six weeks pregnant

* Originally written April 23, 2009

I haven’t really been able to digest all that has happened over the past week or so. I had barely gotten my positive pregnancy test result when the spotting started. I had spotting in my first pregnancy, but this time, it didn’t seem to be stopping. It wasn’t a lot, it was just a little bit, every day. Every. Single. Day. My first prenatal appointment wouldn’t be for about 3 weeks, which made me nervous, but I also wasn’t prepared to go to the emergency room because of a little spotting. Maybe I would have if it had been my first pregnancy, but when you’ve got a toddler and a dog and your husband is travelling for work, you really weigh the pros and cons of spending hours at a hospital before you make your decision. I started calling up other OB/GYNs in an attempt to get an earlier appointment. I love my OB/GYN, but her office is way the hell across town, and if I could find a good doctor in my neighborhood, I wouldn’t mind switching. One whole Friday morning of phone calls later, and I had an appointment for the following Monday, April 20.

Over the weekend, I started feeling cramping, especially when I was nursing Marie. And boy, did it hurt! It was like the afterpains following Marie’s birth. I was beginning to believe that this pregnancy wasn’t meant to last. On Sunday, I had a lot of bleeding, and I took it as a sure sign that I was having a miscarriage. I met up with my sister in law and her boyfriend for the afternoon so that I wouldn’t be quite so alone with my thoughts and so that they could help with Marie. When Toffi got home that evening, we talked about everything that happened. I had also told my sister in law that I was fairly sure I had miscarried. Toffi said to me, “I know it goes against all the symptoms you’re having, but my gut is telling me the baby is still alive.”

By the time I arrived at the gynecologist’s office the next day, I was pretty much resigned to the fact that I had lost the pregnancy. When the nurse took down all my information, I explained that I had originally made the appointment as a prenatal check-up, but that I now believed that I had lost the baby. She was very kind and supportive, as was the doctor when I told her the same thing. She wanted to examine me before we got into the subject of miscarriage and all that, so I undressed for the ultrasound and – wait, what’s that? An orb-like thing on the screen! It almost looks like … no, couldn’t be. And then she said, “Well, what I’m looking at right now is an embryo in the 7th week. And look, there’s the heartbeat.”

The long and the short of it is: we don’t know for sure why I bled so much or why I had such painful cramps. Based on the ultrasound, though, it’s likely that I was originally carrying fraternal twins and that one of them became unviable, perhaps about a week before I experienced the bleeding. A vanishing twin. One thing that is certain, however, is that my body is not making enough progesterone, which could also explain the bleeding. So for the next six weeks, I have to take progesterone supplements. The progesterone deficiency could have something to do with the fact that I’m still breastfeeding, though there’s no way to know that with any certainty. The OB was very open to talking about breastfeeding during pregnancy, and I felt that she was very neutral on the subject. She continued to emphasize that the decision is entirely up to me and tried to provide me with as much information as she could, especially regarding the hormonal interplay between progesterone, prolactin and oxytocin. I told her about the recent aversion I had been feeling toward breastfeeding and the painful cramping during and after breastfeeding. She then gently suggested that I might want to wean for my own comfort and well-being, especially since I don’t exactly have a lot in the way of fat reserves. I admitted that I had begun thinking this myself and that I was no longer really wondering whether to wean, but much more when and how to do it.

My husband and I spent a lot of time talking about weaning that day and the next, and we came up with a plan. Since Marie only nurses twice a day on most days, we figured we’d start by eliminating the feeding she seems least attached to: her before-bedtime feeding. Two days in a row now, Toffi has brought her to bed without her having nursed, and it seems like it hasn’t even phased her. We’ll see what happens when Toffi is away on the weekend and I have to put her to bed, but so far, the ease with which it has happened is a huge relief, because I couldn’t bear to think that I was traumatizing Marie by weaning her before she’s ready. We’ve also been giving her an explanation, of course. Whenever we see babies or the subject of nursing comes up, we talk about how little babies need lots and lots of milk and how they nurse all the time and how mamas have lots of milk for little babies. Then we say that as babies get bigger and can eat other things, mamas have less milk, and when they are big kids who can eat and drink all sorts of yummy things, mamas eventually don’t have any milk for them anymore. It’s not the 100% truth, but we decided it’s close enough and it’s within Marie’s capacity to understand. The acid test will be, like I said, the weekend, when I have to put Marie to bed without nursing. If that goes smoothly, then we’ll work on eliminating her morning feeding next week. Toffi will get up with her in the mornings and go out and do something fun and exciting to distract her from her nursies. If the weekend doesn’t go well, however, we’ll probably wait another week before proceeding with step two.

And how am I feeling? Well, exhausted, mostly. The doctor warned me that the progesterone would make me sleepy, which is why I am taking it before bed. But despite timing it that way, I am definitely more tired than I was before I started taking it. I keep telling myself that I only have to take it for six weeks and that my energy level will likely go back up after that, both because I will no longer be taking it and because I’ll be emerging from the woes of the first trimester. In the meantime, I’m trying to cut myself some slack. One thing I definitely feel weird about is the twin I may well have lost. It seems like I should feel a sense of loss. Indeed, my gut tells me that the vanishing twin theory is correct. And yet, I am so thrilled that I am carrying one healthy embryo with a strong heartbeat that I just can’t feel sad about the one I probably lost. I talked to Toffi about it, and he feels more or less the same way. We came up with all sorts of reasonable explanations for our feelings, explanations that make it perfectly understandable that we feel no real sense of loss, but despite all this, I can’t help but feel a little bit guilty for not mourning our baby’s twin.