Tuesday, June 17, 2008

utility theory

A bunch of people have asked why I didn’t take home any ultrasound pictures. The answer’s simple. Costs and benefits, people, costs and benefits.

What’s the upside of getting ultrasound pictures? Well, I guess the main benefit is that I’d, uh, have ultrasound pictures. But the downside is enormous. Not only would the pictures themselves remind me of Bad Things from the past, but, if things go wrong this time, I’ll have to spend effort and energy getting rid of the photos at a time when I really won’t need anything else to worry about. Plus, the pictures will serve as a painful reminder of how naive and stupid I was to ever hope that things would go the way I wanted them to.

For the same reason, I’m not planning to put up a ticker or to buy things in advance or to tell my friends or family. If I act like things will work out and, in fact, things do work out I haven’t really gained much of anything. But if I act like things are going to work out and then they don’t, it’s going to hurt even more than it would have otherwise. The more you’ve invested in something, the worse you’re going to feel when it breaks into a million pieces.

Now, if I wanted to be completely logical about this, I’d make an attempt to factor in the relative probabilities of good and bad outcomes. But that’s hard to do. Not only is my perception of the odds skewed, but there’s the complicating issue of loss aversion. For not-wholly-understood reasons, the amount of pain caused by a given loss is almost always going to vastly exceed the amount of pleasure caused by an equivalent gain. And like a lot of things in this world, though it doesn’t make a whole lot of sense, that’s just the way it is.

What would you do? How do you balance these kinds of costs and benefits?

52 comments:

thordora said...

I don't blame you. I wouldn't want them around either.

Being cautious isn't anything strange, at least I don't think.

thailandchani said...

Wow. Interesting. I don't think any of this can be looked at in terms of rationality. The whole purpose of "rationality" is to make complex things simple - and this situation can't be reduced to logic. There is no rhyme or reason to the truth, nothing that can be put in the finite so that it can be in the realm of human control.

Follow your heart. What your heart tells you to do will be the right thing. :)

janis said...

I don't see the need to be "logical"... for things had happened to us that were not "logical".
No need to justify.

susan said...

I tend toward the conservative approach myself, protecting myself from possible hurt to the extent possible.

Yolanda said...

In this culture, where we have home fertility monitors and early pregnancy tests, and 45-year-old celebrities announcing pregnancies immediately after missing their periods, we're used to viewing pregnancy only as a nine-month long ohh and ahh fest, with nothing but cause for celebration. But if birth is more complicated than that for you--if it is tied with memories of loss and grief--there are no models for how to proceed. There's only your gut telling you what you can deal with, and what you absolutely cannot. For me that means I will not be throwing a giant birthday bash with jumping machines and pony rides for my daughter. My family disapproves strongly with my lack of enthusiasm. What they can never understand, though, is that acknowledging that day is far more complicated for me than deciding which ice cream to match with my cupcakes.

yummysushipajamas said...

It's hard for me to even comment on this because I feel like it is such a hugely personal thing... However, for me I feel almost the opposite way. I think that when we are ready to try again, I will probably be quieter about the beginning but then there will come a point where I will want very much to tell everyone.

For me, one of the biggest support systems I had when we lost Aodin was knowing that so many people cared. People knew, were following the pregnancy, and were invested in what happened. When he died, it was like a huge extended family came out of the woodwork to offer support and love. It was priceless to me, and so I think I want to make sure I have that system in place again this time.

Again though, this is such a personal thing!

Mrs. Spit said...

Umm, I'm not such a big ultrasound person. I'm not a big beta person. I figure a pregnancy is viable when I hit 12 weeks. I'm not anxious to know anything before then. No news is good news to me. As for pictures, I think people do what is the best for them. I don't think they hand out medals.

LAS said...

I totally relate to what you are saying. I have a couple of things in my life at the moment where I feel just exactly this way - "But if I act like things are going to work out and then they don’t, it’s going to hurt even more than it would have otherwise." And this - "Now, if I wanted to be completely logical about this, I’d make an attempt to factor in the relative probabilities of good and bad outcomes. But that’s hard to do." I'm totally with you on this.

Coggy said...

I'm in complete denial. I refused all the pamphlets from the midwife. I refuse to go to any of the classes she tried to sign me up for.

Denial, because obviously it won't hurt half as much when it all goes wrong....right?

Karen said...

if I could protect myself, I would. Knowing myself, as I do, I find I can rarely actually do that no matter which way I act, so I tend to indulge myself in a little hoping or planning, just to pass the time and keep me straining towards what I know I want - I find I'm not very effective at training my heart, but if I could, I would do it your way, just to try and stay in the moment.

cinnamon gurl said...

Bea once wrote a post about defensive pessimism, which is pretty much what you're describing. I'm the same way, although less intensely I think. That said, I can't ever seem to totally squash the hope, and I end up hurting anyways... but still, I keep trying.

Furrow said...

My dear, I'm a bit late, but I just to say hooray. Hoo-frickin-ray! I'm overjoyed that things are going so well, still.

Which Box said...

I am generally an optimistic person. OR I used to be. But I've always believed in the cost/benefits thing. No need to get all worked up, you know. So I'm with you. No need for ultrasound pics. If things work out, thy'll still just be around for years mocking you for not doing a baby book. I won't do a ticker or anything either. And not telling people? If I could get away with it, I'd keep it quiet, too.

Aurelia said...

Whether you count on it or not, whether you buy everything or not, whether you have ultrasound photos or not, it will still hurt just as badly if something goes wrong and you will still be very happy if things go well.

But, if you haven't bought a thing and you have the baby come home, you will regret not having anything. I know that because I regret it right now. Shopping with a newborn at 2 am looking for colic drops and baby tylenol while the kid screams in agony is no fun at all.

At minimum, order the furniture and items ahead of time and arrange for delivery after the kid is safely born. Plus make a list of non-ordering things to buy that you can hand to your husband or a friend who lives locally right after the baby is born and they can shop for you.

If it all goes wrong, throw the list in the garbage, and get the friend to cancel it.

I'm happy to be the friend who makes the phone call to the store to cancel, but since I do not live nearby, I can't shop for you at the last second.

But I still think that it will hurt just as bad no matter how much you try to guard your heart by not looking at photos.

Tash said...

For me it's not so much cost/benefit, it's risk/reward. Odds are extremely meaningless to me anymore knowing full well that I could very well be that 1. So who cares about the other people or scenarios? But I also feel if I'm willing to take a risk, I want the ultimate reward. It's going to hurt if I lose a child, regardless of the circumstances. But if I win the lottery, what do I *really* want at the end? And I think those questions will probably carry me through any future scenario.

Aurelia, on the one hand, I think you're right. I didn't set anything up for Maddy (I mean that. I ran a load of laundry. Period. No room, no crib, nothing bought, only 1 pack of diapers, nothing) and it hurt like hell. On the other hand, I can't IMAGINE how much worse it would've felt if I had to dismantle/reconfigure a room, return/donate clothes, undo a baby shower, call to cancel announcements, etc. And my u/s photos and photos of her immediately after birth? I haven't looked at a one in almost a year and half. They are lies of what I thought existed, not what really did.

Eva said...

I think it would totally suck if "something happened" whether or not you had bought a car seat. I really am not convinced that not buying one will make you hurt less.

Didn't you say you wouldn't go to the prenatal visits and now you are? I just mean to say that maybe you can cut yourself some slack of things get near the end and you see a cute baby thing you want to buy. Sometimes good things do happen. Even to you.

I was in a panic most of my pregnancy, convinced "something horrible" would happen. Various not-so-hot things did happen, but of course things have turned out well. The other shoe may drop later, of course. I don't want to dwell on it. My approach is and was to throw all my love and excitement into it and enjoy that part of anticipation. If "something bad happens", like I said, I think it will be horrible regardless of the emotional preamble, so I don't want to cut myself off from all joy just because the joy may end.

catherine illian said...

While I haven't experienced late term losses like you have, my miscarriage at twelve weeks defintiely made me not want to share news the second time and I was very very nervous and didn't believe the doctor every time they told me things looked good-- I kept waiting for the other shoe to drop-- in my case-- I treasured the ultrasounds because if that was all I had-- then I had those-- and I figured I would deal with the loss when it happened and what to do with the stuff-- I don't know if having or not having the said stuff-- whether that is ultrasound pictures or baby items would make the loss harder or easier-- the loss is still there-- but again-- you know yourself and what you can handle-- I guess I would just push deeper into why you don't want them-- or then again-- just do what you can handle-- and revisit the decision again in a month or so. It got easier for me as the pregnancy went on the second time to see/hear/feel the baby and not feel nauseous or afraid.

Betty M said...

I'm a not tell kind of a person. I haven't told any real world individuals about the 4 rounds of IVF. My family don't know about the miscarriages and my pregnancies have been secrets until after the nuchals (when they have got that far). I never bought anything until after 32 weeks either. So I can see why you wouldn't want the scan pictures or to tell people.

DD said...

My head now hurts. That's all I can say.

Rosepetal said...

I put up a ticker at about 15 weeks. It was a hard thing to do but I felt I owed it to the baby to show some if only half-hearted, belief in him / her.

I told only close friends and family. Aside from my mother and brother, even close friends only found out at about 16 / 17 weeks. I didn't tell very many people at all.

There are some people I still haven't told!

Rosepetal said...

and for my second pregnancy, I didn't tell anyone apart from close family and it hurt just as much when it ended at 16 weeks.

Patti said...

I don't know, I think it depends on the person. Personally I try to take at least one picture home from each of the ultrasounds I've had. I haven't really purchased anything, but I imagine I will before the child is born.

I've decided that, for me, whether I think positively or not, if everything comes crashing down, it'll be equally as devastating.

But that's just me.

We all have to do what's best for ourselves, and if not having the pictures works for you, then go for it!

debbie said...

Not only do I have the ultrasound photos from my only pregnancy that ended in a medical termination, but I have a DVD from the last appointment highlighting each limb, the heart, the bones. Even though it's horrible and I can't look at them, the truth is, I really don't care that much about them because I know they're just reproductions. Even when I brought the pictures home I didn't feel that connected to them. It was more the live streaming video I saw in the office that killed me. So, while I think you've made a good choice, for me I don't so much care about those reproductions. I would much rather have someone erase the images imprinted on my brain showing our little baby kicking and sucking her thumb. Those are the ones that kill me.

Aurelia said...

And just to be clear, I'm really not saying that you have to buy anything or look at anything, just that you might want to have a plan in place just in case everything does turn out okay.

Kami said...

I rejoiced in each good u/s and kept the pictures and had a video from 20 weeks, but I didn't buy anything until about 38 weeks along. I still only have a few basics. I could have the house cleared out in under 20 minutes. I still speak in tentatives 90% of the time.

I completely understand and support your choices on this. Everyone needs to find a way through the fear.

thirtysomething said...

Well shit. I feel a novelle coming on!
You put it so matter of factly, the argument is hard to find, but indeed there is one to be had I think.
Despite the fact that you do not have the pictures and aren't looking at them every day in great anticipation doesn't mean that they don't exist, right? You have in fact seen the picture of your baby on the u/s screen. Not physically having the pictures doesn't change the fact that the baby is growing. Your baby. Why are you hiding from it? I don't see how the pain is any lesser if something happens and the outcome isn't a positive one. The pain would be horrible, just as before. The connection is still there - you are still the mother of this baby, though it isn't living in your body. I don't believe you can deny that bond.
As for not telling family, waiting awhile is always a good thing I feel...at least until most of the early part is over and things are progressing like normal and on schedule. No one can forsee the futre or prepare for it adequately. The moment we think we are prepared, life changes course and we are thrown off. Reality is impossible to shield agaist or erase or even change. It just...Is.

Quite simply, you are having a baby. You can't hide from that in your own heart, though you might be able to put up a front for other people. It is a magical time that can be full of joy and frought with trepidation no matter the circumstances, even for mothers who haven't experienced loss for the shere fact that at any moment something unforseen can occur, but certainly more pronounced after having been through the tragedy that you have walked through.
You are amazing and courageous for giving it a try despite your pain, and that in and of itself shows your deep longing for a child.
I find that in life there doesn't seem to really be any balance or much that makes sense by definition. The more we try to make sense of it all and add logic to the equasion, the more things go awry.
Pain/Pleasure principle is a classic argument. Does the pleasure outweigh the pain? The Cost vs. Benefit. Sometimes yes, sometimes no. We get what we invest, we reflect in payoff the depth of what we risk.

Give yourself a pat on the back. You are strong and brave and deserving. The Universe knows that.

And you totally deserve a nonfat vanilla latte if you read this entire comment all the way through. BeGeez! I can ramble on...

Libby said...

I think you are taking care of yourself the best way you know how. I am quietly being thrilled for you.

Photogrl said...

Costs and benefits, costs and benefits...well said.

I'm amazed everyday at your strength.

Monica H said...

Well, i originally thought the same thing when you wrote that she put the photos in her purse. THen I read in the comment section, that you didn't want any physical memories in case things didn't work out. I get it, but I don't think I could do it. I am all about creating memories even if it's with a piece of paper.

But my question to you now is- If everything works out, will you want copies of the u/s pics later? I know having the real thing is so much better, but seeing him/her on paper at such a young age is always nice too. Even if you just keep them in a box under your bed, you'd have them. Just curious.

Road Blocks and Roller Coasters said...

I completely understand. When dealing with these things I just go with my gut at the moment and I don't look back. If something is too hard to deal with I take another path. It's not worth it. IF and the loss of my twins taught me a huge lesson in self preservation--mainly that if I don't look out for my emotional well being no one else will.

And as far as factoring in odds, once you've been on the receiving end of really shitty odds, that teaches you the lesson that maybe odds don't matter. What matters is getting through each day relatively unscathed and still intact mentally, emotionally, and physically.

As always, hoping and praying for the best for you. HUGS.

CLC said...

You don't need to explain yourself. Personally I would want them, but I like to look at mine of my baby. I like to think about the memories, but we are all different. So keep on doing whatever it takes to get you through this anxious time.

Mad said...

Honestly? I think ultrasound photos are a crock of shit. I wrote about that once a long, long time ago. I was given 2 of Miss M at the very appointment where they told me that there may be serious things wrong with her and that I ought to consider amnio. I hate those freakin' pictures. I think our culture invests too much significance in sonogram images.

Molly said...

So what happens once the baby is here? Are you free and clear?

Lisa b said...

I don't know. I'm not sure preparing for the worst really helps. Though I used to.

Azaera said...

I agree with the others who said you have to do what's right for you. Personally I would want the U/S pictures of this baby even if he/she doesn't make it because it will be like proof that she/he did exist, and when people act like nothing happened and I should be moving on in a week or two I can remind myself that this baby was real no matter what anyone says. But yes I absolutely can see how that would be horrifyingly painful

JamieD said...

I have to say I whole heartedly agree. I miscarried at 8 weeks, but my doc did an US on my first appt. After I left, I chastised myself for not asking for a copy of my little black circle.

After my MC, I think it would have hurt even worse to have something tangible that I could hold. Something solid to represent what I had lost.

If I get pregnant again, I won't ask for copies of anything.

c. said...

This makes a whole lot of sense to me, although I did take the u/s pics home recently. They've been tucked away, out of sight. I'm hoping I won't have to pull them out one day because they're all I have left.

Smiling said...

As always you make complete sense... even though I'd take a different track, cuz I know myself and how I grieve.

I am really good at denial and have this strange need to beat my head against reality when the world caves in on me.

When my best friend died I called his voice mail over and over and over again to make myself cry. It was horrible, but I knew me and that it was how I'd get through it. I kept listening to his driving tapes (we were 18 this was a bit deal), touching a shirt he left at my place, and driving myself crazy remembering and hurting.

When I realized my ovaries migth be dead, I took out my ultrasounds and my yellowing surgery report and studied them over and over again until it seemed real and the tears dried up a bit. Right after the surgery I would touch my scar and cry...every morning for weeks until I was done.

That pain is intense, I don't know why i need it (didn't even realize it until I read your post) but it is why I sometimes keep things even though I know they will hurt like hell if things go wrong...

You seem to have a much wiser and gentler approach- but I hope this type of preparation is never necessary for you again:)

AJW5403 said...

You asked "what would you do". Well that all depends on the person. With me even though I knew I could have another bad outcome when I got pg I still have to have some kind of hope to stay stane. So for me I always got the u/s pictures. That was my one little bit of hope that I carried around with me. Because even if it did end badly again u/s pictures or not I would have been devestated. But at least for that little bit of time I could at least enjoy the u/s pictures. And the way I looked at for me I did not know if it would end badly again so I at least wanted to enjoy what little bit of time I had. And also because if it did work out for the good I did not want to regreat missing out the happy moments. Since I know first hand you can not go back get what you lost out on.

Elizabeth said...

I completely understand and agree that you have to do what works for you. I tend to self-protection by not expecting treatments to work, getting hopes up, etc. I can already tell that as we get closer to cycling, I am starting to pull away and not talk so much about it to friends and family. I'm preparing myself for it not to work.

Antigone said...

I don't really feel much of anything anymore.

I've got another u/s in an hour and a half. If it's dead, I think I'll just shrug my shoulders.

K @ ourboxofrain said...

People always said to me "nothing ventured, nothing gained" but I always wondered if "nothing ventured, nothing lost" was more descriptive of my mindset.

That said, I find that I can at least pseudo-compartmentalize, allowing myself to, say, have ultrasound photos or order furniture, so long as I don't think about or spend too much time emoting on such things. I think of them as things, and try to avoid thinking of them in any way as symbolic of anything more than that.

Andrea said...

I think you have to do what's right for you. I know it wouldn't work for me--I'd want the photos, even if everything cock-eyed, and I'd keep them and probably enjoy looking at them one day.

I had a cousin who died when she was five and I was nineteen (I know it's not the same, I'm not trying to compare it). The only photo I have of her is hte one off of the funeral program, a photocopied fading mash of grey on yellow copy paper. That makes me very sad. And there was a time when the pictures of Frances in the hospital all covered with tubes and wires and much smaller than she was supposed to be hurt like hell; now I'm glad I have them, though they still make me sad sometimes.

But that's me. I keep everything. I think your way of handling this is very understandable.

STE said...

I think you need to do what leaves you with the least anxiety. If that means not having ultrasound pics on hand, then do that. Sometimes I linger over u/s pics. Sometimes I come across them and have to put them away because I start to shake.

When we were trying and had a number of chemicals, I didn't tell anyone (except one friend) until they were over. With this last pg with the boys, I told my dad that I was getting positive tests. I told him that I couldn't make any promises, but wanted him to be able to enjoy it while it lasted (however long or shot it might be), instead of just getting the bad news after it was over. Even though I was so nervous, this one was different for me. Maybe I knew it would go further so I decided to try to enjoy it while I could.

My sister kept herself separate as long as she could, and I do think that has helped her healing -- she doesn't have the loss of dreams that I do. As much as it hurts me, though, part of me is glad that I took the time to dream for them, since it may be all I ever have of parenthood.

In the end, you do what you can live with. What you think will do the least harm.

Anns said...

I feel you.
I have 2 sets of u/s pictures stashed away in a pregnancy book that I refused to read, and still do... and I'm now 38 weeks.

I think we each need to find our own coping mechanism and if that one is yours, then own it.

But please know you are not alone and that we are all here quietly urging you along.

Bon said...

for me, obviously i end up telling, eventually, but i do hate the idea of reminders of my own naivete and premature investment.

the u/s pics are an odd thing. i am glad, in a quiet, small way, to have Finn's...i don't look at them but they are one more scrap of him, for me. whereas the baby i miscarried in the first trimester? those meant nothing to me, though i grieved that pregnancy a great deal. the distinction - again, for me - comes down to that amorphous point at which i cease to be engaged in the pregnancy as a potential and a dream of my own, solely, and begin to actually perceive and - this is key - love - the baby, even in spite of my caution and fear, for him or herself. for me, this seems to be somewhere in the 16-20 period. where they might possibly exist outside of me, even for moments, i guess. i dunno.

i mourn Finn because he was not just a lost pregnancy to me, and thus the u/s pictures are pictures to me, of him, whom i loved. whereas the other pictures, to me, are pictures of my own folly, my own foolishness.

long-winded way of saying i sort of get it. and that is how i balance until about 16-20 weeks. after that, i'm the quivering mess you see before you.

Bon said...

ps - i totally get that there are significant political implications to my distinctions above, and my apologies to anyone with whom they do not jive. how it balances for me is quite different from how friends and family members of mine perceive their own losses.

Christine said...

hmmm. . .i get not wanting the pics. i really do.

as for not telling people, you have to go with your gut. it's that simple.

missing_one said...

Just when you let people in, they disappoint you. If you don't let them in, they just might surprise you.

I totally get this. In the end, you have to do what your internal being is telling you can live with

Ms. Planner said...

If it all works out, what you will have gained is a new baby. I understand your not wanting to collect talismans related to the embryo but I do hope that time will allow you to become more confident in your prospects this time.

painted maypole said...

oh, i suppose I'm mostly a pollyanna at heart, and would proudly have the pictures on my fridge. but my life experience is quite different than yours, and who can say for sure how I would react in your shoes, so I totally respect where you're at, and thanks for answering the question. I am actually far more comforted to know that it is a choice on your part, and not a slight on Kyrie's part (or the technician's)

TEOM said...

"If I act like things will work out and, in fact, things do work out I haven’t really gained much of anything."

You would have gained months of living with hope in your heart.