Personally, I think his survival rate is higher, because I was given steroid injections to advance his development 6 ½ weeks ago, when my pre-term bleeding began—and he’s big. And based on the gymnastics moves he’s performing in my belly, seemingly 24 hours a day, he’s feisty, a fighter.

I have been cursed in the fertility department, struggling with embryo implantation and suffering early pregnancy losses, due to my in utero exposure to diethylstilbestrol (DES), which led to my underdeveloped, one-third-normal-size T-shaped uterus. And due to my DES deformities, my pregnancies are high-risk.

But my one prior successful pregnancy gives me comfort: When I was pregnant with my 5-year-old son, my complication was premature dilation due to incompetent cervix, which led to hospitalization, steroid injections and bed rest starting in my 27th week of pregnancy. After all that, my son was born on his due date, a rarity that occurs in only 5% of pregnancies, according to my pregnancy books, and he weighed a whopping 9 pounds 7 ounces.

My son did have to stay in neonatal intensive care (NICU) for the first five days of his life because he’d aspirated meconium (his first bowel movement, in utero), but his size and corresponding strength helped him overcome being born in acute respiratory distress.

The nurses told me that he was the biggest baby they’d ever had in NICU. And while there were strict rules not to look at the other NICU babies, the day my son was being released, the dad of a 4-pound twin, who also was being released that day, walked over and admitted, “I looked at your baby last night.” He continued, “That’s what a baby’s supposed to look like.”

If the little man inside of me is anything like his older brother, he will overcome whatever is thrown at him from this point on, because he’s also had the benefit of the steroids, and he’s also big for his gestational age.

So, today, for the first time in my seven months of pregnancy, I’m permitting myself to feel confident that, between now and my due date of April 23, my husband and I will be bringing our healthy, huge baby boy home.

I know there are no guarantees. Even at full-term, a 100% infant survival rate doesn’t exist.

But for today I’m allowing myself the luxury of feeling like my dream of having another biological child will come true. I’m still realistic. I’m still scared. But I’ve hit a milestone so significant that the tears in my eyes right now are not sad ones, but ones of hope and happiness.

Day after day I make a conscious choice not to let my anxiety overwhelm me. And that’s difficult for me, because I’m a Type A woman, diagnosed with Generalized Anxiety Disorder. I’m a natural worrier.

So I take Prozac. I have weekly sessions with my psychiatrist, now by phone because I’m on bed rest. My husband, who’s Type A too, and I have weekly or biweekly appointments with a Family Systems Therapist, who now comes to our home due to my bed rest.

And I have made the decision to not ruin my pregnancy by obsessing about outcomes that may never occur. I am aware of all potential complications so I’ll recognize any symptoms of them. I am perhaps overeducated about every aspect of my high-risk pregnancy, so, if and when a problem arises, I will be prepared. But, in the meantime, I am living the cliché of “taking things one day at a time,” which has worked well for me.

But, with less than nine weeks until my due date, I feel compelled to start preparing for my son’s birth because, as part of my Type A-ness, I’m a planner. While I have the big-ticket items—the crib, the glider, the stroller—left over from my son, now 5, I gave away everything else, including almost all of his first-year clothes, to friends, because, at the time, my husband and I weren’t planning to have another child.

I’ve e-mailed the friend to whom I gave my son’s clothes to see if I can have them back, since she won’t be needing boy clothes for her newborn daughter. Several other friends have promised to look through their storage boxes to see if they still have the items I passed on. And others still have offered to give or loan me everything from clothing to a car seat with two bases.

But nothing for a newborn has arrived yet. This is, of course, normal, considering that I’m not due until April 23, two months from now. But, being a planner, I can’t stand the possibility of not being ready if my son is born before his due date, which is likely.

As a result, last week, my husband drove me, now on partial bed rest, to the discount retailer Marshalls®, so I could buy some newborn clothes. I explained to him that I won’t take off any of the tags, in case, after my friends come through, I don’t need the clothing. But, the unspoken truth is that I also won’t take off the tags in case we end up without a baby to bring home.

It makes me feel better to have these teeny-tiny outfits in hand, but it took me an entire week to actually go though the Marshalls bag in order to put these maybe-unneeded clothes away. Because I can’t oooh and aaaah at how cute they all are. I can’t blissfully prepare the baby side of my 5-year-old son’s bedroom.

I’m not that naïve. Oh, how I wish I were…

Why?

Because the physical, emotional and financial horrors of infertility will forever be a part of me. 

I will never forget how difficult it was to do all of the right things—see the recommended specialists, follow their instructions to the letter, ingest and inject every medication prescribed—and still fail to become pregnant cycle after cycle. 

I will never forget feeling like a crazy woman, staring longingly at babies in the grocery store, on the sidewalk—in fact, everywhere.

I will never forget the euphoria of a positive pregnancy test, only to receive a call from a nurse notifying me that my blood test results showed that I would lose the baby.

I will never forget starting to bleed, single and alone in my condo, and having to collect the miscarriage material—my baby—in a plastic bag, then place the bag in the refrigerator for the weekend, so its contents—my baby—could be tested the following Monday.  The testing, by the way, revealed nothing.

I will never forget, whenever I heard that yet another woman was pregnant, feeling not only happy for her, but also a sense of loss and jealousy because I couldn’t get pregnant too.  Then, I would feel incredibly guilty that I was so self-involved that I had connected my infertility to such a joyful announcement.

I will never forget feeling as if I had absolutely no control over becoming a mother, the role I felt I was most supposed to fulfill.

I will never forget not being able to attend baby showers, not because I wasn’t happy for my friends, but because I was afraid I would cry for myself, ruining their special days by making them feel guilty.

I will never forget analyzing my finances and the risks of infertility medications, trying to determine how many cycles I could afford to pursue, both monetarily and physically.

I will never forget feeling increasingly irrational with each failure, becoming convinced, through the haze of hormones, that the only action that would keep me sane was to try to get pregnant again—as soon as possible.

I will never forget the feelings of isolation, for unless others have suffered through infertility themselves, they have no idea how to react—and, in my case, two close friends made the choice to distance themselves, with one telling a mutual friend, “I feel bad, but I just can’t handle what she’s going through.”

I will never forget lying on an ultrasound table in September, with the technician telling me she was sorry because one of my twins, Baby B, didn’t have a heartbeat, demonstrating to me for the second time that becoming pregnant doesn’t guarantee a live baby.

Because I will never forget these experiences, and because I know that I am no more deserving than any other person who has dealt with the trauma of infertility, I feel guilty whenever I hear or read about others who are still struggling.

I don’t have a martyr complex in which I want to trade places.  I am beyond happy to be pregnant right now, but I want all of these others—these millions of others—to be able to become parents too.

When I confided in a friend about my pregnancy guilt this week, she tried to talk me out of it, saying, “M.K., come on.   You’ve been through plenty.”

I’m not saying I haven’t paid my dues.  But so has every other infertile person.  I just wish that all of us could have the happily-ever-after.

I met my now-husband in May 2004, nine months—and six unsuccessful attempts—into pursuing my goal of being a single-mother-by-choice via insemination with anonymous-donor sperm.  I was about 30 days into the medications involved with my seventh cycle; we stayed up all night talking; and I told him every detail of my past failures, which included a miscarriage, my present medication protocol, and my future plans, if my upcoming, final insemination didn’t work. 

He was impressed by—and attracted to—my strength in not only pursuing my dream of being a mother, but also suffering through infertility, solo.

We spend the first nine days of our relationship facing the concept of me potentially becoming pregnant, using donor sperm. 

I did.

We spent the first nine months of our relationship handling not only my high-risk pregnancy, but also the range of emotions involved with our brand-new romance complicated by me being pregnant with “another man’s baby,” as his less-evolved friends referred to my unborn child.

Nine months minus one day after we met, we pulled an all-nighter at the hospital, he as my birth partner, Beatles music playing in the background, as I gave birth to my son.

Ten months into my son’s life, he asked me not only to marry him, but also for permission to adopt my son. 

He also said he’d be happy to get married over the Christmas holidays.

“This Christmas?” I asked, flattered by his eagerness, but stunned that he thought we could plan a wedding on such short notice.  I’m a Catholic girl, after all, meaning hoops need to be jumped through.  Lots of hoops.

We got married 13 months later, on December 16, 2006.  He started the adoption process on December 18, the first business day afterward.

So, my son has been part of our relationship since Day 1:  as a concept; as my primary focus during the nine months of my high-risk pregnancy; as an incredible bonding experience for us through childbirth classes and his birth; as a subsequent bonding experience when he was in the Neonatal Intensive Care Unit for the first five days of his life; as a newborn whom I was not separated from for the first 3 ½ months of his life; as a baby; a speech-delayed, frustrated toddler; an attitudinal 3-year-old; a compassionate, funny 4-year-old; through every milestone, from first smile, to first step, to first word.

And, he is reason we lasted beyond those first few days. 

He is the reason my husband didn’t feel pressured by me, for I was not looking for a man to make me a mother; I was trying to be—then going to be—a mother on my own.

And, he is the reason I didn’t try to prematurely advance our relationship because of my blaring biological clock.  Once again, I was dealing with that issue on my own.

My husband and I are meant to be, but, if not for my son, our timing would have been disastrous.

My husband, married a month out of college to his first girlfriend, had only been divorced for 13 months when we met.  Finally free of a long, combative marriage, newly a single dad to his two sons, remarriage and becoming a father again were not short-term goals.

I, on the other hand, had suffered through 21 years of dead-end dating.  Admittedly, I had compromised as I got older, settling for less than I deserved because I wanted to be in love, to get married, to have children.  But, by the time I met my now-husband, my philosophy was “I can always fall in love, but I won’t always be able to have children.”  The fact that neither he nor our relationship was my priority was appealing and refreshing to him.

So, unpressured, he and I fell in love; I had my own baby; we got married, making me a stepmother to his two sons; he adopted my son; and now I’m 21-weeks pregnant with our fourth son.

We’re unconventional, but it works well for us.  So, tonight, the three of us—husband, wife and the 4-year-old reason we’re together—celebrated. 

My husband drank two glasses of wine, while our son and I drank water.  My husband served as deejay, selecting music on his iPod.  Our son played air guitar, air drums, and danced until he, who is never, ever tired, said he needed to rest.  Then he and my husband would jump up and dance some more.  I would have loved to dance too, but, protecting another high-risk-pregnancy, I snuggled up on the couch, sang to the music and cheered them on.

No, it wasn’t romantic, but we were blissfully happy celebrating our anniversary. 

It belongs to all three of us.

Each night as I lie next to him for a few minutes while we talk before his bedtime, he caresses my hair and says, “I’m sorry one of the babies died.”

And, I say, “I know.  So am I.”

Sometimes he asks to listen to my stomach, to see if he can hear anything.  He asks specifically where Baby A and Baby B are located.  I’ve told him that Baby B won’t be moving or making noises anymore, and he accepts that.

He makes statements like, “I wanted Baby B to be named Whiplash”—a character in the Ironman television series—that make it obvious he’s just 4.  (He wants Baby A to be named Ironman.)  But then he’ll follow up with adult-sounding statements, such as, “Maybe your body will absorb him,” which he overheard from Dr. H, who counseled me after we learned of Baby B’s loss.

Two nights ago, he asked me if God could walk on water.

I said, “God can do anything He wants to do.”

“God will do anything we want Him to do?”

“No,” I corrected.  “God can do anything He wants to do, but it is not necessarily what we want Him to do.”

Because we’d just been talking about Baby B, I continued, “For example, we didn’t want Baby B to die, and he did.”

My son was silent for a moment, then said, matter-of-factly, “So, God killed Baby B.”

I thought for a minute, recognizing the importance of my response.  Then, I replied, “No, God didn’t kill Baby B.  He just didn’t stop him from dying.”

Then I started with the rationales, the ones I need to believe in, even though the doctor said we’ll never know why Baby B’s heart stopped beating a week ago.  “I think that maybe there was something wrong with him, that he was sick and could never have lived.  So, God didn’t make him die, he just let him die because it was best for Baby B.”

My son was quiet for a few minutes, to the point where I thought maybe he had fallen asleep, but then he said, “I think maybe Baby B was a robot baby.”

“Oh…”

“And, maybe his system just shut down.”

Last night, after he started off with, “I’m sorry one of the babies died,” then continued with, “I wanted two babies,” he said, “We’ll have to bury him.”

I explained that Baby B won’t be born, that hopefully he will just get smaller and smaller inside of me, until he disappears. 

“Even the tiny speck?” he asked, remembering that Dr. H said Baby B may end up as a tiny calcification that will look like a white speck on the ultrasound screen.

“Even the tiny speck.”

“Oh.”

I’ve explained that Baby B is now a guardian angel, that he will watch over us and Baby A.  And, my son wants to know if Baby B can see through buildings, if he has wings, if he can fly.

My conversations with my son, who looks at the world with innocence, affect me.  Since we learned of Baby B’s death last Friday, I’ve thought day and night about this issue of God and His/Her role in our lives.  What I’ve determined is that, although I had originally felt that God was “fucking with me,” He/She doesn’t have that kind of time.  And, what I’ve been taught, as a Catholic girl, is that God permits free will—and its resulting fallout.

So, 42 years ago, when my mother was pregnant with me, God didn’t intervene when her beloved doctor, misled by pharmaceutical companies, prescribed her an anti-nausea medication that included diethylstilbestrol (DES), the completely useless synthetic estrogen that seeped through the placenta into me, deforming my reproductive organs.   

And, God has let “nature takes its course” ever since, although my “nature,” my body, is now unnatural, for my uterus was never fully formed, it was in the shape of the letter T, and it was one-third normal size before I carried my son to term, because of the profit-above-all-else pharmaceutical bastards. 

So, I’ve lost baby after baby because of implantation problems and miscarriage.  But, God isn’t participating.  God didn’t take Baby B from me.

I will never know if the reason Baby B died is because his gestational sac wasn’t fully attached to my uterine lining from the first ultrasound, if although the progesterone-oil injections made him able to reattach within one week, his developmental delay in those critical first days was too much to overcome. 

I will never know if he had some sort of other problem that made him, in the end, “incompatible with life,” a term used by our genetic counselor, who managed the preimplantation genetic diagnosis (PGD) of our embryos.

I will never know if this loss, my seventh loss of a child, is due to DES or something else.

But, I’ve finally come to terms with the fact that this loss has nothing to do with God.

And, for this realization, I have my 4-year-old son to thank.

Me neither.

I didn’t expect to be single when I turned 35, the beginning of “advanced maternal age.”

I didn’t expect to have my only child, at age 36, as a single woman who conceived using anonymous-donor sperm.

I didn’t expect to suffer from infertility as the aforementioned single woman trying to have a biological child.

I didn’t expect my infertility to be a result of a misused, misrepresented medication, the synthetic estrogen diethylstilbestrol (DES), which was given to my mother when I was in utero.

I didn’t expect to meet the love of my life nine days before getting pregnant during my seventh intrauterine insemination (IUI).

I didn’t expect my son to have a father figure in his life from the day he was born.

I didn’t expect to get married at age 38.  Actually, I was 38 ½…

I didn’t expect to marry a man who had been married before. 

I didn’t expect to be a “second wife.”

I didn’t expect to be a stepmother.

I didn’t expect to throw myself into these roles, to read every book about being a stepmother and mother to sons, to be in weekly Family Systems Therapy in my attempts be the best wife, mother and stepmother I can be—and to still come up short. 

I didn’t expect to be pregnant at 41.

I didn’t expect to have such a difficult pregnancy this time around, considering that my formerly one-third-normal-size T-shaped uterus is now a larger arcuate uterus, my uterine lining is now sufficiently thick, we’d done preimplantation genetic diagnosis (PGD) of our embryos, and I’d already proved that I could carry a 9 pound, 7 ounce child to term, to his actual due date.

My life is made up almost entirely of circumstances, events, relationships that I never would have imagined. 

But I love my husband and feel that he is the best match for me I’ve ever found—and vice versa.

My son is an absolutely amazing little person, fully of humor and affection and empathy.  Yesterday, I vomited in the morning and stayed in bed all day, and, when I took a bath in the late afternoon to try to make myself feel better, he knocked on the door, peeked around it, and asked, “Do you need help with anything?”  He’s 4 ½…

And, I love my stepsons and, even though I didn’t bear them, I would do anything for them, and I have always put them and my son first, above anything related to my husband, me and our relationship.  Maybe that hasn’t always been the best for my husband’s and my relationship, but they’re children, so how do we not make them the priority?

And, this pregnancy is hard.  Others’ reactions to my pregnancy have made it even more difficult, almost intolerable.  But, my pregnancy with my son was difficult too, and it was worth every blood test, every ultrasound, the hospitalizations, the best rest, the anxiety, the 60-pound weight gain, the 17 ½ hours of labor, the three epidurals (because the first two didn’t take).  He is worth any misery I experienced—and then some.

And, this baby, dubbed Baby A, who is hopefully still alive inside of me, he will be worth it too. 

So, no, my life isn’t what I thought it would be.  I’ve come to my later-in-life happiness in unconventional ways.  But, while it isn’t what I’d expected, in some ways it is far richer and more rewarding than I ever would have imagined. 

And, our little Baby A, whom I guess doesn’t need to be called Baby A anymore, since he’s the only living baby inside of me, will enrich our lives even more.  I know it.  Otherwise, I wouldn’t have undertaken this complicated, sometimes painful, journey through infertility to high-risk pregnancy once again.

This knowledge of how much Baby A will enrich our lives comes from the experience of raising my son.  Therefore, this knowledge also makes the loss of Baby B all the more devastating.

Losing yet another child, a child whom I had seen in four previous ultrasounds, a child whose tiny heart had been pulsing inside of me, a child who had grown teensy little arms and legs, isn’t part of what I thought my life would be like.

I’ve lost seven unborn children.  My husband has lost two, our baby girl embryo who didn’t implant in June and now our son. 

This isn’t what we thought our lives would be like.  But, we have no positive alternative but to keep living the unexpected, complex lives we—and God—have made for ourselves.

When I first starting trying to get pregnant in 2003 and 2004, I was a single woman using intrauterine inseminations (IUIs) with donor sperm in my attempts to conceive, and I had little to no support from my Catholic family and varying levels, from skepticism to total devotion, among friends.  This time around, I’m a married woman, legitimate, so I expected my journey through infertility and any resulting pregnancy to be different, better, less stressful.

My family members, concerned the first time around with their embarrassment more than the Catholic Church’s stance on assisted reproductive technology (ART), have now offered their congratulations, for I’m no longer leading a lifestyle they consider “alternative,” as a single mother by choice.  I’m married and pregnant, which is completely acceptable to them, even though I had to once again use ART to get here.

My friends are uniformly supportive, offering to do anything they can to help me, from watching my son, to giving me injections, to listening to me vent, to hugging me as I cry, as I’ve suffered through two in vitro fertilization (IVF) cycles and this high-risk twin pregnancy, which we now know, as of yesterday’s ultrasound, has only one surviving twin.

But, while I was able to cope during my first bout with infertility and throughout my first high-risk pregnancy by separating from all negative people, in order to protect myself and my unborn child, I do not have the luxury of doing so this time around.  I don’t have pregnancy nausea, but have been so upset that I have dry-heaved and vomited.  When I’m anxiety-ridden, I suffer from insomnia, and, because I’m pregnant, I’m unable to take medication to combat it.  I am unable to go off of my antidepressant/anti-anxiety medication, because of my stress levels, so I continue to take Prozac, which is safe during pregnancy, but the anxiety and depression that precipitate its use are not conducive to carrying a child or two.

I have been blogging five to six days a week, which is therapeutic for me, but the flip side is that I have felt so much pressure to secure an agent and sell my memoir because we were adding two sons to our family.  I have been making gemstone bead jewelry day and night, because, although I had considered it a hobby, my friends convinced me it could be a lucrative business, and, once again, I have felt incredible pressure to make a financial contribution because of my unexpected twins.

I had my first jewelry show on Tuesday night and Wednesday day.  Monday I didn’t nap, which my body requires, and I stayed up late making as many jewelry pieces as I could.  Tuesday, I didn’t nap because I was readying everything for the show, determining prices, labeling the necklaces and bracelets and earrings with descriptions of the materials used.  On Tuesday night, the night of the show launch, I was selling until about 9:30 p.m., then up until midnight making more children’s bracelets, because they were selling so well.  Wednesday, I woke up at 4 a.m., fired off e-mails about the meeting for my son’s preschool class that, as a room parent, I was hosting on Friday afternoon, and, even though exhausted, I had to be “on” all day at the show.  Thursday, with my jewelry show over, I took a nap, then started preparing for the Friday preschool meeting, reading through all of the room parent materials in order to draft an agenda, revising documents for distribution, cleaning the house.

My baby died one of these days this week, one of these days in which I was overstressed, overtired, overextended. 

And, even though I had just learned of my baby’s death, on Friday morning I couldn’t conceive of cancelling the 1 p.m. preschool meeting with so little notice.  So, scarlet-eyed and splotchy-faced from crying, I left the doctor’s office and went to the grocery store, where, like Jack Nicholson, I wore sunglasses inside, as I shopped for the refreshments and food for the meeting.  As I loaded up my car with the groceries, I saw one of the preschool parents in the parking lot, and she said, “One o’clock, right?” 

I wanted to tell her I’d just found out that my baby died, but I just said, “Yes, see you then.”

I got home, unloaded the car, and seeing my next-door neighbor Anna Marie out gardening, walked over and asked her why exactly her doctor had mistakenly told her that she was losing her unborn child three years ago. 

This is where the crazy kicked in, where I was looking for hope that, somehow, no heartbeat might not mean definitive death for my Baby B. 

She explained that, when she went in for her first pregnancy appointment, she had to urinate on a stick, and the pregnancy line was very, very light, which caused concern.  And, when her HCG levels were decreasing, instead of rising, as they should, she was told she would lose her son.  Her little guy had some sort of miraculous turnaround, or maybe she originally had twins inside her, with her HCG levels declining with the loss of one.  Either way, she was told that her baby was dead, and he’s now an adorable 2-year-old.

Her story gave me no hope, for no heartbeat is no heartbeat, regardless of how much I wish otherwise, so I told her about my morning.  And, she hugged me and cried with me on the sidewalk.   And, we decided that Baby B is going to be Baby A’s guardian angel, and then we cried again.

I walked back to my house and started getting ready for the preschool meeting, as I cried.  I called another room parent and left her a message that everything was ready at my house, but I was going to need her to completely run the meeting because I was a mess.

Then my friend Jessica called, worried that my son and I hadn’t been at his 10 a.m. swimming lesson, which he takes with her son.  I cried to her, I told her I didn’t know how I was going to host the meeting, that I couldn’t cancel it with so little notice, that I didn’t know what to do.  She told me I had to cancel the meeting, that she would come over to help me make the notification calls, that she would do anything to help me.  I told her I would try to reach the other room parent again to see if we could just move the meeting to her house—or else reschedule—and that I’d call her back.

Ten minutes later, Jessica knocked on my door, saying she couldn’t go home after the swim lesson without hugging me first.  And, she just hugged me, stayed with me, ate a huge cinnamon roll alongside me, and convinced me, rationally, for I wasn’t rational, that I had to cancel the meeting, that a preschool meeting was not a priority on the day I found out my baby had died.

My fellow room parent called and seconded Jessica’s position that anything preschool was irrelevant, that anything preschool wasn’t an emergency and could be rescheduled.  She also offered to do anything to help, and she took over my carpool.

Around 11:15 a.m., I sent out an e-mail to all of the meeting attendees, apologizing for having to cancel the meeting because of a medical issue.  I called the ones I didn’t receive confirmations from.  And, the preschool program director notified those whom I wasn’t sure had received either the e-mail or phone messages, as they dropped off their children for school at 12:45 p.m. 

So, yesterday, after prodding from friends, I made myself the priority.  I have Baby A inside of me, and I can’t lose him too, so I have to avoid any further negativity and stress and pressure throughout this pregnancy. 

With me protecting myself and him, plus Baby B as his guardian angel, hopefully he’ll be fine, hopefully he’ll continue to be a little miracle of mine, a little living miracle.

If I take care of myself, hopefully he won’t suffer the same fate as Baby B, whom my body couldn’t sustain, my Baby B who fought so hard to reattach himself to my uterus, to grow, to survive.  

Baby B was always a bit smaller, but he was tough, my tiny guy. 

But not tough enough to share space in my misshapen uterus, housed in my 41-year-old, stressed-beyond-belief body. 

I’m so sorry.

My 4-year-old son stood next to me, so he could easily view the ultrasound monitor, so he could see his brothers, how they’ve grown since he saw them at the in vitro fertilization (IVF) clinic, and hear their hearts blipping. 

But, today there was only one heartbeat. 

Baby B died within the past few days, based on the doctor’s analysis of his growth.

The technician calmly told me she didn’t see his heartbeat.  She was emotionless.  She said she was sorry.  She said she wished she had better news.  She said that Baby A looks fine, as if to compensate for the loss of his twin.

I didn’t react.  I couldn’t react.  My 4-year-old was right there.

She asked if I was going to see a doctor after the ultrasound, and I said I had only a nurse appointment, so she said she’d notify the nurses of my status, then return.

While she was out of the room, I explained to my son that one of the babies had died.  He hugged me, with tears in his eyes, and said, “But I wanted two babies.”

Feeling as if I was outside of myself, I reassured him.  I said that it was OK.  I said that there must have been something wrong with Baby B.  I said that we are still going to have one baby. 

But I shouldn’t have said that, for we could lose both.  I think I was trying to reassure myself, as much as him, with that wishful-thinking statement.

The technician returned to say that one of the doctors was going to meet with me, but there wasn’t a room available, so we would have to wait in chairs in the hallway.  She said they didn’t want us to have to go back out in the waiting room.

So, my son and I sat down to wait, and I tried to call my husband.  I tried his work phone twice, and twice it went into voicemail, so I called his cell.  During the work day, I NEVER call his cell, so I thought doing so would alert him that there was an urgent matter.  It went into voicemail too.

A nurse came to retrieve us, weighed me, took my blood pressure, then another woman, who never identified herself, asked me if I’d had an ultrasound.  I said yes, that that’s how we found out that Baby B is dead.  She then escorted us to Exam Room 4.

I tried to call my husband again and again.  I needed him, but kept getting his voicemail.

This is when I lost it.

I tried not to, because of my son, but I’d just found out that I’d lost my baby, I know that losing one could mean the loss of both, and it became impossible to act as if that didn’t matter.

So I cried.  My son walked over from the rotating stool he’d been playing with, and he hugged me.  I told him that I’m sad that one of the babies died, but that I’m tough, that I’ll be OK.

I tried my husband’s cell phone again, with no luck, and I kept crying.

My cell phone rang, with its caller ID showing that my husband’s colleague Jessica was calling.

I picked up and said, “Jess, we lost one of them.”

“I’ll get him now,” she said.

He got on the phone a minute later, and I told him that we lost Baby B.  He asked how I knew, and I told him there was no heartbeat.  He said he was on a conference call that he couldn’t get off of, but it should only last a few more minutes, then he’d call me right back.

A few minutes later, Dr. H came in.  She is the only doctor in the practice with whom I’ve met, so it was a relief that it was her, rather than some stranger.

She said she was sorry.  She said that Baby B had grown since my last ultrasound, that his three-day lag behind his twin had become about a week’s lag, so he must have died within the past few days.

She said that Baby A looks great, that he has little arms and legs, that he is “staking out his territory.”

She said that we’ll never know why we lost Baby B.  While we did pre-implantation genetic diagnosis (PGD) with our IVF cycle, it is impossible to test for every possible abnormality.

I asked, “What happens now?  What are the chances that I’ll miscarry both?” 

She said that miscarrying both is possible, but she thinks the odds are slim.  She explained that I had two separate pregnancies, two genetically distinct babies in two different gestational sacs.  She said that, considering how strong Baby A appears to be, it is unlikely that the loss of Baby B will affect him.  She said that my body is probably going to reabsorb Baby B over time, that during each ultrasound his gestational sac will be smaller, that eventually he may simply be a calcification that looks like a white dot on the ultrasound screen.

With that, my cell phone rang, and it was my husband, so we ended the consultation, and my son and I left the office.

I told my husband that I felt better, which he thought meant that Baby B wasn’t really dead.  I explained that he was, but that the doctor had reassured me about Baby A. 

Then I revealed something I’d never voiced to him—or anyone else—before.  I was so attached to Baby B, our little underdog who came back from near-death weeks ago, that I’d been afraid that I would love him more than Baby A. 

And, now he’s gone, my tiny less-than-one inch to whom I’d become so devoted.

And, what I don’t understand right now is the reason.  Because, as we all say, when we need to be reassured that there is some grand plan that explains our suffering, “Everything happens for a reason.” 

Why did this little guy implant, because I would have been fine if only one embryo had done so?  My husband and I had only hoped for one child, never considering, based on my difficulties with embryo implantation, that two would ever have been possible. 

But, once I knew that there were two of my husband’s and my babies inside of me, I loved both of them, and I wanted both of them, but I was told in that first ultrasound that Baby B, smaller in his “considerably smaller” gestational sac that was separating from my uterine lining, was likely dying.

And, I spent a week coming to terms with that, the loss of him. 

But, at the ultrasound a week later, a week after doing once-daily progesterone-oil injections, he was fully attached to my uterus, he had grown, and he had a heartbeat.  So, I assumed that the problem had just been an implantation issue, way too common for me with my DES-induced misshapen uterus with too-thin uterine lining. 

I was overjoyed.  But I was still cautious.  But, then two days later, I had another ultrasound, and both babies had grown, giving more reassurance.

And, then last Wednesday, I had yet another ultrasound, and, at this point, Baby B was within a couple of millimeters of Baby A, which could have just been due to margin of error.

So, with all of this good news, I started to get comfortable with the concept of having twins.  I imagined their close twin bond.  I imagined every member of our family reveling in twice the love.  I starting seeing twins everywhere and asking their parents about them.

And, now Baby B is gone.

So what is the reason for him to have lived these past 3 ½ weeks, for me to go from acceptance of his death, to pure joy at his comeback, to boundless love for him, only to have him die now?

I feel like I will be able to cope and move on if I can just understand the reason. 

My doctor has already said I’ll never know.

So, I just have to have faith, although right now I feel like God has been fucking with me. 

How many babies do I have to lose? 

Why did I have to experience the horror of seeing my dead baby on an ultrasound screen this morning?

Why do I have to live day to day, for the next few weeks, with the knowledge that I have two babies inside of me, one living and one dead?

What, please, is the reason?

After doing in vitro fertilization (IVF) with pre-implantation genetic diagnosis (PGD), my pregnancy with twins was confirmed by blood test on Monday, August 17.

I had my first ultrasound at my IVF clinic on Wednesday, August 26.  The technician identified my twins in their gestational sacs, but said Baby B was separating from my uterine lining, and his sac was considerably smaller than Baby A’s, leading her to believe that Baby B was dying.  She said that, if my body absorbed him, making him a “vanishing twin,” Baby A would be safe.  But, if I miscarried Baby B, I would perhaps lose Baby A also.  I started doing one-daily injections of progesterone oil, and I waited, anxiously, for the next week’s ultrasound. 

My second ultrasound was on Wednesday, September 2.  Baby B had miraculously reattached himself to my uterine lining, both babies were growing, and I saw both of their heartbeats.  I cried.  I was overjoyed.

But on Thursday, September 3, I started spotting. 

I increased my progesterone-oil injections to twice a day, per the IVF nurse, whom I paged.

I had another ultrasound the following morning, on Friday, September 4, as part of my initial consultation with the Maternal-Fetal high-risk pregnancy group at the local hospital.  The technician identified two subchorionic hemorrhages in my uterus, but also both heartbeats.  She also let me listen to the heartbeats, showed me how both gestational sacs were securely attached to my uterus, and reassured me that the hemorrhages weren’t affecting either of my twin boys.

Five days later, on Wednesday, September 9, I had another ultrasound, my final one at the IVF clinic, as part of my close-out consultation.  Once again, I saw that my twins’ tiny little macaroni-sized bodies, yolk sacs and gestational sacs had grown; viewed their pulsing hearts, little lights flashing inside their translucent forms; and heard their heartbeats.  All of this reassured me.

But I started bleeding again on Sunday.  Once again, I had no cramping or pain associated with the bleeding, so I tried to stay calm.  The spotting was lighter than before, and it stopped the same day, so I relaxed a bit.

All week, my body has continued to exhibit positive pregnancy signs:  I’m exhausted; I’m starving; I have acne; my stomach is growing daily, it seems; the veins on my chest are still prominent; and my breasts are still sore. 

But, my body has deceived me before. 

Five and a half years ago, I knew from my blood tests that my baby was dying, that the miscarriage would commence shortly, but my body kept exhibiting pregnancy symptoms until the miscarriage started, making me convinced that some mistake had been made—that blood samples had been switched, or my baby was making a miraculous comeback. 

From that experience, I know that my body will continue to do its job, fighting to sustain these babies, until they’re gone.  So, my body can’t be trusted.  My body doesn’t recognize pregnancy problems; it, like me, overlooks them, in its valiant attempt to protect its offspring.    

Because my body can’t reassure me, only ultrasounds can.  And, while I go in tomorrow for an appointment with the Maternal-Fetal group, it is only an appointment in which a nurse will explain every aspect of the practice to me.  But, while I won’t be able to see my babies, I will be able to hear their heartbeats.  So, at least I’ll have that to sustain me.

But, after four ultrasounds in three weeks, I crave the full ultrasound experience.  I want to see my babies, not just hear them. 

I might resort to begging.

I’ve never spotted during pregnancy, unless I was miscarrying, so I was terrified.  I yelled for my husband, who was working from home, to come upstairs to our bedroom. 

“I’m bleeding.”

“What does that mean?”

“I don’t know, but it’s not good.  I’ve never bled before, except during my miscarriage.”

“What can I do?”

“Just hug me.  Then I need to call the IVF nurse to see what to do.  But, first, can you give me my injection?”

“You should call first.”

But, I know that my problem with pregnancy is my uterine lining, so I wanted that progesterone-oil injection immediately, because the progesterone is supposed to thicken my lining, because I wanted to somehow stop what was happening to my body.

He injected me with the 1ml of progesterone oil, then I called the IVF clinic just a few minutes after 5 p.m., when it closes for the day.  I had to maneuver through technology hell, pushing this button, then that, until I finally got to the message in which I was given the number to page the on-call IVF nurse.

She picked up immediately, and I explained that I was bleeding; that it was reddish-pink, which I know is bad, because it means fresh blood; that it was visible on my panty liner, necessary because of the constant discharge from the Endometrin® vaginal progesterone suppositories; that, after I urinated, blood was on the toilet paper used to wipe myself, meaning it kept flowing; that I needed to know what to do.

She remembered that I’d had a vaginal ultrasound the day before, confirmed that I wasn’t having any pain or cramping, then told me not to stress, that maybe my cervix was closing after the ultrasound, maybe the ultrasound wand had been pressing down on it.  She told me to rest, to increase my progesterone-oil injections to twice a day, and to call the next day, Friday, to let her know how I was doing.

But, she continued, if I starting bleeding heavily and/or having a great deal of pain, I was to go immediately to the emergency room.

I was not reassured.  When I was pregnant with my son, I had many, many vaginal ultrasounds, and I never bled as a result.  And, the IVF coordinator had told me during my ultrasound that my cervix had been completely closed.

I stayed in bed the rest of the night, reading everything I could about first-trimester bleeding.  But, not knowing the source of my spotting, none of the information could appease me. 

I already had an appointment with the local hospital’s Center for Maternal and Fetal Health at 12:30 p.m. on Friday, so I focused on that appointment, my opportunity to know what was wrong with my body—and maybe our babies.

I was so drained that I slept for 10 hours on Thursday night, so I felt better emotionally on Friday.  The healing properties of ample sleep are a benefit I rarely experience, life-long insomniac that I am.  My spotting seemed lighter Friday morning, with little blood on the toilet paper after urination, so I felt a bit of relief with that realization.  Now I just had to wait until my 12:30 p.m. appointment.

When ny name was called, a technician brought me in for an abdominal ultrasound, and I outlined my recent history, including the bleeding.  As always, Baby A, who is larger and on my front left, revealed himself first.  She declared him “perfect” in size, right within range for his gestational age, then showed me his pulsing heart.

I felt relief about Baby A.  He was still alive.

She then found Baby B in his still-smaller gestational sac.  She said, “There’s the second heartbeat,” but I was so nervous, I wasn’t sure I’d heard her correctly.

“There is a heartbeat—or isn’t?” I asked, desperately. 

“There is.”

She said that, while Baby B is smaller than Baby A, he is still within range for his gestational age. 

Then she pointed out the reasons I’m bleeding:  Two areas within my uterus that she referred to as “subchorionic hemorrhages.”

“It sounds worse that it is,” she explained. 

She said, “We see this.” 

And, “This doesn’t worry us, unless you’re also having cramping or pain.”  I’m not.

And, “This doesn’t mean you’ll miscarry,” but said that doctor with whom I’d have my initial consultation would be able to tell me more.

I asked if either or both of these hemorrhages were affecting Baby B’s gestational sac.  She said that the entire outer edge of his sac is solid, which is reassuring.

She then let me hear both of our babies’ heartbeats, declaring Baby B’s as “pretty good.” 

Of course, now I’m worried that his heartbeat is only “pretty good,” rather than perfect.

She handed me printed-out ultrasound scans of our babies, two each of Baby A and Baby B.  Then she directed me to the bathroom, because my bladder was overflowing, necessary for an abdominal ultrasound, then back to the reception area to wait for my consultation.

I called my husband to tell him we still had two heartbeats, to explain why I was bleeding.

Then I kept staring at the pictures of our babies.  They were real to me before, because of the changes in my body, because of seeing them on prior ultrasounds, because of seeing their miniature hearts blipping on screen.  But now I’d heard their heartbeats, seen them grow again, just within two days, and have pictures of them.  I am so attached to our babies.  I know I’m doing everything I can, I know that their lives are ultimately in God’s hands, but I want them to live, both of them.   

In my next post, I’ll outline what the doctor told me in my consultation.  In the meantime, feel free to stare at the pictures of our babies too.  And, keep those prayers coming…  Thanks.

Baby A, 7 Weeks Old

Baby B, 7 Weeks Old