the last good time

JuliaKB said in one of her comments: I actually remember the day before very well. It was a good day.....

Which made me try to remember if there had been a time during the pregnancy when I had been truly happy. Not brave. Not pretending. But just honestly happy. And now that I think about it, there was one -- well, not day -- but moment when the future stretched out in front of me, bright as a river in the sun.

As I've said before, it had been a tense pregnancy, and I was afraid long before I had any reason to be. I told myself that, after the 18-week ultrasound, I would stop worrying. But the night before, I sat up suddenly in bed and said, in a tone of utter conviction, "I have preeclampsia and I'm going to die."

The ultrasound procedure was reassuringly normal. I pulled up my shirt, had my stomach coated with gel, and closed my eyes as the technician slid the scanner back and forth. She asked if I wanted to know the genders, and when I said yes, told me that twin A was a boy and twin B was a girl. Then she said she was going to get the doctor, "just to do a few more measurements." And before the doctor arrived, during those few minutes that I lay there, half-undressed and staring at the ceiling, I was, for once, completely, absolutely happy.

safety in numbers

Statistics lie. Or, rather, someone always ends up on the wrong side of them. So, let's take a look at the approximate percentage of babies who survive at various pregnancy milestones in women with no previous history of miscarriages or chronic conditions that might endanger the baby:

After detecting a strong heartbeat? Around 92% Ummm, in my case, no.

After successfully completing the first trimester? About 97%. Well, not exactly.

If the mother develops preeclampsia? Approximately 90% Sorry about that.

At 26 weeks' gestation? Close to 85% Not so much.

Ultimately, whether your baby survives is an on/off switch. Either it happens or it doesn't. So, really, the only statistic that matters for me is:

How many of my twins lived? 0%

a question

Given my extremely high risk of developing preeclampsia in any subsequent pregnancy, I've been seriously considering the idea of working with a gestational carrier.

For those not familiar with the concept: The gc would (fingers crosssed) get pregnant using our frozen embryos and would (fingers crossed even harder) carry the child to term. It's different from adoption in that the gc has no genetic relationship with the baby and doesn't have the legal option to keep the baby.

I hated being pregnant and have no problems with the idea of another woman carrying my child. I realize that I would still be devastated if another disaster struck, but my hope is to give the baby the best chance possible.

What do you think?

MgSO4

My extensive research (consisting of several minutes of googling), reveals that magnesium sulfate, otherwise known as epsom salt was first discovered in the early 17th century, unsurprisingly, in the village of Epsom.

During a severe drought, a farmer dug a new well for his cattle, only to realize that they refused to drink from it. People soon noticed the healing powers of the bitter-tasting water, as well as of the crystals left behind when it was boiled. Epsom suddenly became a fashionable tourist destination, and its new-found popularity lasted until the supply of mineral water was almost exhausted and cheaper, easier ways of obtaining epsom salt were invented.

I mention this only because, for over 60 years, at least in the United States, magnesium sulfate has been the treatment of choice for preeclampsia. Administered intravenously, it prevents seizures, and, therefore, maternal deaths. Other countries were slower to adopt the procedure, mainly because no-one understood the reason that it worked. But it does work. It's saved thousands of womens' lives. Perhaps including mine.

At the hospital, once they diagnosed me with preeclampsia, they put me on two rounds of mag, as they called it. At first I felt as if I were burning up, then as if my life were being slowly snuffed out. Just like a candle, I thought, as I contemplated how much energy it would take to reach the intercom to call the nurse. This is what it must feel like to die.

When the resident stopped by I told him I was having trouble breathing. "Well," he said "If you can't breathe, be sure to let us know." I didn't have the strength to laugh, but it was the first thing that I'd found funny in weeks. And it was then that I began to believe that I was going to get better.

et ils eurent beaucoup d'enfants

Catherine at Everything is Under Control wrote a post a little while ago that I couldn't stop thinking about. Read it yourself, but the gist of it was that sometimes it seems like people assume that the only way to "cure" the loss of a child is, as she puts it, to "go on to have a subsequent child."

It's a sad thought, not just because, obviously, a new baby won't replace the one that's gone, but because in many cases (like mine, I suppose) it just isn't an option. Oh, theoretically, I could certainly try again. We have a bunch of frozen embryos, probably enough for two or three tries -- even with the expected loss through unfreezing.

But, but, but . . . The odds that this would happen to me again are extremely high. It's far from impossible to develop preeclampsia in one pregnancy and not in another, but when it happens, as it did to me, so early and so severely, I would be running an enormous risk of ending up pretty much exactly where I am now.

Some kinds of pregnancy or neonatal loss don't really increase your chances of recurrence all that much -- if at all. But I would be playing with fire and I know it.