Monday, August 10, 2015

Will you try again? Thoughts on another pregnancy after a pregnancy after loss.

Recently, we've had several people ask whether we would have try for more children after this pregnancy. None of them were nosy strangers; they were all people who knew about our losses and are generally concerned about our future, know that we have wanted a large family and also the toll that several miscarriages have had on us.

We don't really have a definitive answer at this point. Truly, I don't feel comfortable making that decision now...or ever. I just can't say that we'll never have more children because we really do try to take it one month at a time. Since this baby isn't even here yet, I have no idea where we'll be physically, mentally, emotionally, and financially when my cycles return (it took 11 months after Lucia was born, so we're looking at somewhere around October 2016 before we'd even need to make a decision of any kind). But, it is something we do think about and talk about and so here's where we're at right now.

My pregnancy, labor, and delivery were Lucia was incredibly affirming of our desire for a large family. Aside from the normal symptoms of morning sickness in the first trimester and heartburn in the third, I felt wonderful my entire pregnancy. The pregnancy was textbook perfect, without a single complication. The labor and delivery were also complication and intervention free. And I was probably one of the most laid back pregnant women - I never once called my midwives with questions, never worried about my health or the health of the baby, I can't remember ever being anxious or confused or scared about any aspect of pregnancy. After Lucia was born, I was so confident in the ability of my body to create and nurture children and I looked forward to the pregnancies to come and the large family we would have.

That pregnancy was such a gift. I know so many women who have never been able to have that experience. Their first pregnancies ended in miscarriage, or were overshadowed with serious complications or mental health issues, or came after years of infertility struggles which left them with little confidence in their bodies' abilities to do what should come naturally.

But early motherhood for me came easy, physically and emotionally. Even after Lucia was here, being a mom seemed natural and I never struggled with my changing roles. I always wanted to be a mother and when I became one, everything about it seemed so intuitive. It all seemed like an affirmation of where my life was going; if motherhood felt so right - physically, emotionally, practically - then didn't it make sense that I would have many children, the chance to replicate these experiences over and over?
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My due date for this baby is exactly three weeks shy of four years since my due date with Lucia. We certainly didn't expect our children to be this far apart in age. Many couples wait much longer than we have for a living child. We know that while our path hasn't been easy, it could have been much more difficult and we are grateful for our blessings. But we are also wary for our future.

This pregnancy has been very trying for me. After four miscarriages, the belief that my body knows what it's supposed to do, or even that it's a safe place for our child, is no longer intact. Physically this pregnancy is much more difficult and I constantly feel worn down and in some form of pain. It's nothing to complain about really, it's all within the realm of "normal" for a pregnancy and certainly is worth enduring for my child, but it is another reminder that my body isn't quite so conducive to pregnancy as I once thought. Emotionally, this pregnancy has been strenuous and when I look ahead to future pregnancies, I can't imagine that they'll be much easier. It's tempting to try to assume that a healthy labor, delivery, and baby at the end of this pregnancy will heal much of the pain of the past and make future pregnancies easier, but it seems much more likely that the scars will remain long after this pregnancy.

At this point, the thought of ever getting pregnant again is terrifying. I cannot count the times during this pregnancy, during moments of extreme anxiety, when I've made my husband promise we'd never, ever try to get pregnant again.  Just the thought of trying is panic inducing. Attempting to conceive a child is not an exciting, hope-filled endeavor for us anymore. After all, two-thirds of our children have died, a sobering statistic that sucks the joy out of thoughts of growing our family. We have no way of knowing whether I carried past the first trimester this time because of the surgery that removed endometriosis or whether this was just a random occurrence. Perhaps endometriosis wasn't even the problem in the first place, and the real issue is still there. I have no idea what my chances are for future miscarriages. As anxiety-ridden as it has been, I believe I could probably handle another healthy pregnancy, but I'm not entirely sure I could cope with more miscarriages or a complication-riddled pregnancy. I have obligations to care for husband and living children and worry that attempts to expand our family further would prevent me from caring for the family I already have.

Perhaps after this baby is born, our future fertility plans will become more clear. I pray that circumstances may change so that we might still have the large family we always longed for. I'm young enough that I have more than a decade of fertility ahead of me, so I assume we will try again at some point. However, because I had endometriosis, which even after surgery has a high chance for coming back (and only gets worse over time), there is a lot of pressure to get pregnant again right away. I don't think we'll do that and perhaps I'll need to have surgery again later down the road if we decide to try for more children. Perhaps I'll have more miscarriages. Maybe I'll suffer from secondary infertility.

Looking ahead at our future family, we acknowledge that it's entirely possible that, for whatever reason, this baby may be our last living child. It's a thought that brings me sadness but, at the same time, a measure of relief. Knowing that, if we find ourselves in the position of needing to, we can avoid pregnancy the rest of our childbearing years is a blessing. It's not a decision we take lightly; we are dedicated to being open to life and not using artificial means to prevent pregnancy and would welcome any surprise children God sent our way, but having that option is something we need to know is available to us. We are blessed in that while NFP has been emotionally draining when trying to conceive and navigate the medical side of miscarriage, it's been pretty easy for us to utilize to avoid pregnancy and I wonder if this is not the reason why - because perhaps we'll need to use it for many, many years.


4 comments:

  1. Oh, my goodness. I get so frustrated when people ask me if we're going to have more when I'm currently pregnant. It's like - "Let's concentrate on getting this one out of the womb before we even think about putting any more in the womb." And whether or not to have another child just depends on a whole host of factors - without the ability to foretell the future we have no idea what our discernment will look like. We just take it day by day, cycle by cycle.

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  2. Obviously, everyone has a different experience, but I found that having my first child did help in some measure cover over or heal some of the pain of the past miscarriages. The second child also healed me further, and I got to enjoy the somewhat novel experience of a complication-free pregnancy. It didn't happen automatically, and I went through some serious anxiety and PPD with my first for a good year (in retrospect I should have gotten help sooner), but now, three years out, I am ready for any children that have come my way and also at peace with the notion that I will possibly (likely) have more miscarriages in my future and possibly no children for all that. Not that your experience will be the same, but I hope and pray you can gain some measure of peace after this baby is born. And if you are still feeling anxiety or depression after the baby is born, it might be worth it to get treatment. I really wish I had addressed the PPD earlier, as it sucked the joy out of my oldest son's first year of life when it didn't need to.

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    1. Tia, I think it will help if this baby is born alive and healthy, I just am not sure it will help enough, or at least I don't want to assume it will. The difficulty of this pregnancy was very unexpected even though I had previous losses. My last pregnancy, I was not nearly so anxious in the first several weeks even though I knew a miscarriage was possible (and I did end up miscarrying) but I think the early bleeding this time maybe prompted such early anxiety? Anyway, I just want to face future pregnancies with the full knowledge that they may be just as hard or harder than this one and not naively assume that it will automatically get better after this one.

      I'm so glad you had such positive experiences with healing during subsequent pregnancies! And yes, I will be sure to address PPD if I face it.

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    2. of course, no one can know how they will feel until they go through it, and it's wise to anticipate the full potential range of reactions and emotions you may experience when it comes to future pregnancy. Either way, I'll pray for an easy, uncomplicated birth and a joyful time with your new little one, and that the anxiety will ease up in these last few months.

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