In the days after my miscarriage all I could think about was having another baby. I deeply felt that our family was not complete and that I did not want to end my fertility journey with this loss. I have always felt set apart from others in how intensely and for how long I have wanted to have babies. In college all I really wanted was to be a mom. I couldn't wait to finish school, get married (my husband and I have been together since high school), fully become an adult, and get pregnant. I even researched birth related topics and wrote papers for a research class.
Once we had been married for about 6 months, I was more than ready to start our family! I started learning about the fertility cycle, how to chart your temperature and other fertility signs, and ways to naturally increase your odds of getting pregnant. Our infertility journey before we had our first daughter was long and difficult. It was the first really hard thing I had gone through in life. I had a "break" from infertility while I was pregnant and my daughter was young but I knew I wanted more children. So I had to go through the process again and this time different issues came up. After another long and difficult time, we had our second daughter.
This third time I thought I had everything finally figured out, and indeed we did get pregnant on the first try. But a part of me was not surprised when the babies died and it turned out I have another long and hard journey ahead of me in order to (hopefully) finally get my baby. I know it doesn't necessarily work this way, but I am hoping that I have gone through that difficult part of trying to get pregnant now, which seems to happen every time, and that maybe things will go well from here.
So this has been a really big part of my life for over 10 years. 10 years, with breaks in between, of being focused on the intense struggles of just trying to complete our family.
I have prayed every day since my miscarriage that if I cannot or am not supposed to have another baby, that God would take this desire out of my heart and replace it with contentment. But it never wavers. It is as intense as it ever was.
I was discussing this with a kind friend who said she believes that good, deep desires such as this do not come from us alone, but are given to us by God. So now I wonder if God has given me such an intense desire to have children because He didn't want me to give up when it got really hard.
And it has been so very hard at times. We have a unique infertility situation where I think most people would not have decided to not try again after this 16 week loss. I think most people, if in our situation, would have accepted having two children and moved on. I can't. I really wish I could because to risk getting pregnant again is to risk another loss. But I just can't let this be the end of my story.
So after deciding that we are not meant to be done having children yet, I had to navigate the hows. I wanted to do everything I could to prevent another miscarriage from happening. I thought that if I could figure that piece out, I would feel more confident about our chances. I also regard all life as precious and I did not want to be flippant about my babies lives. I did not want to go through more miscarriages before I decided that there was something medically wrong that I needed to address.
I went to an OB who is well known for helping women with infertility and recurrent miscarriage and who uses NaPro technology. Essentially, NaPro can help prevent miscarriage by supplementing with bioidentical progesterone if the woman has low levels of natural progesterone. The OB thought that low progesterone may have played a role in my miscarriage. He said that the protocol at their clinic is to closely monitor HCG levels (which aren't always accurate. And I don't want to know ahead of time if my baby is "probably" going to die), lots of ultrasounds (when pressed he admitted that they are mostly for mom's peace of mind and rarely do medical decisions change because of early pregnancy ultrasound results. Basically there's little you can do to prevent a miscarriage if things don't look good on ultrasound). He also suggested to do a full clotting panel to make sure I didn't have any conditions that can cause miscarriage.
The clotting panel showed that I have the most mild type of MTHFR - heterozygous A1298C. People with MTHFR cannot process synthetic folic acid into folate, so they have to avoid foods with added synthetic folic acid and take vitamins with natural folate instead of the typical folic acid. Sometimes MTHFR can cause miscarriage.
I was really surprised and distressed to learn I have MTHFR. I have no symptoms and have taken synthetic folic acid in the past. Of course I started researching MTHFR like crazy, joined several Facebook groups, read books. Most of the information I found was inconclusive at best and contradictory at worst. I tried taking this recommended form of folate called methylated folate. My anxiety was through the roof. I had trouble sleeping and just basic level functioning during the day. Severe anxiety is a side effect of methylated folate and my indecision about what to do in my next pregnancy was amplifying everything tenfold. One of the most difficult decisions for me was deciding whether to take daily low dose aspirin.
MTHFR can cause blood clotting issues as well. The theory behind low dose aspirin is that it crosses into the placenta and prevents clots that can lead to the baby's death. I really did not feel comfortable with taking this drug during pregnancy even though I tried to convince myself it was the right thing to do. No drugs have ever been proven to be 100% safe for an unborn baby. My oldest daughter's kidney abnormalities may have been tied to an antidepressant I was on during her pregnancy. I heavily researched aspirin and found that there are several severe risks to the baby. But if I decided not to take aspirin there was the risk that another baby might die. I thought maybe having two healthy, uncomplicated pregnancies previously was just luck and that maybe I go too far down the natural route sometimes.
The research on my specific type of MTHFR was very unhelpful. Mostly because there is very little research on it. Some experts say it is just as bad as the more extreme form, some say it has little to no effect on health. The Facebooks groups I was in were divided as well. What to do? Who to believe?
I kept researching, did more blood work on my thyroid (another huge rabbit hole) and overall nutritional status. I consulted with other practitioners in the area, most of whom wanted to sell me their expensive services and products. I reached a point of extreme anxiety and fear. And this was what I wanted to avoid most.
In pregnancy after loss, it is very common for women to have a lot of fear and anxiety. This is very understandable as their sense of safety has been torn away. So many women turn to more medical care during pregnancy to provide reassurance and a safety net. They have lots of testing and ultrasounds done to help them feel like everything is alright. The problem is those tests aren't always accurate and ultrasounds carry risks, one of which actually is miscarriage. And many women don't even feel relieved for long afterwards. They spend their entire pregnancies in a state of intense anxiety and fear that their baby is going to die. I do not want this for myself. I'm sure that I will have some difficult times in my next pregnancy (assuming I will get pregnant again) but I refuse to spend 9 months in agony for something that, at the end of the day, I cannot even control.
I had a long talk with my friend Jody who asked me if maybe I was delving so deep into everything as part of my grieving process. That maybe I was trying to find out what happened and exert a sense of control over my next pregnancy that I might not be able to have. I also discussed this issue, trying to figure out whether to go a more medical route or not, with other women who decided not to go the medical route in a pregnancy after loss. I decided that I needed to make decisions that were right for me regardless of what all the "experts" said.
Taking aspirin during pregnancy is not right for me. Hiring an OB who is medically minded and will push lots of tests and ultrasounds, as kind and well meaning as he is, is not right for me. Taking methylated folate is not right for me. Obsessing about my thyroid not being picture perfect and making difficult lifestyle choices because of that, which may do more harm than good, is not right for me.
Taking vitamin E instead of aspirin is right for me. Of course there's no research on this but I have seen it recommended in several places as an alternative of sorts to aspirin and it does not carry the same risks. Taking food derived folate is right for me. Hiring homebirth midwives who are trained in the NaPro technology and who can empathize with my loss and my desire to mostly avoid the medical path, is right for me. Using supplemental bioidentical progesterone is right for me. I have not found any risks to the baby with bioidentical progesterone and I do have some indications that low progesterone might be an issue for me - specifically that I have a short luteal phase. So I am not against all interventions, but I am against the ones that carry risks and increase anxiety without any clear benefits.
I had to come back to the place of trusting my body, trusting my baby, and trusting pregnancy and birth. Trusting the process, as it has been so exquisitely designed by God, has always deeply resonated with me. My pregnancies and births have been such amazing and indescribable spiritual journeys instead of medical procedures. I will always be grateful for the gift of that insight. Trying to go against that was causing me intense anxiety and distress and I needed to lean back into what God has shown me to be true.
This entire experience has been a time of tremendous spiritual growth. I have reacted so differently to this situation than I have reacted to negative situations in the past. Normally I get very angry at God and blame Him for not intervening, and then push Him away. This time I have really leaned, so deep, into my faith. I wonder if that is what He is using this terrible experience for. To teach me to trust in Him more, to lean on Him more. To trust that if another baby is meant to be, she will be. And to trust that if another baby is not meant to be, that I will be ok.
This all sounded so cliche to me in the past. It really resonates with me now. And most days I feel much more peace than anxiety. I am still mourning for my babies. I don't think that will ever really "go away." I still have my moments of doubt. But now instead of feeling overwhelming hopelessness I feel hopeful.
