Pregnant

So, I started this post over a month ago and now that it’s starting to feel like baby could come any day now, I should probably go ahead and post it!

So yeah… we’re expecting a baby! Her due date is this week!

Insta and FB have a way of encouraging us to only share the positive sides of life, but I don’t feel comfortable posting a picture of my smiling, super pregnant self without also sharing the complex emotional and physical stories from the past 9 months. I am always torn between a desire for privacy and my hope to be a person others can connect with, learn from, and relate to. This post is one of those where I’m leaning in to the discomfort that comes with being so open and vulnerable in such a public way.

I also don’t want to contribute to the romanticization of pregnancy or the culture of silence and condescension around reproductive health, and women/trans/GNC folk’s healthcare.

And, pregnancy is emotionally, socially, and politically so loaded that I want to share in a place where I feel safe and where others can control how much of my social media presence they consume. 🙂

I still remember a few years ago when I really wanted to have a child, and it physically hurt to see photos of my friend’s babies, children, and pregnancy journeys. I hid them from my newsfeed until that time passed. Which, surprisingly, it did, until I wasn’t sure I wanted to give birth myself, but was still pretty sure I wanted to be a parent to lots of children someday.

And here we are now!

I’m probably way overthinking this, but hey, this is me.

::waves::

Feel free to skip through the details if you are squeamish or simply not interested. 🙂

Mid-October and November

I took the pregnancy test because I hadn’t been feeling well for about a week and had gone in for a physical and everything had come back as fine. That Friday I had a medical school exam and felt weird the whole time.

I don’t know if I would describe it as nausea, but I felt really off. My boobs were super sore, my face swollen, and I had a huge, huge pimple taking over most of my chin.

I dismissed it all as PMS.

When the test came back as positive, we both laughed — our minds kind of blown. The test was old so we played with the idea that it wasn’t accurate and went out and bought a new one (which also came back as positive).

We went to the arboretum and spent the rest of the day in a surreal state talking about what we were going to do and how we would make it work.

That night we called our parents and siblings. We were mostly excited — a little nervous, of course — but surprised and excited.

About 1 in 4 recognized pregnancies end in miscarriage (and up to 50% of all pregnancies end in miscarriage — often before the person knows they’re pregnant) so I didn’t want anyone to get too excited. I thought I had 9 months to do some of the pre-motherhood things I still wanted to do, and to figure out how to balance medical school with a baby.

But it’s honestly hard to remember how quickly things changed after that.

Within a week I was dry heaving and then soon after the nausea took over every cell of my body.

The first few times Matt heard me head to the bathroom, he came and sat a few steps away in solidarity. I didn’t feel comfortable with that so I asked him to just help me keep track of the vomiting to see if there was a pattern to it.

Hah.

The nausea and vomiting quickly took over my life.

I will never refer to it as “morning sickness” because that minimizes this condition that can happen at any time of the day (or all day!) and can lead to dehydration, depression, malnutrition, kidney failure, gastrointestinal bleeding and death.

TBH I don’t understand how anyone jokes about it…

For me, the nausea and vomiting was continual, debilitating, and soul-crushing.

I struggled a lot with taking medications because the first ones I tried had unpleasant side effects (sleepiness to the point of falling asleep at my desk, painful constipation, etc.) and nothing has been approved as completely safe for baby.

I resisted going to the hospital because I worried they would think I was weak (“doesn’t every pregnant person go through this?”), a hypochondriac (“it’s just morning sickness… it’s actually a sign that the baby is healthy”), and silly for not taking the prescribed medication.

I also thought the nausea and vomiting would go away in a few weeks. Now that I am able to think more clearly, I believe that it would have been better to risk the potential side effects of medication than the dehydration I fought against daily.

Every day (with help) I measured out a certain amount of fluids in the form of ice chips and protein shakes and ice cream.

My other sources of nutrients included doritos and clementines.

I felt so guilty eating things that I would never normally eat, but almost everything made me throw up.

And I wasn’t just sick with food and smells.

I got sick looking at computers and phone screens — especially while scrolling. Going up and down stairs. Nodding during conversations with other people. Showering. Brushing my teeth or my hair. Washing my hands. Anyone touching me. The heat of another person’s body too close to mine. Rolling over in bed. Drinking water. Going from a cold place to a hot place like from outside to inside.

I felt so isolated — often unable to hold conversations or even look at my phone long enough to text.

I walked around with bags in my pocket and a jar in my hand (they were scattered around the apartment so I always had one in reach) and gagged/vomited everywhere — up and down the street, on the bus, in bed, in the shower.

I got so scared of showering.

One of my lowest moments was standing in the shower trying to clean out the drain that was clogged with vomit while the vomitwater pooled around my feet and I continued to let the excess saliva drip out of my mouth because I couldn’t swallow.

And because I was still trying to do medical school at the time, Matt was sitting in the bathroom diligently quizzing me in between my gags.

Bless him.

“Did you try using wipes or consider a sponge bath?” is one example of the many questions I would get about things that I tried or not tried.

My vomit was so forceful it would splash back up and get in my hair and who knows where else… so while a shower might mean I couldn’t do anything else the rest of the day, at least I felt clean once every few days.

It was unreal.

 

And as the weeks became months and I didn’t feel better, I truly stopped feeling human.

This was how I studied:

Early December

In terms of medical school…

I started meeting with a learning specialist. So many people told me I would feel better soon and I held on to that hope so hard.

I hoped that if I started to feel better at the beginning of my second trimester (as many people do), that I would be able to finish out the semester and possibly the year.

But around Week 13 (last month of school semester when I “should have” started to feel better), I started to feel worse.

In terms of accommodations for testing, the school allowed me to take my midterms in a smaller room with access to food (whew — a must), but they couldn’t allow me to pause the exam while gagging/throwing up or have extra time to make up for the time I lost while being sick.

They allow rescheduling, but for those who feel better within a few days — which of course I couldn’t predict. I wanted to postpone my exams until after Christmas break, but that also wasn’t possible. So I took a leave of absence, and will begin the unit again this fall with a newborn.

Needless to say, the financial implications of this pregnancy have been huge for me, and as a general rule, are disproportionately unfair to pregnant people everywhere.

On an individual level, I felt the administrators cared about me, but the curriculum and medical school and medicine (as a whole) is simply not well equipped to support students or physicians with unpredictable health, family, or life problems.

I have no doubt this contributes to the almost 30% of medical students who suffer from depression or symptoms of depression, the 1 in 10 who have reported suicidal thoughts (making medical students five times more susceptible to depression than the general population), and the 26% of students who have admitted to suffering from anxiety.

I suspect any reports are artificially low due to stigma and the fear of potential professional repercussions. Unfortunately, the numbers do not seem to get better once we graduate and move into life as a resident and then as a physician. Anyway…

Although my school makes health and wellness a priority (for example, by offering unlimited, free therapy sessions), more needs to change.

 

I am frustrated that even as a medical student, I couldn’t figure out what was “normal” and that I needed professional help. I have had health issues in the past, and I *thought* I knew how to be an advocate for myself, but this pushed me into new territory.

It’s actually surprisingly difficult to find statistics on the incidence rate of nausea and vomiting in pregnancy and its debilitating effects.

According to UptoDate,

Some degree of nausea with or without vomiting occurs in up to 90 percent of pregnancies [5]. In a prospective study including almost 800 women followed from conception, 57 percent reported nausea and 27 percent reported both nausea and vomiting by 8 weeks of gestation [6]. In another prospective study of over 360 women, 28 percent experienced nausea only and 52 percent had both nausea and vomiting [7].

Most articles published for the public simply say “80-90%+ experience some nausea and vomiting during pregnancy.”

I found this unhelpful because there are SO many different kinds of nausea and vomiting, and as a first time pregnant person, I had nothing to refer to, and very few friends who have gone through the experience themselves.

There’s the “oh, I don’t feel so good” nausea.

And then there’s the “I can’t move, I want to die” nausea.

And then there’s everything in between.

And with vomiting?

There’s the “excuse me for a few minutes” vomiting and then there’s violent, uncontrollable, projectile vomiting that comes so forcefully it comes out your nose (triggering bloody noses every day for months), while the vessels in your eyes break, you can’t control your bladder, and your back and shoulders and neck muscles ache from the dry heaving that doesn’t stop.

It’s torture.

And again, there’s also everything in between.

I am frustrated at the hours (days!) I spent weighing what I saw as my “comfort” against possible, unknown, negative side effects for baby if I used medications off-label that had originally been designed for cancer victims undergoing chemotherapy.

I am frustrated at the lack of continuity of care in the OB world (at 9 months pregnant, I have yet to see the same provider more than once at UWHealth).

And I am frustrated at the lack of evidence supporting any specific treatment for almost ANYTHING regarding pregnant people.

If you get sick (a cold, migraine, flu, or infection) there is a very short list of OTC or prescriptions deemed “safe” for those expecting, and even those can’t be trusted. For example, in November a new study came out showing that long-term maternal use of acetaminophen (tylenol) during pregnancy is associated with ADHD.

With all my research, my take-away was don’t take any medications unless you absolutely need them.

As I’m sure you’ve gathered, I found that judgement call a really difficult one to make.

And finally, I was pro-choice before, but the idea that someone could force me to go through this makes me extremely angry.

Extremely….

Angry.

Anyway……

One day I realized I dreaded waking up. I felt totally detached from the creature inside me.

The noises my throat involuntarily made sounded like a dying animal. And at times, I really felt like I was dying.

Especially when I couldn’t catch my breath while gagging.

And when I didn’t feel like I was dying, I mostly felt nothing, like nothing at all. Which was its own kind of scary.

We had just moved a few months before and all of my friends here had only known me for (at most!) 7 weeks before I started getting sick.

I am so thankful to them for their love, support, and patience.

Around April, I felt like a bear popping my head out of my winter nest to look around and ask “anyone still here?”

Yes, everyone is still here! And they’ve been here, checking in and protecting my little nest the whole time.

Literally my eyes can’t think about them without filling with tears.

I am so, so grateful.

Ah… I am getting ahead of myself.

In December, we started planning a trip that I called “the make me want to live again” trip.

I just felt so dead. Inhuman. Incapable of doing basic things for myself.

I really needed to focus on the basics.

Breeze. Green leaves. Sun. Ocean. Life.

So we went to California.

January

Here we are at Joshua Tree!

And on our way to Catalina Island!

After Catalina Island, we stopped in San Diego where my aunt took care of me for a few days. It felt so good to be with family and to talk to someone who understood what I was going through.

After Southern California, we headed back to Oakland, our old city.

It was in Oakland and San Francisco, around week 18, staying with Matt’s aunt and uncle, that I spent a long time talking to one of my oldest friends, Julia, who is a nurse, and Matt’s aunt’s best friend, Jerusalem, who is also a nurse, about the risks and benefits of a medication called ondansetron (zofran). I will forever be grateful for the hours they both spent dragging my thoughts and doubts about the medication out into the light.

I had been given a prescription for ondansetron very early in the pregnancy which I really appreciate: many have to fight with their providers to be taken seriously for this prescription, but one of my physicians prescribed it immediately when previous prescriptions failed. However, you’ll find conflicting information about it’s safety and I was saving it for an “emergency.”

I only met with this physician once, but I wonder how different my care may have been if there had been more continuity.

However, I was still nauseous and throwing up and was down about 6% of my body weight which doesn’t sound like a lot, but at this point I should have been gaining weight. So after talking to them both for hours about my fears and insecurities, I finally tried it.

And it did help!

I wish I had tried it sooner.

I started eating and keeping down some food.

Upon returning home, I went in for a visit around 20 weeks pregnant and said “I still can’t eat almost anything except salty chips and ice cream and toast and reese’s chocolates… so I finally started taking the Zofran prescribed to me months ago, and I have been able to keep down a little more… eating a few bites of “real food” a day… and drinking water again!” I was so proud of my progress, but also concerned about baby.

The doctor (different doctor) told me that “zofran should only be used as a last resort…” and quickly followed up with, “Have you tried eating chicken? Potatoes? What about broccoli? Kale? Peanut Butter? Beans? Eggs? Meat? Lentils?” She listed about 20 different foods.

I know she was just trying to be helpful, and I tried not to get defensive as I tried not to cry. I explained that usually I eat a fairly well balanced diet, but that I just couldn’t right now, and that it was killing me.

I left the physician’s office with the advice to try high doses of ginger and limit the zofran if possible, eat less junk, and try foods with substance.

I liked her as a person, but felt like she hadn’t actually heard me.

February

The vomiting decreased. The nausea, while still constant, became less debilitating.

A few days or a week would pass in between episodes and I started to be able to walk outside for longer, hold conversations with less nausea and vertigo, and use the computer again for a few hours a day.

At the end of February, we went to Scotland to visit with some of our bestest friends with the goal of reintroducing foods, walking to rebuild my strength, and strengthening my will to live.

I know you can’t see my belly bump in any these pictures, but it was such an important time for me to connect with the baby growing inside me that I held my belly for most pictures anyway.

Mid-March

Around 27 weeks, I threw up for the last time!

I also got an infection and spent a few hours in the ER and maternity ward in Edinburgh where I had a FANTASTIC experience with no bill afterward (yay for the NHS).

In this case, I was in so much pain and having scary contractions that it became an easy decision to go to the ER (during a historic snow storm with all taxis and buses not running! Adventure!).

The women (nurses and doctors) were all SO nice and dedicated to my care that I returned to the US a little less scared of hospitals, and with a renewed sense of what kind of doctor I want to be for my patients.

I remember the last time I vomited so well. I had to catch the vomit (in a bag, of course) to fish out the antibiotics I was taking to then retake them because I didn’t want to miss a dose. Ew.

Mid-April

I switched from OB care to midwifery care, and (in addition) started meeting regularly with a home birth midwife who encouraged me to try acupuncture to tackle the lingering nausea and back pain, helped me address the anemia I had developed over the months, and suggested that I track my blood sugar (which we found spiked quickly without continual protein intake, and then dropped quickly to low fasting levels every hour which probably contributed to my nausea and shakiness).

My midwife has been my angel of light guiding me through these last few months.

The nausea mostly went away around this time, although certain smells, foods, and fatigue still trigger it — it’s nowhere near as debilitating.

I also started seeing a therapist to focus on rebuilding trust in my body (and trust in baby’s wellbeing) and in my ability to advocate for myself.

May

And here we are now!

Just a few weeks or days or hours out from baby’s arrival and I am so excited to meet her that tears are coming to my eyes as I write this.

Right now, baby has the hiccups and I can feel the twitching below my belly button.

Breech Baby!

For the last month, baby was in a breech position (head up under my ribs instead of down by my cervix).

I did the spinning babies exercises, met with a chiropractor who performed the Webster technique, and continued seeing an acupuncturist. I also tried moxibustion.

All along, my support partners and I talked to her and encouraged her to turn. Sometimes playing music, putting ice packs on her head, and shining a light in the direction we wanted her to turn.

I walked as much as possible, and tried swimming (doing lots of hand stands and flips in the pool). Her activity often increased (especially during the acupuncture, the moxi, and talking to her) and sometimes it felt like she was trying to flip. But in the end, she didn’t flip on her own.

Unfortunately, the knowledge of how to deliver breech babies vaginally is being lost as physicians stop doing it and stop teaching it, and as hospitals stop allowing it. I want to point out that this is yet another area where pregnant people do not have a choice about what they allow to be done to their bodies and their babies.

With no practitioners in the Madison area willing to deliver breech, my “choice” was between scheduling an external cephalic version (ECV) where they forcefully turn baby manually (with about a 50% success rate) or a cesarean, which, although common, is still major abdominal surgery.

The External Cephalic Version…

…was terrifying, but it worked!

The hardest part was not eating or drinking (even water!) from 6am to 2pm in case I needed an emergency cesarean. While mild, the thirst and hunger made me nauseous and reminded me of all the times I would drink and eat just to throw it back up again… never able to quench my thirst or hunger.

After checking in and getting changed, the wonderful nurse set me up with an IV and fetal heart monitor.

I was given a tocolytic agent (terbutaline) to relax my uterus which also had the unpleasant side effect of making my heart race.

The procedure was over in less than 4 minutes (maybe even less), and felt like what you’d expect it to feel like if someone tried to grab one of your internal organs from the outside and turn it upside down as quickly as possible. It was painful and kind of an out of body experience. Different practitioners have different methods so I am guessing experiences vary.

 

SO YAY!

Here we are now! About to have a baby!

The past few months have been challenging, and we are SO, so, so incredibly grateful to our family and friends who have loved and supported us the whole way through.

We feel so lucky to bring a baby into this world who is sure to be overwhelmed with love and guidance.

About a month ago we drove to Detroit to celebrate with Matt’s family and it was so wonderful to meet his extended family and friends at the baby shower. We are so thankful to everyone who was able to come celebrate with us and to those who have helped us prepare by collecting clothes and furniture, knitting blankets, and giving us gifts.

We also had a wonderful time celebrating baby’s impending arrival with our friends in Wisconsin after they finished their final exams of their first year of medical school!

Thanks so much to Liv who stepped into the role of photographer for the afternoon!

It was a bit of a non-traditional baby shower where the food theme was all the foods I have been able to eat over the last 9 months.

June

And now?

How do I feel now?

In this moment, I feel so good.

Occasionally I have scary thoughts about all the things that could go wrong in the next few days or weeks. And quite often I feel totally unprepared, but luckily this feeling comes with a burst of energy to get things done.

I am just so glad to feel human again. To adore life again.

And I am finally excited to nurture and love this little soul growing inside me.

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