Wednesday, August 1, 2012

Conquering the crib (kind of)

This is one of those "a moment in time" posts. I wrote it the morning after my daughter spent her first-- and only, to date-- night in her crib. The next night I stared at her through the white bars as she shuddered with tears, and I took her back into bed and have kept her there (mostly happily) ever since. Our cats are relieved to have their 400 shekel cat bed to themselves again. An edited version of this was published on Offbeat Mama.

Last night, my four-and-a-half-month-old daughter slept in her crib for the first time. This was huge-- not because co-sleeping isn't working for us, and not because I even think that it's so important that she can sleep in her crib. This was huge because it reminded me how making decisions as a parent works for me.

We've been co-sleeping since our daughter was born, and it has worked beautifully for us. On her own terms (touching me, preferably with a boob in her mouth), Nitsah is a wonderful sleeper, even adjusting with ease to a seven-hour time difference when I visited my family in the US when she was two months old. Not on her own terms-- well, we got a taste of that each time we took Nitsah in the car, and she was not within reach of my boob (and sometimes not even within reach of me). As my niece eloquently put it, "she's roaring."

At the same time, we always knew that we didn't want to co-sleep forever-- at least in theory. In practice, I kept putting off deadlines to try out The Crib. We'd wait until after my trip to America; after all, we'd have to cosleep there. We'd wait until she was four months old. Until six months. Maybe longer. Secretly, I began to feel terror at the prospect. I didn't want bedtime to be like a car trip-- I didn't want to watch her scream, staring at me with quivering disbelief that I wouldn't just give her a boob and unbuckle her already. Even when she fell asleep in the carseat, she would wake up the moment the car stopped. In bed, too, she would usually wake up seconds after I moved away from her.

Doing research online wasn't comforting. Everything I read started with the suggestion to put the baby in her crib for naps. Nitsah was happy to play in her crib during the day, pushing herself off the rungs like monkey bars, but sleeping there? ALONE? No way. Cosleeping began to feel not like a beautiful choice but like something I did because I had no other choice. It also seemed to shunt me into a parenting orthodoxy-- even though nothing I read sounded exactly right for us long term, when it came to sleep it seemed like I had to be 100% attachment parenting or 100% cry-it-out, with no middle ground (unless I had a baby who would simply go to sleep when set down in a crib, which I certainly did not), and with both camps persuaded I would maim my child if I did anything other than what they proscribed. When I envisioned attempting to put Nitsah in her crib, I imagined frantic screaming, desperate sleep deprivation, brain damage from excessive crying, and rigid schedules and routine. But the only alternative I could imagine was a baby in bed with us well into preschool. Last night, I weighed the pros and cons of attempting the crib to my husband, and the number of times I said "on the other hand" rivaled Tevye in Fiddler On the Roof. Then my husband uttered the delicate words that he has had much reason to utter during the course of our relationship: "I think you might be overthinking this."

And then I remembered: parenting was going really well for us, actually. It was going well because we were approaching choices with a sense of humor and experimentation... we were figuring out what worked for us, and we were enjoying the process. We were sleeping pretty well. Our daughter was thriving. We didn't have a sleep problem, so I didn't need to worry about adopting someone else's sleep solution.

Then, as I was getting ready for bed, I put Nitsah down in the crib and was about to go brush my teeth when I looked down at her. She was rolling around, smiling happily at her beer coaster mobile (a post for another day) and then at me. Not one bit sleepy, but not one bit desperate or unhappy, either. I reached a sudden decision. We were having a sleepover. Here, in her nursery, where she had never slept for even a minute. Without a system, without a plan beyond this one night, without a parenting guide to tell me whether to let her cry or pick her up. Without a deadline or huge buildup. If I ended up sleeping with her on the day bed in the nursery, so be it. If I didn't get much sleep and ended up snacking, singing songs, and reading stories all night-- well, that's what a sleepover is for, right?

So I nursed her to sleep as we rocked in the rocking chair (also almost unused), telling her a long story. At 11 PM, when she was soundly asleep, I carefully put her down in the crib... and she stayed asleep! I stepped back, stunned this had been so easy. At 11:07 she woke up crying. I settled down on the daybed with the good book I've been trying to read for the past month, and nursed her back to sleep. I tried put her back in the crib, but she started crying instantly. I picked her back up. No rules. I rocked her, sang to her... not out of desperation to put her to sleep, but because I felt lucky to have this little, warm, stubborn baby all to myself. At 11:30, I put her back down, and she started to fuss. I glanced at my watch, not because I was going to let her cry for a certain time limit, but because I knew how time can slow when a baby is crying and wanted a reality check. Under two minutes later, she sighed and tightened her grip on my thumb through the crib bars. She turned her head to the side and relaxed. Then she slept-- for three whole hours. I know because I watched them all... apparently, I'm the one who can't fall asleep without nursing.

The rest of the night passed smoothly (though, to be honest, I have been to sleepovers that were more fun, and next time I need to make popcorn before the baby grabs my hand). When she started to get restless, I rested my free hand on her head, and she would relax again. I read several chapters in Middlesex, by Jeffery Eugenies, with What to Expect Your Baby's First Year and The Baby Book by Dr. Sears safely lodged away in the office bookshelf. When Nitsah eventually woke up and wanted to nurse, I took her out of the crib and nursed her. When I put her back in, warm and content, she didn't even wake up. That time, I even slept a bit. About two hours later she woke up again, and this time I took her into bed with me, and that was fine too-- it was getting chilly in the room, and I felt too tired to safely sit up and nurse. We slept until 9, and the rest of the day today we've gone back to normal-- Nitsah has played on the floor, nursed in a sling, and naps now on my lap as I type this. The only way in which we're the worse for wear is the crick in my back from holding my baby's hand all night.

I don't know if Nitsah will sleep in her crib regularly from now on. I don't even know if I'll put her to sleep in it tonight. I don't know when she will sleep through the night, and I don't care, so long as we are both well-rested and happy. What I know now, though, is that we can navigate our sleep choices the way we've navigated everything else as parents. We can experiment. We can be inconsistent at times as we figure out what we want to be consistent about. I can go with my gut, but that doesn't mean that I should let fear control me. The crib is now an option, not an ultimatum.

Now, when I figure out how I'm ever going to sleep without a baby in my arms, I'll let you know.

An ode to poop

This (with more profanity but fewer pageant mom jokes) was originally published on Offbeat Mama.

Poop face!

When I was about seven months pregnant, I found the website STFU Parents and vowed never to commit the site's cardinal sin: posting about my baby's bowel movements on Facebook. This seemed like an easy promise to keep... I was freaked out by the concept of changing a diaper myself, let alone sharing this experience with my former college roommates and coworkers.

But now that my daughter is two months old, it's becoming more and more tempting to post about poop. I'm pretty sure the reason is that my daughter's excrement is exceptionally fascinating, exhibiting signs of brilliance and creativity in the bowel department, not disgusting and smelly like that of other babies.

Or maybe I've just become a mom.

During the first days after my baby was born, poop became a source of both pride and fear. Pride: with every sticky meconium-tarred diaper, I found validation that she was getting enough to eat. Take that, nurses who suggested my newborn was wailing because I didn't have enough milk! Fear: so why WAS she wailing? Had I put her diaper on wrong? Was I going to be able to put on those tricky hospital clothes again if I took them off to change a diaper? Would her umbilical cord start bleeding again if I bumped it? Where exactly was I supposed to swab with alcohol? How many wipes would it take to scrub away that little bit of black poo?

When her poop turned to wet, curdled yellow (at three days! So advanced), I felt more pride-- more than my aching boobs, this was incontrovertible proof that my milk had come in. It also felt like the first significant milestone in my baby's life, the first distance from the womb. She was now pooping out the milk I gave her, not the scum from her amniotic fluid. She was a real person now-- an eating, pooping little person.

It seemed weird to feel proud of someone else's poop, and I hope this isn't the precursor to becoming one of those parents who sees every one of their child's outputs as an extension of their own. (And, let's face it, I may have fixated on my baby's poop because my own, er, outputs weren't going so smoothly a week after vaginal birth. In celebrating my baby's poos, I was a bit like those overweight, disheveled pageant moms tending to their pristine daughters' manicures.)

But I also felt fascinated by the effort my daughter made with each poo, proud she was willing to work so hard to master a complex task. She would start to grunt, her eyes glazed over with internal concentration, arms jerking as she tried to bear down. Her cheeks would get red. Her face would contort. Then-- SQUIRT! (Who knew baby poos were so loud?) Newborns have limited social interaction; she would nurse, cry, and sleep. But when she pooped, she was animated. I posted a picture on Facebook of my daughter with her mouth in an "o," eyes bright, and people commented on how thoughtful and alert she looked. They didn't need to know that this was her poo face.

Diaper changing, like everyone said it would, quickly became second nature. It continued to be a proxy for growth. While at first my daughter screamed so hard with every diaper change that our neutered male cat literally leapt onto the changing table to her defense, soon she became calmer, able to be fascinated by the black-and-white border on the mirror over the changing table or the flower mobile dangling above her. Her skinny chicken legs developed fat folds, then fat folds inside of fat folds. She went up a diaper size.
At six weeks, I started finding more diapers that were simply wet-- before, every single diaper contained poop, so fewer than eight poopy diapers in a day seemed like a sign of maturity. Then she inexplicably stopped pooping for three days, finally pooping with such vengeance that I cut a onesie off of her body instead of pulling it over her head. (I think baby poop should be classified like house fires-- instead of a four-alarm fire, that was a ten-wipe poo.) She started smiling during diaper changes, looking around and kicking with her legs so hard that it took me several tries to close the diaper. Three days ago, her poop suddenly turned bright green for two dirty diapers before reverting to mustard yellow. Come on, tell me that doesn't make fascinating fodder for a Facebook update. Green poop!

One of my favorite baby care books, a Hebrew guide called "Why Babies Cry," says it's important to respond positively to your baby's dirty diapers because negative reactions ("Yuck! Nasty diaper!") can make children ashamed of their bodies. I tell myself this is why I praise my daughter for each bowel movement. But really, in her poops I see my own process of becoming a mother. I see my ability to feed and provide for my child. I see the way I need to respond and care for her, on her own schedule-- I can't decide when she poops, and I have to change diapers even when it's 5 AM or I am already ten minutes late for a doctor's appointment. It highlights the deep love motherhood draws out, the affection I didn't know I could feel for the act of wiping down my little daughter's butt. (I've heard I should enjoy this odorless, breastmilk-only stage while it lasts.) In the horror in my friend's eyes when I say my daughter needs a diaper change, I see just how much I have changed in the past two months. Forget water-- parenting involves baptism by poop.

And, let's face it, that sh**'s fascinating.

My beautiful hospital hypnobabies birth

I originally posted this on a hypnobirthing forum just after my daughter's birth. To learn more about hypnobabies, go here. Funny thing, by the way... nine months later I honestly can't remember feeling any pain during her birth, so if I hadn't written this before this post-partum amnesia set in, I might swear my birth was pain-free!

Also, like any good birth story, this one contains generous doses of T.M.I. You've been warned!

On my way into the hospital where my daughter was born

My ideal imagined birth story went something like this: labor at home for as long as possible, arrive at the hospital 7 cm dilated, experience no pain, only peaceful euphoria, and spend only a few hours in the hospital before giving birth. That wasn't at all what happened, but in retrospect the way my birth happened was its own kind of perfect, and hypnobabies helped a lot.

A week ago, I felt like I would be pregnant for 41-42 weeks at least... I was having basically no signs of labor being eminent, and I wasn't even sure I'd "dropped." On Wednesday (39 weeks 3 days) I had a dream that I would go into labor that day... I'm never usually the kind of person to experience or believe in things like that, but when I woke up on Wednesday morning I felt a little gush of fluid. I mentioned it to my doctor at our appointment that day, but he didn't think it could be my water... I actually asked for a cervix check, and my cervix was back and closed. That night, though, I started experiencing my first real pressure waves (aka contractions). They were pretty irregular but different from any Braxton Hicks I had been experiencing, I was having more little leaks of fluid, and then I passed something that looked like clear mucus... suddenly I felt very sure that I wouldn't' make it to my due date, let alone to 42 weeks! I listened to my fear clearing track and birthing day affirmations that night, and experienced pressure waves all night long... I tried to sleep but didn't get much. I finally got out of bed at 6 AM, only to have the pressure waves slow down to once every 20 minutes at most. The feeling of the pressure waves unnerved me a little, because they didn't just feel like "pressure"-- they felt more like period cramps, and I felt a little bit of panic that my hypnobabies tools might not work the way I expected.

All day Thursday I had very irregular pressure waves and more little leaks of fluid. I found the section in my hypnobabies book about when to go to the hospital, and how to tell the difference between a leak vs. a gush of fluid, very helpful, and I'm so glad I didn't go the hospital then. Thurs night my husband and I went out to a local arts festival with some friends... I kind of didn't tell those friends that I was starting to experience regular pressure waves again. When we were leaving, I had a bigger gush of fluid (luckily still not TOO much to soak through the pad I was wearing), and I had a strong feeling that I would be in actual labor soon.

At 2:30 AM Friday morning, I got out of bed and started timing pressure waves. They seemed to be about a minute long and were coming about every 4 minutes. I was also having more gushes of fluid. Suddenly I decided that I DID want to go to the hospital, even though I knew I wasn't quite as far along as I'd planned. I listened to the hypnobabies fear clearing track in the car, and we arrived at the hospital at about 4:30 AM, along with our doula.

At the check-in at L&D, I had a cervical check. I was trying to mentally prepare myself to be "just" 4 CM dilated... only to hear that my cervix was CLOSED, though 60% effaced. They hooked me up to a monitor and I was having regular pressure waves, 5 minutes apart. I listened to birthing day track 1 while I was hooked up to the monitor, and I just focused on thinking "open, open, open" with each pressure waves. They became a lot easier to deal with when I stopped thinking about what they were supposed to FEEL like and instead focused on what they were supposed to DO. I felt very glad each time a pressure wave came, and I focused on welcoming them and helping them become stronger. They actually looked kind of like the humps of a camel on the monitor, and I really think that the second "hump" represented when I would focus on welcoming the pressure wave using my hypnobabies techniques.

The hospital was very full that morning, so they actually gave me the option of switching to a different hospital. Technically I wasn't allowed to return home because my waters had broken, but I considered doing that anyway... yet somehow I just really wanted to stay in a hospital and focus on being calm in that new situation. The pressure waves were uncomfortable when I was in the car, so I was glad I didn't drive home. Instead, we parked pretty far away from the second hospital, walked around the block, went out for breakfast, and finally checked in at 7 AM. The second hospital had a much warmer atmosphere, and I was very glad we ended up there.

Right away I had some lessons in being calm and assertive, and stating what I wanted. The hospital gave me a hospital gown to wear, and told me that wearing my own jersey dress wasn't an option. I said that I felt much more comfortable in my own clothes, and asked if they could make an exception. Nobody ever said anything else to me about what I was wearing, and I was very glad that I was in my own dress when I was walking the hallways and the stairs of the hospital during my long labor!

After about two hours, the doctor in the new hospital finally checked me. I was still having pretty strong pressure waves, about 3-5 minutes apart. At this point I was dilated to 1.5 cm, 70% effaced. My doula was amazing about helping me focus on the positive, and hypnobabies helped me also stay deeply relaxed and focused on helping the pressure waves do their job. Throughout the next few hours, I walked the hallways and rocked on a birthing ball a lot, relaxing into a deep squat with each pressure wave. I felt like my "lightswitch" was in the middle position pretty much the whole time... I felt just kind of calm, in my own world. (Actually, when I DID start having a more animated conversation between pressure waves, I found that my pressure waves slowed down, so I had motivation to stay calm!)

After a few more hours, we were told we could move into the natural birthing room even though I hadn't had a cervical check in a while (so they didn't know if I was in active labor). I was glad of this, because when they DID check my dilation, it was just 2 cm... though now I was 90% effaced. I FELT, though, like my pressure waves were becoming much more intense (and often more than a minute, less than three minutes apart)... they seemed like the description of active labor, not latent phase. This was the hardest part of my birth... I struggled with the idea that it could feel SO intense when I wasn't even to the point where I could be accepted into a hospital without broken waters. I did a fear clearing session to deal with the worry that "real" labor would be SO much more intense, though that worry took a while to fade away. I kind of gave myself a vacation from trying to help my labor progress at that point, and for about an hour I focused on just laughing, talking, and listening to music.

Soon I started to really NEED the hypnobabies tools to help me deal with each pressure wave. My doula (who wasn't a trained hypnobabies doula, but did amazingly anyway) would read me parts of the scripts in the birthing guide while my husband would hold me up during the contractions. The intensity of the contractions meant that I now needed to focus on pain relief rather than on helping the pressure waves work, and I focused on putting my light switch in the OFF position before each one. It became very uncomfortable to stay lying down during the intermittent monitoring, but when I moved around or stood in the shower it was manageable.

Finally, I had another cervical check, and I really hoped to see progress... I was actually starting to feel a teeny bit pushy. I was 100% effaced... but all I really heard was when the doctor said that I was "4... no, let's say 3.5 centimeters" dilated. A lousy 3.5 cm! But I just put it out of my mind, and took off to walk the stairs with my husband and doula one more time. (We had to sneak out of the birthing ward each time to do so... if I were in my hospital gown, I doubt we could have managed the escape. :) I allowed myself to give tiny little pushes at the start of each pressure wave, because that's what my body was telling me to do... I didn't tell anyone, though, and I focused on relaxing for the rest of each pressure wave. I NEEDED the scripts. When we got back, I sat in the shower on the birthing ball for about an hour and sang any song I could half way remember that seemed uplifting. I saw a video on youtube before my birth of a woman singing during her pressure waves, and while my voice is nothing like hers and I completely butchered the lyrics of every song I sang, it REALLY helped me in that moment focus on things other than the pressure.

My voice started seriously breaking at the start of each pressure wave, and I found myself feeling VERY pushy. The doctor offered to check my dilation, but I said I didn't want another check... I'd just heard that I was 3.5 cm two hours before, and because I was already starting to feel pushy then, I didn't trust that to mean anything. But on my next pressure wave, I PUSHED... all out, gutteral, powerful bearing down. It wasn't anything I could control or cared to stop. Then I agreed to be checked by a midwife. She reached inside to feel my cervix, looked confused, and said, "it's not there." In just TWO hours, I had gone from 3.5 cm dilated to FULLY dilated and ready to push!! I couldn't believe it, and I was just amazed that my body knew exactly what to do. Pushing wasn't optional, and making sounds wasn't a choice... it was just what I was doing. We put on the "birthing stage 2" track and were off! It was such a relief to be able to do exactly what my body wanted.

In the final phase of labor, the only annoying thing was the doctors insisting on monitoring... I was NOT going to lie still on my side or back during pressure waves, but they were having trouble finding my baby's heartbeat on the monitor and were adamant that I needed to be monitored for 5 minutes every 15 minutes (which would quickly turn into more than 5 minutes when they didn't get a consistent reading). I was deeply in the zone at this point and just felt comfortable saying NO to the monitoring. I made sure that they picked up my baby's heartbeat from time to time (and it was always perfect), but I refused to be strapped down to the monitor for five minutes. They started to pressure me to put a scalp electrode into her head, but my husband and I said NO... we could see that our baby was doing fine (they could pick up her heartbeat, just not continually) and we didn't want anything screwed into her head. At that point the doctors kind of left the room in a huff, which was great, because they left me in the care of a very supportive midwife.

In retrospect, the way I pushed is one of the only things that I might have done differently... I allowed myself to be coached by other people (the midwife, my husband, and my doula) instead of just completely listening to myself, and I think it might have been better for me to just do exactly what my body demanded. But at that point I just wanted my baby out as quickly as possible, especially since the doctors were giving me such a hard time about the monitoring. I had just two little stitches, but I might have avoided even those had I allowed myself to direct my pushing phase.

After only about an hour of pushing, my daughter was born at 1:05 AM on Saturday-- pink, crying, and perfect. Her APGAR score was 9/10, which is the highest score they actually give. She was put right onto my chest and actually managed to latch on and nurse in that first hour. She was very alert and looked straight into my eyes and my husband's eyes.

Now she's three days old and wonderful. :) I feel great, and I feel like my birth actually has really empowered me as a mother... I FELT my body taking over and doing things in exactly its own way, and in its own time, and I'm trusting my instincts as a mother too. (Having a good bubble of peace seems even more important now that I'm faced with an onslaught of parenting advice!) We continued to make our own decisions after the birth, insisting on staying with our baby at all times and convincing the doctors to let us out of the hospital on Sunday night instead of Monday morning.

Some things I learned about using hypnobabies during my birth:
  1. The lightswitch and relaxation cues are very important, but even more important turned out to be all the messages in hypnobabies about staying relaxed, confident, and making my own decisions.
  2. There were times when I didn't feel like my hypnobabies tools were working, because I did feel pain and didn't always feel positive. But then my husband said something to me about how I looked like the very calm, cheerful woman we saw on a youtube video of a hypnobabies birth. That surprised me and helped me realize that I didn't know what was going on inside her head either, but I WAS succeeding at staying calm and relaxed. Whether I felt pain or not wasn't really important... what WAS important was what I did with that pain. My husband and doula are actually now big converts to hypnobabies!
  3. I had to use hypnobabies in a way that worked for me, which was different at each phase of my labor. Sitting in the shower and singing wasn't a tool I read about in hypnobabies, but it was exactly what I needed at that moment.
  4. Progress is progress, and your body knows what to do. My labor wasn't following the "script" I thought it would, but my relaxation helped everything advance steadily.
  5. Having a doula was amazing. I really debated whether it was worth it, because I felt very confident in my ability to handle birth, but she was SO helpful... both in pointing out the progress I was making (when I told her I felt like I needed to throw up, for example, she said, "Wonderful! That's a great sign!") and in helping me with hypnobabies cues. My husband often supported my weight during a contraction while she read to me.
  6. Everything really is all worth it when your baby slides out. :)

    Without hypnobabies, I think it's quite likely that I would have had pitocin and an epidural at least, and perhaps a c-section because of "failure to progress." With hypnobabies, I had an all-natural birth in less than 24 hours without any kind of intervention, despite no dilation when I arrived at the hospital, and now I mainly remember how deeply I felt like I was in the zone, relaxed, and listening to my body for my birthing time.

Misdiagnosed miscarriage, version 2

Note: a shortened version of this was posted on the blog Offbeat Mama.

Just over a year ago today, I was diagnosed with my second miscarriage. And not only did my doctor turn out to be wrong, but the misdiagnosis may have been the best thing that could have happened for my pregnancy.

In the summer of 2010, I had missed miscarriage that ended in D&C (dilation and curettage, the simple surgery that removes early pregnancies) at about 10 weeks. At first I believed that I NEEDED to get pregnant again RIGHT AWAY and that I was DEFINITELY READY... but when I found myself blubbering to my husband about how I didn't feel at all excited about getting pregnant again, just stressed out, and that I never thought I would feel excited again, we realized that we weren't actually ready. After trying again for one month post-D&C (when I'm convinced that Yom Kippur falling pretty much exactly on ovulation day didn't help!), we took time off. I got my two-star scuba diving certification and started training for a half-marathon, doing lots of yoga, and generally trying to keep myself busy and enjoy NOT being pregnant as much as possible.

After a few months we felt ready to try again-- TRULY ready, excited-to-be-parents ready, optimistic ready. On our second month trying, on Valentine's Day, I took a pregnancy test a few days before I thought I actually had a chance of seeing a positive... but there was a faint second line!! We were delighted... and stressed out, and intimidated at the thought that I was supposed to run a half marathon in just a few days. Ok, maybe the stressed out and intimidated part was mostly me. I had this tape playing in my mind that said something like "don't stress, stress is bad for the baby, OMG I'm STRESSING OUT, I'm DAMAGING IT, NOOO I NEED TO STOP STRESSSING.... AAAAAH!!!! STRESS!!!!" I barely slept at all for the first few nights after getting that positive pregnancy test. While I think I had recovered from the miscarriage enough to be excited, it still played with my mind... and for the record, telling a pregnant woman not to stress because stress can hurt the baby is basically the MOST stressful thing you can possibly say to any woman who is, shall we say, a bit high strung.

I was also debating whether or not to run the half marathon, and I decided not to-- I didn't want to blame myself if this pregnancy, too, ended in a miscarriage. Instead, I ran the 10K at the same event, feeling nicely over-trained and horribly smug whenever I sailed past a huffing and puffing non-pregnant guy. The first person we said the words "I'm pregnant" to (ok, technically "Ani beheraiyon"-- we live in Israel) was one of the race coordinators who agreed to change my registration to the 10K when we explained my "delicate condition."

On March 1st, I had my first doctor's appointment at 6 weeks exactly. We waited three hours to see him because I had the time wrong, and I sat in the waiting room with this growing feeling of dread. Last pregnancy, it felt like I got scarier and scarier news at every ultrasound... the baby was too small, its heartbeat was too faint, there was no heartbeat, it had stopped growing... now, seven months later, just after what should have been my first baby's due date, I sat in my new doctor's waiting room, getting up to pee every five minutes, fearing the worst.

And then it happened.

The doctor didn't see a fetal pole on the ultrasound, just a sac. He also started drawing pictures on his pad that looked kind of like deer antlers, explaining to me that he thought my uterus was bicornuate, and that I was carrying the baby in the left side. Yes, this could be the cause of repeated miscarriages. He sent me to get my HcG levels drawn: 38,000 one day, 40,000 the next-- high (so high that every website I googled told me that there should DEFINITELY be a baby and a heartbeat seen on ultrasound) but not going up fast enough. One website told me it would take something like 76 days for my HcG to double at this rate, while it's supposed to double every 24-72 HOURS at this point in pregnancy. I also felt a little crampy, convinced that my breasts were less sore than they had been the week before.

So when I went back for a second appointment four days later, at what should have been 6 weeks 4 days, and heard more bad news, I was expecting it. I had to ask my doctor specially to print out a picture of the ultrasound... I've found that they don't give you pictures when they think your pregnancy isn't viable.

He diagnosed me with another missed miscarriage, and told me that lots of women have two miscarriages and go on to have healthy babies. It didn't feel that way. It felt as if getting pregnant (or rather, staying pregnant, since we got pregnant on our first or second try both times) was going to be this insurmountable barrier, as if something so effortless to so many women was going to be incredibly difficult for me. I felt as if I had plunged into a different category, the scary world of "multiple miscarriages," compounded by this news about my defective uterus.

The doctor printed out two referrals for me to take to the hospital the next morning-- one for a D&C, one for medically-induced abortion if that's what I preferred. I asked him if it would be ok for me to wait this one out to see if it would happen naturally. He said yes. I said I'd give it two weeks.

And then I went home.

I had cried so much in the days between the two ultrasounds that now I just felt numb. Even calm. My baby, my poor little nonviable baby was still inside me, which didn't bother me the way it seemed to bother other women on the Babycenter miscarriage support forum. I felt like at least I would get a longer goodbye this time, at least I could wait for natural miscarriage so that I would have no doubts that this had to happen in the end. I knew it could take a while; I read the stories of women who waited four weeks, with pregnancy symptoms churning along, before finally releasing their babies. I felt a kind of peace with this, a kind of confidence that waiting would be the best thing. I just hoped the miscarriage would happen on its own before my doctor would pressure me into getting a D&C.

In the meantime, I went back to my normal life. I ran faster and harder, intervals and tempo runs. I ate poached eggs with runny yolks, camped out all night on the rocky ground beneath Masada fortress and didn't worry about lack of sleep, drank a small light beer on two separate occasions. I didn't eat sushi, but only because our favorite sushi shop had closed. I reveled in iced coffee, hot "cafe hafuch."

And yet I felt I was living in a twilight zone between "pregnant" and "not pregnant"-- those jokes about how you can't be "a little bit pregnant" didn't seem funny anymore. In the Ein Gedi Spa at the Dead Sea, I decided to dip my toes in the sulfur water pool rather than go in with my whole body, thanks to the big signs prohibiting pregnant women from entering. When we took my parents on an introductory scuba dive in the Red Sea coral reef, I agonized about whether to go with them-- I had to sign that I WASN'T pregnant on the waiver before entering the water. But it was such a short and shallow dive that I decided to risk it.

I didn't want to give in to the "denial" that kept whispering in my ear about that bloat in my lower stomach, about the breast soreness that was back in full force, that light nausea in the evenings-- the "denial" that kept playing pictures in my head of going in for another ultrasound and seeing a developing baby on the screen. I felt that I had let denial string me along too much in my last pregnancy-- my doctor was gloomy about my prospects at every appointment then, but I had dismissed him as an Eeyore, and I told grandparents, second cousins, fellow theater board members, acquaintances, friends all about my pregnancy at just 7 weeks. And then told them the sad news at 10. This time I was going to face reality. It felt important to stop taking pregnancy precautions so that I could truly wrap my head around the loss of this second baby. But still, I didn't go in that sulfur pool, I didn't go on a deeper or longer scuba dive (even though I had the opportunity), I avoided any medication that could be harmful during pregnancy, and I kept taking my prenatal vitamins.

Three weeks after my last appointment, I called my doctor, ready for him to yell at me for waiting longer than I'd said I would. Instead, he wasn't worried. He scheduled an appointment for me in a week. I was grateful for more time to wait, more time to let this happen naturally instead of being pushed into making a decision to end this pregnancy.

I didn't bother to set the appointment for a time when my husband could make it. It would be at 10 weeks 3 days, so I knew that it was now or never-- if nothing had changed for the better on the ultrasound, I felt ready to take medication to end this pregnancy. My main question was whether I could wait until after the 5.7K field race that my husband and I had registered to run that weekend, back when it had seemed my pregnancy would be long over by this point. I didn't even look at the screen when my doctor inserted a wand to see what was going on with this pregnancy; I studied the gray curtain beyond my feet, ready to hear the worst.

"Maya, do you realize what we're looking at here?" my doctor said. And then I turned to the screen. And there was a moving, beautiful, heart-beating, perfectly-sized 10 week fetus.

I started crying-- maybe one of the only times in my life that I've burst into tears because of pure joy. This was literally my dream, this was that moment my "denial" kept playing in my head. This was my BABY, my actual kicking baby, there on the screen. At 10 weeks, my last pregnancy had looked like a smudge on the ultrasound, a little gray spot at the edge of the long, collapsing wedge of sac. This baby was waving at me.

The doctor also told me that he no longer saw signs of a bicornuate uterus on the ultrasound. He thought possibly originally there had been twins, leading to the high HcG numbers and odd ultrasound results, but I'd lost one early on. He was practically on the verge of tears himself.

The next few days felt more dreamlike than anything I've ever experienced in my life. I couldn't stop smiling, and while I passed one restless night after finding out the news (should I sleep on my side? What if something happened to the baby now?) but I found the calm that I'd felt when I thought I was miscarrying returning. This baby was strong. She (a girl, though I didn't know it then) had thrived during the interval running, the sleepless nights, the-- *gasp*-- caffeine consumption. She was tough, and one nervous mother couldn't change that.

In retrospect, being misdiagnosed with miscarriage was perhaps the best thing that could have happened to me. During the two weeks between finding out that I was pregnant and being told I had miscarried, I twanged with fear. I felt like the agent of my baby's destruction, not just its growth. When I thought I was waiting for miscarriage, for the first time I did something simple: enjoyed being close to my baby. When I thought I would lose her, and there was nothing I could do, I allowed myself to do nothing.

I wish I could say that I lived in constant bliss for the rest of my pregnancy, but I still had my Google-fueled panic-stricken moments. (The most infamous of these: an emergency trip to my doctor's office at 20 weeks when vanilla-scented toilet paper convinced me I was leaking amniotic fluid, which women on my birth board swore smelled sweet.) But in the moment when we discovered my baby on ultrasound, a conviction began to germinate, one that would blossom when I saw her emerge pink, slippery, and determined, at the end of October: that my baby was strong, and that I could put some trust in her and give myself a break.

That Friday, I ran the 5.7K and didn't even bother going too easy-- while I made sure I was never overly out of breath, I also pushed myself just enough to pass a teenage girl on the slope down to the finish line. I finished just under a half hour, winning third place overall among women, thanks to the 11K race at the same event that siphons off the serious runners. At our next ultrasound, our baby had even picked up an extra "day" of growth between appointments.

My misdiagnosed miscarriage (version 1)

This was originally a guest post on A Mother In Israel.

The ultrasound at six weeks, second pregnancy

About a year ago, I left an anonymous comment on this blog [A Mother in Israel]. In response to the disturbing story about feticide at 40 weeks, I shared my own fears about prenatal testing here in Israel. When should I call my doctor to get his confirmation of the news I’d only discovered two days before, via two faint (and very welcome!) lines on a home pregnancy test? I didn’t want to go through the roller coaster of inconclusive early ultrasounds I’d experienced during my first pregnancy, the summer before.

Back then, at my first appointment, when I was still giddy, terrified, and freaked out that I had woken up with cramps the night before, my doctor had glanced at the ultrasound screen and said “There’s nothing in your womb.” Then he moved his wand a bit, squinted, and said, “Wait, no, there it is. But it doesn’t have a heartbeat.” This can be normal, he explained—often a fetal pole is invisible at five weeks, and my dates were probably slightly off. He drew his mouse cursor across the screen and measured the little black blob that I already thought of as my baby, and received an estimate of its age: four weeks five days. He sent me for a blood test and told me to come back in two weeks.

On to the roller coaster. The results of the blood test to confirm my pregnancy were great! Mazel tov! At seven weeks, we saw the flicker of a faint heartbeat! But the sac was growing slowly and was shaped irregularly, losing “days” every time it was measured.

Perhaps I should have known that something was off when my doctor still hadn’t sent me to any blood tests beyond checking my pregnancy hormones, but then I wasn’t yet familiar with the thirst of Israeli kupot cholim (health funds) for the blood of pregnant women. Besides, I had gotten pregnant my first cycle trying, and my mother had had four textbook pregnancies, so surely fertility problems and miscarriage were things that happened to other people. Stories on the site The Misdiagnosed Miscarriage helped convince me that what looked like a “blighted ovum” was no doubt a healthy baby nestled in a tipped uterus.

So I told everyone I was pregnant– my family, fellow board members of the Haifa English Theatre, the dressing room lady at Mango. I was convinced that I needed maternity clothes and loosened my belts. I bought plane tickets to fly to the US at the end of my first trimester and was sure I’d be “showing” by the time I returned from it. We concluded that my doctor was simply a negative person, delivering good news with the enthusiasm of Eeyore.

And then I went back to my doctor at nine weeks five days. Another ultrasound. No heartbeat, just a collapsed crescent moon with a smudge on it where my baby should have been, measuring just seven weeks along. The doctor diagnosed me with miscarriage after studying the ultrasound for five seconds. I grabbed the ultrasound wand and tried to make him look harder—my baby couldn’t be gone. I asked him for a referral to second opinion, which he printed out in a huff, telling me that he was the best doctor in the area and that if I used the referral, I should never come back to him.

Three days, and two ultrasounds from two different doctors later, I sat in the recovery ward of Rambam hospital, post D&C (Dilation and Curettage, the simple surgery that removes early pregnancies)—utterly, literally, drained. Not pregnant. “There will be no miracles here,” the last doctor had told me, before sending me in to surgery to vacuum out my womb.

So when I finally got pregnant again, six months later (after a delay caused by my emotional recovery more than my physical one), I dreaded that first ultrasound. I dreaded that limbo of not knowing, that “chetzi mazel tov” (half congratulations), those weeks of being told that probably everything was ok, or then again maybe not. We got the time wrong for our first appointment, so I sat in my new doctor’s office for three hours, heart pounding, preparing for the worst.

And then it happened.

I had waited until six weeks into my pregnancy for this first appointment, when every pregnancy website told me that there should be a heartbeat on the ultrasound. Instead, all we saw was a misshapen black blob, or maybe two black blobs, neither the size they should be, and neither containing anything that looked like even a yolk sac. My new doctor seemed as stricken as I was, and he searched for a long time to try to see something more clearly, trying different angles, pressing his hand on the outside of my stomach. He sent me for blood tests on consecutive days. While my hormone levels were very high, making a mistake in my dates almost impossible, they weren’t going up as quickly as they should have been– at this stage in pregnancy, they should have been doubling every 48 hours. Mine, on the other hand, were on track to double about every 30 days. I came in for a second ultrasound at six weeks and four days into my pregnancy, and left that appointment with a referral for a second D&C. At least this time I didn’t have to wait in limbo– I had a definite answer. Another “missed abortion.” (I never bled or lost all pregnancy symptoms in either of my pregnancies.)

This time, I decided to wait for the miscarriage to happen naturally. I went back to my normal life– drinking the occasional beer, going on a shallow scuba dive, running hard intervals. (I wasn’t in the mood to be gentle to my body.) This time, I was determined not to live in denial. The stories on that misdiagnosed miscarriage website convinced me that it was a good idea to wait for miscarriage at home, but that was the only concession I was willing to make to the tiny possibility that this pregnancy wasn’t over. I felt oddly free, no longer stressed that everything in my environment, including stress, was probably damaging my baby. I posted tearfully on miscarriage support forums online and tried to wrap my head around the scary world of multiple miscarriages. I felt oddly grateful for this long goodbye to my second baby.

Four weeks passed, though, and nothing happened– not even a cramp. The mild pregnancy symptoms that I thought had gone away in my sixth week seemed to be back. It was growing harder to tamp down that bit of hope. I called my doctor and set up an appointment, ready to think about “taking care of it” if we saw the same thing on the ultrasound.

As my doctor examined me, I focused on the gray curtain in front of the examination chair.

“Maya… do you realize what we’re looking at here?” he asked.

I turned toward the ultrasound screen.

There was a little gummy-bear-shaped fetus, measuring ten weeks one day, right on target. Even I could see her fiercely beating heart. As I stared at the screen, eyes welling up, I swear I saw her wave.

The ultrasound at 10 weeks
Why am I sharing this now, with my beautiful three-month-old daughter sleeping on my chest? Partly it might be a desire for vindication– see, commenters who told me that five-week or six-week ultrasounds weren’t inconclusive, I was right after all! Partly it might be because I’m still processing how lucky I feel that I didn’t use that referral to a D&C (though sorry, dad, but my baby’s story is not nearly as dramatic as Tim Tebow’s). And in a way I feel conflicted about telling my story, because reading stories of misdiagnosed miscarriage only fed my denial during my first pregnancy (though they might have saved my baby’s life during this one). I’m grateful for the prenatal care that we get here in Israel. I’m glad that I get to decide which tests to take based on my preferences, not my bank account. (Women in the US usually don’t get their first ultrasound until around week eight to 12 of their pregnancies, and thanks to the great expense of health care in the US, more women there wait for miscarriage to happen naturally than here in Israel, where the few people who knew thought I was crazy for not getting a D&C). I don’t know if I’ll pass up on early ultrasounds in (G-d willing) my next pregnancy, because I would probably drive myself just as crazy waiting for week 12 on my own. I don’t regret getting a D&C in my first pregnancy, because I’m fully convinced that pregnancy wasn’t viable.

But the thing about going through almost any kind of pregnancy twist is that you quickly find other women who experienced the same thing. As crazy as it is that my doctor told me my pregnancy was over in week six– when it really IS too early to be sure of what you’ll see on an ultrasound– I now know personally of three other women in Israel who were told something similar, thanks to early prenatal testing. Neither of my doctors volunteered the possibility that I could wait for miscarriage on my own. In 2010, misdiagnosed miscarriage made headlines in Ireland when a woman was told her pregnancy wasn’t viable and was given an abortion drug, only to discover a healthy baby when she sought out a second opinion. How often does this happen in Israel?

Misdiagnosed miscarriages are rare– far more rare than you hope they are when you get diagnosed with miscarriage. At the same time, they do happen, and they happen far more often when miscarriage is diagnosed before ten weeks, which happens far more often when women are lucky enough to get ultrasounds so early. Our healthcare system, which makes giving birth so inexpensive and easy, also makes ending a “nonviable” pregnancy inexpensive and easy. What would have happened had I gone to the hospital with that referral for a D&C? Would the final ultrasound before surgery (which I’m told sometimes doesn’t even happen) have caught a heartbeat or reason to wait? I’ll never know. But I do know that if I had gone to the hospital and they hadn’t found a reason to stop me from getting a D&C, I would be talking about my second miscarriage, not my daughter Nitsah. No matter how warm her body as she sleeps heavily against my right shoulder, that thought gives me chills.

Thank G-d that, sometimes, there are miracles here.