One.

I remember that morning.  Walking downstairs, pulling out the last pregnancy test, and for my own peace of mind, peeing on it.  The results read positive immediately as the liquid soaked across the strip.  I had never gotten a positive.  In our almost ten years of marriage, and countless test, there had never even been a possible hint of a second line.
My whole pregnancy, I resisted the urge to take more test. Just to see it again. I wondered if I'd ever have another positive test, or if we'd go back to 'unable to get pregnant.'  It didn't end up mattering because we made the permanent decision after things went horribly, to prevent any future pregnancies.  The risks for my life and our sons were too much for us to take again.

That test. That one and only positive pregnancy test, it resides in my underwear drawer. I still look at it occasionally.  I try to figure out how I feel about our whole journey.  It's such a mixed up thing that I can't think on it too long. Most of the time.
But, even with the aforementioned permanent procedure, I know there's still a small possibility.  Occasionally, things will play out and I'll get anxious enough to take another test.  And, every time, despite logical me wanting it to be negative, I whisper, 'Be positive, be positive.'

For a long time I refused to call myself infertile.  And, I certainly didn't struggle with my infertility.  It just was. We were content with our children being adopted.  I had long since stopped wondering what it might be like to have biological children.  It didn't matter to me.
The whole and honest truth is that in the parenting, the day in and day out stuff, it doesn't matter. They're all amazing, and silly. Maddening, hard, and wonderful.  They each come with their very own set of incredible gifts and challenges for us as parents.

So my longing is separate.  My longing is for that of feeling like I finally belonged as a woman.  I didn't feel excluded before so my words may be hard to completely understand.  But, it's the best I can do with the words I have available.
If I'm completely honest, it's the longing to redeem the things I feel like I still missed out on.  Asher never had hiccups in utero that I felt.  He never woke me up moving or kicking.  The further along I got, the less I felt him move (likely from his small size, my ample fluid, and his low muscle tone).  The birth. Even if I could just be awake and have my husband in the room, that would be enough for me.  To hear his first cries.  To see him still connected to me through his umbilical cord.

So I keep that test.  I moved it to our new house.  Jason asked about it.  He thought it seemed weird.  And, a little gross.  It is.  I know this.  I hope that someday I'll be able to just take a picture of it, and throw the actual plastic test away.  But, for right now, I need it.  I need it tucked in that drawer, reminding me, that even if it was only that one time, I didn't carry the label of 'infertile.'  And, when my heart longs to do it again, as it occasionally does, I can look at it, hold it, and grieve the way things went. I can wonder for a bit if things hadn't gone so wrong, if we might have gotten to experience it again.  Then, I can tuck it away safely, with all of my other hopes for what I wanted things to turn out like, wipe the tears, and move on with my new set of hopes and dreams.

c-sections or, when your child had been cut out of you.

in just a few days, 18 months will have passed since the day a doctor cut open my abdomen and uterus to pull my son out.  the act saved my son's life.  while his heart rate had started to drop with contractions, more importantly, we had no idea that his two vessel cord had very small amounts of Wharton's jelly around it.  this is the substance that keeps the umbilical cord from collapsing, twisting, etc. so that it stays open supplying oxygen and nutrients.  if Asher had been born vaginally, it's very likely that he would have suffered brain damage and possibly even have died as a result of this. it's the reason his heart rate was dropping during contractions.  as it is, we're pretty thankful he didn't pass away in utero.

but, that's not entirely what i'm here to talk about it.  C-sections are often seen as the easy way out.  no work. no pushing.  you get a spinal block so you don't feel the contractions.  it's like you didn't even really experience birth.
there are reason upon reason people have a C-section.  some are medically necessary.  some are by choice.  not a single one of them gets my vote of disapproval.  i'm learning that the best thing we can do is support other people's decisions, even if they're different from ours. even if from the outside, they make absolutely no sense, at all.
i'm not sad, at this point, that I had a C-section.  it was necessary.  it happened.  my son is alive, and doing great. 
but, let me tell you a few things about my experience so those who think that delivering vaginally is somehow better, can possibly empathize.
some people have to be put completely under for a C-section.  my epidural, and then spinal block only worked on half of my body.  I missed my son's first cries.  I don't even have a video of it because things happened in an emergency fashion.  I didn't get to see him at all until 8 hours after he was born.  then, I was wheeled to the nicu where I got to look at him and touch him for a few minutes before going back to my room, because one of the many meds I was on made me unable to walk, stand, or stay awake for long periods of time..
I woke up from surgery, on my abdomen, to someone pushing on my abdomen.  it's probably the closest I've ever come to punching someone.  for me, I couldn't have Tylenol because my liver was failing, narcotics because I had, had a spinal block (that didn't work), and ibuprofen because of one of the other meds I was on.  I woke up from abdominal surgery with NO pain control on board, and someone pushing on me. 
getting in and out of my hospital bed, literally, required me to sit the bed up, and still took me at least five minutes because of the pain.  coughing required holding myself, and bending over.  and, when you've been intubated, you cough. 
I couldn't lift anything over ten pounds for six weeks.  at this time, I had a 25 pound three year old who couldn't walk, or climb, and a two story house.  so for the next six weeks, I had to have someone home with me at all times to help me care for little.  while i'm SO thankful to the friends who stepped up and sat with us, it was hard on the days that I wanted to just spend time figuring out breast feeding, and being a mother of three all by myself.
there is not a day that goes by that i don't see my scar.  when i go to the bathroom.  when i shower.  when i change clothes.  there it is.  the reminder that my son was cut out of me.  i can physically run my fingers over the place, and feel where the scalpel was.

but, the real kicker, for me, is that almost every day, for eighteen months, I've continued to have pain.  I've had growing issues, and am amidst appointments and imaging.  i likely have adhesions-a type of scar tissue that can happen with abdominal surgeries, and it's likely bad enough that i'll have to have something done.  sometimes, when i cough or sneeze, i still have to put counter pressure on my scar to keep the pain at bay.

i'm not looking for a badge of courage for the way my son came into the world.  i'm not looking for sympathy because of everything that went wrong.  what i'm looking for is people to just walk along side and encourage others on their journey.  everyone's journey can be different, and still good.  it can be different, and still right.  it can be different and still beautiful.
also, C-sections aren't an easy way out.

a healing step.

after the arrival of tiny, I had some things that I was sad about.  disappointed.  and, there was nothing I could do about most of them. 
one of the lingering ones though, was the fact that I had Asher a few days before our scheduled pregnancy shoot.  I wanted photos of me at the end of pregnancy.  I had found some really non-cliché ones that I loved, and we just wanted a few that could be thrown in with our newborn shoot.
we knew we wouldn't be doing a pregnancy again.  we made sure.  so I mulled over the idea of doing them anyway.  but it seemed so cheesy. 
and, I decided to do them.  it would be part of the process of healing for me.  so a year after our son was born, no longer pregnant, we did maternity shots.  these are a few of my favorites.

the healing process is different for everyone.  this what part of it for me.  i'm so glad we did it. 

*these photos are copyrighted*

Just, a little....

It's a phenomenon that most people probably don't fully understand.  But, I've heard it from lots of other parents.  I've heard it from spouses.  I've heard it from people themselves.  So, I know that lots of people experience it.

Doctor crushes. 

Now, let me start by saying, a doctor crush is in no way shape or form of a sexual nature.  If you are truly attracted to a doctor, that's not what I'm talking about here.  This is a whole different form of crushing. 

It can be a male or female.  Old. Young.  Attractive.  Or someone you find not so attractive.  But, whatever happened with that doctor led you to get fluttery feelings every time you see them, talk about them, or think about them. 

I have a few of them.  Doctors who have gone above and beyond. The fellow who literally made the life saving call to check Shilo's thyroid numbers when she got very sick at a few weeks old.  The developmental pediatrician who looked into issues with Abigail when she was really young and figured multiple things out. The doctor who delivered Asher.  The list goes on and on for me. 
And, a friend who's husband broke his neck felt this way about one of the doctors who cared for him.  A friend who had a mass removed from her abdomen, talks about feeling this way.  A parent who had a doctor step in and step up to prevent unnecessary interventions.  A parent who stepped up and stepped in to make certain a child got a surgery that some doctors thought wasn't needed.

I find myself thinking about these doctors.  Looking forward to the next appointment with them.  Wanting to bring them gifts, and invite them over for dinner.  I replay our conversations, and can't help but smile when I think of how they treated me, and my children. 
For a while, I thought it was just me.  And, that it was a little weird.  Until I admitted it.  Then, time after time, in conversation, someone else would describe something similar. 

So here's a public declaration for those of you who didn't know this was a thing.  And, here's a thank you to the doctors who are so great, that a phrase needed to be developed to describe the feelings they invoke.  You make the world of navigating medical stuff a little more enjoyable. 

 

asher's story.

when I found out I was pregnant, I sought out encouraging natural birth stories and books.  one of them that I came across was Ina May Gaskin's 'Guide to Childbirth.'  One of my favorite things she said is, 'your body in not a lemon.'  Someone telling women that their bodies were designed to grow and birth babies without crazy medical intervention.  i felt hopeful and empowered.  The rest of this post is Asher's birth story (or the parts i can easily recall). 

we found out at Asher's twenty week ultrasounds that he had a two vessel cord (single umbilical artery).  this happens in about 1% of pregnancies with a single baby.  i had none of the categories that made me higher risk for this (over 35, birth of three plus children).  however, everything else looked great.  and it's possible to have a two vessel cord, and a perfectly healthy pregnancy. however, most doctor's won't let you go over 39-40 weeks due to the higher risk of the baby passing in utero if the placenta starts to break down.  you also get a lot more ultrasounds due to the risk of intrauterine growth restriction.  it can be an indicator of other genetic disorders, but they show up with other markers and defects on the ultrasound.
I wrote out my birth hopes (i refused to call it a plan because i wanted to be somewhat flexible).  i had plans for a natural water birth. i wanted to be able to move around during labor to use different positions to help alleviate pain. i wanted intermediate fetal monitoring.  i did not want internal monitoring.  we took birthing classes.  i practiced my relaxing breathing.  i went to every appointment. 
we had an ultrasound at 34 weeks.  he was still growing, but seemed to be slowing quite a bit in growth so we made an appt. for four weeks later to follow up and make sure he was growing.
on Friday, December 19, we had put the girls to bed, and I was sitting on the couch.  I started to feel a little dizzy, and was having some weird visual disturbances.  I called my doctor, and she had me come to labor and delivery to be monitored.  my blood pressure was up, but all of my labs were perfect.  after a couple of hours of monitoring, it came down on it's own, and I went home.  over the next few days I kept an eye on it with an at home monitor.  I didn't feel great, but did my best to rest as much as I could and take breaks or lay down if it got high.
on Tuesday, December 23, I woke up, and it was already really high.  the doctor had me go in again, and once again, labs were perfect.  the nurse who took care of me that day just kept telling me it wasn't that big of a deal, and I might have to take a pill to help keep it down. she told me there was nothing genetic about it, and really down played it.  i still couldn't quite shake the feeling of being overwhelmed and scared.  i was extremely swollen from it as well.

the next couple days were more fluctuations.  and on Christmas day, we drove the six hours to visit my husband's family for Christmas.  we got there in the late afternoon.  I ate dinner, helped get the girls ready for bed, and just sat there.  as the night went on I felt worse and worse.  I started to feel nauseous, and my stomach hurt.  we had eaten steak and shake for lunch that day though, so I wasn't so surprised.  I took my blood pressure before bed.  it was up, but decided to try to lay down for a bit.  I laid down for about an hour, then got up and got sick multiple times.  I woke Jason up, and he called the doctor.  by the time we got the return call, I had decided we were going to the hospital because my blood pressure was still so high.
off we went to an unfamiliar hospital, six hours from home.  I puked as they checked me in.  they put me on the monitors and asher sounded great.  they did urine and blood work.  at some point the doctor came in and told me they were going to keep me for a 24 hour urine collection. he also said he was going to start me on a magnesium sulfate i.v. to keep me from having seizures.  we decided to send Jason back to his parents so the girls didn't wake up with us gone, and I would stay. everyone was calm and together.  nothing seemed that far outside of my other two experiences.
he left, and they moved me to a room.  a few minutes later, the doctor came in.  his assumption was that I knew or understood how sick I was.  my assumption was that like every other time, the labs would be fine, and they were just taking extra precautions.

'you're having this baby.'
'what?'
'oh.  I thought you knew how sick you were.  you have HELLP syndrome. your liver enzymes are high, and your platelets are low.'

I called Jason and told him to come back.  he had to give the run down on how to use shilo's g-tube and just the girls in general to his family.  he woke Abigail to tell her the basics.  meanwhile the doctor is going through all sorts of things with me, and working to get my paperwork faxed from the doctor's office back home.  when he came back, we talked. there were multiple points where we both wept together and talked about how it seemed like nothing ever got to be easy for us.
at about two a.m. they started the magnesium sulfate.  at seven a.m. a new doctor came on.  I REALLY liked her.  at around eight they started the Pitocin, and by nine I was having contractions.  I continued to labor with the Pitocin until around nine that night.  I couldn't have anything to eat because I was high risk for needing a C-section.  I was making it on Jell-O and water.
they were continuing to draw blood and run labs on me all day to make certain my numbers weren't changing to drastically.  at about 8 p.m. the doctor came in and told me that I was not only peeing protein, but also sodium.  my sodium levels had dropped to 'dangerously low' and could start affecting my brain.  Pitocin can exacerbate this so they had to stop it.
I was two centimeters and about 70% effaced.  we decided to go ahead and rupture my membranes in hopes that would make my labor continue to progress.  from about ten p.m. when they ruptured them until around eight a.m., my contractions slowed to about every ten minutes, and not nearly as intense.  I wasn't making much progress.
they still couldn't start the Pitocin, and at this point I was no longer allowed to drink anything because it could further deplete sodium levels, and my ice chip intake was extremely limited.  they decided to try a drug called cytototek that is inserted against the cervix.  it caused me to go back into active labor having contraction every four minutes.  at this point Jason and I had been up for over 48 hours.  we were both, literally falling asleep between contractions.
my contractions were all down low, and quite a bit in my back so Jason spent every contraction rubbing my lower back and telling me I could do it, or encouraging me to breathe. he kept the peaceful music playing and diffused an essential oil to help me relax.  by late that afternoon, we were both exhausted, and I wasn't sure how much longer I could make it.  the doctor checked me and I was at a five.  not great, but still progress.  i tried to focus each contraction on opening up.  a few hours later i felt some pressure so the doctor checked me again. i was at a five still and 80% effaced.  asher had moved down (hence the pressure i was feeling).  i started to cry.  i told Jason i couldn't do it.  i was exhausted, in pain, having blood drawn every couple hours (often during contractions), and my mouth was like a dessert from not being able to have anything to drink.  the worst part for me though was that i couldn't move around because i had to stay on the magnesium and multiple other things at this point.  i periodically rolled from one side to the other.  laying on my back made contractions worse because so much of the contraction was focused in my back.
at this point, someone explained that the magnesium I was on causes the smooth muscles to relax.  therefore, with every contraction I was having, the magnesium was fighting against it.  I was feeling extremely overwhelmed, and defeated, and asked for something to help with the pain.  the med they gave helped a little, but didn't last long.
i still wasn't dialating any more.  i finally just asked for an epidural. the first doctor i saw when i first arrived had encouraged me to consider it anyway because it can help bring blood pressures down.  Jason and i were both relieved when it kicked in, and we could rest.  my sodium had come up enough that they started a very low dose of Pitocin as well.  for the next little while i labored and let my body do all the work.  after about thirty minutes, the epidural stopped working on one side.  so while the pain wasn't as intense as it had been, i could feel the contractions.
at this point, people started to rush in every third or fourth contraction because asher's heart rate was dropping. they started by putting in an internal monitor for contractions.  they also used it to put a little more fluid back around asher.  they put an oxygen mask on me, and at one point had me get up on my hands and knees in hopes of taking the pressure off of him during contractions.  it worked, but i couldn't stay like that long term because i couldn't feel my legs.  they eventually put an internal monitor on him to follow his heart rate as well.
i was at eight centimenters, and decided to focus all of my energy on trying to get my body to open up again.  after a few more contractions i started to feel the pressure to push.  the doctor checked me and i was at nine.  asher was at a +2.  we just needed that last centimeter so he could come out.
but, his heart rate continued to drop. i was getting nervous for him.
after a few more contractions, the doctor said, we have to get him out. we were wheeled into surgery for a C-section.  they gave me a spinal block, but like my epidural, it didn't work.  i could still feel quite a bit.  so they had to put me completely under.  Jason couldn't be in the room as a result.  i remember them putting the mask on my face, but that's it.  i didn't hear his first cry when he was born.
when i woke up in recovery, there was a nurse checking my fundus to make sure it was contracting.  however, the epidural and block hadn't worked.  they couldn't give me ibuprofen because of the magnesium.  they couldn't give me Tylenol because of the liver failure.  and, they couldn't give me narcotics because i had, had a spinal block.  i'm not sure what i said to that nurse but i know i grabbed her hand and moved it away from me multiple times.  while i was still trying to wake up, the neonatologist came in and told me something.  i have no idea what he said to me.
eventually i got wheeled back to my room, and Jason came in.  i started to asks questions.  how big was he?  was he okay?
3lbs 13oz.  17-1/2 inches long. born at 6:43. he was okay, in the NICU and on c-pap.  he showed me a pictures, although i was having a hard time keeping my eyes open and focusing.  he told me his parents had come and gotten to see him.  i started crying because they got to see him before i did.
he told me about the nurse taking the camera to get pictures when they got asher out, and how when she walked by with him, he started to cry. 

i had to be on magnesium for another 24 hours after delivery.  i still wasn't allowed to walk.  and i wasn't even allowed to go see him until i had been out of surgery for 6-8 hours.  so at about two a.m. i got wheeled to the NICU to take my first look at my son.  he had the c-pap mask on, and was just so very tiny.  in those final 24 hours of magnesium, my calcium also dropped, and they had to give me i.v. calcium after I was done with the magnesium.

I learned from different doctors and nurses over the next few days that asher's small size was likely cause by a combination of things.  first of all, his two vessel cord did not enter the placenta like it was supposed to, but instead he had peripheral cord insertation (about 10% of umbilical cords don't insert into the placenta as they should).  also, umbilical cords are surrounded by a jelly like cushion called Wharton's jelly. this helps protect the cord from completely collapsing if there is pressure put on it.  asher's cord had very little of this jelly, and it's the reason he went into distress during the end of labor (something would compress the cord during the contraction, and it would close off blood supply instead of being able to hold up to it like most cords can).  and lastly, while I haven't researched it a bunch, HELLP syndrome and pre-eclampsia are often something that is going to happen, and is determined by the way the blood vessels formed in the placenta. so from the get go it's likely that the syndrome lurking below the surface was hindering things.  all of these things meant that asher did not grow like he should. 

as it turns out, my body might just be a lemon.  if we were to get pregnant again, i would be at very high risk for HELLP syndrome.  but, we have already decided that we are completely unwilling to take that risk.  i was extremely sick, and going down hill fast during labor and delivery.  had asher made it closer to term, he likely wouldn't have lived.
while i wouldn't say i'm happy i developed HELLP syndrome, i will say i'm thankful that it happened when and how it did because it likely saved my son's life.
i am on the mend.  he's doing great. he's just small.  and i will forever remember this time as one where my husband was above and beyond amazing.  i have likely thanked him 100 times over for how great he was during labor and delivery despite understanding more of what was going on, and knowing that at some point he sent a text to some people telling them he was scared i was going to die.

newborn

meeting papa

on c-pap

hanging out with mama this morning.