The sigh heard around the world - well around the doctor's office at least.

Today we went in for our 13 week visit and first visit with our regular OB doctor.  Knowing that we had been waiting for over an hour to see her, the doctor apologized upon entering the room.  "I'm so sorry for the wait... I couldn't find the heartbeat on my last patient and I ended up having to send her out for an ultrasound so things took a little longer."  There it was, my greatest fear for the day, inflicted on the patient ahead of me.  The statistician in me started to wonder if the doctor was having an unlucky day and I would suffer the same fate or if the fact that her previous patient may have had a complication meant I wasn't going to.  Of course neither option would be statistically correct.  My odds of complication are independent of what is happening to other patients in my proximity.  I was anxious to hear that little heartbeat again, even more so than before the doctor's entrance, and it seemed like hours before we'd get through all the medical history questions where once again I had to lay out the wretched details of the previous 4 losses and everything that went along with them.  Finally we got through all that and the information on all the special tests for old pregnant ladies and moved on to the examination part of the appointment.  She pulled out the doppler and moved it around and around and around and around.  I think my heart may have stopped for a minute while we waited to hear the heartbeat, but after a few seconds, there it was, strong and steady and "perfect".  I let out a sigh of relief like I've never expressed before.  We have officially made it through the first trimester!!!

We have fought hard for this pregnancy, this child, for a long time.  After our 4 losses we took some time off to restore my health, to pray, and to decide if this was still something we wanted.  The kids were several years older than they were when we started this journey and would be almost out of the house by the time we'd have another child.  My husband had just started his career.  I was still healing and my resilience was still low.  I was finally getting to spend more time with the kids and feared that another loss would take away from them.  We decided last fall that this may not be the best for us and resigned ourselves to be content with our family as it was.  And for about 6 months we were content, or so we thought.  My husband would come home and talk about the kids he taught and how much he enjoyed them and how sweet the kindergarteners were and how sometimes he still longer for little ones to be around again.  Every time I would hear of another friend or acquaintance being pregnant I would get angry and distant.  It still hurt...a lot.  Around the anniversary of the last loss we opened the subject back up to prayer and discussion.  We still both wanted more.  And we prayed.  We realized that fear, fear of losing again, fear of change, was driving our decision making.  We decided that fear ought not be the impetus for our choice, but rather love ought to be.  My husband was more confident than I was that we were making the right choice in pursuing this dream again.  I, of course, wanted to control everything, especially the timing.  I had mapped out our travel and work schedules for the summer and highlighted the late summer as the optimal time for IVF, with a possible very narrow winder in April in between trips.  I was leaning toward the late summer time frame, but unlike our first visit to the doctor over 3 years ago, this time I actually listened to my husband.  He said, "if the April window works out with the schedule, then we go in April, if not, then not."  It seems very simple and logical, but how was I supposed to KNOW months in advance if that time frame would work?  Things were not exactly being the most predictable at the time.  When the narrow window came I was incredibly anxious.  Go?  No Go?  Tick tock tick tock.  C'mon body, cooperate!!  Since we decided we were going to do this I wanted to get started right away and grew impatient.  When it looked like the window would close without my body cooperating I cried out to God.  The next day we got an answer:  Go.

IVF is complicated.  There are all kinds of shots and appointments and the timing is absolutely critical.  I had to miss a couple of days of work on little notice for the retrieval.  My husband and I had to be home every evening by a specific time in order to give me my injections.  Every time you see the doctor they can cancel the cycle and you have to start all over again buying thousands of dollars worth of medications.  I was responding very mildly to the medications.  Most women produce twice the eggs I did, but my doctor wasn't concerned.  According to him we "only need a couple of good ones."  I ended up with 4 retrieved.  Only 4.  Typically they get 5-15.  I was below average.  I do not like to be below average.  We waited for the phone call the next morning to tell us how many had fertilized.  I was in the shower when my husband came upstairs to tell me the news that all 4 had fertilized!!!  He said the nurse was very excited as they rarely see then all fertilize.  I started crying tears of joy and relief.  It felt God was showing us that He was preparing to bless us.  We scheduled the transfer for the 3rd day.  On the morning of the transfer, we had no idea how our embryos were doing.  We got changed into sterile scrubs and escorted back to the transfer room.  The doctor opened the tiny door in the wall to the lab and asked what they had for us:  Two perfect top grade embryos for transfer and two others that were coming along slowly.  Day 3 and all 4 were still progressing.  Typically you lose a couple before transfer day.  They transferred the two best and gave little hope that the others would survive to freezing.  We prayed diligently for all our embryos, not wanting any of them to fail.

I was at work several days later in all day meetings on a project implementation kickoff with consultants.  I had my phone with me, but missed the call from the doctor's office.  I couldn't see that they left a voicemail and I called them back and left a message with the nurse.  You can never get through to a nurse directly.  You have to leave a message and be prepared to answer when they call you back.  After I hung up I received a notice that they left a voicemail.  I played it back expecting the typical "give us call..." line.  I was astonished to hear that the nurse actually left real information on the phone and it was overwhelming.  Not only did they transfer 2 top quality embryos, but the two remaining ones made it to freezing!!  We hadn't lost any of them.  She went on and on about how rare and special this is.  I cried in the hallway outside of the conference room and trembled at the enormous blessing and great work that God was doing.  What incredible news.  It gave me peace of mind that if the transferred embryos didn't implant that we would have a second chance without the full cost, and if they did implant that we would have two more to try for a sibling.  I called my husband and shared the news with him.  We were both just completely overwhelmed.  The hymn, "Little is much when God is in it.." played on repeat in my head.

Then came the hard part:  waiting for the pregnancy test.  I know I drove my friends crazy while I waited.  And I totally didn't wait like I was supposed to.  I was testing early on and knew days before the blood test that it would be positive.  Still, I nervously awaited the rests.  118.  That was a Friday.  The number needed to at least double by Monday.  This is where things always went wrong before.  We never passed the second blood draw.  Our numbers always dropped.  And even though we "took the ferry instead of the tunnel" as my husband put it and things were different than before, my heart was choked with fear.  Usually I can dream big and imagine grand outcomes.  My heart would not allow it and I could not even imagine a world where those numbers would double.  And yet they did. 380.  And for the first time I began to feel hope for our child.  The next step was the ultrasound at 7 weeks.  Here they would determine how many babies I was carrying, and they would look for the heartbeat, measure, and determine a due date.  After reading account after account of women going in and there being no heartbeat I was once again gripped with fear.  We prayed.  Friends prayed.  I specifically asked for strong pregnancy symptoms to reassure my heart that all way well.  And that prayer was answered.  My husband and I made an agreement that I was not allowed to complain about my symptoms and instead we would give praise to the Lord for answering our prayers.  At that first ultrasound I was sick with worry, but for no reason.  Within seconds we could see the heartbeat flicker on the screen.  131 beats/minute.  perfect.  The doctor hooked up the audio and we could hear it.  I can't describe the elation in our hearts at that sound.  I was scheduled to come back at 10 weeks to check on progress and to graduate to the normal OB doctor.

4 days later we had an unwelcome development.  I had started bleeding.  Having never had any bleeding or spotting with my surviving children, I was convinced I was miscarrying.  It was a beautiful weekend.  I had got up, exercised, grocery shopped, did yard work, and we were hosting a cook out.  I have several other people over when it started.  I withdrew to my room for a spell, and reemerged after I composed myself.  The evening was winding down and we tried to enjoy the last moments with our company.  As soon as they left I retired to my bedroom.  My husband got on the phone with the doctor, and our 16 year old daughter cleaned up the aftermath of the party.  The doctor was not too concerned based on our description.  He said it was quite common and usually doesn't mean anything other than I may have overdone it a little.  He suggested taking it easy and said to come in for an ultrasound during the week if it continued.  I was slightly relieved, but very much on edge.  My husband put me on full bedrest for the remainder of the weekend, and I did not object.  Friends and family were enormously caring and helpful during those scary days.  The bleeding did subside, but spotting persisted.  We went in for another ultrasound and there was our little gummy bear, with heart as strong as before.  They had no explanation for the bleeding but said to keep them informed.  The following week, the spotting continued and we went in again for reassurance.  I am so thankful for the doctor's office for the support they gave.  They did not protest my insistence on multiple scans and were very understanding of the fear we felt.  They treated us with great compassion and dignity.  Once again all was well and we even got to see the baby wiggle.  The doctor then suggested that it could be from what's called a subchorionic clot, which is where the sac separates a little from the uterine wall, but could not tell from the ultrasound as it could be too small to see.  He still wanted to see me again at the 10 week mark, which was only a week away.  At 10 weeks, we came in and once again everything looked great.  The spotting was mostly gone by then and he could finally see a subchorionic clot.  He pointed it out and said it was "well-organized" or healed.  It was such a relief to have an answer, to have the complication resolved, and to see our little one and its heartbeat once more.  And at this ultrasound our baby had moved from simple wiggling to total dance party boogying!!  Doctor exclaimed, "that is an active one!!"  Sounds like we will have our work cut out for us.

In the three weeks since then, I've traveled quite a bit and camped.  I've kept quite busy and it has been a good distraction from the worry over the first trimester.  I had the opportunity to tell all 4 of my bosses now face to face within a week of each other when I was around 9 weeks and I did so.  I heard through the grapevine that those who were familiar with my previous losses could not believe I would say anything so early in the pregnancy.  Our child must have been one of the most photographed 9 week embryos ever at that point.  I suppose it just goes to show that people always have something to say.  In fact in my situation I thought it perhaps more prudent to be open with my superiors about my situation as my role is somewhat critical and they need to be prepared to backfill it in case of a more serious complication.  I still get irritated with the notion that pregnancies should not be made public until after the first trimester (and I get the irony that I've gone fully public with this one until then).  I understand that it is difficult to have to tell when something tragic happens, but if something tragic happens you need people around you who know and who can support you.  It seems like its a carryover of the days where miscarriage and pregnancy loss is a faux pas subject and something to be dealt with privately while the women grieves deeply in isolation.  It may be your persuasion, but it is not mine.  I know I do not handle pregnancy loss well.  I know what it can do to me, and I prefer people to know so they can support me.

The fear of loss is still there, but it shrinks everyday.  I wonder as parents if we are ever free from the fear of losing our children.  This is, after all, what it means to be a mother or a parent in a fallen world where there is death.  A couple years ago, before we moved to our current church, we visited there a couple Sundays.  The first sermon I heard there was in the Origins series and the message was from Genesis 3 and the fall of man.  The pastor read the curse of man and woman resulting from the fall.  To paraphrase, the woman would suffer much pain in bearing children.  That sentence caught my eye.  Having had 2 losses at that point I had a different perspective on the verse.  You see, I had always associated it with the physical pain of labor, but something nagged at me about the word pain and when I got home I had to look up the greek origin.  I don't recall the specific Greek word and am too lazy to look it up again at the moment, but I would encourage you to do so if you are interested.  Basically the word meant "toil or labor" and was used in other contexts like the curse on man and how he would toil the ground.  It occurred to me that the pain of bearing children goes far beyond the pain of birthing a child.  There is so much toil in having children, including the anxiety of losing them.  As long as there is death in the world, we fear losing our children.  We fear losing them in miscarriage.  After birth we fear losing them to SIDS or whooping cough or whatever the disease of the day is.  As children we fear horrific accidents on the playgrounds, in the medicine cabinet, at the pool, etc.  As teenagers, we fear motor vehicle accidents.  And I'm told it doesn't stop when they become adults.  My mother still wants my flight information every time I get on a plane so she can watch me on flight tracker and see my plane land safely.  There is always fear.

So how do we overcome fear?  The Bible says to fear not and to trust in God.  I'm admittedly not good at this and definitely not an expert on the subject.  But there were moments here are there when we would pray or when friends would pray and I would be overcome with peace.  When I remember all that He has done for us and that He is for us my fear diminishes.  I am so thankful that He is faithful even when we are not.