G3

In the OBGYN world we describe a woman’s pregnancy history in terms of G’s and P’s.  There is an alpha numeric code that tells the story- “GTPAL.”

G stands for gravida. It’s the number of times a woman has physically been pregnant.

T is for term- the number of term pregnancies a woman has had.  Any baby born at 37weeks or after counts here.

P is for preterm births, those babies born after 20 weeks but before 37 weeks.

A is for abortion. This is a medical term, not a political one.  Medically we call any end of pregnancy before 20 weeks an abortion.  It may be spontaneous, aka a miscarriage. It may be elective, aka a termination.  A also includes ectopic pregnancies.

L is for living children.  No further explanation needed.

To make it even more confusing we shorten the the GTPAL to G_P_ _ _ _.  In this instance G still stands for gravida and P stands for para- para meaning the number of births (term or preterm). It might be better to explain by example:

A woman who has had one term living child with no other pregnancies would be a G1P1001 versus a woman who has had one living preterm child would be a G1P0101 versus a woman who has had one miscarriage and no other pregnancies would be a G1P0010.

It can be used to describe a pregnant woman too.  My friend who is pregnant for the first time is expecting twins.  She is currently a G1P0000.  When she has the babies, if she has them at term (fingers crossed) she would be a G1P1002.

Make sense?

So why does this matter?

As of late, I have recently added a new G to my history.

After Mabel I became a G1P0100.

After Felix I became a G2P1101.

I am now a G3P1111.

My loss story continues.  I’m having a very early miscarriage.  So early I barely became attached. But it has still stolen the breath out of me.  Did I take five pregnancy tests just to be sure? Did I figure out my due date? Sure did. Think about maternity leave? Toss around baby names in my mind? Imagine telling Felix he’d be a big brother? Dream of a living sibling for me son? Did I get excited? You bet. So when it turned out to be just a shadow of a pregnancy, a whisper of something I’ve been wanting and trying for since Felix was born, I grieved. I am still grieving. I feel broken in so many ways, untrusting of my body, unsure of my ability to be happy.  I know I will find my way out of this darkness- I have crawled out of deeper holes.  But in the meantime, I will mourn my little whisper…

 

 

Sunday Synopsis

Why I don’t want my miscarriage to stay a secret- great post that brings miscarriage into the babyloss community.  Miscarriage is a different kind of loss than stillbirth or neonatal loss, but there is still so much grief that can accompany it.

How should an abortion be– WARNING.  I know I have many readers who will not like this article. I post it not to make a huge political statement, but instead I post it because it fits into my latest theme- feeling pressure to grieve the right way.  I also post it because people terminate a pregnancy for many reasons- including medical, because her health is at risk or the baby has a fatal condition.  Babyloss is a taboo subject, as is termination- so there are some similarities there.  They come with complex and nuanced feelings with pressure about how we are supposed to feel.  Many people in the babyloss community might feel complete different/separate from the abortion community and that’s OK and totally reasonable too.  I post only to show that people in different circumstances can also feel the pressure of how to grieve/not grieve appropriately, just like us.

Here are just some of the people living with an extra chromosome and rocking it– I love this.  In some ways it’s a very nice contrast to the article above this.  Yes I am pretty open minded about people’s personal decisions when choosing to continue (or not) a pregnancy- it’s their choice.  And most (up to 92% some sources say) women choose to terminate a pregnancy with a Down Syndrome diagnosis.  Getting the diagnosis means at best a lifetime of caring for a special needs child, likely a host of medical problems, and a disability of unpredictable significance (mild to severe).  At worst it means a miscarriage, a stillbirth or a dead child.  When people make their decision, I just hope they also consider the info in this video.  No one is guaranteed a perfect child and those with trisomy 21 can do so much more than we sometimes imagine.

Speaking of dead moms– I love the ending of this.  “Sometimes speaking of death isn’t necessary, and sometimes sharing it isn’t possible. We do as we do to get through. We eat the black jelly beans.” As Mabel’s birthday approaches, I’m torn between wanting to shout from the rooftop and huddling down, not speaking of her and keeping her memories to myself.  I have just ordinary days like that too.  Speaks to my recent theme- there is no right way to grieve.

Sunday Synopsis

10 types of disenfranchised grief– though the list addresses miscarriage and abortion, I’m going to argue that babyloss in general should be counted.  Though, in a weird way, I consider myself “lucky” in the babyloss world (hah!), because my daughter technically lived for 6 hours and thus gets some recognition for life, I also feel disenfranchised because few people met her, so she wasn’t real to them. Plus she had birth defects, and I constantly worry that people think she was worth less because of them.  And then there are those who lost babies to stillbirth- the same kind of disenfranchised grief.  And those whose babies lived only inthe NICU.  When it comes down to it, people listen easily when people talking of their parents,  or grandparents dying, but nobody likes to hear about a dead baby.

64 things about grief– do you agree? anything else you’d add to the list?

Grief Gifts Guide– What do you think?  Did you get any gifts like these for the holidays?  Did you get anything else that you would add to the list?

Confessions of a burnt out physician– Though this might not resonate with those non-providers out there, I hope it can help bring some understanding.  I do love so many aspects of my job, but the intense timing of it is not one of them. I’m given 15 minutes to see patients- whether it’s a simple fetal heart rate check or discuss their recent miscarriage.  It’s not a lot of time.  It does force me to put up some barriers and boundaries, which is not how I envisioned practicing when I enrolled in midwifery school.  ah, reality.  I also post this because I know many of you have had difficult experiences with your providers.  This is not an excuse for bad behavior, but perhaps can provide insight into the pressures at work.  I remember a patient being ticked about waiting 45 min for her routine prenatal.  I wanted to tell her, “I’m sorry I’m running late,  but I just spent all that time talking to the patient before you who is carrying a baby that is going to die.” I couldn’t and didn’t, so I simply apologized.  Sometimes the stress of closely packed patients can make some providers even leave the profession.

Experiences which expanded my empathy  I find babyloss has certainly expanded my empathy in many ways.  I am much more sensitive to loss in general, especially at work.   Though, sadly, I also find some situations harder to find empathy as well.  You?

A Sensitive Topic

Warning: I am touching on a controversial topic.  I am trying very hard to share my feelings but also be respectful.

One of the things I like to do is to monitor the “stats” of my blog- how many views, number of visitors, search terms, where people link my blog.  It makes me feel heard.  I am amazed seeing how far my blog reaches (hello South Africa, Montenegro and Finland!).  And sometimes I stumble on other blogs I want to follow.

There is one site that links to my blog that I can’t see- it’s a closed group on baby center for those who have terminated a pregnancy for Down Syndrome.   I cannot see what they’ve written about my blog, but I do know it falls under the heading ”the mom who chose to carry her t21 pregnancy to term and the result.”  I am not here to pass judgment on women who choose to terminate and women who choose to continue- whether it be a baby with Down Syndrome or average chromosomes, whether she be a healthy baby or one that will be born sick, if even alive.  I am not here to make anyone feel bad about the decisions they make.  I recognize I cannot possibly understand other people’s circumstances, and so I support women in their own decisions about their bodies and their families.

But I hope no one reads this blog and thinks- well, that’s too hard, so I might as well save myself the heartache and just terminate.

This blog tells the story that not every pregnancy turns out the way you would think.  Accepting a Down Syndrome diagnosis did not give me a take home baby.  But choosing to terminate might have ended a pregnancy that would have ended in health.

People can terminate their pregnancy, whether it be complicated by Down Syndrome or not.  That is there personal choice; I have my own personal views.  There are things I would hope I would do in my own life when faced with certain circumstances.  I also recognize I can’t know what decisions I would make until I am faced with them.  However, my professional and political views are simple- support women throughout their life cycle, in whatever way they need.

If there were a woman in this online group who was my patient, I would care for her as gently as I would any other woman.  In fact, I have cared for women who have terminated pregnancies with Down Syndrome.  I want this group to know that their choice was hard, that I do not judge them.

Though I do want to share a few thoughts with these women.  To the women of that group who have read my blog:  Please do not use my baby’s story as justification.  I don’t want Mabel to be anyone’s reason she uses in choosing to terminate her pregnancy.  You had your reasons, and I am sure they were good ones.  Since you are in an online support group for terminating, I can tell you are struggling with your decision.  You were faced with two impossible choices: terminating a pregnancy and continuing one when you are unready. You made the best decision you could with the information you had at the time.  But please leave Mabel out of it.  I made the difficult choice to carry her and give her the chance, understanding my risk of losing her.  She deserved every second of the six hours she lived.  Despite my heartache, I would do it again, even knowing the outcome.