We’re Pregnant*

I feel like our pregnancy deserves an asterisk.  Or, maybe a footnote.  (We’re partial to Chicago style in this house.  Controversial, I know.)  Any woman can tell you that pregnancy is one of the most anxiety-riddled experiences you’ll ever encounter.  It’s always hovering around a 10.  Well, this pregnancy goes up to 11.

My doctors want me to keep my stress level as low as possible and yes, they know how dumb they sounded.  I’ve been encouraged to find healthy outlets for my anxiety and stress.  That’s where the blog comes in.  Even if no one chooses to read it, this blog will be my outlet.  This will be the place where I come to celebrate.  This will be the place where I come to worry.  This will be the place where I come to continue sharing our story, wherever it may lead.

There are a few things to consider regarding this pregnancy.  However, my doctors and I have a plan for moving forward in a way that is safe and will increase my likelihood of a positive pregnancy outcome.  When considering this pregnancy, we also need to consider the following: Factor V, risk of preeclampsia, and emotional health.  It’s a lot to keep track of, but knowledge is power.  (Please bear with me as I show off my newly acquired medical jargon.  Admit it, we all like to show off sometimes.)

FACTOR V LEIDEN GENE MUTATION:

For starters, I have something called Factor V Leiden gene mutation.  This is a clotting disorder where my blood can clot too much.  Factor V is relatively common in people of European ancestry, but many who carry the gene will never develop a clot.  I was tested for Factor V due to my history of pregnancy loss.  Because of my diagnosis, my team includes a hematologist (blood doctor) who helps to monitor my condition as it is related to pregnancy.  Pregnant woman already have blood that is more likely to coagulate (clot), so I am at an increased risk because of my disorder.  However, I am heterozygous which means I only have one copy of the gene so my increased risk is only slightly higher.

What do we do about this?  For right now, I am giving myself 40 mg of Lovenox daily via subcutaneous injection in the abdomen (shots of blood thinner in the layer of skin around my stomach).  My team is currently discussing if this will be necessary for the whole of my pregnancy.  There is conflicting research about whether or not it actually helps to prevent loss in pregnancy.  But, for the time being I’m still on it until I hear otherwise.

RISK OF PREECLAMPSIA:

During my last pregnancy, I was diagnosed with severe preeclampsia in my 29th week of pregnancy.  Even though preeclampsia is more common in first pregnancies, there is concern that I could develop it again.  My risk is higher for developing preeclampsia because of my clotting disorder, my stillbirth, and the severity and early onset of my diagnosis last time.

So, what do we do?  Unfortunately, there’s not much we can do to prevent preeclampsia (doctors believe that its connected to your placenta and you can’t control the makeup of your placenta), but there are things we can do to help delay the onset and lower the severity.  The first thing I will do is regularly take my blood pressure.  I have been doing this since February.  This helps to determine a baseline so the doctors can more accurately diagnose me later on.  Also, starting at 12 weeks I will begin a daily regimen of low-dose aspirin.  Research shows that this has a modest effect on lowering the risk and reducing the severity of preeclampsia.  However, because aspirin is also a blood thinner, my doctors are weary of having me on both Lovenox and aspirin at the same time.  This is why I might not continue with Lovenox after 12 weeks.

EMOTIONAL HEALTH:

Believe it, or not, this is more important than any medical intervention my doctors will put in place.  Even with all of the measures we’re taking to prevent a loss, there is a chance it will happen again.  (While the risk of a stillbirth is low, a previous stillbirth will increase that risk.)  We are experiencing a pregnancy that will lead up to Dorothy’s 1st birthday.  The milestones with this baby will be a reminder of the milestones we met with Dorothy and the ones we never got a chance to see.

So, how do we handle this?  The same way we’ve been working through the rest of this experience.  We will communicate with each other, we will support each other, and we will be honest with ourselves.  We will continue to go to therapy, we will continue to reach out to friends, and we will take this experience day by day.  We want to enjoy this pregnancy so that no matter the outcome, we can look back on this as a beautiful experience in our life.

So, yes, we’re pregnant.  Yes, it’s exciting.  Yes, it’s absolutely terrifying.  Yes, we have doubts.  Yes, we have MAJOR anxiety.  And, yes, we have hope.