them for expenses incurred directly as a result of being pregnant. These things can include food, gas for getting to appointments, medications, maternity clothing, wages for missed work for the surrogate or their spouse (if their spouse is required at legal or medical appointments), child care, updated wills, life insurance, and their lawyers’ fees to name a few. Stephanie submits her receipts monthly to the agency, and we keep an account with the agency that she is paid from.

In addition to the agency’s fees and reimbursements for our surrogate, we had our own costs, which included legal fees (for an in-depth surrogacy contract prior to fertility treatment), our own missed wages, travel, and childcare. Because there is no fee for matching with a surrogate, you pay fees to the agency after you have made a viable match. The biggest bill of all came from the fertility clinic. That one hurt!

I’d say the cost is the main negative part of choosing surrogacy. The cost is so incredibly high, and no doubt we feel it is worth every one of the tens of thousands of dollars it adds up to. Unfortunately, that also means surrogacy isn’t an option for everyone. Financially you have put an enormous amount into process and even so, there are no guarantees. We had the advantage of having financial help with the whopping grand total, but if we hadn’t, this option never would have happened for us.

Fertility Treatments and In-Vitro Fertilization 

Maria gives a thumbs up at the fertility clinic waiting for her egg retrieval

Maria gives a thumbs up at the fertility clinic waiting for her egg retrieval

The most difficult part of the journey was retrieving my eggs via fertility treatments, and the dreaded two-week waiting period after the embryo was transferred to our surrogate through In-Virto Fertilization (IVF), meaning, that time waiting for the embryo to implant and a positive pregnancy test. There is so much riding on the results. With your egg retrieval you hope for enough eggs to feel comfortable that you will end up with viable embryos for transfer, but not too many eggs that their quality is poor. With the two-week wait you are simply trying to not think about the fact that you just want it to be test day when you can find out if it was successful. Every moment is spent praying for it! Emotionally you can’t help but be hopeful, scared, and frankly a little bit crazy.

After our first egg retrieval, we were able to successfully conceive several embryos but had a failed transfer. This meant that the embryos transferred to our surrogate did not result in a pregnancy. It was such a huge disappointment. I was not prepared for the waves of devastation I felt. I felt defeated, and I was overcome with a wide range of sadness, grief, anger and bitterness. I had a hard time finding the motivation to accomplish anything. I felt like after all we had been through the universe owed us this. We had come so far but it just didn’t seem fair, yet somehow we still had hope. I felt bad for Stephanie because I knew she was also disappointed and going through her own emotions as well, and there was nothing I could do to make her feel any better. We had all done exactly what we were supposed to do, but even though you don’t go into the journey with that mindset, there was always a real possibility that it wouldn’t work.

The soon-to-be newest member of the Fletcher family

The soon-to-be newest member of the Fletcher family

After the failed transfer, we knew right away that we would do a second egg retrieval. In total, I took about 7 weeks off of work for the two retrievals. I ended up needing two egg retrievals, and I took a total of about 7 weeks off work. Everyone I work with was so excited and hopeful for us, including my boss (sincerely, who has a boss like that?!?). My co-workers were all interested and sent me text messages while I was away wishing us well, and reminding me that it would all be worth it when we had our next miracle baby.

As luck would have it, the second round was the one that got us where we are today. Our surrogate is 21 weeks pregnant with our second child as I sit and write this. Just typing those words make me smile and feel like I’m going to burst! There is no less cheesy way to put how I feel.

You can read part three of Marisa’s story by clicking here.

 

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Categories: Pregnancy, Birth + Family Planning

It’s Time to Stop Judging Mothers for How They Gave Birth

By September 7, 2015 3 Comments
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 I have sat down to write this particular post several times. Each time I’ve spent more than half of the post justifying why I had an emergency c-section, and the steps I took to avoid a c-section in the first place. But that’s not the point I actually want to make. I think it says a lot that in a post that I’ve intended to be about how we can support mothers no matter how their children came into the world, I felt the need to justify that I really wasn’t “too posh to push.”

First, I’d like to take the entire concept of “too posh to push” off the table, because statistically it’s not a thing. If anything it’s “I’m posh, therefore I push,” with white women of higher socioeconomic status having a significantly lower c-section rate than other groups. *

But, again, that isn’t the point of this post.

Having an emergency c-section was the single worst experience of my life. It was physically and mentally traumatic. After having an epidural administered approximately 20 hours earlier, its effects had started to wear off by the time the decision was made. For the safety of my son they couldn’t give me any more pain medication in the operating room. The anesthesiologist called a time out, concerned that I wasn’t adequately numb.  I remember the OB saying “we have to go” and then feeling the incision. Let me be clear, I was in pain. I felt everything. Once my son was safely out I asked to be completely knocked out, but not before the stitching began.   I don’t regret the decision to be completely sedated.  I would not wish an emergency c-section on anyone.

I did find it difficult to bond with my son after my c-section, but NOT because we’d been separated for the first 30 minutes of his life (we’d been separated when I requested to be completely sedated). It was because the trauma of his birth was so overwhelming that I had a hard time reconciling this round-headed, chubby-cheeked cherub with how he had come into the world, and that made it difficult for me to bond with him.

Leslie in labor.

Leslie in labor somewhere around hour 18.

What I’ve found since my son’s birth is that my experience was not unique. If you ask any woman who has had an emergency c-section, she will likely tell you that they wouldn’t wish the experience on anyone. An emergency c-section is not the easy way out as it is often characterized. It is traumatic, it is painful, and it is scary. It is an emergency life-saving procedure where the comfort of the mother is secondary to ensuring mother and baby survive.

In public health we’re all acutely aware that private decisions often have public consequences. When I told colleagues that I had an emergency c-section, I was typically reminded of the increasing c-section rate, and then asked to describe in minute detail what lead up to the procedure. They were trying to figure out if my emergency c-section was truly an emergency, or if my OB simply wanted to go home and catch The Daily Show at 11pm. I became another data point, which as a data nerd I understand to a certain extent, but sometimes in public health we can forget that our data points are people.

When I told friends how my son was born, I received one of two responses: 1. Empathy and commiseration from other women who experienced an emergency c-section or 2. Disdain from those who have given birth the old-fashioned way or who felt their c-sections were medically unnecessary. From the latter cohort, I’ve been told I did birth wrong, I gave up too soon, I wasn’t fully informed of the risks, I was taken advantage of by the medical profession. The most common and hurtful was that I took the easy way out. Let me assure you, after 26 hours of labor and feeling each individual stitch being made in each individual layer of my body, I can assure you that an emergency c-section is NOT the easy way out.

I have been in tears more than once after a well-meaning conversation with a friend or colleague who needed to tell me how badly I birthed my son. Something Julia and I say over and over again on this blog is that language matters. When we tell women that they didn’t do birth the right way, it breaks motherhood into two tiers: those who are “Mom Enough” and those who are not. The research shows that this judgment of mothers who have had c-sections is ripe among women, with mothers even judging themselves for giving birth the “wrong way.”

Perhaps the most stinging phrase I’ve heard since my son’s birth is one that mothers heap on themselves: their bodies failed them. This is usually accompanied by cries that their bodies let their babies down, fears that their children won’t love them as much because they weren’t able to birth them the “right way.” It breaks my heart when I hear women say it, because it says that their bodies were somehow less natural than other women. It says that at a base, biological level one woman is fundamentally less “female” than a woman who is able to give birth naturally.

This language cuts and we must stop using it against each other and ourselves.

Leslie and her son minutes after he was born.

Leslie and her son minutes after he was born.

It took me well over a year to mentally come to terms with my c-section.  I didn’t set out to do that.  In fact at one point I wasn’t sure I’d ever reconcile my birth experience, what others told me about it, and whether or not I had the mental fortitude to go through it again.  But several events eventually lead me to make peace with my son’s birth.

The first events were unfortunately tragic. A friend of a friend had a labor similar to mine, yet refused to consent to a c-section when it was recommended by the OB on-call. She was convinced the doctor was motivated to perform the c-section for selfish reasons. By the time she consented, her son was stillborn and couldn’t be revived. My friend reached to ask how she could support her friend who was wracked with guilt and grief. My only advice was to not judge her, because whatever my friend thought of her decisions, her friend’s own judgment would be ten times of what anyone could heap on her. The second event involved an acquaintance from high school who had a labor similar to mine. While she consented to a c-section promptly, the procedure was delayed and her son was also stillborn and could not be revived.

To be clear, these events were personally transformative, and that’s why I mention them here.  I don’t mention them to scare women into c-sections.  If you can safely push that baby out, then push that baby out! More power to you!  And it obviously goes without saying that c-sections and specifically emergency c-sections carry risks above and beyond a vaginal birth.  I say this because I know there is a contingency on the web that will be quick to accuse me sharing these two stories in an attempt to scare women into having unnecessary c-sections.  If that’s what you think, please re-read the third and fifth paragraphs of this post.

But, these two tragedies caused me to reframe my son’s birth from something I viewed as traumatic and less than ideal to “there but for the grace of god goes I.” These tragedies reframed birth in my mind from an end in itself, to a means to an end.

The next two events happened in close succession. I switched OBs during my current pregnancy and requested a copy of my medical records. When I read the c-section report it was like reading a hidden history. The first half read as I’d remembered the day progressing, but many of the details leading up to the procedure and the procedure itself I hadn’t been aware of. Those details made me realize the situation was much more serious than I’d been aware of at the time.  It also put my OB’s comment, “we have to go” into better context.  I’d always thought that his comment had more to do with wanting to keep to hospital policy and in/out times, but after reading the report I realized he meant that my son had to come out now, not five minutes from now.  Despite the trauma of the experience I’m grateful that he made that call.

Shortly after reading the report, and with the knowledge that I was pregnant again, a friend began to lecture me on how I couldn’t let my OB take advantage of me again in this delivery. She repeated the phrases I’d heard before, that I could do it right this time, that with more time and patience my body could do what came naturally.  This time, instead of focusing on the other person in the conversation and trying to validate what they were saying, I stood up for myself. I let them know how her language made me feel, how I felt about my birth, and that their judgment was extremely hurtful.

I expected the friend to get angry, to tell me how she was just trying to empower me to stand up to the medical profession, but what I got instead was a sincere apology. I think the moment was a bit of a wake-up for her as well.  I don’t think she’d realized how much the language she was using to encourage vaginal birth actually stigmatized women who’d had cesareans.

This issue around the language and ranking of birth doesn’t just extend to women who have had caesarian sections, but also to women who became mothers through surrogacy, adoption, or by step-parenting. We must stop defining each other by how we came to be mothers and instead value each other as partners in a shared, wonderful, maddening, frustrating but joyful journey.

Leslie, her husband and son when he was only a few months old.

Leslie, her husband and son when he was only a few months old.

* To be clear this is a vast overgeneralization of the issue. There are many, many factors that go into both an individual’s risk of having a c-section as well as traits and behaviors associated with demographic groups including access to prenatal care, nutrition and underlying medical conditions.

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Categories: Mental, Emotional, + Behavioral Health, Pregnancy, Birth + Family Planning

My Journey to Surrogacy (Part 1) – Another Pregnancy Could Kill You

By September 2, 2015 2 Comments
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November 6, 2011 was hands down the best day of my life so far. It was the day I became a mother.

The day itself was anything but the best day of my life. I was only 26 weeks pregnant, I had been dangerously sick throughout my pregnancy and I was scared we wouldn’t be bringing our son home with us from the hospital. I would later find out that my pregnancy had put my life in danger as well.

Despite the complications and the fear, our beautiful son, Elliott Murray Fletcher, entered the world at 4:34p.m. via emergency c-section. He was just over 13 inches long. He still had one eye fused shut and not an ounce of fat on his perfectly developed little body. He had fine, fuzzy hair all over, he looked and was so fragile. My Grammy said she thought he would fit just perfectly in a two-liter berry basket, and she was right.

Elliott couldn’t breathe on his own in the first weeks of his life, so he had a C-PAP machine and oxygen around the clock. He was in an incubator for 46 days until he could maintain his own body temperature without burning too much energy, and had tubes and wires hooked all over his body to deliver nutrients, monitor his heart rate, breathing and oxygen saturation.

And this is how my husband and I turned to gestational surrogacy to complete our family.

When I was 10 years old, I was diagnosed with Type I Diabetes. All in all it wasn’t that hard to maintain decent control of my sugar levels as long as I ate properly, took my insulin, and tested my blood sugar as instructed. I was aware that I would need to try my best every day for the rest of my life to avoid complications, most importantly so I could have babies when I was ready. I even selected my profession as a dental hygienist, not only based on my love of teeth, but because office hours would be kind to managing my diabetes, and it would make it easier to work part time while also being a stay-at-home mom the rest of the time.

When it was time, I got the go ahead from my doctor to “have as many babies as I wanted.”All of my blood work came back with excellent results and there was no reason I couldn’t have a healthy, although high risk pregnancy (all diabetic pregnancies are considered high risk).

Elliott's arm while he was still in the NICU. His father's wedding band fit over his hand.

Elliott’s arm while he was still in the NICU. His father’s wedding band fit over his hand.

As soon as we made the life-altering discovery that I was pregnant, my whole life became about testing my blood (when I was pregnant I tested on average 18-22 times per day), eating and drinking copious amounts of carbohydrates to keep my sugar at a safe level,  all while trying desperately not to vomit because I was so stuffed and also suffering from “morning sickness.” I was at one doctor appointment or another at least once a week. I had ultrasounds every 2 weeks to monitor our baby. I had a high risk OB/GYN that we had to travel 4 hours to see every 2-4 weeks.  I was also very swollen, because my kidneys did not agree with my being pregnant (I had gained a total of 42 pounds when I gave birth at 26 weeks and promptly lost 32 pounds in week, which was almost entirely water weight that my kidneys didn’t have the ability to deal with).

The whole time I was pregnant, I was feeling very overwhelmed, but I didn’t mind too much, because we were going to have a baby, and I was finally going to be a Mom!! It wasn’t a walk in the park, but it was worth every moment, and I would have done it again, if my doctors weren’t so adamant that I don’t ever attempt a pregnancy again, given what was happening to me.

At 25 weeks my water broke and I was admitted to the hospital for another week to try to stave off labor. I was in the hospital for another two weeks after that as it turned out that pregnancy had caused me to suffer from acute nephritis (inflammation of the kidneys), and at that point I had lost about 60% of my kidney function.

One day in the hospital my doctor asked how many children I had. I told him just Elliott so far, and he replied,“well I think he will have to be the only one.”

He said it as gently as possible, and I just said “okay”, because I didn’t want to cry and I was also in shock, despite the circumstances. A few days later, my OB came to talk to me. Her words were “Do not ever let anyone tell you that you can try to have a baby again, another pregnancy could possibly kill you,” and told us we were extremely lucky that Elliott was thriving despite his extreme prematurity.

Elliott had a 90-day NICU stay. Fortunately, he has none of the frequently occurring long-term complications of premature birth. I still count these blessings frequently.

It took me two and a half years to feel like myself again. I was put on 7 different prescription medications to control my blood pressure and help my damaged kidneys. My blood sugar was very hard to control. I was low frequently and postpartum, I couldn’t feel it dropping (this is called hypoglycemic unawareness, and it is extremely dangerous and also life-threatening for a diabetic). On top of it all, I now had a baby to take care of.

I felt defeated. I had always had a positive outlook on being diabetic and now that was gone. I was fed up! I felt like diabetes had taken away so much from me, and it was so painful to know that I wouldn’t be able to give my husband another child, or Elliott a sibling.

But there was hope.

Hope came in the form of gestational surrogacy.

You can read Part Two of Marisa’s Story here. 

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Categories: Pregnancy, Birth + Family Planning