Joy and Pain

I will be twelve weeks pregnant tomorrow.  We had our early genetic screening this morning, where they combine the results of ultrasound analysis, a blood test, and the mother’s age to spit out the likelihood of certain genetic abnormalities. As the technician was examining me, she asked, “This is your second pregnancy?” And I said, “Yes,” and took a deep breath, trying to prepare for what I knew was coming. “And how old is your older child?” she said with a smile, anticipating the glowing response of normal parents in our situation. I, of course, began to tear up and said, “Our older daughter passed away earlier this year.” She said, “Oh, I’m so sorry,” obviously chagrined that she had brought it up. Through my tears, I tried to make her feel better and said, “Oh, that’s okay.” She said again, “I’m sorry.” I spent the next several seconds trying to calm down so that my abdomen wouldn’t be so tense—I was irrationally worried that it might somehow affect her ability to do the ultrasound.

A little while later, but while I was still on the table, the genetic specialist came in and we had to do it all over again. “Do you have older children?” “I was just telling the tech that our older daughter died in May.” Tears again. The specialist, an older woman with a very mama-bear personality (forgive the now co-opted expression, but it really did apply here), immediately said, “Oh, sweetie, you poor thing.” She came over and put a hand on Ed’s shoulder and then put both her hands on my shins and squeezed. This was exactly the kind of reaction I had been waiting and hoping for from someone in the OB’s office from the time we first had to share the news during our first visit with this pregnancy. Sometimes I think doctors just maintain too much professional distance. I understand why they do it, but the compassion and humanity that this doctor showed us helped me feel relaxed and normal almost for the first time since we found out we were having this baby. Her hands on my shins as I was lying on that table, so vulnerable, marveling at the growth of our next baby, crying over the death of our older baby—well, it just changed everything. I continued to cry a little bit as the scan went on, but it felt okay.

Everything on the scan looked fine, but we have to wait for the results of the blood test before we know what the actual risks are. After the ultrasound was over, we went to the specialist’s office where she took a full history from both Ed and me (since I’ll be delivering after age 35, I’m considered “advanced maternal age,” so they do a genetic counseling session in addition to the early screening). She was, again, so full of compassion and motherly love and warmth, yet also very knowledgeable and straightforward. She told us about our options to do amniocentesis and suggested that this procedure is now considered so low-risk that the ACOG says they can offer it to anyone, whether they are in a heightened risk category or not. In tears again, I said, “Well, we’ve already thought about it and given what we’ve been through, we don’t want to take any risks at all.” She totally understood and didn’t say another word about it, then put her hand on my knee and kindly told me that crying is actually good for women’s coronary arteries (but it doesn’t have the same effect on men). We all immediately started to laugh and I said, “Well, then, I will end up with a very healthy heart.”

We mentioned that the infectious disease doctor had told us that the only time they usually see a child’s immune system get overwhelmed by infection the way Hudson’s did is if the child does not have a spleen. The specialist had actually worked with a family who lost two young babies to infections, at which point they discovered that the mother had hyposplenism (a small spleen), and were able to protect the third baby by getting earlier immunizations, etc. She ordered abdominal ultrasounds for both us of just to take a look at our spleens and recommended that we get one for the baby when it arrives as well. When she was finished, I asked her if we needed to check out or anything, and she said, “No, you just have to get a mama hug,” and she pulled me to my feet and embraced me warmly.  Wow.  We left feeling comfortable, comforted, and well-informed about how we were going forward.

Back during the summer, when Ed and I were trying unsuccessfully to get pregnant again (even though it happened on the fourth cycle, it truly felt like forever—every month that we were not pregnant felt almost like losing Hudson all over again), Jess said to me in an email that she really wanted us to get pregnant because, she said, “I so want joy for you. I know this will bring you joy. I know it won’t take away the pain. But joy and pain has to be better than only pain.”

She was right. And I’ve thought about it over and over again since she first said it. How could we not feel joy today when we heard the whoosh-whoosh-whoosh of this baby’s heartbeat for the first time (a strong 146 BPM) and when we saw these beautiful pictures?  (Like Hudson, this baby is measuring several days big.  Unlike Hudson, this poor kid is definitely getting my nose.)

And yet, as soon as we stepped out of the office, I started to cry, and kept crying all the way back to the car. I said to Ed, “I just hate that it’s like this. I remember how happy I was when I left this appointment last time.” I couldn’t stop thinking about these two little kids I’d seen in the Johnny T-Shirt catalog last night, a little girl about three years old sitting next to her little brother about a year old. Each wore a UNC t-shirt, but the girl’s read, “I’m the big sister,” and the boy’s read, “I’m the little brother.” I just can’t understand why Hudson never gets to wear one of those and hold her little sibling in her lap.

Extraordinary joy. And still heart-wrenching pain. But indeed, joy and pain is better than only pain.