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…

 

 

Bravery

Sometimes I need to be reminded that I’ve done some hard things. I have survived. I am brave. I am brave because….

I hung up the phone, the news of a Down Syndrome diagnosis for my baby still ringing fresh in my ears. I took a deep breath, basked in a moment of acceptance and relief, and then continued on my day, keeping my personal life and professional life separate. I continued seeing my patients that day, all pregnant with healthy babies, all while holding my news secret.

I said yes.  Yes to a baby with special needs.

I walked into the CT Down Syndrome Congress annual conference, scared but trying to keep an open mind to learn all I could about what life is like parenting a child with Down Syndrome.

I left the hospital with a likely life limiting diagnosis for my baby, choosing minimal fetal monitoring until the baby had any hope of survival, knowing that I was choosing to preserve my fertility over heroic measures for a baby that would likely die, knowing that I might forever struggle with guilt if she was stillborn before the set date we were willing to intervene.

I told the doctors to take out the vent and held my baby as she died.

I held my lifeless baby.

I handed my baby to the nurse, never to hold her again.

I left the hospital empty handed.

I continued to live life.

I went to my first support group, though I cried tears of fear in the hallway before going in.

I went back to work and told hundreds of people, “my baby died,” and continued to care for them with a smile.

I chose a new career path.

I talk about my baby to strangers, to try to break the silence.

I try to ask for what I need.

I had had another baby despite crippling anxiety that I might lose him too.

I’ve been to baby showers.

I’ve held babies.

I write about my feelings here, for all to see.

Why are you brave?

Damned if I do….

October 2013- that was the last I had seen her.  I knew because that was the date on the last note I had written.

You had a baby! Congratulations!

Thank you, I smiled warmly.

So much has happened since I was here last!

Yes- a lot has happened. The emphasis in my words hinted at a hidden story…

Well now you really know what it’s like, huh? she jested, referencing my my former life as a midwife who hadn’t given birth, who didn’t have kids yet.

My heart beat a little faster and my head spun a little- it was the shadow of a feeling I used to know very well, in the early days.  I used to tense up- heart racing, palms sweating, chest tightening- when someone would ask “How’s the baby?” or “Do you have kids?” It’s a feeling of fear, grief, sadness, anger all mixed up, when asked a question I wasn’t quite sure how to answer.  It was a feeling of anticipation- wondering how the other person would react, how to tell of my daughter without making the situation overly awkward.

Now the situation has changed. The tense feeling has softened.  She didn’t ask if he was my first.  There was no question to respond to.  It was all assumption.  The only way she could know the whole story was if I volunteered the information, something I have yet to master in a way that feels good. I wanted to say. I sure do! Two kids since I’ve seen you last! But doing so would only lead to follow up questions- how old is your first... I’d share that she had died and the requisite polite words or unhelpful platitudes would come. And it would feel like I’m fishing for sympathy.

I chose the path of least resistance-maybe not an outright lie but a lie of omission almost. It didn’t feel great.

Not telling the whole story felt wrong, telling the whole story felt wrong.  Damned if I do, damned if I don’t.

what do you do?

 

Same question, different reactions….

I feel like my posts about Mabel lately are somewhat repetitive.  They all center around the seemingly inevitable question of “is he your first?” I write about it because I’m finding that the question leads to so many different outcomes.

I awkwardly made my way into the shop door, pushing the stroller with one hand carrying a bag and the carseat base with the other.  As I waited in the office of the autobody shop, I cooed at Felix and made silly faces.  The shop owner asked “Is he your first?”
“My second ,” I said with a smile that I like to think comes off as peaceful.
“Oh yeah? How old’s your first.”
“She would have been almost two, but she died.” My tone was calm and warm.
“Oh, I”m sorry.” He should have stopped there, but sometimes people just don’t know when to shut up. “So he’s really you first?”
No, stupid, I just told you.  He is my SECOND. My first baby- my daughter- my Mabel- she died.  Her death does not negate her existence. If your mother died, it doesn’t mean you never had a mother.  
“He is my first living child.”
ugh.
I sat on the floor of an apartment we rent out as a handyman made a repair on the door.  He had done some work for me in the past- a couple things over the past few years, so I had seen him very sporadically.  He helped with a messy bathroom repair a bit over two years ago- it was messy in the literal sense as well as the figurative sense- with lots of fighting with the upstairs unit owner whose toilet overflowed causing water damage in my unit’s bathroom.  The owner had given me a hard time and finally quite nastily snapped at me “I’m having ankle surgery in a few days, I don”t have time for this!”  At the time I was newly pregnant with Mabel, but we thought I was miscarrying and I so badly wanted to snap back “Well I’m miscarrying a very wanted baby and I don’t have time for you!”  But I didn’t.  This handyman was doing the work on the bathroom and so he is intertwined in my memory of that time.
When I was letting him in the door, he say me juggling to hold Felix and find my keys in my pocket and offered to hold the baby. I let him easily. We chitchatted a bit as he made the easy repair.  He was asking about Felix and to continue to small talk I asked if he had kids- a question I ask with nervousness, reminded of how hard that question has been for me.  But I asked because I was totally prepared for an answer about dead children.  I could handle it.
“No,” he said ” And it’s too late for that.  I dont want to be a grandfather to any kids-” suggesting he thought he was too old . His parents had him in their 40s and he would want to be a younger father.  I sensed a bit of sadness in him, though I wasn’t in a position to address it.
“And he’s your first, right?”
“My second,” again that peaceful smile crossed my lips.
“Oh I didn’t know you had another!  How old?”
“She would have been almost two, but she died last year.”
“Oh my goodness, I’m so sorry.  I’m sorry I asked!”
“Thank you- and it’s ok.  I like talking about her.”
“Well I bet she would have made a really awesome big sister.”
I smiled at that.  The first time I heard those words.  My heart swelled. “Yes. Yes she would.”

I couldn’t do it.

I couldn’t do it.

We were out to brunch at our local spot.  I had Felix dressed in one of my favorite outfits. “Little brother” the onesie read.  I have three shirts that say this telling phrase.  One from a long distance friend who hold Mabel close in her heart.  Another from a kind patient. A third I bought, unable to resist.  He’s outgrown two of them and the third he practically busting the seams, but I’m reluctant to let it go.  I proudly dressed him in it that morning.

The waitress cooed at him and he flirted back.  “Little brother!” she read his shirt. “Where’s your sister?” she continued and looked at me.

I sat with a dumb smile plastered to my face- mouth partially open, waiting for the words to come.

I couldn’t do it.

She’s dead. She died. She’s gone.  I couldn’t find the right words.  I’ve said it dozen of times; I’ve gotten quite good at it, actually.  But in the bustle and noise of the restaurant, with the smiling waitress making fast chit chat, I just couldn’t do it.

Whether she sensed my hesitation or assumed I didn’t hear, she moved on to the next bit of chatter.

I couldn’t do it.  I’m sorry, my baby, I didn’t know how to tell her about you.  I’m sorry, Mabel.

A complicated holiday

The holidays are upon us again.  I’m both looking forward to them and not.  I’m looking forward to be at this big family event with a living baby.  Two years ago I was at Thanksgiving, pregnant with a child that we knew had Down Syndrome, but did not yet know had failing kidneys. Though I was at the point in my pregnancy where I was trying to celebrate, I did so cautiously.  I was still in the second trimester, when the risk of loss was 20%.  I treaded lightly.  I was among family, some of whom where pregnant with healthy babies, and I was secretly (or not so secretly) envious, wishing I could simply just be pregnant.  It was a complicated holiday.

Last year was my first Thanksgiving without Mabel.  I longed for the year before when I could still hope, even if cautiously, for a take home baby.  Those were easier days.  On this next family gathering, I was well acquainted with the new life of child loss and I did not like it.  I did not like attending holidays without my daughter.  It felt empty and and wrong.  I even held within me a little secret- I was newly pregnant but this small developing life inside me was known only to me and my husband. The hope of this new baby was not enough to lighten my heavy heart- and it shouldn’t have been. A new baby did not negate the loss of my daughter. It was a complicated holiday.

And now this Thanksgiving, my second Mabel-less turkey day.  This year I bring with me, my son, a warm squishy body to fill my once empty, aching arms.  That hope of a new baby has turned into the reality of one.  He is my protection- a shield against some of the sorrow that is bound to creep in.  He is also my light- he has brought me so much joy and I am excited to share him with the family.  Because he is here with me, I have begun to enjoy things again- but cautiously. I would hate for people to think that because he is here I am no longer sad, no longer long for my first baby.  So still, it will be a complicated holiday.

May Thanksgiving be gentle to you.

at the dog park

At the dog park, we watch our dogs run around and play together.  We refer to each other in relation to our pets.  “I’m Muppet’s mom.” and “Oliver’s mom brought dog toys.”  We swap names of groomers, complain about those who don’t clean up after their dogs and laugh our dogs romp around.  Occasionally, the conversation turns to life outside of our dogs.  Bringing Felix to the park often invites this kind of conversation.  Today, I had the same question, but different conversations.

_____

“He’s been cranky all day, which is not easy when I work from home!” I shared when someone asked about the little guyI was wearing in the baby bjorn.

“What do you do for work?”

I explained about my two jobs- I work part time as a midwife and part time for a non profit. Usually people, especially other women, pounce on the midwifery as an area of interest.  But this time it was different.

“What non profit?”

“Hope After Loss- we support the pregnancy and infant loss community. We run support groups, do outreach and give financial support for burial and cremation.”

“Oh….” the light hearted tone of the conversation had changed.  A beat later, the lightness returned as she changed the subject. “How was your labor with him?” she asked, nodding toward Felix.

“Hah! That’s a story!”

“Oh, was it long?”

“Oh no, it was super quick,” I said as I gave her the breakdown of how after a fifteen minute labor he was born into my hands over the toilet.

“Wow! And he’s you’re first!?” she said questioningly.

“My second, that’s why he came so fast.”

“How old’s your first?”

“She would have been 20 months…” I could see the confusion in her face as she tried to understand the past tense.  “But she died.”

Her face fell as she struggled to comprehend. “Oh I”m so sorry… She lived for 20 months?”

“No, she lived for six hours.”

“I’m so sorry,” she repeated, looking distressed.

“Thank you.  I like talking about her,” I reassured her.  Then followed a short conversation about my daughter.  It felt good to be open and honest.

As we wrapped up the details of Mabel’s birth and death, she looked at Felix in the baby carrier and said “at least you have him now.”  Looking for the silver lining in the death of a baby.

I kissed my son on his head and said “Yes, I am so grateful to have him.  But I miss his sister still.”

________

“Is he your first?”

“My second.”

“Oh, well then you know what you’re in for!” she said with a smile.

“Nope.  No I don’t.” Except I didn’t say that.  I thought it.  I thought about saying it, especially after the previous conversation I had. But I didn’t.  There’s just a split second I have to make the decision, whether I tell her.  I spent that split second thinking and not speaking and the moment was over.  Sometimes I wonder what the conversation would have been like had I spoke.  It’s just so much easier to answer direct questions rather than volunteering the information.