Embryos and Choice

A friend of mine shared with me over the phone the other day that when she received the message I wrote her about my pregnancy, her first thought wasn't "Oh I'm so happy for Katie," It was "I love those babies!" She said, "I mean I don't want to get all weird and pro-life on you, but I just felt like I fell in love with them as soon as I know they existed." I was taken aback, and have since been mulling on this. For I am pro-choice, always have been, and yet I have loved the little beings inside me all seven times I've been pregnant from the moment I knew they existed, maybe even before, and that has never threatened my belief in a woman's right to terminate a pregnancy.

I believe in the right to choose. I believe I asserted a piece of this right when I chose IVF. I asserted it again when we genetically tested the 12 embryos and donated the 9 that were chromosomally abnormal to the clinic to calibrate their machines. We will at some point make a choice about the one embryo that sits in a freezer at our clinic. Do I believe that all of those embryos were babies? Do I believe that in the five miscarriages I endured I passed dead babies? No. and Yet, they weren't just a tiny collection of cells without meaning, without import.

The embryos from which my twins grew, six days after conception.

Those little pinpricks of light, about the size of a head of a pin, carry much potential. In them are the codes for life! Human life. But it is just that, potential. There are many steps that occur between conception and birth that create a child. I wanted each of those potential babies so badly, and I felt each time that there was a baby spirit with me. I borrow from many other teachers and traditions in the idea I am about to put forth: I don't believe that the spirits that came to visit me with each of those pregnancies were fully inside their bodies. Liliana Barzola Read described it to me as a thin golden chord that connects the spirit to those early embryos, almost the way you feel connected to your partner or parent, and that as an embryo grows the chord grows thicker and stronger until sometime near birth the spirit fully inhabits the body. Peggy Orenstein in Waiting for Daisy describes a Japanese idea that we are all from the water, and that our spirits sort of gradually emerge from the water, entering our bodies more and more fully as the embryos develop, as children grow. In this tradition, the spirit doesn't fully step out of those primordial waters and fully stay in the body until about age 7 or 8. In these ideas there is not one clear moment in which "life begins." It is a gradually unfolding process of leaving heaven for earth. This idea feels right to me. Each time I lost a pregnancy, I felt like I had lost a baby, because for me, I had. I had lost, again, the child I hoped to have, and it was devastating. The physical miscarriages, although varying in intensity and gruesomeness, never matched up to the catastrophe of my emotional suffering. And each time I would try in the blood and ropes of uterine lining to find the embryo, and I never could- it was too small. I do not think the journey those spirit babies made was traumatic for them- I believe they stuck a toe out of the primordial waters, and said, hmmm, no thanks. It was me who suffered, but I do not blame them.

A private ceremony to honor one of my first trimester losses.

Do I believe that people who choose abortion are baby killers? No. Do I believe that life begins at conception? Yes, I do. Some glimmering esoteric piece of life begins at conception- possibly even before, but I do not believe that means that a woman who is not ready is obligated to nurture that speck of possibility into a child. To carry a child to term- to be pregnant for 10 months, to give birth, is a public, irrevocably life changing journey, whether or not that mother decides to keep that baby or give it up for adoption. I would argue that abortion should also carry weight, as I do see it as terminating life, but it is a private event, and small. Just as my first trimester losses cannot be compared to second trimester losses, stillbirth, or SIDs, early abortions cannot be compared to infanticide, and it is a leap of imagination to call women who choose early abortion baby killers.

I don't think there will ever be consensus on the abortion debate, but I do think that if we on the pro-choice side don't acknowledge that there is magic, potential, spirit involved in the conception of child, we are doing everyone a disservice. No one who believes that life begins at conception will ever be convinced otherwise, but perhaps there is room to talk about the life of the mother, to talk about the impossible fragility of early pregnancy, to talk the quality of life that child would have if brought into the world.

I believe that there is a way to honor an early pregnancy, and let it go. I believe that it is a woman's right to choose whether or not she wants to carry a baby to term, keep that baby and raise it as her own, or give it to another in adoption. I believe that all of those decisions are monumental and life altering and should not be taken lightly. I believe that each woman deserves the right to make decisions regarding her own body and her own reproductive future.

In looking at the Guttmacher Institute's Fact sheet on abortion (http://www.guttmacher.org/pubs/fb_induced_abortion.html), there is much that stands out to me. 89% of all abortions in the United States occur before 12 weeks gestation and greater than 60% occur before 8 weeks gestation. According to Baby Center, at 8 weeks an embryo is about the size of a kidney bean (http://www.babycenter.com/6_your-pregnancy-8-weeks_1097.bc) and weighs about four hundredths of an ounce. This is a far cry from a baby. 33% of abortions occur before seven weeks, and this number includes people who choose plan B, so it may or may not have been an actual abortion as this occurs before a pregnancy is confirmed. 42% of women seeking abortion have incomes below the federal poverty line, and 61% of women seeking abortion already have one or more children. I can imagine that giving a baby up for adoption would be near impossible when you already have children who would be cognisant of a sibling, and are you going to be the one to tell that mom she HAS to have another kid? The good news is that Instances of abortion are currently at their lowest since 1973, which is thought to be attributable to better access to and education about contraception (Go Planned Parenthood!). 

I know that there are families who desperately want children, and find it hard to stomach that other people would choose to terminate pregnancies that could result in live children. I was there, for many, many years. But even so, I would never have insisted that another woman must unwillingly give her body over to pregnancy and childbirth because I couldn't. We all have our own journey, with our own struggles, and it doesn't come out tit for tat. I know that it is better for our society that the children who come into this world be wanted and well cared for, born to women who willingly bore them, whether to parent them or give them up for adoption. There is nothing to be gained by forcing women to continue pregnancies they do not want to see to fruition. I know that some argue, adoption, adoption, adoption, but when you step back and think about what that means for a birth mother, is that truly something to force upon someone unwillingly? 

And I come back to the notion of choice. Because in the end it isn't so much a matter of wrong vs right, but a matter of giving women agency over their own bodies and futures. I am so grateful for the technology and choices available to me that gave me these two squiggly 20 week old babies moving all around inside me. I think that all women should have access to the health care they need to make choices about their reproductive future, whether that be to enable them to have children, or to prevent them from doing so. We all deserve to have a choice.

19 weeks with twins.

Anatomy Scan, Check!

Today we had our 17.5 week anatomy scan. This was a huge milestone. I have been stressing for days, worried that something would be missing: a brain hemisphere, a kidney, a liver, but lo and behold, both my little beans are normal, normal, normal. My cervix was also nice and long and closed, and measured long enough that my risk of preterm labor is greatly reduced. They are side by side right now, both head down, their feet kind of overlapping up near my ribcage. I didn't even realize my uterus had grown all the way up there already! I'm so grateful, and things feel much more real now, and yet, I am still waiting for the other shoe to drop.

What does that expression mean? Like you've got one shoe on, and the second one might fall from the sky and hit you on the head? That's what I see in my head, but it makes no sense at all. In all our years trying before Caden came, it always seemed we could manage the first shoe. We got pregnant with some medical help, but no grand heroics, and then every time, the other shoe dropped, and we lost the baby. When he finally did come, it was of his own volition. No doctors, no meds, no charting or temperatures or timed sex. I was grieving deeply during the cycle we conceived Caden, and I don't even remember having sex that month, but he came. With this pregnancy, it was a highly orchestrated act of science. We asserted our will to have more children, and at every step of the way, things went right. It has been somewhat shocking, and I keep waiting for something to go wrong. Or I keep waiting to start having more faith. Or just let down my guard. Do I really think keeping my shoulders up around my ears will keep my babies from leaving? Do I really think worry will keep that shoe up in the sky?

I am starting to trust these babies. I am starting to believe that they, like Caden, want to be here. That they chose me, chose us. That they are excited to come be a part of this life. What I am struggling with more is trusting my body. Today as the ultrasound tech was fishing around in the murky waters of my womb, and finding hearts with four chambers beating away, hands with five fingers, femur's and humerus, I was thinking what a feat my body is doing growing these beings. What a feat my body did growing Caden, carrying him, birthing him on his due date in the water, allowing me the birth I'd always wanted. I have so much to thank my body for in terms of childbearing already. And beyond making babies, this body has survived car accidents and surgeries and reckless use. This body has paddled me through rivers, carried me up mountains, skied me through snowy forests. This body has allowed me to stay up all night tending sick babies and laboring women. I've got to give myself some credit.

Thank you womb for carrying Caden to term and giving me a smooth labor and delivery. Thank you for growing such a healthy strong boy. Thank you legs and for all the dancing and hiking and moving through the outdoors. Thank you arms for all the holding and rocking. Thank you back for all the shoveling and hauling and planting. You are a strong body. We can do this. We can keep these babies safe inside until they are big enough to safely leave. We can keep my inner ocean a hospitable environment in which they can grow. I trust you. I trust me.

If I say it enough, maybe I'll get there. I set the intention now of honoring myself for what my body has done. I suppose this is a time of building relationships- me, the babies, my body. We are a team. For now, there is no separation.

Why Gestational Diabetes is a Pain in my Ass

Caden spots chickadees in his bird feeder

Last night Caden had a sleep over with his Grommy, and Cameron and I got to go on an early date. As seems to be the pattern with dates for us, I had a terrible resurgence of nausea in the afternoon that left me whimpering in bed not wanting to do anything. I took some Zofran, I slept, and around 3:00 asserted that I could do it. I told Caden he needed to put on clean clothes (as opposed to the egg, dog hair, and peanut butter covered ones he was sporting), and he cried and clutched at his clothes until he spotted in his closet a button down shirt with a little red tie I bought at some Christmas clearance sale. "I want to look fancy. I want to wear the shirt with the ribbon!" Be my guest son. So he chose his ripped and patched, but ever so soft blue corduroys, and a gray striped button down with a red pretied tie that velcros around his neck. Pretty dang cute. I ate a sandwich, Caden packed his backpack with the essentials (a mickey mouse keyboard) and we piled into the car. I entered my mother in laws condo and went straight for the fridge in a desperate search for something carbonated. Let us just pause now and consider the fact that I have gestational diabetes. Fucking gestational diabetes. Dealing with nausea, trying to catch up on weight gain, and following a diabetic diet has not been easy, and even though through these fertility struggles I have been the queen of special diets, I am not doing so great with this one. I found the carbonated stash, read the label on the lemon/lime Izzie's that looked so delicious, yikes! No way. Way too many carbs (read: carbs=sugar). I moved on to some vaguely flavored sparkling water and started munching on some gluten free pretzels she was using to make bread crumbs. Wait! Shit, carbs without protein! Pulled a cheese stick out of my purse and sat down to try and get the queasiness to settle. Caden, on the other hand, was wildly gesticulating telling Grommy about the chickadees that came to the bird feed he made, the pinball machines he played with his dad, and what he'd had for lunch that day. Then he stopped and said "Grommy, do you want to play with me?" Cameron and I left, our boy barely waving goodbye so enrapt with his Grandmother was he.

Next stop, Inside Llewyn Davis, the new Cohen Brother flick, at the Cinemagic. That theatre is in sad shape, but I appreciated that there were no weird commercials running before the show other than a little slide show of still ads for local business. I was again, totally nauseous, and bought a sprite. No, soda is not allowed on a diabetic diet, but as I have stopped carrying a little blue hospital puke bag with me, I really wanted to avoid hurling during the movie. I tried to temper it with nuts and cheese, and know what? The sprite was magic. Nausea went away! And I could settle into my broken back squeaky chair and travel through 1960's Greenwich Village without fear of vomit. I held my husband's hand and enjoyed. Sigh of relief.

Movie ended and we began to discuss dinner. I was verging on hungry, and hungry often means nausea and/or low blood sugars followed by spiked blood sugars when I eat, so I was anxious to get on it. My super smart husband had made reservations at a fancy Mexican restaurant for right that second! He called, and they said they would hold our table. At Xico, we were led to a cute little corner table with a window seat in a warm, colorful room with beautiful paper flowers, a chandelier of twisted orange and pink lights, and real calla lillies blooming within sight. We ordered appetizers, trying to temper all my needs: low glycemic index, low spice, gluten free. The agua fresca was prickly fruit, and I knew I couldn't have it, but I asked for soda water with just a splash. Delightful. We had queso fundido (salsas and chorizo on the side) with home made tortillas, guacamole and chips, and lamb barbacoa gorditas. Everything was so good, and my heart was all full and happy nestled in the corner with my husband who makes me laugh and lets me ramble about babies and other people's stories and my fantasies of travel for our ten year wedding anniversary. I tried to be aware of the carbs- not too many chips, not too many tortillas, but I was not really in the mood to deprive myself. When we wrapped up the meal I felt full and solid in my body, no racing heart or zingy limbs that can mean too much sugar in my blood. We walked for a while as that can help to keep sugars from spiking, and Cameron realized he needed to use some test card for his work so went into a convenience store and bought a couple things. when it was time to test, my blood sugars came in just within the normal range. Victory, or so I thought.

Here's the thing. With carbs, you get pretty immediate feeedback. In general they peak about an hour after you've eaten, and you've burned all the way through them in 2-3 hours. Proteins and fats are different. They burn slow, and fats raise your blood sugars slowly over the course of about 8 hours. As someone who is carrying twins and needs to gain weight to make up for what I lost in the first trimester, everyone agrees that I shouldn't follow the diabetic restrictions on portion size and fats. Being that I have for the past year or so been eating a high protein, high fat diet, this was a relief to me, and yet, those chips? That fried masa cake all that juicy lamb was stuffed into? Did that contribute to my high high high fasting glucose reading? Or was it my poor choice in night time snacks? Or maybe a combination of the two.

Remember that convenience store? I bought a Kind Bar advertised as "Low glycemic index, high protein!" When I looked at the label, it seemed alright, even though it had chocolate in it. I put it in my cooler bag I keep next to my bed at night with a glass of milk, and when I woke in the middle of the night I ate about half of it. Did it spike my blood sugar? Which was followed by a big drop, which then caused my body to dump a bunch of morning glucose? Probably. Because when I saw my blood sugar was really high this morning, what did I do? Did I get out of bed and make some eggs, which I know bring my morning blood sugar down? No. I ate the rest of that bar and finished off my milk because it was 5:30 and my son was at his grandmother's and I wanted to sleep in. Except that 20 minutes later my heart was slamming in my chest and my skin was prickly and itchy. I tested my blood sugars again. and Shit. Through the roof. I still tried to go back to sleep, but I felt all kinds of wrong, and I didn't want to have my blood sugar totally bottom out after the sugar high, so I got up, made some kale and eggs, and here I sit.

This isn't the first time I've been though a cycle like this, although this was the worst. For the most part in my day to day life I'm dong really well controlling the diabetes with diet and some mild exercise, but going out to eat, dates with friends, a night out with my husband, these are much harder for me to navigate and often leave me with whacked out blood sugars. I also pretty consistently have high numbers right when I wake up- and nothing has seemed to make much of a difference in that regard save eating yogurt and nuts around 3am, but I'm not always awake at 3am. And of course, this stresses me out. It stresses me out to think of my little turnip sized babies also going through weird sugar highs and lows, and their little pancreases working overtime to produce extra insulin because I made a ridiculous choice of a night time snack. And I worry that I will have to be induced or have a c-section early when we get near the end if I can't keep this under control. And I worry that when they are born they won't be able to regulate their blood sugars, and if they are small or early this could be another thing for their little bodies to handle in a rough transition into the world. I have been worrying.

It seems like the professionals counseling my on my diabetes don't completely know what to do with me. They are used to people with gestational diabetes being much further along in their pregnancies, carrying only one baby, and being overweight. At my first appointment the dietitian asked my with scolding in her voice "So, how much weight have you gained?" and was completely flabbergasted when I told her I'd actually lost weight since I'd been pregnant (how would she have reacted if I'd gained a lot? It seemed like a set up for some shaming, but I digress). Since then everyone keeps telling me I'll be fine, just keep eating, but my numbers are telling me differently. Also, since I'm in this for the long haul of the pregnancy, not just the third trimester, I keep getting the message that it's ok to splurge every now and then, but I'm not just not so sure. I've been so happy lately to have the energy to even go out, to see friends,  to sit in a restaurant and not find the smell of food completely repulsive, that I have been allowing myself to step outside the diabetes box from time to time, but I think as I see this pattern emerge, it is not worth the physical and emotional stress. My blood sugar is back in normal range now, but I still feel a little strange and jittery. In the end, it was a perfect date, and I don't want to ruin it with an overlay of guilt, but I have to be more careful. It was probably that bar more than dinner that whacked me out, but when I look at all the different cheats during the day yesterday, I wonder about the cumulative affect. I will probably have to go on some sort of medication soon to control those fasting morning numbers, and I can't help but feel like I've failed. And as someone who usually likes to do things naturally, I am on a lot of medication already! But then again, I suppose this pregnancy could never have occurred without medication. IVF is hardly natural.

The sun is up. I'm exhausted. Maybe I can forgive myself and sleep a while before it's time to go fetch Caden from his slumber party. Start the day again.